Grief That Won't Go Away: What to Know About Prolonged Grief Disorder
You expected the grief to ease. Maybe not disappear, but ease. Instead, months have passed, and it still feels just as heavy. The sadness, the longing, the inability to imagine life making sense again. If that sounds familiar, you may be experiencing prolonged grief disorder (PGD).
PGD is a recognized mental health condition where grief remains intense and disabling long after a loss, not because something is "wrong" with you, but because your pain deserves real support. As a grief counselor with 13 years of experience, I work with people in exactly this place. You are not broken. And you don't have to stay stuck.
In This Article:
What Is Prolonged Grief Disorder?
Bereavement vs. Prolonged Grief Disorder
Signs and Symptoms of Prolonged Grief Disorder
What Causes Prolonged Grief?
How to Treat Prolonged Grief Disorder
Gentle Steps to Support Your Healing
Ready to Find Relief? Let's Talk.
What Is Prolonged Grief Disorder?
Prolonged grief disorder is a clinical condition where grief after the death of a loved one remains intense, persistent, and deeply disruptive to everyday life, lasting more than 12 months in adults (or 6 months in children). It was officially added to the DSM-5 by the American Psychiatric Association in 2022, giving a name and framework to a form of suffering that many people carry silently for years.
What makes PGD different from ordinary grief is persistence and impairment. The pain doesn't fade with time; it stays at an acute level and makes it hard to function. Research estimates that approximately 7–10% of bereaved adults will develop prolonged grief disorder, with higher rates among those who experienced a sudden or traumatic loss.
Something I hear from almost every client who comes in for grief counseling is some version of: "I feel like I should be over this by now." The truth is that PGD isn't about how long it has been—it's about whether your grief is still running your life. That distinction matters, and it's where good treatment starts.
What is the difference between bereavement and prolonged grief disorder?
Bereavement is the natural grief response to losing a loved one—it's painful, but most people gradually adapt. Prolonged grief disorder is diagnosed when intense grief symptoms persist beyond 12 months after a loss.
Bereavement vs. Prolonged Grief Disorder: What's the Difference?
Bereavement is a normal, healthy response to loss, and most people move through it without needing professional intervention. Prolonged grief disorder is different: it's what happens when grief doesn't follow that natural path toward integration, and instead stays locked in its most acute, most disruptive form.
Here's a simple way to think about it. Normal grief comes in waves that, while painful, tend to lessen over time. You have hard days and then slightly easier ones. Memories of the person bring sadness, but sometimes warmth too. With PGD, the waves don't ease. The pain stays sharp. The future feels impossible to imagine without the person who died.
The diagnostic criteria for PGD include persistent yearning for the deceased, difficulty accepting the loss, emotional numbness, feeling that life is meaningless, and significant impairment in daily functioning, all lasting well beyond what's culturally expected after a loss.
Signs and Symptoms of Prolonged Grief Disorder
Prolonged grief disorder has specific, recognizable symptoms that set it apart from normal bereavement, and recognizing them is the first step toward getting the right support.
The American Psychiatric Association outlines clear criteria for PGD in the DSM-5-TR. If you're still struggling with intense emotional pain over a loss, well beyond what feels normal, see if any of these feel familiar:
Intense, persistent yearning for the person who died—going beyond sadness to an aching, consuming longing
Difficulty accepting the loss, even after many months have passed
Emotional numbness or disconnection from people and activities you used to enjoy
Feeling that life has no meaning without the person who died
Avoiding reminders of the person because the pain is too sharp to bear
Trouble functioning in daily life—work, relationships, or self-care
Believing the grief will never improve—that you'll always feel this way
Identity disruption—a sense that you don't know who you are without them
These symptoms are real, they have a name, and they respond to treatment. That's important to hold onto.
How long does prolonged grief disorder last?
By definition, prolonged grief disorder is diagnosed when intense grief persists beyond 12 months after a loss in adults (6 months for children). Without treatment, PGD can last for years.
What Causes Prolonged or Extended Grief to Develop?
No single factor causes prolonged grief disorder. It's shaped by the nature of the loss, the relationship to the person who died, and a person's broader life history.
