Grief is a very personal and difficult journey for those who have lost a loved one. Sometimes relief and the return to “new” normal functioning is slow to happen. A new disorder addressing this issue, “prolonged grief disorder,” will be included in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-5-TR, the psychological standard for making clinically accepted diagnoses.
From the standpoint of a grief and loss therapist, this appears to be a timely adjustment to the understanding of the nature of grief. After a non-violent loss, approximately one in every ten adults suffers over a prolonged period of time from significant grief. Significant grief may include a pervasive inability to move past the loss of a loved one. Symptoms are significant enough to affect day-to-day functioning.
Diagnostic Criteria for Prolonged Grief Disorder (F43.8)
The newly described disorder is characterized by the following group of symptoms:
- The death, at least 12 months ago, of a person who was close to the bereaved individual (for children and adolescents, at least six months ago).
- Since the death, the development of a persistent grief response characterized by one or both of the following symptoms, which have been present most days to a clinically significant degree. In addition, the symptom(s) has occurred nearly every day for at least the last month:
- Intense yearning/longing for the deceased person.
- Preoccupation with thoughts or memories of the deceased person (in children and adolescents, preoccupation may focus on the circumstances of the death).
- Since the death, at least three of the following symptoms have been present most days to a clinically significant degree. In addition, the symptoms have occurred nearly every day for at least the last month:
- Identity disruption (e.g., feeling as though part of oneself has died) since the death.
- Marked sense of disbelief about the death.
- Avoidance of reminders that the person is dead (in children and adolescents, may be characterized by efforts to avoid reminders).
- Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death.
- Difficulty reintegrating into one’s relationships and activities after the death (e.g., problems engaging with friends, pursuing interests, or planning for the future).
- Emotional numbness (absence or marked reduction of emotional experience) as a result of the death.
- Feeling that life is meaningless as a result of the death.
- Intense loneliness as a result of the death.
- The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The duration and severity of the bereavement reaction clearly exceeds expected social, cultural, or religious norms for the individual’s culture and context.
- The symptoms are not better explained by another mental disorder, such as major depressive disorder or post-traumatic stress disorder, and are not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.
Are You Struggling with Prolonged Grief?
Gratefully, years of research and clinical experience have resulted in a definitive categorization of this extended grief malady. If you are struggling with grief and loss symptoms and wish to have the support of a grief and loss counselor, call for an appointment with our Compassionate Bereavement Care Certified Provider, Marie Ricks at (480) 668-8301 ext. 1016.