When grief doesn't loosen: prolonged grief, explained

Grief itself is not a diagnosis

Intense sorrow, waves of yearning, and grief that resurges around anniversaries are part of normal human loss — they are not symptoms to be treated away, and no timetable applies to them.

When grief becomes a condition

Prolonged grief disorder is now a formally recognized diagnosis (DSM-5-TR), affecting roughly 5% of bereaved adults. The hallmark is persistent, consuming yearning and preoccupation with the person who died, lasting a year or more, with real functional impairment — life stays organized around the loss in a way that does not loosen with time.

Grief, depression, and trauma are not the same thing

They overlap, and sorting them matters because they are treated differently. Grief's pain centers on the loss and the relationship; depression is a more generalized collapse of mood and interest; post-traumatic symptoms center on threat — intrusions and avoidance tied to how the death happened. A careful evaluation distinguishes them, including when more than one is present.

What actually helps

Grief-focused therapy is the treatment of first choice, with strong trial evidence and durable effects. Notably, in the one randomized trial testing it, an antidepressant alone did not outperform placebo for grief itself — though medication can treat depression that co-occurs. Foundry's role is the evaluation, treating co-occurring conditions, and coordinating with grief-focused therapists rather than substituting for them.

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