Symptoms of Prolonged Grief Disorder
Symptoms of PGD may include:
- Emotional numbness
- Intense loneliness and emotional pain
- Finding it challenging to go on
- Being preoccupied with thoughts of the loved one who died
- Finding it hard to engage with friends or be productive at work
- Avoiding any reminders of the person who died
- Keeping a loved one’s belongings as if they’ll soon return
- Not being able to believe someone is gone
- Talking frequently about the person who’s gone
“Prolonged grief disorder can be diagnosed when a person reports having an intense longing for someone who has passed away. They might often be preoccupied with thoughts about that person and may talk about them often with others. When these symptoms become intense, it’s good to seek help and support from a therapist.” — Bisma Anwar, MA, MSc, LMHC, Talkspace therapist
Symptoms in Children
Children experience PGD somewhat differently:
- Becoming fearful that other people in their life might also leave
- Waiting for or expecting loved ones to return
- Going back to places where they were with their loved one
- Developing intense separation anxiety
Additional Symptoms
People with PGD may also have difficulty trusting others, struggle to recall positive memories, or turn to substances as coping mechanisms. In very extreme cases, some may have thoughts of self-harm or suicide.
Causes of Prolonged Grief Disorder
The exact cause is not fully understood. Contributing factors include:
- A sudden or violent death (traumatic grief)
- Death by suicide
- The death of a child
- Being the caregiver of the person who passed away
- A personal history of depression or another mental health condition (e.g., anxiety, PTSD)
- Other life stressors such as financial hardship
- Lack of a positive support system
- Loss from a prolonged disaster (such as COVID-19)
Newer research suggests PGD is more common in older adults.
“Individuals who are at higher risk of suffering from prolonged grief disorder include older adults or people with a history of a mood disorder diagnosis. Individuals who were caregivers of the person who passed away are also at higher risk. During this time, therapy can help them process through their negative thoughts and feelings so they can cope with the grief.”
— Bisma Anwar, MA, MSc, LMHC, Talkspace therapist
Diagnosing Prolonged Grief Disorder
PGD has historically been challenging to diagnose because some grief is healthy, and its symptoms overlap significantly with depression. The recent DSM-5-TR classification of PGD as a distinct condition provides clinicians with a definitive guide.
DSM-5-TR Criteria
To be diagnosed with PGD, a person must:
- Have experienced the death of a loved one
- Be experiencing grief for at least 12 months (6 months for children)
- Have an intense longing for the deceased, or be preoccupied with thoughts or memories of them
- Have at least 3 of the following 8 symptoms present for at least 1 month:
– Identity disruption (feeling like part of you has died)
– Disbelief about the death
– Avoidance of reminders of the person who passed away
– Intense emotional pain
– Difficulty moving on — unable to engage with friends or make future plans
– Emotional numbness
– A sense that life is meaningless since the person died
– Extreme loneliness
These symptoms must be clinically significant — more intense than could reasonably be expected of the general population.
Treatment for Prolonged Grief Disorder
Healing from PGD is possible. With help, guidance, and support, you can regain a sense of peace and stability. The primary evidence-based treatment is a specialized form of cognitive behavioral therapy (CBT) designed specifically for grief. This therapy teaches coping skills, supports a return to daily functioning, and helps the person move toward acceptance.
