There’s no wrong way to grieve the loss of a loved one. But if grief persists longer than expected and prevents you from returning to your usual routine or relationships, you may meet the criteria for prolonged grief disorder.

The loss of someone or something you love can be one of life’s most difficult challenges. It’s natural and expected to experience grief and feelings of disbelief, sorrow, bitterness, or anger. There’s no “right” or “wrong” way to grieve. It’s an individual process, and it’s OK to grieve for longer or shorter than someone else might when experiencing the same kind of loss.

In the immediate aftermath of loss, grief can feel debilitating. But as you adjust to the loss of your loved one and share fond memories of them with others, grief tends to subside.

If grief lasts longer than expected and does not begin to subside, or if it gets worse, you might meet the criteria for a mental health diagnosis known as prolonged grief disorder, which is also called complicated grief.

Prolonged grief disorder is a formal mental health diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

The DSM-5-TR describes complicated grief as persistent grief that lasts at least 12 months (6 months for children) after a death. The condition limits your ability to function in important areas of your life and cannot be explained by another mental health condition you might have.

Prolonged grief disorder features intense yearning for your loved one or preoccupation with thoughts of your loved one almost all day, every day, for at least 1 month before you receive a diagnosis.

In addition, the DSM-5-TR explains that at least three of the following symptoms must be present all day, nearly every day, for at least 1 month in order to qualify for a diagnosis:

  • Identity disruption: feeling as if part of you has also died or been lost since the death of your loved one
  • Marked sense of disbelief: having a deep, persistent difficulty accepting the loss despite acknowledging that it happened
  • Avoidance of reminders: going out of your way to avoid people, places, and things that remind you of the loss or your loved one
  • Intense emotional pain: experiencing overwhelming, distressing feelings such as anger, sorrow, or bitterness
  • Difficulty reintegrating: finding it hard to get back to your usual routine or to engage in your relationships in the same way you did before the loss
  • Emotional numbness: experiencing a sense of disconnection from your emotions or a feeling of being “empty” of emotion
  • A feeling that life is meaningless: not being able to find purpose in moving forward in your life without your loved one
  • Intense loneliness: feeling isolated and empty even when you’re in the presence of others

The inclusion of prolonged grief disorder in the DSM-5-TR as a formal diagnosis was met with some controversy. Some experts feel that it’s not appropriate to standardize the grief experience since intense, prolonged, and impairing grief may be natural for some people and in certain cases.

Some mental health professionals are concerned that classifying prolonged grief as a mental health condition will lead to stigma around grief, which may result in negative outcomes such as reduced support from family or friends after a loss.

Grieving is not unnatural, wrong, or unhealthy. But in some cases, especially when it’s prolonged, it may be linked to unhealthy outcomes.

One of the features of prolonged grief disorder, according to the DSM-5-TR, is a significant degree of difficulty functioning in important areas of your life, such as work, home, and relationships.

If your loss happened more than a year ago and you still cannot work, study, or relate to others in the way you could before the loss, you might benefit from professional support to improve your quality of life.

Complicated grief can change your personal and social behaviors and might lead you to engage in coping strategies that can affect your emotional and physical health.

The DSM-5-TR states that people living with complicated grief often report physical issues such as loss of appetite or sleep disruption, which might also be attributed to co-occurring depression or anxiety.

Potentially unhealthy habits such as substance use, social isolation, and neglected self-care are also common in prolonged grief disorder.

If you’ve received a diagnosis of prolonged grief disorder, it does not mean that you’re doing anything wrong. Instead, getting a diagnosis might open doors for you to get the support you need for the symptoms you’re experiencing.

Prolonged grief disorder responds well to treatment. According to the American Psychiatric Association, cognitive behavioral therapy (CBT) and complicated grief therapy (CGT) are effective in reducing symptoms.

CBT and CGT are types of psychotherapy that help you work through unhelpful thought and behavior patterns while gradually accepting the reality of the loss you’ve experienced.

In addition to therapy for grief, you might benefit from joining a support group that focuses on coping with grief. Connecting with others who share your experience can provide a sense of community and help you feel less alone in your thoughts and emotions.

You don’t have to wait a year before speaking with someone about grief. If your grief is overwhelming and persistent and prevents you from engaging in your usual daily activities and relationships, a mental health professional may be able to help. You’re not alone.

Help is available

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

Prolonged grief disorder is a formal mental health diagnosis that you may qualify for if grief is limiting your ability to function and has persisted longer than expected according to social, cultural, or religious norms.

While there’s no “wrong” way to grieve the loss of a loved one, prolonged grief can negatively affect your mental health, physical health, and interpersonal relationships. It’s OK to talk with a mental health professional any time grief is overwhelming, regardless of the timeline.