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Health condition · Clinically reviewed

Complicated grief, when the ache does not begin to ease.

Grief is not an illness. But when it stays intense, all-consuming and unchanging months or years on, that pattern has a name, prolonged grief disorder, and specific, compassionate support can help.

Jump to support

If you are struggling right now, the Samaritans are on 116 123, day or night. You can also text SHOUT to 85258. In an emergency, please call 999.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against ICD-11, DSM-5-TR, NICE and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects prolonged grief disorder as recognised by ICD-11 and DSM-5-TR, and current UK bereavement services.

Key facts

Complicated grief at a glance.

The essentials, in plain, gentle English. What prolonged grief disorder is, how it differs from grief, and what helps.

  • What it is

    Prolonged grief disorder (PGD) is intense, persistent grief that lasts beyond six months (ICD-11) or twelve months (DSM-5-TR) and significantly affects daily life.

  • How common

    Around 7 to 10 percent of bereaved people develop prolonged grief. Rates are higher after sudden, violent or traumatic deaths.

  • Not weakness

    Complicated grief is a recognised health condition, not a failure of coping. It responds to specific, evidence-based support.

  • Different from grief

    Normal grief is universal and softens over time. Prolonged grief stays intense, feels stuck and gets in the way of living.

  • First-line therapy

    Complicated Grief Treatment (CGT) and grief-focused CBT have the strongest evidence for reducing symptoms.

  • Safety first

    Suicidal thoughts are more common in prolonged grief. The Samaritans (116 123) and SHOUT (85258) are always available.

Why this guide matters

Grief is not something to be fixed.

But when grief becomes prolonged and impairing, it deserves the same care as any other health condition. Three ideas shape the rest of this page.

  • Prolonged grief is a real, named condition

    ICD-11 and DSM-5-TR recognise prolonged grief disorder. Naming it is not pathologising love. It is opening a door to specific help.

  • Continuing bonds, not closure

    Modern bereavement care does not ask you to “let go”. It supports adaptation and a lasting, changed relationship with the person who died.

  • Safety is part of care

    Suicidal thoughts are more common in prolonged grief, especially in the first year and after suicide bereavement. They can and should be talked about.

How assessment is done

From a first conversation to a plan that fits you.

What a compassionate GP, therapist or bereavement service will normally do, in the order it usually happens. There is no rush and no right answers.

  1. 01

    Listening

    A gentle history

    The clinician will ask about the person who died, the circumstances of the death, your relationship, and how you have been since.

  2. 02

    Listening

    Timing and impact

    Symptoms lasting beyond six months (ICD-11) or twelve months (DSM-5-TR), with real effects on work, relationships and daily function.

  3. 03

    Listening

    Mental health and safety review

    A compassionate check on mood, anxiety, PTSD symptoms, sleep, alcohol or substance use, and any thoughts of suicide or self-harm.

  4. 04

    Understanding

    Validated questionnaires

    Tools such as the PG-13 (Prolonged Grief 13), Inventory of Complicated Grief, PHQ-9, GAD-7 and PCL-5 help measure severity.

  5. 05

    Understanding

    Ruling other things in or out

    Normal grief, adjustment disorder, depression, PTSD and substance misuse can look similar and often overlap.

  6. 06

    Support

    A physical health check

    Bereavement affects the body too. A GP review of sleep, appetite, blood pressure and any long-term conditions is worthwhile.

  7. 07

    Support

    Onward referral if needed

    To NHS Talking Therapies, a specialist bereavement service, psychology, psychiatry or crisis services if risk is high.

Typical pace: no hurry, no pressure, and always at a speed that feels manageable.

What it can feel like

The shapes prolonged grief can take.

Everyone grieves differently. These are patterns that clinicians look for when grief has become persistent and hard to live with.

  • Intense yearning

    A deep, aching longing for the person who died that does not ease with time.

  • Preoccupation and rumination

    Persistent, intrusive thoughts and memories of the person or the circumstances of their death.

  • Identity disturbance

    A sense that part of you died too, or that you no longer know who you are without them.

  • Avoidance or over-contact

    Steering clear of reminders, or the opposite, seeking out places and objects almost constantly.

  • Emotional numbness and disbelief

    Feeling flat, frozen or unable to accept the death, even long after it happened.

  • Loss of meaning

    Life can feel purposeless or empty, with hope hard to find and the future difficult to picture.

  • Social withdrawal

    Pulling back from friends, family, work and activities that used to matter.

  • Red flag - thoughts of suicide

    Thoughts of dying to be reunited, or of self-harm, need urgent support. Please call 999, 111, or the Samaritans on 116 123.

Support and treatment

What can help, from peer support to specialist therapy.

Not everyone needs formal therapy. Many people are helped by community and peer support. When grief is severe or stuck, evidence-based therapies make a real difference.

  • Peer and community support

    Cruse Bereavement Support, At A Loss, faith communities and local peer groups can be a first, gentle step for many people.

  • Complicated Grief Treatment (CGT)

    A 16-session evidence-based therapy developed by Katherine Shear, combining CBT elements, revisiting the story of the death and imaginal conversation.

  • Grief-focused CBT

    Structured therapy that addresses unhelpful thoughts, avoidance and behavioural patterns that keep grief stuck.

  • Interpersonal therapy (IPT)

    Focuses on the relationship with the person who died and on rebuilding current relationships and roles.

  • EMDR or trauma-focused CBT

    For grief entangled with traumatic memories, PTSD or a violent or unexpected death.

