Have you experienced the loss of a loved one recently? Are you finding it difficult to enjoy activities or hobbies that you once found pleasurable?
Grief is a normal emotional response to loss. However, if you find yourself experiencing prolonged grief, a persistent mourning period that seems difficult to overcome, it may be a sign that seeking support could help you.
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Key points
- Grief is normal after losing a loved one.
- Each of us grieves differently.
- Prolonged Grief Disorder describes an inability to get life back on track after a mourning period.
- Recognize when you need help to manage grief.
Overview
Grief is a common human emotion that arises when we experience a significant loss. Mourning is the natural process of acknowledging and expressing this grief. Sometimes, grief can manifest with symptoms similar to depression, such as low energy levels. In certain cases, when grief becomes exceptionally intense and persists for an extended period, it may meet the criteria for Prolonged Grief Disorder.
Grief typically involves apathy and dejection, loss of interest in the outside world, and diminution in activity and initiative. These reactions are similar to depression but are less persistent and are not considered pathological.
Prolonged Grief Disorder (PGD)
After losing a loved one, the intensity of painful emotions and thoughts usually diminishes within six months (twelve months for children and teens). However, if these feelings and thoughts continue to be intense beyond this period and become difficult to manage, you might be experiencing Prolonged Grief Disorder (PGD). This condition can significantly interfere with your daily functioning.
Following the loss of a loved one, the intensity of painful emotions and thoughts usually lessens within six months (twelve months for children and teens). However, if these feelings and thoughts continue to be intense beyond this period and become difficult to manage, you might be experiencing Prolonged Grief Disorder (PGD). This condition can significantly interfere with your daily functioning.
Some researchers use the term “complicated grief” to describe this prolonged grief.
Studies suggest that approximately 7%-10% of bereaved adults may experience prolonged grief disorder, while 5%-10% of children who have lost a loved one might experience depression, PTSD, or prolonged grief disorder.
Symptoms of Prolonged Grief Disorder
According to the American Psychiatric Association, the conditions for prolonged grief are met when at least three symptoms are experienced nearly every day for at least the last month when at least six months have elapsed (for children or teens) or twelve months for adults.
- Feeling as though part of oneself has died.
- Difficulty believing that the death actually occurred.
- Avoiding reminders that the individual is deceased.
- Death-related intense emotional suffering (such as rage, resentment, and grief).
- Difficulty engaging with friends, pursuing hobbies, or planning ahead.
- Feeling numb emotionally.
- Feeling that life has no purpose or value.
- Loneliness (feeling detached from other people).
Risk factors for prolonged grief
Risk factors for PGD include:
- Having been a primary caregiver for the person who died, especially for the spouse or partner of the deceased.
- When death occurred suddenly, unexpectedly, or under traumatic circumstances.
- Advanced age.
- Prior history of depression or bipolar disorder.
Treatment for prolonged grief
Research has shown that treatment for prolonged grief can be effectively addressed through therapeutic approaches that incorporate elements of cognitive-behavioral therapy (CBT).
Complicated Grief Treatment focuses on accepting the reality of the loss and working towards finding a sense of satisfaction amidst grief. This therapy integrates cognitive-behavioral techniques alongside other therapeutic approaches.
CBT is particularly helpful in managing symptoms often associated with prolonged grief disorder, such as insomnia.
Bereavement support groups can play a crucial role in preventing social isolation and reducing the risk of prolonged grief disorder. These support groups offer a valuable source of social connection and emotional support during the grieving process.
Can medication alleviate symptoms of grief?
If your grief is complicated by other mental health issues, such as anxiety or depression, a healthcare professional may consider prescribing medication as part of a comprehensive treatment plan. Antidepressants or anti-anxiety medications may be prescribed to alleviate specific symptoms and provide some relief during the grieving process.
The decision to use medication should be made in consultation with a qualified healthcare professional who can assess your specific needs and circumstances.
Click here to read more about the role of medication in psychiatry.
Are the “five stages of grief” accurate for all mourners?
