Still stuck in grief after half a year, unable to move on — when to see a psychiatrist or clinical psychologist
Grade ABig benefitLifespanLow costSome timeSome willpower
About 1 in 10 bereaved adults gets stuck. After more than half a year they still miss the person so much that they cannot eat, cannot go to work, and cannot look after a child. They feel numb, and life seems to have no point. This is not a lack of strength. It has diagnostic criteria, and it has a treatment made for it. Targeted treatment works in 51% of cases, ordinary psychotherapy in 28%, and the targeted treatment also starts to work sooner.
- Cost
- This includes registration fees and treatment costs. Treatment is delivered in sessions; on average, 16 sessions are given over 19 weeks in clinical trials. The main challenge is simply mustering the courage to make that first appointment.
- Benefit
- Fourteen studies involving adults whose loved ones died of non‑violent causes and who had not previously sought mental‑health care reveal that prolonged grief disorder affects 9.8% of this group (95% CI 6.8–14.0), meaning about 10 out of every 100 bereaved adults are impacted. The rate rises with age. Another study tested the diagnostic criteria on 291 bereaved individuals through interviews at 0–6, 6–12, and 12–24 months after loss. The core symptom is intense longing for the deceased; at least five of nine additional criteria must also be present. The first five criteria are emotional numbness, shock, feeling life lacks meaning, distrust of others, and distress caused by the loss. The remaining four are difficulty accepting the loss, trouble defining one’s own identity, avoidance of reality, and an inability to carry on daily life. All these symptoms must appear daily or be severe enough to impair functioning, and they must persist for at least six months after the death. A randomized trial of 95 participants receiving 16 therapy sessions over 19 weeks found a 51% success rate for specialized treatment versus 28% for standard interpersonal psychotherapy (P = 0.02, a statistically significant difference). Consequently, only 4.3 patients need to be treated for one additional person to experience improvement.
- Notes
- Don’t fixate on exact time limits. The real indicator is whether grief interferes with eating, sleeping, work, or childcare — if so, it’s time to seek help. The appropriate clinics are psychiatry, psychology, or clinical psychology departments, all of which are available at public psychiatric hospitals. This condition is known as prolonged grief disorder or complex grief in various sources; required duration varies from six to twelve months across different guidelines. The 9.8% prevalence figure stems from 14 studies with differing methodologies, so authors caution that it may not apply universally to all populations.
Sources · 3
- Lundorff M, et al. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders. 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. doi.org/10.1371/journal.pmed.1000121
- Shear MK, et al. (2005). Treatment of complicated grief: a randomized controlled trial. JAMA. doi.org/10.1001/jama.293.21.2601