How To Break Free From Prolonged Grief Disorder

How To Break Free From Prolonged Grief Disorder

Grief is one of the most painful experiences people face. After the death of a loved one, feelings of sadness, longing, anger, guilt, and disbelief are normal. For most individuals, those emotions gradually become less intense over time as they adapt to life without the person they lost. However, some people find themselves unable to move forward months or even years after a loss. Their grief remains overwhelming and persistent and can disrupt relationships, work, daily functioning, and overall well-being. When grief becomes chronic and debilitating in this way, it may be a condition known as Prolonged Grief Disorder (PGD), also sometimes referred to as complicated grief. It is important to understand the difference between a healthy grieving process and the profound, unyielding sadness that can manifest as PGD. Grieving on its own does not, necessarily, require intervention; but PGD often does.

What Is Prolonged Grief Disorder?

Prolonged Grief Disorder is a recognized mental health condition characterized by persistent, intense grief that lasts significantly longer than would be expected based on cultural or social norms. To meet diagnostic criteria, symptoms generally must persist for at least 12 months following a loss in adults (6 months for children and adolescents) and cause substantial impairment in daily life.

People with prolonged grief often feel emotionally "stuck" in the loss. Instead of gradually adapting, they continue to experience intense yearning, emotional pain, and preoccupation with the deceased that interferes with daily functioning. Research suggests that as many as 14% of bereaved individuals develop Prolonged Grief Disorder.

What Causes Prolonged Grief Disorder?

There is no single cause of prolonged grief disorder. Rather, it appears to develop from a combination of biological, psychological, and social factors. That being said, there are many risk factors that may increase the likelihood of developing PGD:

Sudden or Traumatic Loss

Unexpected deaths due to accidents, suicide, violence, overdose, or medical emergencies can make it more difficult for individuals to process their grief and accept the reality of the loss.

Loss of a Close Attachment Figure

The death of a spouse, child, parent, or someone who played a central role in a person's life can create a profound disruption in identity and daily functioning.

Previous Mental Health Conditions

Individuals with a history of mood disorders, depression, anxiety, or attachment difficulties may be more vulnerable to prolonged grief.

Limited Social Support

Isolation, strained family relationships, or inadequate emotional support can make navigating grief more challenging.

Unresolved Trauma

When grief is accompanied by traumatic memories or unresolved emotional issues, the healing process becomes more complicated. Emerging research suggests that prolonged grief may involve disruptions in brain circuits related to attachment, reward processing, emotional regulation, and memory. The brain may continue responding to reminders of the deceased in ways that prevent adaptation and acceptance.

How Is Prolonged Grief Different From Normal Grief?

One of the greatest misconceptions about Prolonged Grief Disorder is that it simply means grieving longer than expected. Length of grief alone does not determine whether someone has a disorder. Healthy grief does not follow a strict timeline.

Instead, the difference lies in the intensity of symptoms and whether the individual is able to gradually reengage with life.

Typical Grief

In the "normal" grieving process, intense emotions often come in waves. The pain gradually becomes more manageable and, while initial withdrawal is not uncommon, the individual is ultimately able to reconnect with relationships and activities. Positive memories eventually coexist with sadness, and acceptance of the loss develops after a time.

Prolonged Grief Disorder

With PGD, the intense emotional pain does not stop. The person is unable to accept the reality of their loss, and daily functioning is significantly impaired as a result. Feelings of emptiness and deep sadness do not improve much or at all, despite the passage of time. Someone experiencing prolonged grief often feels as though life stopped when their loved one died.

Common Signs and Symptoms of Prolonged Grief Disorder

For adults, Prolonged Grief Disorder may be diagnosed when grief lasts for 12 months or more and at least three of the following symptoms have been present almost every day during the month preceding the diagnosis:

Difficulty Accepting the Death

Individuals may struggle to fully acknowledge that the loss occurred (or even refuse to accept it at all) even many months later.

Emotional Numbness

Some people describe feeling detached from their emotions or disconnected from others.

Loss of Identity

A common experience is feeling that part of oneself died along with the loved one.

Avoidance Behaviors

People may avoid reminders of the deceased or, conversely, become excessively preoccupied with memorializing them.

