Complicated Grief Disorder: When Grief Becomes Prolonged and Disabling
By CRYSTAL BAI •
The short answer: Complicated grief disorder (now called Prolonged Grief Disorder in DSM-5-TR) is a recognized mental health condition affecting 7-10% of bereaved people, characterized by grief that remains intense and disabling for more than 12 months after a loss.
What Is Complicated Grief / Prolonged Grief Disorder?
While grief is a normal human experience, for some people it becomes prolonged and disabling in ways that significantly impair daily functioning. The DSM-5-TR (2022) formally recognized Prolonged Grief Disorder (PGD) as a distinct diagnosis — validating what grief researchers and clinicians have observed for decades.
Symptoms of Prolonged Grief Disorder
PGD is characterized by intense yearning for the deceased, difficulty accepting the death, bitterness or anger about the loss, feeling that life is meaningless without the deceased, difficulty engaging in activities, and emotional numbness — persisting at a clinically significant level for at least 12 months after the loss (6 months for children).
These symptoms distinguish PGD from normal grief, which typically decreases in intensity over time, even if it never fully disappears.
Risk Factors for Complicated Grief
Factors that increase risk include: violent or sudden death (suicide, accident, homicide), loss of a child, loss of a spouse or life partner, prior history of depression or anxiety, limited social support, history of trauma, and a relationship with the deceased marked by conflict or dependence.
Evidence-Based Treatment
Prolonged grief disorder has a specific, evidence-based treatment: Complicated Grief Treatment (CGT), developed by Dr. Katherine Shear at Columbia University. CGT combines elements of cognitive behavioral therapy, motivational interviewing, and grief-specific techniques. Multiple studies show CGT outperforms standard depression treatment for PGD.
Other approaches include EMDR for trauma-related grief, interpersonal therapy, and medication for co-occurring depression or anxiety.
How to Get Help
If you believe you may have prolonged grief disorder, speak with your primary care physician, a psychiatrist, or a therapist specializing in grief. The Center for Complicated Grief at Columbia (complicatedgrief.columbia.edu) maintains a therapist directory.
Frequently Asked Questions
What is complicated grief disorder?
Complicated grief disorder (now called Prolonged Grief Disorder) is a recognized mental health condition where grief remains intensely disabling for more than 12 months after a loss, affecting 7-10% of bereaved people.
How is prolonged grief disorder treated?
Complicated Grief Treatment (CGT), developed at Columbia University, is the most evidence-based approach. It combines CBT, motivational interviewing, and grief-specific techniques and outperforms standard depression treatment.
How do I know if my grief is 'normal' or complicated?
Normal grief typically decreases in intensity over time, even if it remains. Prolonged Grief Disorder involves intense yearning, functional impairment, and difficulty accepting the loss that persists at clinical levels for 12+ months.
Where can I find a complicated grief therapist?
The Center for Complicated Grief at Columbia University (complicatedgrief.columbia.edu) maintains a therapist directory. You can also ask your primary care physician for a referral to a grief specialist.
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