Some people are more vulnerable to developing PGD based on circumstances and personal history. Common risk factors include:
Sudden or traumatic death(accident, suicide, homicide)—the shock of unexpected loss significantly raises PGD risk
High emotional dependence on the person who died—losing a partner, child, or primary attachment figure is especially difficult
Lack of social support—grief that's carried alone tends to become more entrenched over time
Unresolved issues in the relationship with the deceased—complex feelings of guilt, anger, or ambivalence can complicate mourning
History of depression, anxiety, or PTSD—prior mental health challenges can make PGD more likely to develop
Loss of a child or spouse—the American Psychiatric Association notes these relationships carry the highest PGD risk
One thing I share with clients that often surprises them: PGD isn't a sign of weakness or of loving "too much." It's a sign that the loss was significant and that your nervous system got stuck in a protective response that no longer serves you. That's not a character flaw; it's something we can work through together.
How to Treat Prolonged Grief Disorder
Prolonged grief disorder responds well to treatment—and there are specific, evidence-based approaches that go beyond general grief support to address the unique features of PGD.
Prolonged Grief Treatment (PGT)
PGT was developed by Dr. Katherine Shear, whose three decades of research established it as the gold standard for treating PGD. It's a structured therapy that works on two tracks at once: helping you process and accept the reality of the loss, and rebuilding a sense of meaning and connection in your life going forward.
I've been fortunate to train extensively in PGT under Dr. Bonnie Gorscak, a key leader in the field of grief and loss who has worked closely with Dr. Shear for over 16 years. That training shapes how I approach every client navigating prolonged grief. In our sessions together, I'll create a safe, supportive space to help you understand what's keeping you stuck and work with you to face those challenges and build a life that feels meaningful again.
Acceptance and Commitment Therapy (ACT)
ACT helps you make room for grief, not eliminate it, while reconnecting with the things that matter most to you. Rather than fighting or suppressing painful thoughts and feelings about your loss, ACT teaches you to hold them differently. You learn to keep living in alignment with your values even when grief is present.
I find ACT particularly helpful for clients who feel paralyzed—who know they want to move forward but feel like doing so would mean abandoning the person they lost. ACT gently challenges that belief and opens up space for both grief and life to coexist.
Both approaches can be delivered in person or through online sessions for Kentucky and Ohio residents.
Gentle Steps to Support Your Healing
If your grief has lasted longer than you expected, or longer than the people around you seem to understand, it doesn't mean something is wrong with you. Persistent grief isn't a failure. It's a signal that your pain is real, your loss was significant, and you deserve support.
While therapy is the most effective path for PGD, these practices can support your healing in between sessions:
Let yourself grieve without a timeline—there's no "should be over it by now" here.
Talk about your loss, even if it's been a long time. Grief doesn't expire.
Reconnect with one small thing that used to matter to you—a walk, a hobby, a meal you enjoyed. You don't have to feel ready. Just try.
Reach out to a grief support group—hearing others carry similar pain can break the isolation that makes PGD worse.
Work with a therapist trained in PGDT or ACT, who understands the specific features of prolonged grief.
Can prolonged grief disorder be treated without medication?
Yes. Evidence-based psychotherapy is the first-line treatment for prolonged grief disorder. Approaches like Prolonged Grief Disorder Therapy (PGDT) and Acceptance and Commitment Therapy (ACT) have strong research support.
Still Grieving After a Loss? Let's Talk.
If you've been carrying this grief for a long time, and part of you is starting to wonder if this is just how life is now, I want to gently push back on that. PGD is treatable. People do heal. The grief doesn't disappear, but it changes shape. It becomes something you can carry rather than something that carries you.
Whether you've recently been wondering if your grief fits the criteria for PGD, or you've known for a while that something feels different about your loss, there's a place to start.
Here's what that first step actually looks like: you reach out, I'll get back to you, and we'll have a brief conversation to make sure we're a good fit before anything else. No pressure, no commitment. Just a chance to talk to someone who gets it.
Reach out today. You don't have to carry this alone.
