When someone's loved one passes away, it is an immensely painful experience. They are perhaps flooded with the memories of the person they lost. However, with time, grief starts to fade away just enough not to hamper their daily functioning. While this is the case for most people, some cannot move on from the grief, and it may even worsen.
Grief is a natural response to losing a loved one, and it may include feelings of sadness for a period of time which eventually subsides. However, prolonged grief can be detrimental to the overall well-being of an individual. Recently added to the Diagnostic and Statistical Manual of Mental Disorders, prolonged grief disorder is a condition in which a bereaved person is unable to cope with the death of a loved one. While grief is a natural reaction to losing someone, it generally lasts up to 6 months. On the other hand, Prolonged Grief Disorder only increases instead of grief resolving over time. It involves a deep yearning for the deceased by thebereaved. Left unattended or untreated, it can cause severe disruptions in the bereaved individual's life.
According to Szuhany et al. (2001), an estimate of 7 to 10 percent of bereaved adults experience prolonged grief disorder. Along the same lines, 5 to 10 percent of children and adolescents may also experience prolonged grief disorder along with depression, anxiety, or PTSD after bereavement.
In a study conducted on 206 individuals with prolonged grief disorder, 75 percent had other comorbid conditions. Of these, 62 percent had anxiety disorders, 55 percent had major depressive disorder, and 48 percent had post-traumatic stress disorder. Other comorbid conditions also include alcohol abuse and an increase in smoking. A study also proved that prolonged grief disorder leads to poorer sleep among the bereaved.
Prolonged grief disorder occurs only after a person loses someone close to them. It has several symptoms, which include −
Disbelief about the passing of the loved one.
Intense feelings of pain, anger, or powerlessness.
Inability to find meaning in life.
Feeling detached from others
An intense longing for the bereaved.
Assessing prolonged grief involves self-report measures. A 13-item questionnaire called the Prolonged Grief Disorder-13 examines the thoughts, feelings, and actions that occur in one month. The brief grief questionnaire is a shorter, five-item tool for screening prolonged grief disorder. Nevertheless, another widely used tool is the Inventory of Complicated Grief, which has 19 items and has been used to assess the intensity of the disorder's symptoms.
Prolonged grief disorder was recently added in the DSM-V Section 2, trauma- and stressor-related disorders chapter. It lays out detailed criteria for the diagnosis of prolonged grief disorder. According to it, the following symptoms must be present for a period of at least 12 months after bereavement:
Yearning for the deceased.
Inability to come to terms with the death.
Being preoccupied with the thoughts of the deceased.
Intense emotions like bitterness and sorrow.
Emotional numbness.
Being unable to reintegrate into life.
Intense loneliness.
Thinking that life is meaningless.
Functional impairment, such as being unable to do domestic chores.
While everyone may develop prolonged grief disorder after losing a loved one, some people may be at a higher risk of developing it following bereavement. These risk factors may include.
A history of mood disorders such as depression or bipolar disorder.
Lacking social support after the death of a loved one.
If an unexpected incident caused the death, for example, suicide or murder.
Caregivers of the deceased are also at greater risk.
Prolonged grief disorder can be treated with the help of the following
Medication − Some studies have shown that selective serotonin reuptake inhibitor antidepressants may be beneficial in treating symptoms of prolonged grief disorder. However, studies looking into it are still going on.
Psychotherapy − Cognitive behavioral therapy has proven to be highly effective in relieving the symptoms and improving an individual's condition. A type of psychotherapy called complicated grief treatment helps adapt to life after the loss.
Support groups − Support groups provide a social support system for an individual to rely on and seek comfort. They help in letting the individual feel that they are not alone.
Internet-based Interventions − Interventions for prolonged grief disorder can also be conducted online for those who cannot afford psychotherapy. It may include remote therapists but mainly focuses on behavioral change through exercises such as journal writing.
Prolonged grief disorder is extremely common, with 1 in 10 people having gone through it at least once in their life. Even though it is a recent addition to the DSM, it has had several years of research backing it. Its symptoms are easy to notice, and plenty of help is available in therapy and other interventions.
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