Prolonged Grief Disorder
When feelings of sadness, rage, and grief interfere with your life and last for months or years after losing a loved one, you may be dealing with prolonged grief disorder. A normal reaction to losing a loved one is grief. The majority of people see a gradual decline in their grief symptoms. A tiny percentage of people, however, continue to experience great grief, and their symptoms are strong enough to interfere with their ability to live their lives normally. This is a defining feature of prolonged grief disorder. PGD is considered a disorder when these symptoms persist for at least 12 months after the loss.
What are the Symptoms of Prolonged Grief Disorder?
The symptoms of Prolonged Grief Disorder (PGD) include:
Intense longing and yearning for the deceased: People with PGD often feel a deep sense of emptiness and a constant need to be with the person who died.
Preoccupation with the loss: People with PGD may find it hard to think about anything else other than the person who has passed away.
Difficulty accepting the death: People with PGD may have trouble accepting that the person is really gone because they may believe that the death might have been avoided in some way.
Difficulty moving on with life: People with PGD may have trouble engaging in activities that they once enjoyed and may struggle to build new relationships.
Physical symptoms: PGD patients may develop physical signs and symptoms such as fatigue, changes in appetite and sleep patterns, and difficulty concentrating.
Emotional distress: People with PGD may experience feelings of anger, guilt, and hopelessness, and they may find it difficult to control their emotions.
Social isolation: People with PGD may distance themselves from friends and family and may find it difficult to maintain relationships.
Functional impairment: People with PGD may have difficulty functioning in their daily lives, including work, social, and familial relationships.
Why does prolonged grief disorder occur?
Prolonged Grief Disorder (PGD) can happen for a variety of reasons. Some of the factors that may contribute to the development of PGD include
The nature of the loss: PGD is more likely to occur after the death of a loved one who was close, such as a spouse, child, or parent, rather than a more distant acquaintance.
The circumstances of the death: PGD may be more likely to occur if the death is sudden, traumatic, or violent.
The person’s emotional and psychological state: People who have a history of depression, anxiety, or other emotional difficulties may be more likely to develop PGD.
The person’s coping mechanisms: People who have difficulty coping with stress or expressing their emotions may be more likely to develop PGD.
Lack of social support: People without a supportive network of loved ones may have a higher likelihood of experiencing PGD.
The cultural and societal context: Certain cultures and societies may not have the same understanding and support of grief and mourning, which can result in a lack of understanding of the process and difficulty in accepting the loss.
How is prolonged grief disorder diagnosed?
Prolonged Grief Disorder (PGD) is diagnosed based on the criteria outlined in the Diagnostics and Statistical Manual of Mental Disorders, 5th Edition. To be diagnosed with PGD, a person must meet the following criteria:
- Persistent and intense grief reactions that occur after the loss of a loved one.
- The presence of at least six of the above-mentioned symptoms.
- Symptoms must last for at least 12 months after the loss
- Symptoms cause significant impairment in the person’s ability to function in daily life, including work, social, and familial relationships.
A skilled mental health professional, such as a psychiatrist, psychologist, or licensed therapist, should only diagnose PGD after conducting a thorough examination that includes a medical and psychological evaluation and taking into account other possible causes of the symptoms.
What are the treatment options for Prolonged Grief Disorder?
There are several treatment options for Prolonged Grief Disorder (PGD), including:
- Cognitive-behavioral therapy (CBT): This therapy aims to help individuals identify and change negative patterns of thinking and behavior related to their loss.
- Complicated Grief Treatment (CGT): This is a form of therapy specifically designed for PGD, It is a time-limited, structured, and evidence-based treatment that aims to help the person to process their grief and find a way to move forward.
- Medications: Antidepressants may be prescribed to alleviate depression and anxiety symptoms often accompanying PGD.
- Supportive therapy: This type of therapy provides a secure and supportive environment where individuals can express their feelings and emotions related to the loss.
- Psychoeducation: This type of therapy helps individuals understand the normal process of grief and how to cope with the different stages of grief.
- Group therapy: Group therapy allows people who have gone through similar experiences to connect and receive support from each other.
How to Help a Friend with Prolonged Grief?
If you have a friend who is experiencing Prolonged Grief Disorder (PGD), there are several things you can do to help:
- Listen: Offer a listening ear and let your friend talk about their feelings and emotions without judging or interrupting.
- Encourage professional help: Suggest that your friend get help from a psychiatrist, therapist, or counselor who can provide specialized support and treatment
- Be patient: Recovery from PGD can take time, so be patient and understanding.
- Offer support: Let your friends know that you are there for them and offer to help with practical tasks or provide emotional support.
- Help them with their daily routine: Offer to help with chores or other tasks that may be difficult for them to do on their own.
- Help them to remember the good times: Share happy memories of the person who died and encourage them to look at pictures and other mementos.
- Help them to find new hobbies: Suggest new hobbies or activities that your friend may enjoy and encourage them to try new things.
- Educate yourself: Learn more about PGD, its symptoms, and how to support your friend to understand better what they are going through.
- Encourage self-care: Guide your friends to take care of themselves, eat well, get enough sleep, and exercise.
- Be there for them: Let your friends know that you are there for them, no matter what, and that you care about their well-being.
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Dr. Sohail Nibras is a double board-certified psychiatrist in child, adolescent, and adult psychiatry. He completed his education at Saint Louis University and the American University of Integrative Science. He excels in treatments based on psychiatric care and therapeutic sessions and has experience treating dual psychiatric and substance use disorders. He is an assistant professor at the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston, Texas. He serves as an attending psychiatrist at Texas Children’s Hospital. He trains future psychiatrists and engages in scholarly research projects.
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