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What is chronic grief disorder? How does it change your outlook on life?
Prolonged grief disorder (PGD), also known as complicated grief, is a psychological disorder that often develops after the death of a family member or close friend. This often-overlooked mental health issue profoundly affects many people’s outlook on life and daily functioning. It is estimated that around 10% of lost people experience this condition, particularly those who had a close relationship with the person.
"People with persistent grief are immersed in grief and continue to experience feelings of loss, often to the point of clinically significant distress."
Studies have shown that PGD can lead to a range of symptoms, including but not limited to depression, emotional numbness, loneliness, and difficulty managing interpersonal relationships. Many patients often find it difficult to accept the fact of loss and repeatedly think about the departure of their loved ones, longing to reunite with them.
Symptoms and Effects
PGD symptoms can be divided into two categories: behavioral and emotional. Common behaviors include:
- High rates of suicidal ideation and suicide attempts
- Functional impairment, unable to lead a normal life
- High treatment seeking behavior
- Poor health behaviors, such as alcohol or drug abuse
“PGD symptoms vary widely depending on the closeness of the relationship with the deceased, and are usually most severe in spouses, parents, and children.”
The emotional pain felt by many people experiencing PGD may be closely related to the level of intimacy and mode of loss. The likelihood of developing PGD increases significantly when the death occurred in a violent manner, such as suicide or murder.
Diagnostic criteria
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR), to be diagnosed with PGD, the following conditions must be met:
- The deceased’s death occurred at least one year ago (six months for children and adolescents)
- Experienced persistent feelings of sadness or missing the deceased at least every day in the past month
- In addition, at least three other symptoms must be met, such as identity confusion and strong disbelief in death.
“Symptoms of prolonged grief include emotional numbness, a sense of loss of meaning in life, and intense loneliness.”
The combined impact of these symptoms not only causes significant impairment to the individual's functioning, but also manifests as an inability to improve oneself emotionally.
Treatment methods
Treatment for PGD is a difficult but necessary process. The preferred treatment is grief-focused psychotherapy, especially continuity grief therapy, which has shown good results. Although antidepressant medications may be considered, medication alone is not recommended to relieve grief-related symptoms and should be combined with psychotherapy.
“Accepting the irreversibility of death is considered a prerequisite for further acceptance and understanding of loss.”
Also, while group therapy can help some people, its effectiveness compared with other treatments is controversial and it may not be appropriate for everyone.
Social and cultural impacts
Sociocultural background often affects the presentation and treatment of PGD. Certain cultures have inherent expectations about grief reactions. The study found that the closer the relationship with the deceased, the greater the risk of PGD.
"In some cultures, prolonged grief may be seen as normal, making it difficult to identify PGD."
As time goes by, the understanding and acceptance of grief changes, and society's understanding of chronic grief continues to evolve.
In the past, the social discrimination and stigma that were common to grief still affect those who are grieving today. Can the emergence of the definition and diagnosis of continuous grief disorder further improve this situation?
