Clarity Counseling Seattle

The Many Types of Grief blog series: Complicated/Prolonged Grief

September 1, 2022
Posted By: Clarity Counseling Seattle
Complicated Grief or Prolonged Grief

This is part of our series of writings focused on the many types of grief we can experience, within which we’ll write a brief description of each.

Complicated/Prolonged Grief is the term we often use when “normal” grief becomes quite long in duration. Most people experience more normal grief and bereavement as a time of feeling great sorrow, possibly numbness to emotions, and often some forms of guilt, and even intense anger. But with normal grief, these experiences fade or ease up over time, and the loss is more accepted and adapted to. After some period of time, the person experiencing normal grief is able to move forward and function much as they did before the loss. But with complicated/prolonged grief, some quite disruptive symptoms can occur for at least 6 months for adolescents and children, and for at least 12 months for adults, after the bereaved person has had a major loss.

There is actually a mental health diagnosis, and quite honestly a controversial one within the grief therapy and grief counseling community, called Prolonged Grief Disorder that was recently added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is what the American Psychiatric Association (APA) uses to define and classify mental disorders. *It's important to note that with complicated/prolonged grief, especially if it is to be considered a disorder, the grief symptoms are not just lingering for 6 to 12 months but are significantly impairing the person’s ability to engage in daily functioning.

The grief may show up in some of the following ways:

  • Violent outbursts
  • Radical lifestyle changes
  • Low self-esteem
  • Substance abuse begins or increases over time
  • Consistent feelings of guilt
  • Rumination
  • Hallucinations of the deceased
  • Yearning for the other person
  • Suicidal thoughts


There are a number of factors that can contribute to someone experiencing grief in this way, including the following:

  • The nature of the loss
  • The relationship with the deceased
  • Life experiences including trauma
  • Attachment style
  • Social issues

Should prolonged intense grief be classified as a mental disorder? That’s certainly up for debate, and we’ve experienced many people entering into grief therapy in Seattle after a loss with the concern that they will be diagnosed by their therapist as being mentally ill. When to consider healthy grieving as a valid mental health issue can be difficult to define, even for mental health professionals who specialize in grief and loss, including our own grief therapy specialist Hanna Kokko, but what every grief therapist or grief counselor tries to do when people come to us with concerns about being pathologized is to help clients to realize that regardless of what type of grief they’re experiencing, or whether their symptoms fit into an official diagnosis, they still absolutely get to have the experiencing they’re having, and that they will not always feel the way they do upon entering into therapy.

Normal grief…complicated grief…it can all be helped by working with someone who is skilled in grief work. Want some help with what you're going through? Please let us know.

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