Sadness is the price people pay for love. The costs come in the form of pain, sadness, anger, disorientation and numbness. The good thing is that these feelings will likely change over time.
But here’s the catch! Not all people are lucky enough to deal with grief. The loss of the loved one becomes more intense and painful as time passes, trapping people in a long-term desire to see or be with their loved ones.
When the grieving period reaches a threshold, simple grief turns into ‘prolonged grief disorder (PGD)’. PGD is no longer a theoretical condition; in 2022 it was added to Diagnostic and Statistical Manual of Mental Disorder 5.
What is Prolonged Grief Disorder?
PGD is a form of grief that does not diminish over time and disrupts a person’s ability to adapt to loss.
In this condition, people have difficulty accepting the loss and moving forward in their lives appropriately.
According to Holly Prigerson, director of the Cornell Center for Research on End-of-Life Care at Weill Cornell Medicine, “PGD is a chronic, intense, distressing response to loss, which is distinct from grief-related depression and anxiety.”
The people who struggle with this disorder experience a distorted reality characterized by emotional detachment and numbness.
Neuroscience behind long-term sadness
Recent neuroscientific insights are changing the way we view PGD, more than just an expression of intense sadness. According to a 2026 review in Neurosciences, the condition results from “a biological malfunction” in the brain’s attachment and reward networks.
For people struggling with PGD, these neural systems remain in a loop, indicating that the deceased loved one is still accessible to them.
Ultimately, a persistent conflict arises between what is actually real and what you want to perceive as real. As a result, the brain fails to update its emotional map and begins to lose its ability to process the loss.
“What seems to be the case is that people with severe grief still show that reward expectation from their loved one, for example when they see a cute picture,” says Mary-Frances O’Connor, professor of psychology at the University of Arizona and author of The Grieving Brain.
Another study, conducted in 2020 and co-authored by Prigerson, also found different activity patterns in the amygdala and orbitofrontal cortex of people suffering from PGD. These patterns hinder their ability to process emotions.
Despite these studies, scientists’ understanding is still at an early stage. Richard Bryant, professor of psychology at the University of New South Wales and co-author of the study, notes that because PGD was only recently classified as a formal diagnosis, the scientific community is still making efforts to unravel the patterns.
Is PGD common?
According to Prigerson, about 4 percent of people develop PDG after a loss. It is more common when a person experiences violence and sudden loss.
Prolonged grief is responsible for causing many health problems, including depression, post-traumatic stress disorder, anxiety, wildly fluctuating blood pressure and high mortality risks.
How to treat prolonged grief disorder?
According to grief experts, PGD does not respond to antidepressants and psychological therapies.
The only treatment is long-term grief therapy. The therapy involves 16 sessions, marked by healing milestones.
The healing journey begins with accepting grief, reimagining a promising future, connecting with the memories of the dead, and remembering the reality of loss.
Research shows that 70 percent of people have shown improvement as a result of these sessions.
