Prolonged Grieving or Clinical Depression?

Close-up of psychologist comforting his depressed patient

Cristi Bundukamara, Ed. D, PMHNP (aka, Dr. B.), founder and creator of the Mentally STRONG Method, discusses prolonged grieving disorder and her grief journey after losing two of her children to natural causes. After losing her son, Reggie, in 2016, Dr. B tried to work through her intense grief for years through what she calls “controlled grief.”  Controlled grief is setting aside time to process and deal with your feelings, keeping them from interfering with your day-to-day activities. After practicing controlled grief for five years, decreasing the intensity and frequency of her grieving over time, her daughter, Maya, passed away in 2021.

How Long is Grieving Normal?

Understandably, there will be a long period of mourning for the loss of a loved one, like a child or a spouse. While a year may be too short a time to limit grieving such a significant loss, one of the criteria in the Diagnostic and Statistical Manual, or DSM-V, is grieving beyond a year, unable to move on. An example is avoiding reminders of that person to keep from crying and actively grieving after a year is a sign of prolonged grieving disorder. Intense emotional pain at the thought of the person you have lost, which interferes with your daily life, is just one of the criteria for prolonged grieving disorder.

Prolonged Grief Symptoms

You may have prolonged grief disorder if you lost someone over a year ago and you have experienced three of the following symptoms nearly every day for at least a month:

  • Identity disruption (feeling a part of oneself has died)
  • A marked sense of disbelief about the death
  • Avoidance of reminders that the person is dead
  • Intense emotional pain
  • Difficulty with reintegration (not engaging socially, pursuing interests, or making plans)
  • Feeling that life has lost all meaning
  • Intense loneliness (feeling alone and detached) (APA, 2022)

For Dr. B, she came to question her role as a mother after losing both of her biological children. Fortunately, she realized that she was still a mother, not only to her biological children that passed away, but also to her adopted children, that still needed her. Pushing away reminders is avoiding coming to terms with your grief. What may happen when you suppress your feelings like this is they bubble up at inappropriate times. Grieving can be intense, but that intensity should dissipate with time. On the other side of severe emotional pain is numbness or a loss of meaning in life – which is also a criterion for being diagnosed with prolonged grief disorder.

Grief or Depression?

Some of these symptoms mimic major depressive disorder, specifically feeling depressed, diminished interest in things that used to be pleasurable, and feeling lonely. However, grieving is tied explicitly to the traumatic event of losing someone dear in your life. If that grieving continues to haunt you after a year, it may be time to seek help dealing with that trauma and moving forward.

Becoming Mentally STRONG

If you are dealing with grief, depression, loss, or just struggling with your day, Mentally STRONG can help. We offer in-office appointments and online resources, including virtual training. We have a variety of books and workbooks that can help you learn the Mentally STRONG Method and start the journey to your mental resiliency.

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