  • Antidepressants

    SSRIs such as sertraline, citalopram or escitalopram, or SNRIs, can help when depression or anxiety are also present.

  • Specific bereavement charities

    Sands and Tommy’s (baby loss), The Compassionate Friends (child loss), SOBS (suicide bereavement), Winston’s Wish and Child Bereavement UK.

  • Crisis and safety planning

    A written safety plan with your GP or mental health team, plus Samaritans 116 123, SHOUT 85258 and Papyrus 0800 068 41 41 for young people.

What this guide is based on

The sources behind every claim on this page.

International diagnostic standards, UK guidance and trial evidence for the therapies described here.

Key references

Guidelines and evidence we relied on.

A gentle reminder

This guide is for information, not personal advice.

A GP, bereavement counsellor or mental health clinician can help you understand what applies to you. Please reach out if things feel too heavy to carry.

  • World Health Organization. ICD-11: Prolonged grief disorder (6B42).

  • American Psychiatric Association. DSM-5-TR: Prolonged grief disorder criteria.

  • NICE guidance on depression, PTSD and end-of-life care and bereavement support.

  • Shear MK et al. Complicated Grief Treatment: randomised controlled trials.

  • Cruse Bereavement Support and At A Loss UK bereavement service directories.

When to seek urgent help

Signs that need care sooner rather than later.

Reaching out early is a strength. If any of the following apply, please contact your GP, NHS 111, the Samaritans on 116 123, or 999 in an emergency.

  • Thoughts of suicide or self-harm

    Any thoughts of ending your life, or of joining the person who died, need urgent help. Call 999 or 111, or the Samaritans on 116 123, day or night.

  • Suicide bereavement

    Losing someone to suicide carries a higher risk of prolonged grief and of suicidal thoughts. Specialist support from SOBS is available.

  • Child, baby or young-person loss

    The death of a child or baby is one of the hardest losses. Sands, Tommy’s and The Compassionate Friends offer specialist, peer-led support.

  • Traumatic or violent death

    Accident, homicide or witnessed death can leave PTSD symptoms alongside grief. Trauma-focused therapy may be needed.

  • Severe self-neglect

    Not eating, drinking or taking essential medication, or withdrawing from all care, is a signal to seek urgent GP or NHS 111 support.

  • Escalating alcohol or drug use

    Using more alcohol, prescription medication or other substances to cope is common but worth flagging to a clinician early.

  • New chest pain or collapse

    Grief can genuinely affect the heart, including takotsubo (broken heart) cardiomyopathy. Sudden chest pain or collapse needs 999.

  • Bereaved children and teenagers

    Sudden changes in behaviour, school refusal, self-harm or withdrawal need a compassionate assessment via GP, school or Winston’s Wish.

  • COVID-19 and pandemic bereavement

    Loss without a proper goodbye, isolation and delayed funerals raised the risk of prolonged grief. Tailored support is available.

Living with grief

A lifelong journey, carried more gently over time.

Grief does not have a finish line. What changes, with time and support, is your relationship to it. Four ideas that help many people through the harder days.

A gentle reminder

Love and grief are two sides of one coin.

The aim is not to feel less, but to carry your love for the person who died in a way that lets life continue alongside it.

  1. 01 Pace

    Grief moves in waves

    Anniversaries, birthdays and small triggers can bring big feelings back. This is normal, not a setback.

  2. 02 Bonds

    Continuing bonds, not closure

    Modern bereavement care talks about continuing bonds and adaptation, not “letting go” or “moving on”.

  3. 03 Support

    You do not have to do this alone

    A GP, a bereavement counsellor, a peer group or a trusted friend can share the weight of what you are carrying.

  4. 04 Safety

    A plan for the hardest days

    Save Samaritans 116 123 and SHOUT 85258 in your phone. If you are in immediate danger, please call 999.

Frequently asked

The questions we hear most often.

Honest, compassionate answers on what prolonged grief is, how it differs from grief, and what actually helps.

  • What is complicated or prolonged grief?

    Prolonged grief disorder is intense, persistent grief that continues beyond six months (ICD-11) or twelve months (DSM-5-TR) after a bereavement and significantly affects daily life. It is a recognised health condition, not a personal failing, and specific therapies can help.

  • How is it different from normal grief?

    Grief is universal and painful, and usually softens and reshapes over time as people slowly adapt. In prolonged grief the intensity does not ease, the person feels stuck in yearning or disbelief, and daily functioning is impaired months or years later.

  • Am I grieving “wrong” if it is taking a long time?

    No. There is no correct timeline for grief and no right way to feel. Prolonged grief disorder describes a specific pattern of persistent, disabling symptoms, not the fact that you still miss someone you loved deeply. A clinician can help you understand where you are.

  • What treatments actually work?

    Complicated Grief Treatment (CGT), grief-focused CBT and interpersonal therapy have the strongest evidence. Antidepressants can help when depression or anxiety are also present. Trauma-focused therapies such as EMDR are used when grief is entangled with PTSD.

  • Where can I get help in the UK?

    Start with your GP or NHS Talking Therapies. Cruse Bereavement Support, At A Loss, Sands, Tommy’s, The Compassionate Friends, SOBS, Winston’s Wish and Child Bereavement UK all offer specialist support. In crisis, call 999, 111, Samaritans on 116 123 or text SHOUT to 85258.

  • I keep thinking I want to be with them again. Is that suicidal?

    Thoughts of wanting to be reunited with someone who died are common in grief, and they can also shade into thoughts of suicide. Please treat them seriously and talk to your GP, NHS 111 or the Samaritans on 116 123. You deserve support, and help is available.

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