Understanding Prolonged Grief Disorder: Persistent Grief

If you’ve ever felt like the pain of losing someone never really eases, you’re not alone. Prolonged Grief Disorder (often shortened to PGD) is a real, recognized condition that shows up when mourning stretches far beyond what most people consider “normal” and starts to take over daily life. In just a few sentences, let’s unpack what PGD looks like, why it matters, and what you can do about it.

Quick Answer

PGD is a mental‑health diagnosis – the World Health Organization (WHO) and the American Psychiatric Association (APA) officially added it to their manuals (ICD‑11 2018, DSM‑5‑TR 2020). It is diagnosed when, for more than a year after a loved one’s death, a person experiences an intense, unrelenting yearning and at least three additional grief‑related symptoms that seriously impair work, relationships, or self‑care.

Diagnosis Overview

What the official manuals say

Both the DSM‑5‑TR and ICD‑11 require a minimum time frame (12 months for adults, 6 months for children) and a core symptom of persistent yearning or longing for the deceased. Around that core, the clinician looks for at least three of the following: identity disruption, disbelief, avoidance of reminders, intense emotional pain, functional impairment, emotional numbness, feelings that life is meaningless, or profound loneliness.

Symptom checklist (in everyday language)

Symptom	What it feels like
Intense yearning	“I can’t stop thinking about them; my heart aches whenever I see a photo.”
Preoccupation with memories	Spending most of the day replaying moments in your head.
Identity disruption	Feeling like a part of yourself died with them.
Disbelief about the death	“It still feels like a bad dream I can’t wake up from.”
Avoidance of reminders	Skipping family gatherings because they trigger painful thoughts.
Emotional numbness	Flat affect; nothing seems to move you any more.
Sense that life is meaningless	“What’s the point of getting out of bed?”
Extreme loneliness	Feeling isolated even when surrounded by people.

These symptoms echo the diagnostic criteria outlined by the Center for Prolonged Grief, which stresses that grief can become “inescapable” and dominate everyday actions.

Risk Factors

Not everyone who loses a loved one develops PGD. Certain circumstances raise the odds dramatically.

Common triggers

• Sudden or violent loss (accident, homicide, suicide) – these can shock the system and block the natural grieving process (WebMD).
• Loss of a child or a partner – the relational bond is so central that its abrupt removal leaves a gaping void.
• Multiple losses in a short period – think of a series of deaths in a family or community.

Personal history that raises odds

Previous trauma, anxiety, or depression already tip the scales toward a prolonged reaction. Financial strain, social isolation, or a history of substance use can also make it harder to process grief (Center for Prolonged Grief).

Demographic nuances

Research shows women report PGD symptoms slightly more often than men, and children exhibit a different pattern – they may cling to routines or wait for the deceased to “come back.” Age‑specific signs are crucial to spot early.

Daily Impact

Physical and mental health consequences

When grief is stuck, it can manifest as insomnia, chronic fatigue, weakened immune function, or increased use of alcohol and tobacco. Over time, the stress can exacerbate heart disease, hypertension, or depression.

Social and occupational effects

People with PGD often withdraw from friends, miss work, or struggle to focus on tasks. The CommonSpirit Health article notes that “preoccupation with the memory of the lost person” can lead to isolation, missed appointments, and strained relationships.

Real‑world case snippet

Anne Murray Mozingo, a young mother featured in a WebMD story, described locking herself in the bathroom at night and “chopping down trees” in her mind to release the flood of desperate energy. Even months after her husband’s sudden death, friends began questioning whether she was “grieving too long.” Her experience illustrates how PGD can feel like living in a perpetual, heavy fog that never lifts.

Treatment Options

Evidence‑based therapies

The gold standard for PGD is Complicated Grief Therapy (CGT), a 12‑20 session protocol that blends cognitive‑behavioral techniques with exposure to grief memories, meaning‑reconstruction, and interpersonal skill‑building. Other approaches that have shown promise include:

• Trauma‑focused EMDR (Eye Movement Desensitization and Reprocessing)
• Mindfulness‑based stress reduction
• Group grief counseling (often offered by community mental‑health centers)

When to seek professional help

If the core yearning lasts more than a year (or six months for kids) and you notice any of the following, it’s time to call a therapist:

• Significant trouble sleeping or eating
• Avoidance of places or activities that remind you of the loss
• Feeling that life lacks purpose
• Increased alcohol or drug use
• Thoughts of self‑harm or suicide

What a typical counseling session looks like

First, the therapist will run a structured assessment (often using the symptom checklist above). Next, they’ll help you map out safe “exposure” exercises – like looking at a photo or visiting a meaningful place – while teaching coping tools such as grounding techniques. Over several weeks, you’ll work on rebuilding a new identity that honors the loss but also makes space for growth.

Self‑Help Tips While Waiting for Therapy

Professional help is essential, but there are everyday actions you can take right now to ease the sting:

• Set a gentle routine. Regular sleep, meals, and light exercise signal to your brain that life is still moving.
• Create a memory box. Gather photos, letters, or small objects and set a specific time each week to look through them – this contains the grief to a defined space.
• Practice mindfulness. Simple breathing or a five‑minute body scan can break the cycle of rumination.
• Join a peer‑support group. Hearing others’ stories reduces isolation and offers practical coping ideas.
• Limit substance use. Alcohol may numb pain temporarily but often deepens the emotional hole.

Common Myths

Myth	Reality
“Grief is a sign of weakness.”	Grief is a natural response; PGD is a medical condition that can be treated.
“If you label it a disorder, you’re pathologizing normal feelings.”	Diagnosis helps identify disabling grief and guides effective care.
“Only violent deaths cause PGD.”	Any loss can trigger PGD; risk is higher with sudden or traumatic losses but not exclusive.

Understanding why we need a diagnosis combats stigma. The Center for Prolonged Grief explains that labeling the condition is not about medicalizing normal sorrow—it’s about recognizing when sorrow becomes a barrier to living.

Further Resources

For deeper reading and professional support, consider the following trusted sources:

• World Health Organization – ICD‑11 page on PGD.
• American Psychiatric Association – DSM‑5‑TR summary.
• National Suicide Prevention Lifeline: 988 (for immediate crisis help).
• Local grief‑counseling centers (e.g., the Brisbane Counselling Centre offers specialized grief therapy).

Conclusion

Prolonged Grief Disorder is more than “just being sad.” It’s a recognized, treatable condition that shows up when mourning stays stuck and starts to hijack daily life. By learning the warning signs, understanding who is most vulnerable, and reaching out for evidence‑based help, you can move from a place of relentless yearning to a space where cherished memories coexist with a hopeful future.

If you or someone you love is experiencing any of the symptoms described here, consider contacting a qualified grief therapist today. You don’t have to walk through this alone—there’s expertise, compassion, and real‑world strategies waiting to support you.