What is Prolonged Grief Disorder?
Before we get into this post, a few disclaimers. I am not a licensed professional (yet!). I am a current MSW student who has taken a diagnosis and assessment course. I am also a person who is VERY intimate with my grief and companioning other through theirs through my work as a grief facilitator. While I welcome the discourse from those within the field on this topic, I want to note that below includes my opinion as well as DSM criterion.
So….Let’s get into it!
What is Prolonged Grief Disorder?
Prolonged Grief Disorder (PGD) is a diagnosis that was officially added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) by the American Psychiatric Association (APA) in 2022. Its inclusion was the result of years of research and debate among mental health professionals. Advocates for its addition argued that some people experience a persistent, debilitating form of grief that significantly impairs their ability to function, and that recognizing this condition could help those individuals access appropriate treatment and support. The goal was to validate the suffering of people whose grief didn't ease over time and to distinguish their experiences from what is considered a “natural bereavement” process.
How Is It Defined?
PGD describes a condition where a person continues to experience intense and disruptive grief symptoms more than 12 months after the death of someone close to them (6 months for children and adolescents). Please note that in the case of PGD the grief is in response to the death of someone. Grief can be felt as a reaction to any sort of unwanted change in life, however, to be diagnosed with PGD, there must have been a death.
This PGD grief goes beyond what is considered "typical" and interferes with a person’s daily functioning, relationships, and sense of self. According to the APA, symptoms may include:
Intense longing for the deceased
Preoccupation with the deceased or the circumstances of the death
Difficulty accepting the death
Emotional numbness
A feeling that life is meaningless without the deceased
Avoidance of reminders of the loss
Difficulty re-engaging in life
To be diagnosed with PGD, these symptoms must be persistent, cause significant distress or impairment, and not be better explained by another mental health condition like depression or PTSD.
How Is It Different from Normal Grief?
Everyone experiences grief differently, but the APA distinguishes "normal" grief as a natural, adaptive response to loss. Over time, most people gradually adjust to the reality of the death, although the pain may still arise on birthdays, anniversaries, or other reminders.
In contrast, PGD is marked by an ongoing inability to adapt or find a new way of being in the world without the person who died. It's not about "still being sad" after a year—it's about being stuck in such intense emotional pain that it becomes difficult to function.
Why I Don’t Love PGD as a Diagnosis
Here’s where I’ll be real with you. As someone who has experienced grief firsthand and is going to be working in this space professionally, I have complicated feelings about PGD as a clinical label.
I would argue that many people who end up with a PGD diagnosis weren’t actually given the place or space to grieve in the first place.
Think about it: our society gives you three days of bereavement leave when your spouse dies—three days to wrap your head around the fact that your partner, maybe your best friend, maybe the person who provided financial stability, is gone. Then you’re expected to get back to work, get back to "normal," and perform like your world isn’t upside down.
We live in a grief-illiterate culture that rushes people through the grieving process, silences open expressions of pain, and labels prolonged mourning as pathological. To me, PGD feels like a diagnosis born out of a society that treats grief as taboo. Instead of asking, why is this person still grieving? we might consider asking, what support did they receive (or not receive) when the loss happened?
Another piece that makes me hesitate: the treatments recommended for PGD—like cognitive behavioral therapy, grief counseling, and narrative work—aren’t radically different from what we offer people who are grieving without the diagnosis. So then what are we really doing? Medicalizing something that might be a natural outcome of unsupported, disenfranchised grief?
I’m not saying that people with PGD don’t deserve support—they absolutely do. But I think we need to be careful about turning deep, enduring grief into a disorder without looking at the societal context that helped create it.
Final Thoughts
Grief is not a linear process. It doesn’t come with a timeline, and it certainly doesn’t fit neatly into diagnostic boxes. PGD may help some people put language to their suffering and access care, and that’s valuable. But we also need to zoom out and ask bigger questions about the culture that makes prolonged grief a disorder in the first place.