‘Prolonged grief disorder’ now officially a mental health diagnosis

Advocates say change means insurance can cover treatment; critics say grief is natural and not a disorder

“Everyone grieves in their own way.” That’s what we say when someone seems fine a few days after a loved one’s death, or when someone is still grieving years later.

However, those who experience an intense yearning for or preoccupation with the deceased person — so much so that their reactions preoccupy them almost every day for at least a month — suffer from prolonged grief disorder.

Prolonged grief disorder differs from regular grieving because feelings of loss leave sufferers incapacitated and unable to function. The disorder officially became a diagnosis when it was recently added to the Diagnostic and Statistical Manual of Mental Disorders, a volume published by the American Psychiatric Association that defines and classifies mental disorders.

According to the APA, symptoms of the disorder include identity disruption (feeling that part of yourself has died); a marked sense of disbelief about the death; avoidance of reminders the person is dead; intense emotional pain; intense loneliness; emotional numbness; or a feeling that life is meaningless.

“The circumstances in which we are living, with more than 675,000 deaths due to COVID, may make prolonged grief disorder more prevalent,” Vivian B. Pender, M.D, president of the APA, said in a press release from the association.

According to the New York Times, inclusion of the disorder in the DSM means health care professionals can bill insurance companies for treating people.

“Including prolonged grief disorder in the DSM-5-TR will mean that mental health clinicians and patients and families alike share an understanding of what normal grief looks like and what might indicate a long-term problem,” Saul Levin, M.D., M.P.A, CEO and medical director of the APA, said in the association’s news release. “Especially now, sharing information and increasing awareness about prolonged grief disorder is essential.”

Not everyone agrees with the disorder’s inclusion, fearing it will cause “false positives and encourage drug companies to persuade the public they need medical treatment to cope with mourning,” the Times reported.

“I completely, utterly disagree that grief is a mental illness,” said Joanne Cacciatore, Ph.D., an associated professor of social work at Arizona State University who operates the Selah Carefarm, a retreat for bereaved people. “When someone who is a quote-unquote expert tells us we are disordered and we are feeling very vulnerable and feeling overwhelmed, we no longer trust ourselves and our emotions. To me, that is an incredibly dangerous move, and short-sighted.”

Paul S. Appelbaum, M.D., chair of the steering committee overseeing revisions to the fifth edition of the DSM, told the the Times he hopes the change will help those who have withdrawn from society after experiencing loss.

“Grief in these circumstances is normal but not at certain levels and not most of the day, nearly every day for months,” Pender said. “Help is available.”

For more content like this, sign up for the Pulse newsletter here.

About the Author