APA Offers Tips for Understanding Prolonged Grief Disorder

Sep 23, 2021

Washington, D.C., Sept. 23, 2021 – Americans are currently facing several ongoing disasters that have caused death and suffering, such as COVID-19, the wind-down in Afghanistan, floods, fires, hurricanes and gun violence. While many Americans are mourning, some may experience prolonged grief disorder, which is characterized by incapacitating feelings of grief.

Prolonged grief disorder was recently added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a volume published by the American Psychiatric Association (APA) that defines and classifies mental disorders. It can happen when someone close to the bereaved person has died within at least 6 months for children and adolescents, or within at least 12 months for adults.

In prolonged grief disorder, the bereaved individual may experience intense longings for the deceased or preoccupation with thoughts of the deceased, or in children and adolescents, with the circumstances around the death. These grief reactions occur most of the day, nearly every day for at least a month. The individual experiences clinically significant distress or impairment in social, occupational, or other important areas of functioning.

“The circumstances in which we are living, with more than 675,000 deaths due to COVID, may make prolonged grief disorder more prevalent,” said APA President Vivian B. Pender, M.D. “If you’ve recently lost someone close to you, it’s very important to check in with yourself. Grief in these circumstances is normal, but not at certain levels and not most of the day, nearly every day for months. Help is available.”

Some of the symptoms of prolonged grief disorder are:

• 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).

In the case of prolonged grief disorder, the duration of the person’s bereavement exceeds expected social, cultural or religious norms and the symptoms are not better explained by another mental disorder.

Prolonged grief disorder is the newest disorder to be added to the DSM. After studies dating back several decades suggested that many people were experiencing persistent difficulties associated with bereavement that are substantially prolonged beyond culturally normed expectations, and a two-year process of review and public comment, APA’s Board of Trustees and Assembly approved it last fall for inclusion in the DSM. It will be included in the new text revision of DSM-5 (DSM-5-TR), which is slated for release in March 2022.

“Including prolonged grief disorder in the DSM-5-TR will mean that mental health clinicians and patients and families alike share an understanding of what normal grief looks like and what might indicate a long-term problem,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “Especially now, sharing information and increasing awareness about prolonged grief disorder is essential.”

Click here for an infographic on Prolonged Grief Disorder

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 37,400 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information please visit www.psychiatry.org.