Grief is an unfortunate, though ‘normal’ part of life – it is inevitable that we will all live through the passing of a loved one. Grief varies in intensity, duration and expression from person to person, so it’s difficult to tell when it has progressed into something more serious such as Prolonged Grief Disorder. Research is still being conducted on this disorder, but we have compiled some points to help you recognise Prolonged Grief Disorder and how it differs from other mood and anxiety disorders.
Prolonged Grief Disorder differs from grief in that it exhibits the immediate grief symptoms, in an undiminished strength over a long period of time. It is characterised by intense longing for the deceased and thoughts constantly preoccupied with the deceased to the exclusion of almost everything else. The person shows little change in how they’re handling the grief, meaning they don’t seem to get back into their daily routine. They feel emotional numbness and avoid specific places and things that are strongly related to that person. They may struggle with blaming themselves or others for the passing. A defining factor of these symptoms is that they are so severe that they are disabling to the person; they cannot carry out ‘normal’ social and occupational duties, for example.
Studies show that if someone has a history of trauma, loss, a mood or anxiety disorder, or the death happened in a sudden and violent way, they are more likely to develop Prolonged Grief Disorder. Circumstances play a huge role in the disorder: relation to the deceased, nature of death, a lack of support and other social factors can increase the likelihood of heading into the disorder.
Major depressive disorder and associated conditions are characterised by feelings of worthlessness, guilt, and even that you are a burden on others. Whilst depression can arise from the loss of a loved one, one doesn’t feel these things from Prolonged Grief Disorder alone. The disorder directs your thoughts and emotions towards the deceased, specifically, whereas depression sees your thoughts generally dim and hopeless. Depressed people may avoid many activities and people due to their loss of verve, whereas those with Prolonged Grief Disorder will avoid places and people specifically linked to the deceased. Lastly, a depressed person will not have a persistent and disabling longing for the deceased.
Normal grief fluctuates for around one year after the death has occurred, so seemingly prolonged healing can be perfectly normal. Conversely, Prolonged Grief Disorder can be diagnosed as early as six months, strongly depending on how the grief impacts the persons daily life. This means that the time frame for either can vary, it is the extent to which the person is disabled by the loss that helps determine the diagnosis.
Healthcare professionals will try to rule out major depressive disorder, generalised anxiety disorder and post-traumatic stress disorder first, before considering prolonged grief disorder. This is because a combination of the former, more researched disorders can render similar symptoms.
If a person seems to be incapacitated by grief beyond the expectations of their religion or culture, has constant, circling thoughts about the deceased, and doesn’t seem to be progressing, it is possible that they are heading into Prolonged Grief Disorder. This is not meant to diagnose anyone, merely to educate readers on the warning signs that grief may have gone a step further.
The South African Depression and Anxiety Group provides counselling between 8am and 8pm every day of the week. To contact a counsellor call: 011 234 4837 or fax: 011 234 8182. Their suicidal emergency contact is 0800 567 567. A 24hr Helpline is 0800 12 13 14.