Prolonged Grief Disorder: When Grief Stays Disabling

Last verified July 30, 2026.

Prolonged grief disorder, or PGD, is a clinical diagnosis for severe, persistent grief symptoms that cause significant distress or impairment. It isn’t a label for loving someone deeply, missing them for years, crying on anniversaries, or grieving in a way that other people find inconvenient.^[1]

In the United States, clinicians use the DSM-5-TR criteria. The diagnosis belongs to a qualified clinician after a full assessment. A checklist or article can help someone decide to seek an assessment, but it can’t diagnose them.

For an adult, the death must have occurred at least 12 months earlier. For a child or adolescent, the threshold is at least 6 months. The person must have persistent yearning or longing for the person who died, or persistent preoccupation with the person or the circumstances of the death.^[1][2]

The criteria also require at least three additional symptoms, such as identity disruption, disbelief, avoidance, intense emotional pain, difficulty returning to activities or relationships, emotional numbness, a sense that life is meaningless, or intense loneliness. The symptoms must be present often, cause clinically significant distress or impairment, and exceed what the person's social, cultural, or religious context would expect.^[1][2]

Twelve months is one minimum requirement inside a larger diagnostic standard. Grief has no deadline, and duration alone doesn't establish PGD.

Grief can remain strong, return in waves, and stay part of a person's life without being a mental disorder. Cultural and religious mourning practices matter. So do the person's functioning, safety, other health conditions, and their own account of what's happening.

A clinician should ask about the death, the symptoms, when and how often they occur, daily functioning, cultural and religious context, medical conditions, medication or substance use, trauma, depression, anxiety, and safety. PGD can occur with depression or post-traumatic stress disorder, and the conditions require careful differentiation.^[2]

Bring a short record of sleep, eating, work or school, relationships, self-care, symptom triggers, and any thoughts of self-harm. The record gives the clinician a clearer picture than a single difficult day.

Prolonged Grief Treatment is a structured, grief-focused psychotherapy with randomized-trial evidence. It helps people understand grief, approach avoided situations, reconnect with meaningful life, and maintain a continuing bond with the person who died.^[3][4]

Medication may be appropriate for a co-occurring condition such as depression or anxiety. A prescriber should make that decision with the person. Peer groups, hospice bereavement programs, faith or cultural support chosen by the grieving person, and practical help can be useful additions. They don’t substitute for clinical care when symptoms are disabling or safety is at risk.

Look for a licensed mental health clinician with specific training or experience in PGD. Ask which assessment the clinician uses, what grief-focused treatment they provide, how they distinguish PGD from depression and trauma, and how progress is measured.

The Center for Prolonged Grief at Columbia University provides education and a therapist directory. Verify the clinician's current state license and insurance participation separately. A directory listing or training certificate isn't a substitute for licensure.^[4]

Get prompt professional help if grief is preventing basic self-care, work, school, sleep, eating, or connection with other people, or if alcohol or drugs are becoming the main way to get through the day.

If you're in the United States and having thoughts of suicide or need immediate emotional support, call or text 988. If there's immediate danger, call 911 or go to the nearest emergency department.