When Grief Won’t Let Go: Understanding Normal Grief vs. Prolonged Grief — and What Helps

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Grief is a universal, deeply personal response to loss — and it can be as varied as the people who experience it. For most people, the intensity of grief changes over time and gradually becomes more manageable. For some, however, painful symptoms persist and interfere with daily life long after the loss; that experience is now recognized clinically as prolonged grief disorder (PGD). This post explains what grief and PGD look like, and a few instances of the available means to manage them.

What is “normal” grief — and when is it different?

Normal grief commonly includes waves of sadness, yearning, intrusive memories, sleep or appetite changes, and difficulties concentrating. People often still find moments of positive feeling or interest in life even while grieving. In contrast, prolonged grief disorder is diagnosed when intense yearning and preoccupation with the deceased persist far beyond culturally expected time frames (DSM-5-TR uses a 12-month threshold for adults; ICD-11 allows diagnosis after 6 months if symptoms are severe and persistent), and the distress causes marked impairment in daily functioning. Key symptoms include intense longing, persistent disbelief, identity disruption, and avoidance of reminders of the loss.

How common is prolonged grief?

Estimates vary by population and measurement, but studies suggest that a minority of bereaved people—commonly cited figures around 7–10%—develop prolonged or complicated grief following bereavement; rates are higher after traumatic losses or where social support is weak. Accurate assessment should always consider cultural norms and the context of the loss.

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Practical self-care and when to seek help

Self-care strategies that can ease grief symptoms include maintaining routines, gentle physical activity, staying socially connected, memorializing the lost person in meaningful ways, and practicing focused emotion-regulation (breathing, grounding, or brief mindfulness). However, if intense yearning, intrusive preoccupation, avoidance, or role/identity problems persist and significantly impair work, relationships, or self-care for months (particularly beyond 6–12 months depending on context), it’s time to reach out for professional help. Early intervention tailored to grief-specific patterns (avoidance, yearning, meaning-making) tends to improve outcomes.

Final note

Grief is not a problem to be fixed quickly — it’s a process that often requires time, compassion, and sometimes guided support. Modern research gives us effective, targeted therapies that help many people move from a place of immobilizing loss toward re-engagement with life while honoring what was lost. If you’re unsure whether what you’re experiencing is within expected bereavement or may be prolonged grief, a consultation with an experienced mental health professional can clarify options and next steps.

References (selected)

• American Psychiatric Association — Prolonged Grief Disorder (DSM-5-TR). APA patient/DSM resource. American Psychiatric Association

• Eisma, M.C., et al. (2020). ICD-11 Prolonged Grief Disorder criteria — review and diagnostic implications. European Journal of Psychotraumatology / PMC. PMC

• Shear, M.K., Frank, E., Houck, P.R., & Reynolds, C.F. III (2005). Treatment of Complicated Grief: A randomized controlled trial. JAMA (demonstrating efficacy of Complicated Grief Therapy). PMC

• Komischke-Konnerup, K.B., et al. (2024). Grief-focused cognitive behavioral therapies for prolonged grief symptoms: A systematic review and meta-analysis. (evidence supporting CBT approaches). ResearchGate

• Kakarala, S.E., et al. (2020). The neurobiological reward system in prolonged grief. Journal of Affective Disorders / PMC (mesolimbic involvement and neural reward pathways). PMC

• Szuhany, K.L., et al. (2021). Prolonged grief disorder: Course, diagnosis, and assessment. Frontiers in Psychiatry / PMC (overview of assessment and interventions). PMC

Disclaimer

The information provided in this blog is for educational and informational purposes only and is not intended as a substitute for professional psychological, psychiatric, or medical advice, diagnosis, or treatment. Reading this post does not establish a therapist–client relationship. If you are experiencing intense or prolonged grief, emotional distress, or thoughts of self-harm, please reach out for professional help from a qualified mental health provider or contact your local distress or crisis service.

In Canada, you can reach the Talk Suicide Canada service at 1-833-456-4566 (available 24/7) or visit talksuicide.ca for chat support.