Complicated Grief

About Complicated Grief

Prolonged grief disorder, also known as complicated grief, is a condition in which grief after the death of someone close remains intense and disabling well beyond what is expected in the cultural and social context of the bereaved person. It was added to DSM-5-TR in 2022, where at least twelve months must have passed since the death in adults, while ICD-11 includes it with a six month period. Core features are persistent yearning for or preoccupation with the deceased, along with symptoms such as identity disruption, marked disbelief about the death, avoidance of reminders, intense emotional pain, difficulty reintegrating into life, emotional numbness, feeling that life is meaningless and intense loneliness. Most bereaved people do not develop the condition, as grief usually becomes less consuming over time. Risk is higher after sudden or violent deaths, the death of a child or partner, very close or dependent relationships, limited social support and prior mental health conditions. Prolonged grief can co occur with depression and PTSD but is distinguished by its focus on the loss. Complicated grief treatment, developed by the American psychiatrist Katherine Shear, combines elements of interpersonal and cognitive behavioral therapy with work on loss related memories, and has shown benefit in clinical trials. Antidepressants may help co occurring depression but appear less effective for core grief symptoms.