Written by: Julia Chivu
Edited by: Holly Paik
Prolonged grief disorder (PGD) is an extremely intense form of grief that is associated with persistent symptoms following the loss of a loved one. PGD is a relatively recent addition to the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) (Prigerson et al., 2021). An adult may be diagnosed with this disorder when they have been mourning the loss of a loved one for at least one year. Children and adolescents also can be diagnosed with prolonged grief disorder if they have been grieving the loss of a loved one's death for at least six months. This disorder tends to be more prevalent when distressing events occur such as natural disasters, gun violence, war, or pandemics like COVID-19 (American Psychiatric Association, 2021). Additionally, older individuals and those who have a history of depression or bipolar disorder have a higher risk of developing PGD. Caregivers may also have a higher risk of developing PGD if they had depression prior to their loss or if they were caring for a partner. Research also suggests that there is a correlation between PGD and coexisting conditions including anxiety, depression, sleep issues, as well as post-traumatic stress disorder (American Psychiatric Association, 2022).
When someone experiences PGD, they exhibit symptoms that are more pronounced than expected grief symptoms and can be dangerous to their well-being. While some of these symptoms may be characteristic of many of the normal feelings and actions associated with loss of a loved one, with PDG, these symptoms last for much longer periods of time than expected. For example, many describe that life feels meaningless. Some struggle to believe that their loved one has passed and prefer to avoid listening to any reminders from others about the death (American Psychiatric Association, 2021). However, some find themselves consumed by recurring thoughts or memories of the person who passed on a daily basis (Prigerson et al., 2021). In addition, it has been noticed that children and adolescents tend to think a lot about the circumstances surrounding the death (American Psychiatric Association, 2022). Some even express intense yearning everyday for the person they lost. Additionally, they may express that a part of themselves has died with the loved one resulting in a sense of identity disruption.
Aside from the emotional impact PGD may cause, this disorder can also significantly disrupt an individual's day-to-day life, including their relationships (American Psychiatric Association, 2022). For instance, people experiencing PGD often struggle to socially interact with others, making it challenging for them to make plans or discuss the future. Furthemore, those with PGD tend to avoid people that remind them of the deceased. In children and young teenagers, this behavior has been linked to the idea that they are avoiding specific people to not have thoughts of their loved one (Prigerson et al., 2021). Unfortunately, these symptoms often lead to loneliness and isolation.
As this disorder is relatively new, we do not yet know all of the best treatment options to assist those with PGD. Thus far, cognitive-behavioral therapy (CBT) has shown to significantly assist people with PGD. For instance, complicated grief treatments use elements of CBT to help to focus the individual to accept the reality of their loss. This treatment also works towards gradually transitioning the individual to a stable state in which they can establish attainable goals and find a sense of happiness without their loved one. Another method involves participation in bereavement support groups. This resource allows for these individuals to make social connections and aid in their loneliness. This support group serves to reduce the risk of complete isolation. Finally, there are no medications that are known to help to treat any of the associated conditions with this disorder yet (American Psychiatric Association, 2022).
References:
American Psychiatric Association. (2021, September 22). APA offers tips for understanding prolonged grief disorder. Psychiatry.org - APA Offers Tips for Understanding Prolonged Grief Disorder. https://www.psychiatry.org/news-room/news-releases/apa-offers-tips-for-understanding-
prolonged-grief
American Psychiatric Association. (2022, May). Prolonged grief disorder. Psychiatry.org - Prolonged Grief Disorder. https://www.psychiatry.org/patients-families/prolonged-grief-disorder#:~:text=However
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Hodge, K. M. (2019, November 20). Man hugging his knee statue photo. Free Grey Image on Unsplash. https://unsplash.com/photos/IqSaG9zv2e0
Prigerson, H. G., Kakarala, S., Gang, J., & Maciejewski, P. K. (2021). History and status of prolonged grief disorder as a psychiatric diagnosis. Annual Review of Clinical Psychology, 17(1), 109–126. https://doi.org/10.1146/annurev-clinpsy-081219-093600
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