The five stages of the grief model advanced by Swiss-American psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying have been much criticized. While the criticism is certainly valid in that not all people experience all the stages, the model can be valuable to you in understanding where you may be stuck.
- Denial: refusing to accept that the person’s actually gone
- Anger: It’s not fair that this happened
- Bargaining: Let this somehow not be true and I promise to____
- Depression: Low motivation, hopelessness
- Acceptance: Coming to terms with the loss
Working through your feelings can build increased resilience and healing. Recognizing the emotions that you feel can keep you from getting stuck.
Disenfranchised grief or hidden grief
Disenfranchised grief, also known as hidden grief, refers to a type of grief that society may not fully acknowledge or even discourage individuals from expressing openly. This form of grief can be experienced when grieving for certain losses that may not receive the same societal validation as more conventional losses. Examples include grief for stillborn babies, healthcare professionals mourning the loss of patients, or individuals grieving the loss of an animal companion.
Experiencing disenfranchised grief can be isolating as the lack of understanding or validation from others may hinder the grieving process. The feeling of isolation can impede the natural recovery and healing that comes with grieving.
Allow yourself to grieve: 7 tips
Give yourself permission to mourn.
- Experiencing loss undermines our sense of stability. We are not permanent! Grieving helps you adjust to a new reality.
- You’re on an emotional rollercoaster. It’s okay.
- There is no set timeline for grief. Be patient with yourself.
- Take care of your health. Get enough sleep. Eat well. Stay hydrated.
- Leverage your social support network. Reach out to friends and relatives. They are likely to want to share memories.
- Consider joining a support group. People who are in mourning can provide the support that your friends may not be able to offer.
- Consider reaching out for professional help, especially if you feel that your grief is prolonged or if you need extra support.
Reach out today
At Oasis Health Services, we treat grief, anxiety, major depressive disorders, OCD, PTSD, ADHD, anger management, social anxiety, BPD, bipolar disorder, life transitions/stress, mood disorders, grief, self-damaging behaviors, and more.
Our psychiatric nurse practitioners and counselors provide tailored mental health care that meets all of your psychiatric and psychological needs in-house. Therapy, medication management, counseling, and coaching can help you make real changes in your life.
In-person and online therapy, medication management, counseling, and coaching are available in Georgia, Florida, Washington, Maryland, and Arizona.
Related information
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). American Psychiatric Association Publishing. https://www.psychiatry.org/psychiatrists/practice/dsm
Boelen, P. A., Lenferink, L., & Spuij, M. (2021). CBT for Prolonged Grief in Children and Adolescents: A Randomized Clinical Trial. The American journal of psychiatry, 178(4), 294–304. https://doi.org/10.1176/appi.ajp.2020.20050548
Craig, D. J. (2021, June 20). When Grief Won’t End. Columbia Magazine. Retrieved April 11, 2023, from https://magazine.columbia.edu/article/when-grief-wont-end
Coping With Grief. National Institutes of Health. Retrieved April 11, 2023, from https://newsinhealth.nih.gov/2017/10/coping-grief
Lichtenthal, W. G., Nilsson, M., Kissane, D. W., Breitbart, W., Kacel, E., Jones, E. C., & Prigerson, H. G. (2011). Underutilization of mental health services among bereaved caregivers with prolonged grief disorder. Psychiatric services (Washington, D.C.), 62(10), 1225–1229. https://doi.org/10.1176/ps.62.10.pss6210_1225
Melhem, N. M., Porta, G., Walker Payne, M., & Brent, D. A. (2013). Identifying prolonged grief reactions in children: dimensional and diagnostic approaches. Journal of the American Academy of Child and Adolescent Psychiatry, 52(6), 599–607.e7. https://doi.org/10.1016/j.jaac.2013.02.015
Szuhany, K. L., Malgaroli, M., Miron, C. D., & Simon, N. M. (2021). Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment. Focus (American Psychiatric Publishing), 19(2), 161–172. https://doi.org/10.1176/appi.focus.20200052
The Columbia Center for Prolonged Grief. Columbia University. Retrieved April 11, 2023, from https://prolongedgrief.columbia.edu/professionals/complicated-grief-professionals/overview/
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