Grief & Loss

Coping with Grief: When Loss Doesn't Ease with Time

Most grief eases with time and support. For a meaningful minority, it doesn't — and that is now a recognised, treatable condition, not a personal failing.

By Dr. Varun Gupta 7 min read Psychiatrist, Jammu
Written By Dr. Varun Gupta, MBBS, MD Psychiatry
Medically Reviewed By Dr. Varun Gupta, MD Psychiatry — Clinical & Editorial Review
Last Updated / Reviewed July 2026

Grief is one of the most universal human experiences — and one of the least talked about in clinical terms. Most people move through it, in their own time, with the support of family and community. But for some, grief doesn't ease. It stays as raw at eighteen months as it was in the first weeks, and daily life never quite resumes.

What Is Prolonged Grief Disorder?

Prolonged Grief Disorder is a recently recognised psychiatric condition in which intense grief persists well beyond expected cultural norms, causing significant distress or impairment in daily functioning.

This is a genuinely new addition to psychiatric classification — prolonged grief disorder was only formally included in the World Health Organization's ICD-11 in 2018 and the DSM-5-TR in 2022, reflecting a shift in how the field understands grief that doesn't resolve.[1] Research estimates that somewhere between 5–7% of bereaved people experience this more severe, persistent form of grief.

Normal Grief vs. Prolonged Grief

Normal grief, however intense, tends to soften over months — the sharpest pain gradually gives way to moments of relief, function, and even joy, alongside continued sadness and memory.

Prolonged grief stays acute and disabling well past a year, marked by intense yearning for the person who died, difficulty accepting the loss, emotional numbness, a sense that life is meaningless without them, and avoidance of anything that serves as a reminder.

Clinical Insight

Patients with prolonged grief often describe feeling stuck at the exact moment of the loss, as though time simply stopped there while the rest of the world moved on without them. What distinguishes this clinically from "just" grieving longer than others isn't the depth of the pain — it's the degree to which daily functioning remains disrupted, sometimes years later.

Normal Grief vs. Prolonged Grief Normal grief — softens over months Prolonged grief — stays acute ~12 months — the point prolonged grief becomes diagnosable
Fig. 1 — How prolonged grief diverges from the natural course of grieving.

What Actually Helps?

Grief-specific psychotherapy, rather than general depression treatment alone, has the strongest evidence for prolonged grief disorder specifically.

A randomised controlled trial found that therapy specifically designed around grief was more effective at treating prolonged grief symptoms than therapy focused on depression alone — an important finding, since the two conditions can look similar but don't always respond to the same treatment.[1]

Clinical Insight

Families sometimes worry that seeking professional help for grief means something is "wrong" with how their loved one is grieving, or that therapy is trying to rush them past it. In my experience, grief-focused therapy does the opposite — it makes room to actually sit with the loss fully, which is often exactly what avoidance has been preventing.

When Should You Seek Help?

Consider a professional assessment if grief remains as intense and disabling as it was in the early weeks, a year or more after the loss, and continues to significantly disrupt daily life.

There is no fixed timeline for grief, and every culture and individual grieves differently — but if the pain has not softened at all, and daily functioning remains deeply affected well beyond a year, specialised support can help in ways that time alone has not.

"Healing isn't linear — but it is possible. Always."
— Dr. Varun Gupta

Frequently Asked Questions

Is grief itself a mental illness?

No. Ordinary grief, even when intense, is a normal human response to loss and is not a disorder. Prolonged Grief Disorder is a distinct, separately defined condition diagnosed only when intense grief persists well beyond expected cultural timeframes and significantly impairs daily functioning.

When was prolonged grief disorder officially recognised?

It was formally added as a diagnosis in the World Health Organization's ICD-11 in 2018 and in the American Psychiatric Association's DSM-5-TR in 2022 — meaning this is a genuinely recent development in psychiatric classification, reflecting growing evidence that some grief responses need dedicated clinical attention.

How is prolonged grief disorder treated?

Grief-specific psychotherapy has shown greater effectiveness for prolonged grief symptoms than general depression-focused therapy in clinical trials, since the two conditions, while overlapping, are not identical and respond somewhat differently to treatment.

References

  1. Eisma MC. Prolonged grief disorder in ICD-11 and DSM-5-TR: Challenges and controversies. PMC, National Library of Medicine. pmc.ncbi.nlm.nih.gov/articles/PMC10291380
  2. Szuhany KL, et al. Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment. PMC, National Library of Medicine. pmc.ncbi.nlm.nih.gov/articles/PMC8475918

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