Prolonged Grief Disorder

Prolonged grief disorder (PGD) is a mental health condition characterized by an intense and prolonged experience of grief after the loss of a loved one. It is also known as complicated grief or persistent complex bereavement disorder.

Definition and Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) includes PGD as a condition for further study. According to the DSM-5, PGD is defined as a grief reaction that persists for more than 12 months after the loss of a loved one, and is accompanied by intense yearning or longing for the deceased, and at least six of the following symptoms:

• Preoccupation with the deceased
• Difficulty accepting the loss
• Difficulty trusting others
• Bitterness or anger related to the loss
• Difficulty moving on or planning for the future
• Feeling stuck or frozen in time
• Intense emotional pain or sorrow
• Preoccupation with the circumstances of the death

Symptoms and Characteristics

Individuals with PGD may experience a range of symptoms, including:

• Overwhelming sadness and emotional pain
• Intense yearning or longing for the deceased
• Difficulty sleeping or concentrating
• Loss of interest in activities that were once enjoyable
• Feelings of guilt, shame, or self-blame related to the loss
• Avoidance of people, places, or things that remind them of the deceased
• Hypervigilance or exaggerated startle response

Causes and Risk Factors

The exact causes of PGD are not fully understood, but several risk factors have been identified, including:

• Sudden or unexpected loss
• Violent or traumatic death
• Close relationship with the deceased (e.g., spouse, child, parent)
• Prior history of mental health conditions (e.g., depression, anxiety)
• Lack of social support
• Cultural or societal factors that influence grief expression and processing

Treatment and Management

Treatment for PGD typically involves a combination of psychotherapy and medication. Cognitive-behavioral therapy (CBT) and complicated grief therapy (CGT) are two evidence-based approaches that have been shown to be effective in reducing symptoms of PGD.

Medications, such as antidepressants or anxiolytics, may also be prescribed to help manage symptoms of depression, anxiety, or insomnia. Additionally, support groups and online resources can provide individuals with PGD a sense of community and connection with others who have experienced similar losses.

Conclusion

Prolonged grief disorder is a complex and debilitating condition that can have a significant impact on an individual's quality of life. While the exact causes of PGD are not fully understood, research has identified several risk factors and effective treatments. With proper diagnosis, treatment, and support, individuals with PGD can learn to manage their symptoms and find ways to heal and move forward.