Prolonged Grief Disorder: Causes, Symptoms & Treatment
Grief is a natural and emotional response of our mind and body to any loss. Prolonged Grief Disorder (PGD) is a condition marked by intense, persistent grief that lasts well beyond the typical mourning period. It affects around 7–10% of people experiencing bereavement and can profoundly disrupt emotional and daily functioning.
What Is Prolonged Grief Disorder and How It’s Differ from Normal Grief
Prolonged Grief Disorder involves unrelenting sorrow and yearning that extends over a year, unlike normal grief, which gradually subsides. The emotional pain in PGD often remains raw and intrusive.
Nature of PGD vs. Normal Grief
Normal grief allows space for healing, where the intensity of sorrow eases with time. In PGD, the person remains trapped in sadness, with little emotional recovery, often feeling emotionally numb or disconnected from life.
Duration, Intensity, and Disruption
While normal grief typically lessens within six months to a year, PGD lasts beyond 12 months. The symptoms are more intense, often impairing relationships, work, and daily life due to constant emotional turmoil.
Prolonged Grief Disorder vs. Other Conditions
PGD shares symptoms with mental health conditions like depression and PTSD, but has unique features. It revolves around loss-specific distress and a prolonged emotional bond with the deceased.
Overlap with PTSD, Depression, and MDD
PGD, PTSD, and depression share symptoms like emotional distress, disrupted sleep, and social isolation. PTSD is marked by trauma re-experiencing and hyperarousal, while depression includes persistent sadness and hopelessness. PGD stands apart through its intense yearning, preoccupation with loss, and prolonged difficulty in adjusting to life without the deceased.
How PGD Stands Apart in Duration, Trigger, and Emotional Focus
PGD arises specifically from the death of a close person and is characterised by persistent grief, deep longing, and intense emotional attachment. Unlike depression or PTSD, it is loss-oriented, grief-specific, and endures beyond 12 months, significantly impairing daily functioning and the ability to move forward with life.
Symptoms of Prolonged Grief Disorder
PGD presents with a distinct set of emotional and physical symptoms that extend beyond typical grief, interfering with an individual’s daily functioning.
Emotional Symptoms
The emotional toll of PGD can be overwhelming, often intensifying instead of easing with time. It can leave individuals feeling emotionally stuck, as if the loss just happened, even months or years later.
Persistent yearning
This is a deep, ongoing longing for the deceased, often accompanied by intrusive thoughts or daydreams. It creates an emotional pull that keeps the person stuck in the past, unable to accept the loss.
Intense sorrow or emotional numbness
Grief may manifest as overwhelming sadness or a complete shutdown of emotions. People often describe feeling like a hollow shell, detached from their surroundings or disconnected from loved ones.
Feeling life has lost meaning
Many individuals with PGD experience a crisis of purpose. The loss can lead them to question their identity, future, or existence itself, resulting in hopelessness or spiritual disconnection.
Physical Symptoms
PGD can take a serious toll on physical health, often presenting symptoms that resemble medical conditions. These may include fatigue, chest tightness, digestive issues, and sleep disturbances—further complicating recovery and increasing the risk of chronic health problems over time.
Sleep disturbances
Those with PGD often struggle with falling asleep or staying asleep due to racing thoughts, vivid dreams, or emotional restlessness, which further worsens mental health.
Fatigue or appetite changes
People may experience low energy, irregular eating, or loss of appetite. Some may overeat as a form of comfort, while others skip meals due to disinterest or sadness.
Aches, headaches, or digestive discomfort
Unresolved grief can manifest as chronic pain, headaches, or stomach issues. These are physical expressions of emotional turmoil, triggered by stress and disrupted biological rhythms.
How Grief Affects the Brain and Mental Health
As mentioned in the above sections, grief comes in many forms, and it can also affect our brain and mental health.
Emotional and Psychological Impact
PGD increases the risk of developing anxiety and depression, making emotional recovery even more difficult. Common responses include persistent sadness, emotional numbness, and withdrawal from social life. Over time, these feelings deepen, leading to a prolonged sense of isolation and difficulty reconnecting with others or finding joy in daily life.
Cognitive Effects
PGD can impair cognitive functioning, resulting in forgetfulness, reduced concentration, and poor decision-making. This state, often referred to as “grief brain,” is caused by the brain’s emotional overload. The ongoing mental strain hinders productivity, disrupts daily routines, and makes it harder to manage responsibilities or engage in problem-solving.
Diagnostic Criteria for Prolonged Grief Disorder
Identifying Prolonged Grief Disorder (PGD) involves clinical guidelines laid out by major diagnostic manuals: the DSM-5-TR and ICD-11. These criteria help differentiate PGD from normal bereavement and other mental health conditions.