Social Withdrawal And Loneliness

Relationships, hobbies, and responsibilities are often abandoned as the individual loses interest in activities that once brought meaning. A person may feel completely isolated and detached from others, whom they feel cannot understand their grief or may try to talk them out of it.

Feelings of Meaninglessness

Many describe believing life no longer has purpose or value without the person they lost.

Intense Emotional Pain

It is not just sorrow that may be present in Prolonged Grief Disorder. Intense feelings of anger, guilt, bitterness, and shame are often experienced as well. Persistent thoughts about what could have been done differently may become overwhelming.

How Is Prolonged Grief Disorder Treated?

The good news is that prolonged grief disorder is treatable.

Grief-Focused Psychotherapy

There are specialized forms of psychotherapy designed to address prolonged grief and its complex nature. One of the most researched approaches is Complicated Grief Therapy (CGT). This treatment focuses primarily on:

• Processing the reality of the loss: healing cannot begin until the individual fully accepts their loved one is gone.
• Exploring attachment to the loved one: understanding the bond with the lost loved one and how that loss interrupted normal attachment.
• Addressing avoidance behaviors: slowly reintroducing reminders of the loved one and letting them invoke positive memories alongside sad ones.
• Rebuilding a meaningful life: learning that one's life has meaning beyond the death of a loved one.
• Strengthening coping skills: practicing gratitude, mindfulness, self-care, and regaining the ability to plan for the future can help bolster healing.
• Restoring social connections: re-engaging with friends, hobbies, and coworkers.

Cognitive Behavioral Therapy (CBT)

More broadly, CBT can also help individuals identify unhelpful thought patterns related to guilt, self-blame, and hopelessness.

Trauma Therapy

When grief is complicated by traumatic memories, trauma-focused therapies may be beneficial.

Medication

Traditional antidepressants may help if depression or anxiety co-occurs with prolonged grief. However, antidepressants alone often have limited effectiveness for grief-specific symptoms.

Emerging Therapies For Complicated Grief

Because research suggests that Prolonged Grief Disorder may have something to do with disrupted neural pathways, ketamine has been suggested as a means of long-lasting relief. The notion is not new: a 2016 study found "rapid resolution of prolonged grief" in a 28-year-old man who had lost his wife suddenly during childbirth.

There are several reasons why ketamine could be especially effective for Prolonged Grief Disorders:

Ketamine Increases Neuroplasticity

Ketamine affects the brain's glutamate system and appears to promote rapid neuroplasticity, which lets the brain form new connections and more flexible patterns of thinking. This may help individuals become less trapped in repetitive cycles of grief and emotional pain.

Ketamine Interrupts Looping Memories

People with prolonged grief often become caught in recurring memories, longing, guilt, and rumination. Ketamine may temporarily disrupt these entrenched patterns and create an opportunity for emotional processing and therapeutic breakthroughs.

Ketamine Can Help Co-Occurring Mental Health Disorders

Many individuals with prolonged grief also experience depression. Ketamine is known for its rapid antidepressant effects, often occurring within hours or days. Improving depressive symptoms may allow individuals to engage more effectively in grief-focused therapy.

Ketamine Can Encourage New Perspectives

Many patients undergoing ketamine-assisted psychotherapy report experiencing increased psychological flexibility, self-compassion, and a greater ability to view their loss from a different perspective. These shifts may help some individuals begin moving toward acceptance without diminishing the importance of the relationship they lost.

Just as with traditional pharmaceuticals, ketamine therapy should be accompanied by psychotherapy where the emotional insights that occur during treatment can be integrated into lasting healing and growth.

Ketamine Assisted Psychotherapy In Destin, FL

If grief remains overwhelming more than a year after a loss, interferes with daily functioning, or leaves you feeling unable to envision a future, it may be time to speak with a mental health professional. Please remember that seeking help is not a sign that you loved someone too little or that you are grieving incorrectly. It simply means that the grieving process may have become stuck and that additional support could help you move toward healing.

The Crane Center in Destin, Florida offers compassionate counseling services for a wide variety of mental health concerns, including prolonged grief. We offer both traditional and alternative therapies, including ketamine assisted psychotherapy, to help you break free from your grief. If you are struggling, please text our office to schedule your visit.