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Complicated grief

Also called: prolonged grief disorder

Grief that stays at its initial intensity long after the loss and blocks functioning — not grief that is “too much”, but grief that does not move at all.

Ordinary grief is painful but it moves. The intensity arrives in waves that space out, and between them moments of normal functioning and even joy gradually appear — without that meaning the loss matters less.

Complicated grief stays put. The criteria for prolonged grief disorder, introduced in ICD-11 and DSM-5-TR, describe intense persistent yearning or preoccupation with the deceased lasting at least six months (ICD-11) or twelve (DSM-5-TR), with symptoms such as difficulty accepting the loss, emotional numbness, a sense that part of oneself has died, and an inability to find meaning.

Figures suggest it affects around 10 per cent of bereaved people, with risk rising after sudden or violent losses, the death of a child, and where the relationship was conflicted or highly dependent.

The timeframes are not a verdict. Nobody has to “get over it” within an interval. They are statistical thresholds that help identify people for whom a specific intervention — protocols for complicated grief therapy exist and perform well — changes the trajectory.

What it is confused with

With depression. They overlap, but in grief the pain centres on the person lost and comes in waves, and self-esteem usually stays intact. In depression the state is steadier and self-evaluation is globally negative.

With “not enough time has passed”. Duration alone does not define the problem; the absence of any movement plus blocked functioning does.

With intense grief. Someone crying a great deal at six months does not automatically have complicated grief. The criterion is whether life has stopped, not how visible the pain is.

Related terms

AnhedoniaRuminationExperiential avoidance

Methods that work with this

Cognitive behavioural therapyEmotionally focused therapy for couples

These definitions are informational. They do not replace an assessment by a professional and are not enough for self-diagnosis.

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