Researchers have been studying prolonged grief for two decades and have made a convincing argument that prolonged grief is a disorder distinct from the normal grieving process as well as depression.
While grief is a healthy and normal reaction that can last weeks and months after losing a loved one, when it persists much longer, it may become problematic. That isn’t to say that all people who are bereaved for longer than a few months should be diagnosed with prolonged grief. Everyone grieves in individual ways, but there are some indications that something is different.
One clear difference occurs in the brain.
Recent studies on bereaved women with and without complicated or prolonged grief show that women with prolonged grief had increased activity in the nucleus accumbens, or the region in the brain associated with reward. For those struggling with prolonged grief, reminders of the deceased still activate the neural reward activity, which may interfere with adapting to the loss in the present.
People experiencing depressive-like symptoms show no such activity in their reward centers. Moreover, unlike depression, prolonged grief doesn’t tend to improve much with antidepressants.
Thankfully, there is hope. Therapists who help their clients focus on understanding grief, managing painful emotions, thinking and planning for the future, strengthening relationships, telling the story of the death, learning to live with reminders and remembering the person who died can help to improve their symptoms.
To that end, research has shown that grief-focused cognitive behavioral therapy combined with exposure therapy in which clients are helped to re-engage with life, significantly improve over a relatively short period of time.