If grief continues to make daily life unmanageable, seek a psychiatric or clinical psychology assessment
Roughly one in ten bereaved adults in one synthesis had prolonged grief disorder. Persistent yearning, numbness, loss of meaning, and difficulty eating, working, or caring for children can merit help. This is not a failure of strength. A targeted treatment trial found response rates of 51% versus 28% with interpersonal psychotherapy, with faster improvement. You do not need to wait a fixed number of months to ask for help.
What it takes
Consultation and treatment fees. The cited trial used 16 sessions over an average of 19 weeks. Making the first appointment can be difficult.
What you may gain
A meta-analysis of 14 studies in adults bereaved by nonviolent deaths and outside psychiatric treatment settings estimated prolonged grief disorder prevalence at 9.8%, 95% CI 6.8–14.0, with higher prevalence at older ages. A separate validation study interviewed 291 bereaved people at 0–6, 6–12, and 12–24 months. Its proposed criteria centered on yearning plus at least five of nine symptoms: emotional numbness, shock, meaninglessness, distrust, bitterness or distress related to the loss, difficulty accepting it, identity confusion, avoidance, and difficulty moving forward. Symptoms occurred daily or to a disabling degree, persisted at least six months after the death, and impaired functioning. In a randomized trial of 95 people receiving 16 sessions over a mean 19 weeks, complicated-grief treatment produced a 51% response versus 28% with interpersonal psychotherapy, P=0.02, and worked faster. The number needed to treat for one additional response was 4.3.
Context & considerations
Do not use the calendar to deny yourself care. If grief is disrupting eating, sleep, work, or caring responsibilities, seek an assessment. Departments may be called psychiatry, psychological medicine, or clinical psychology; public psychiatric hospitals provide relevant care. Sources use both complicated grief and prolonged grief disorder, and diagnostic systems use different duration thresholds, including six and twelve months. The 9.8% estimate combines heterogeneous studies and is not necessarily transferable to every population.
Research & references
Lundorff M et al. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2017.01.030; Prigerson HG et al. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1000121; Shear MK et al. (2005). Treatment of complicated grief: a randomized controlled trial. JAMA. https://doi.org/10.1001/jama.293.21.2601