Trauma- and stressor-related disorders
Prolonged Grief Disorder
Grief is a natural response to loss and has no single correct timetable. Prolonged grief disorder describes a more specific pattern in which intense yearning or preoccupation persists with additional symptoms and substantially restricts daily life.
When grief remains profoundly disabling
For adults, diagnosis is not considered until at least 12 months after the death; for children and adolescents, at least six months. Time alone is never enough. Frequency, functional impact and the person’s social, cultural and religious context are essential.
The central experience is intense yearning for or preoccupation with the person who died on most days, nearly every day in the preceding month. Additional features may include disbelief, identity disruption, emotional pain, numbness, loneliness, avoidance and difficulty reconnecting with life.
Assessment
- The pattern is more intense or persistent than expected within the person’s cultural and religious context and causes significant distress or impairment.
- A clinician distinguishes it from major depression and PTSD while recognising that these conditions can coexist.
- Children and adolescents need developmentally appropriate assessment, including how the loss affects caregiving, school and their understanding of death.
Treatment and support
Specialised grief-focused psychotherapy can help a person face the reality of the loss while gradually reconnecting with relationships, roles and meaningful goals. CBT elements may address avoidance, painful beliefs and sleep difficulties.
Grief groups and peer support may reduce isolation. Medication does not treat grief itself, although a doctor may consider it for a separate co-occurring condition such as major depression or severe anxiety.
When to seek help
Support can be sought before the diagnostic time threshold. Seek help when grief persistently prevents work, school, relationships or self-care, or life feels permanently meaningless. Current suicidal intent, severe self-neglect or inability to eat or drink requires emergency help.