Prolonged Grief Disorder: What to Know

INTRODUCTION

Grief is a natural response to the loss of a loved one.  For those who have not experienced a

significant loss we might think of grief as a deep sadness and longing which begins at the time of

loss and slowly fades with time.  But many feel the hurricane of grief: a storm of emotions that

leaves us out to sea, separated from our loved one and misunderstood by others.  Until

recently, few clinicians could gain training in the area of bereavement.  In the most recent

update to the DSM (the manual clinicians use to categorize mental health concerns), Prolonged

Grief Disorder was accepted.  Let’s explore Prolonged Grief Disorder, “normal” grieving and

what this means for grievers. 

Grief and Bereavement

Grief research and treatment has long been a niche within social work, medicine and

psychology.  Bereavement is considered the condition of having lost a loved one due to death

and Grief is the psychological/behavioral response to bereavement. A bereaved person may

have a wide range of grief reactions and emotions.  It cannot be overstated that these reactions

and the length of one’s grieving varies from person to person.  

Prolonged Grief

In March 2022, Prolonged Grief Disorder became the newest disorder to be added to the DSM. 

There were many factors leading to PGD being added, chief among them Covid-19, the

disruption of normal grief traditions and an unprecedented amount of deaths.  

Only a small subset of grievers will meet criteria for Prolonged Grief Disorder, but it is important

to note some symptoms: lasting impairment in daily life; distressing thoughts about death;

disruption in identity; disruption in grieving/coping; social withdrawal and the potential for

suicidal ideation. Prolonged Grief Disorder is not just about timing: it is intense and pervasive-

affecting almost every part of everyday life for longer than is expected.

1. The Good

Many in the medical and therapeutic worlds were happy with the addition of Prolonged

Grief Disorder to the DSM-it’s inclusion meant recognizing an important public health

issue.  This also meant more funding for research leading to better treatment options

and more knowledgeable therapists and doctors.  

1. The Bad

Prolonged Grief Disorder is also a controversial addition to the DSM as many in the

world of grief and bereavement see it as pathologizing a normal process.  Grief is 

misunderstood and some fear pathologizing it will lead to more stigma around the grief

process.  Others fear it will continue to enforce the idea that grief can last “too long” and

undermine the normalcy of the difficult emotions and reactions which come with grief.

In Summary

There is no timeline or trajectory for grief.  Many grievers begin to feel isolated and

overwhelmed by their loss and choose to seek grief therapy in order to feel more supported in

processing their loss, making sense of their emotions, and navigating their lives in the wake of

loss.