Grieving is known to take a long time. So, why does prolonged grief disorder exist? And what distinguishes it from normal grief?
What is prolonged grief disorder, and why does the concept exist in the first place?
Prolonged grief disorder (also known as complicated grief) is a diagnosis describing grief that lasts longer than it “should.” According to the American Psychological Association, the disorder involves “grief reactions [which] occur most of the day,” and grief which lasts more than one year. It also includes having symptoms that keep a person from engaging in necessary daily activities (say, feeding oneself, sleeping, taking care of the kids), or feeling “significant distress.”
Yes, that description captures a relatively normal course of grief (more on that later).
The diagnosis was officially added to the DSM in 2022, and allows mental healthcare professionals to accurately label patients when dealing with documentation and insurance carriers.
However, according to many, that’s about as much good as the diagnosis does. The news of this new diagnosis shook the internet–especially those well-versed in dealing with grief.
Symptoms of prolonged grief disorder vs. normal grief
According to the APA, prolonged grief disorder involves the following symptoms:
- “Identity disruption (e.g., feeling as though part of oneself has died).
- Marked sense of disbelief about the death.
- Avoidance of reminders that the person is dead.
- Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death.
- Difficulty moving on with life (e.g., problems engaging with friends, pursuing interests, planning for the future).
- Emotional numbness.
- Feeling that life is meaningless.
- Intense loneliness (i.e., feeling alone or detached from others).”
You might ask: how, then, is prolonged grief disorder different from regular grief? The answer: it really isn’t too different. The main difference between grief and “prolonged grief disorder” is how long the symptoms last, how severely they impact your activities of daily living (ADLs), and how well your grief follows cultural norms.
You wouldn’t be wrong to say “This sounds kind of bogus.” After all, who is to say what’s normal? Who decides where the cutoff lies for grieving “too long”?
If you think you might be suffering from PGD, consider establishing care with a therapist, or even just mentioning it to your primary care provider. You deserve to have support no matter what your grief looks like, how long the process takes, or which label it fits. However, don’t be too quick to label your experience as “disordered.”
What’s the controversy about prolonged grief disorder?
Grief is an inherently long and messy process, so to many grieving people and grief experts, this diagnosis feels like overkill.
The diagnosis may come in handy if your mental healthcare is covered by insurance, and your provider needs to justify continued treatment. Proponents of the label advocate that diagnosis is important because it paves a path to treatment. However, treatment is rarely an instant fix, and it is possible to seek treatment without a diagnosis.
“When it comes to grieving, the culture lies–you really do not get over the biggest losses, and you don’t pass through grief in any organized way, and it takes years and infinitely more tears than people want to allot you.” – Anne Lamott
Grief only becomes potentially problematic when its impact prevents you from taking care of the basics, or when it feels like it has completely overshadowed everything else in your life.
Why we should take care not to label normal grief
At worst, the diagnosis of prolonged grief disorder may make people feel broken for having a long grieving period or trouble getting back to their normal routine–both very normal experiences.
It can be counterproductive to look at your grief as a problem to be fixed. Rather, it’s a process to be experienced and engaged with. As Brene Brown once shared on the Today show, “Grief does not have a timeline.” You can grieve as long as you need to, as long as grief doesn’t completely overtake other important parts of your life.