DSM-5-TR Criteria
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), PGD is diagnosed when grief persists for 12 months or more following the death of a loved one.
The person must experience clinically significant functional impairment in social, occupational, or daily activities. Additionally, symptoms often interfere with one’s sense of identity or disrupt daily routines, such as withdrawal from relationships or a diminished sense of life’s purpose.
ICD-11 Criteria
The International Classification of Diseases (ICD-11), developed by the World Health Organisation, outlines PGD as a persistent and pervasive grief reaction lasting six months or more.
Key features include difficulty moving on, accepting the death, or engaging in meaningful life activities. Emotional pain remains intense and enduring, well beyond the culturally expected mourning period.
When to Seek Professional Help
While grief is a natural response to loss, it’s essential to seek support when it becomes unmanageable. Consider professional help if:
- Your grief continues beyond several months with no sign of easing.
- It interferes with daily life or relationships, affecting work, social connections, or self-care.
- Self-help strategies like journaling, mindfulness, or social support do not help improve your emotional state.
- You experience persistent sadness, guilt, emotional numbness, or a sense of meaninglessness.
- Family or friends express concern about your emotional health or notice alarming changes in behaviour.
- You have thoughts of hopelessness or self-harm, which signal a need for immediate clinical attention.
Effective Treatment Options for Prolonged Grief Disorder
Treatment for PGD is often tailored to the individual’s needs and may include structured therapies designed specifically for grief. Let’s understand these treatment options in detail.
PGDT (Prolonged Grief Disorder Therapy)
PGDT is a structured, 16-session therapy designed specifically to address prolonged grief. It helps individuals confront painful emotions, integrate the loss into their life narrative, and rebuild their sense of purpose. The approach combines storytelling, goal-setting, and emotional processing to promote healing and re-engagement with everyday life.
Complicated Grief Therapy (CGT)
CGT is a specialised treatment that blends traditional grief support with cognitive behavioural techniques. It focuses on resolving grief-related avoidance, encouraging acceptance, and re-establishing meaningful activities. Through structured sessions, individuals confront their emotions, reduce distress, and work through unresolved aspects of their loss that prevent natural healing.
Cognitive Behavioural Therapy (CBT)
CBT is considered one of the best therapies to address many mental health conditions, including PGD. By addressing negative beliefs and promoting healthier thinking patterns, CBT supports emotional regulation, improves daily functioning, and fosters more balanced perspectives on loss.
Support Group
Support groups create a communal environment where individuals can share their grief experiences with others facing similar losses. Guided by a therapist or trained facilitator, these groups reduce isolation, offer validation, and build emotional resilience. Participants often find comfort, connection, and practical coping strategies through open, empathetic dialogue.
Healthy Coping Strategies for Prolonged Grief Disorder
Coping with prolonged grief takes time, intention, and support. Practising healthy strategies can help ease the emotional burden and promote gradual healing. Here are a few effective strategies to cope with PGD.
Journaling and memory rituals offer space to express grief, reflect on memories, and honour the person lost. These acts can provide emotional relief and a sense of continuity.
Rebuilding routines brings structure back into daily life, which can help combat the chaos grief often creates. Simple habits like regular meals, walks, or hobbies can restore a sense of control.
Mindfulness or relaxation exercises, such as deep breathing, guided imagery, or meditation, help individuals stay grounded and manage overwhelming emotions. These practices also support better sleep and reduced anxiety.
Mindtalk: Navigating the Path to Healing from Prolonged Grief
At Mindtalk, healing from prolonged grief is a guided journey rooted in clinical expertise, empathy, and personalised care. Here’s how we help you.
Expert-led therapy
Our highly skilled experts and therapists use evidence-based treatments like CBT, Prolonged Grief Disorder Therapy (PGDT), and trauma-informed support to help individuals move through loss at their own pace. Each plan is tailored to meet emotional and psychological needs.
In-person and online options
Mindtalk offers flexible therapy formats whether you prefer face-to-face sessions or the convenience of online care from the comfort of home. Both approaches are equally focused on providing safety, continuity, and emotional support.
Team includes psychologists, psychiatrists, and grief counsellors
Our multidisciplinary team includes trained psychologists, psychiatrists, and grief counsellors who work collaboratively to offer comprehensive care and support at every stage of the healing process.
Take the First Step Toward Healing with Mindtalk
If you're struggling to move forward, know that help is within reach. Book a session with our team today — and begin your path to healing, understanding, and hope.