Prolonged Grief Syndrome – What Is It?

While death is a natural and inevitable part of life, it doesn’t make it any easier when we lose someone close to us. Humans are social creatures; we derive meaning from interpersonal bonding, and our relationships are part of who we are. So it’s not surprising that losing someone results in grief and a significant sense of loss. 

People experiencing grief are at higher risk for depression, but this risk drops by 17% after the first year. Whether it’s a grandparent, parent, partner or sibling, coping with grief has many untold challenges. It’s worth noting that grief doesn’t only occur after the death of a loved one. Grief may also result from a divorce, career-related loss or significant life change in which the person feels a sense of loss.

When experiencing grief, it can be helpful to be aware of the normal stages of grief. While simply knowing about them won’t help alleviate the grief, it can serve as a reference point for you to understand feelings.

But what happens when you’re not passing through the stages of grief the normal way? What happens when you simply can’t get over the loss you experienced? In this article, we’ll discuss something called prolonged grief syndrome. We’ll cover what it is, how it differs from typical grief and how to identify and treat it. 

What Is Prolonged Grief Syndrome?

Prolonged grief disorder is characterized by intense and incapacitating feelings of bereavement. Complicated, traumatic and chronic have all been used to describe the syndrome. Significant changes in a person’s level of functioning are hallmarks of chronic grieving. While sadness is a natural and acceptable reaction to traumatic events or losses, prolonged mourning makes it difficult to accept reality and move on.

Prolonged grief disorder is diagnosed when symptoms last for more than 12 months in adults and at least 6 months in children after a loved one passes away. Symptoms of complicated grief:

  • Severe emotional distress (anger, sadness, helplessness)
  • Strong bewilderment about the death
  • Inability to integrate
  • Emotional numbness 
  • Struggling to make sense of life
  • Feelings of isolation 
  • Disruption of identity (feeling incomplete)

Grief manifests itself in many ways in children and adults. While children may display avoidance and withdrawal, adults may turn to alcohol or drugs to drown out unbearable feelings and thoughts. 
If you think you or someone close to you is suffering from prolonged grief disorder or grief-related addiction, don’t hesitate to get help. 

Introduction of Prolonged Grief Syndrome to the DSM-V

Grief can be intense, and medical professionals know how difficult loss can be. For this reason, differentiating normal grief from complicated grief isn’t clear-cut. Prolonged grief disorder was just added to the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-V) on March 21, 2022. 

According to The New York Times, the new diagnosis is intended to apply to a small fraction of the population that’s crippled by grief. These people display signs of being unable to return to normal life activities and remain overwhelmed a year after a death.

The decision brings an end to more than a decade of debate, with some researchers advocating for the medical treatment of severe bereavement. Although grief is natural, some people experience intense sorrow that leads to isolation.

Difference Between PGS and Normal Grief

The key difference between typical grief and prolonged grief syndrome is the time frame. Grief can last anywhere from a few months to a few years, but people typically get back to normal activities within one year of the loss. In prolonged grief syndrome, feelings of grief and overwhelming loss continue to be debilitating even after one year.

While normal grief is also intense, conditions generally tend to improve within 6 months. People suffering from PGS may ruminate and have persistent, intrusive thoughts about their lost loved one. When this is prolonged and becomes unmanageable, it’s time to seek help.

How to Spot PGS in Others

Knowing whether someone is suffering from prolonged grief syndrome requires being familiar with the symptoms listed above. People differ in their tendencies to self-disclose. While certain people may be forthright about their feelings and their inability to cope, others may try to conceal their pain and put on a brave face. 

If, after one year, you notice that you or someone close to you is unable to return to normal activities like work, socializing or engaging in hobbies, it may be a sign that they’re still feeling intense, debilitating grief. Signs can include: 

  • Loss of job due to inability to cope
  • Alcohol or substance abuse
  • Extreme social withdrawal
  • Severe depression
  • Inability to reconcile the loss

When dealing with grief, speaking with a health care provider is a crucial first step. They’ll conduct an assessment by inquiring about your symptoms and how you’re dealing with them. This allows them to better understand the problems at hand and rule out other diagnoses such as post-traumatic stress disorder and depressive illnesses.

Treatment for Prolonged Grief Syndrome

Getting support from a mental health expert can help you get a more accurate diagnosis and manage your symptoms. A therapist can assist you in processing your loss in a sympathetic, safe and nonjudgmental setting, as well as discuss ways to improve your emotional well-being and functioning.

For long-term grieving therapy, cognitive behavioral therapy (CBT) is a helpful treatment option. The combination of CBT and exposure approaches was found to help reduce symptoms of grief and despair in grieving adults. Participants also reported an improvement in their psychological well-being and social functioning. 

Psychodynamic psychotherapy is another effective psychotherapeutic strategy. Therapy may include: 

  • Discussing the concept and reality of death
  • Recalling positive memories of the deceased person
  • Addressing unresolved feelings
  • Practicing emotional regulation
  • Examining interpersonal attachments

Don’t Wait to Seek Help

Grief after losing a loved one can be difficult to describe, eliciting a wide range of feelings and behaviors. You might feel you’ll never be able to get over the loss. However, while you may miss the person the rest of your life, grief can be something we learn to integrate into our lives and walk with.

If you or someone you know is experiencing prolonged grief syndrome or has developed a substance use problem as a result of grief, reach out for help. Restore Mental Health is equipped to assist. Contact us today at (877) 594-3566. Our team of mental health professionals is standing by, ready for your call.