This post is part of our series exploring the many types of grief—because grief doesn’t come in just one form. By understanding these different expressions of loss, we can begin to make sense of our experience and feel less alone in it.
What Is Complicated or Prolonged Grief?
Complicated grief, also known as prolonged grief, refers to when the grieving process becomes long-lasting, intense, and difficult to manage. While it’s normal for grief to feel overwhelming at first, most people gradually return to a sense of daily functioning over time. They begin to integrate the loss, find ways to cope, and re-engage with life, even while still carrying their grief. But for some, that healing process doesn’t unfold so easily.
In cases of prolonged grief, symptoms may persist well beyond what’s typical—often for more than 12 months for adults and 6 months for adolescents or children. What sets this apart from normal grief isn’t just the timeline, but the extent to which a person’s functioning is impacted. They may find it incredibly hard to resume daily tasks, maintain relationships, or even feel any sense of purpose or hope.
There is now a mental health diagnosis called Prolonged Grief Disorder, which was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). While its inclusion is debated among grief professionals, what matters most is not the label, but whether someone is suffering—and whether support might help.
Signs of Complicated or Prolonged Grief
This type of grief might involve symptoms like:
- Intense yearning or longing for the deceased
- Persistent sadness, hopelessness, or emotional numbness
- Hallucinations or vivid dreams of the person who died
- Ongoing feelings of guilt or self-blame
- Increased use of alcohol or other substances
- Violent outbursts or erratic behavior
- Radical lifestyle shifts or withdrawal from life
- Low self-worth or questioning of identity
- Intrusive thoughts or rumination
- Thoughts of not wanting to live or suicidal ideation
What Makes Prolonged Grief More Likely?
There’s no single cause, but several factors may increase the likelihood of experiencing prolonged grief, such as:
- The nature or circumstances of the loss (e.g., sudden, traumatic, or violent death)
- The closeness or complexity of the relationship with the person who died
- A history of trauma or mental health struggles
- Attachment style and how one relates to others emotionally
- Lack of social support or community
Is This a Mental Health Issue?
This is where things get complicated. Some people worry that their grief is being pathologized when it doesn’t fit into the expected timeline. Others fear they’ll be labeled with a disorder for simply feeling what they feel. In our work as therapists, we often hear these concerns.
At Clarity Counseling Seattle, we believe that grief doesn’t need to meet a diagnosis to deserve care. Whether you’ve been grieving for months or years, whether you’re feeling stuck or unsure what to feel, individual counseling or relationship therapy can be a space where your loss is honored—without judgment and without rushing your process.
Therapy for Grief in Seattle
You don’t have to carry this alone. Working with a grief therapist can help you begin to understand what’s happening internally and explore new ways to cope, even when things feel impossible. If you’d like to talk with someone who understands complicated grief and can walk alongside you, reach out today to schedule a consult.