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Grief is a normal human response to the pain of losing someone. It can be brutal, anguished, disorienting, maddening, enraging, and lonely.
But ultimately, most people will emerge from grief. They may feel forever changed; however, many find meaning in their lives again. Those difficult feelings eventually make way for positive emotions and experiences again. According to the DSM-5, this process is known as uncomplicated bereavement, also known as uncomplicated grief.
For others, the loss of a loved one can make life feel meaningless—even unsurvivable. They struggle to experience anything but debilitating feelings of grief, long after the death of their loved one. This can be classified as prolonged grief disorder.
Let’s take a closer look at both uncomplicated bereavement and prolonged grief disorder and see how individuals can effectively grieve the loss of a loved one and heal.
Definition of Uncomplicated Bereavement DSM-5
Uncomplicated bereavement, also known as normal grief, is the process of feeling the natural, difficult emotions that follow a loss, like the death of a loved one. The way people experience uncomplicated bereavement varies from person to person, as the intensity and duration can depend on a number of factors, such as a person’s personality and culture, the circumstances surrounding the loss, and the grieving person’s relationship with the lost individual.
For example, it may be particularly hard for an individual to process unexpected or sudden death or a suicide, though grief might be more intense for a child grieving the loss of a parent, a spouse grieving the loss of their partner, or a parent grieving the loss of a child, though this is subjective to each person.
While a person may not entirely overcome their loss, eventually, they are able to process the loss, how it has changed their life, and return to a (new) normal life. If someone’s disabling grief persists longer than six months to a year, as it does in about 10% of cases, it might instead be considered an adjustment disorder or prolonged grief disorder (PGD), also known as complicated grief.
What’s the Difference Between Grief and Bereavement?
Bereavement refers to the state of having experienced a loss, while grief describes the emotional reactions to that loss, such as sadness or preoccupation with the deceased. Mourning, in contrast, involves the cultural and social rituals surrounding that loss, like funerals or memorials.
Symptoms of Uncomplicated Bereavement
The symptoms of uncomplicated bereavement, or normal grief, may resemble those of a major depressive episode or even a physical disease. Common physical and emotional symptoms of uncomplicated bereavement can include:
- Crying or emotional outbursts
- Insomnia
- Lack of appetite
- Fatigue
- Difficulty focusing
- Withdrawal from routines and social activities
- Feelings of loneliness or anger
- Questioning beliefs
While everyone experiences grief differently, research from 2009 states that a key sign of normal grief is the shift from acute grief—an intense, immediate reaction—to integrated grief. Acute grief is the intense, immediate reaction to a loss, something that can involve feelings of profound despair, guilt, and hopelessness, as well as uncontrollable crying or anger. A person experiencing acute grief might find it hard to do anything but mourn their loss.
As acute grief evolves into integrated grief, individuals start to regain their usual functioning. Memories of the loss remain, but life becomes more balanced, with the capacity to enjoy other aspects returning. Sadness may still arise during anniversaries or significant moments, but it no longer dominates everyday life.
Definition of Prolonged Grief Disorder
Prolonged grief disorder (PGD) describes an ongoing, intense sorrow that significantly interferes with a person’s ability to function in daily life. A person can be diagnosed with PGD if their grief symptoms persist for a sustained period of time—typically 12 months for adults or six months for children.
Uncomplicated Bereavement vs. Prolonged Grief Disorder
Most people who experience uncomplicated bereavement, or normal grief, can effectively deal with the loss of a loved one with the help of family, friends, and their personal belief systems. Over time, their feelings of despair lessen, and they learn to move forward.
Those experiencing prolonged grief disorder, however, have a more difficult time processing this degree of loss in the long term and find it nearly impossible to continue life as they knew it.
Symptoms of Prolonged Grief Disorder DSM-5
To be diagnosed with prolonged grief disorder as an adult, the affecting loss must have occurred at least a year ago—and for children and adolescents, at least six months ago. Additionally, the individual must have experienced at least three of the following symptoms nearly every day for the last month or longer:
- Disrupted identity
- Feelings of disbelief about the death
- Avoiding reminders that the individual has passed
- Intense emotional pain directly related to the loss
- Trouble getting back to normal life
- Numbness
- Feeling that life is meaningless
- Loneliness and detachment from others
One group at a greater risk of developing prolonged grief disorder includes those who have a history of mental health issues. For those who have suffered from a substance use disorder, grief and loss may be a trigger and could potentially increase the risk of relapse.
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Treating Uncomplicated Bereavement
Grief work can look different for everyone but might include separating oneself from the person who died, learning how to readjust to a world without the individual, and working to create new relationships.
Unfortunately, some may need some extra care and guidance to heal from the pain of losing a loved one. In such cases, people can seek professional help through grief counseling or therapy. Grief counseling helps those grieving manage their reactions to the loss. This type of therapy can involve the following:
- Psychoeducation about the normal stages of grieving
- Talking about the loss and express emotions surrounding it
- Identifying coping issues and recommending more productive pathways
- Shifting focus from the deceased to the client’s own life
- Regular emotional support
Grief is a difficult yet guaranteed part of life, and it illustrates the degree of a person’s love for the loss. Grief counseling helps people learn to continue on with their lives while preserving the memories and legacy of their loved ones.
Treating Prolonged Grief Disorder
Mental health treatment for prolonged grief disorder can be similar to treating uncomplicated bereavement, as it can involve finding support groups, seeking help from family and friends, and using targeted therapy to process loss and reduce the intensity of symptoms. Some types of therapy that can help treat prolonged grief disorder include:
- Cognitive behavioral therapy (CBT): This therapeutic approach helps people manage grief-related feelings by addressing the thoughts and behaviors tied to these feelings. This process can also help address symptoms of grief, like anxiety.
- Complicated grief treatment (CGT): This targeted therapy combines CBT with grief-focused strategies in order to help people accept their loss and build new meaningful goals in life.
- Sleep-focused CBT: For those struggling with insomnia related to grief, this therapy can help people improve their sleep and overall well-being.
Because those experiencing prolonged grief disorder may be overwhelmed by their grief, it can be difficult for them to make the effort to seek help and find support. It’s normal to lack energy and motivation when experiencing intense grief, but without professional support, prolonged grief disorder can be difficult to shake. Consider small steps you could to reach your goal of getting help, such as reaching out to a friend to help you look for a mental health professional or spending five minutes researching grief-related therapy approaches online.
Final Thoughts
Everyone experiences grief differently, as it is a profoundly personal experience. Understanding the distinction between uncomplicated bereavement and prolonged grief disorder is essential in recognizing when grief has transitioned from a natural process to a condition requiring more support and intervention. With the right resources, including therapy, support groups, and a compassionate network, individuals can find pathways to healing. Ultimately, grief is not about forgetting but about integrating the loss into a meaningful life moving forward.
