Prolonged & complicated grief
When grief stays heavy for a long time, it isn’t a sign of weakness or of loving too much. It means you deserve extra support, and help works.
By the numbers
Most grief eases with time. A smaller group needs more support.
How common
Time and help
When grief feels stuck
When the pain doesn’t ease over time, extra support can help.
For most people, the sharpest pain of grief slowly softens over time, even though the love and missing remain. For some people, grief stays very intense for a long time and makes daily life very hard.
This is sometimes called prolonged or complicated grief. It is not a sign of weakness or of loving “too much”. It means the grief needs extra support to move.
Grief may need extra support if, months after the loss, you…
- Still feel intense longing or think about the person most of the day
- Find it very hard to believe or accept the loss
- Feel part of yourself has died too
- Avoid anything that reminds you of the loss
- Feel numb, deeply lonely, or that life has no meaning
- Can’t get back to work, school, friends or plans
Grief is more likely to feel stuck after a sudden, violent or unexpected loss, after losing a child or partner, or when someone has little support around them.
The good news is that help works. Grief counselors and therapists use talk therapies designed for grief. These help people accept the loss, face painful reminders gently, and slowly rebuild a life with meaning. Support groups can also ease loneliness.
Typical grief and prolonged grief
Typical grief comes in waves that slowly soften. Prolonged grief stays stuck.
Most bereaved people are resilient. After a period of distress, typically several months, most return to healthy day-to-day life, while still missing the person.
For most people, grief symptoms lessen between 6 months and 2 years after the loss. With prolonged grief, intense grief lasts well beyond what is typical, and longer than the person’s culture or faith would expect.
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In typical grief, painful feelings tend to come and go in waves. Over time, the waves usually get further apart, and people find a way to live with the loss.
It often looks like
- Good moments mixed in with hard ones
- Slowly taking up work, friends and interests again
- Still missing the person, especially on special days
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Prolonged grief is intense, lasting grief that seriously gets in the way of daily life. It can include feeling that part of yourself has died, deep loneliness, numbness, and feeling that life has no meaning without the person.
Experts only consider grief prolonged when it lasts at least a year after a death for adults, or 6 months for children and teens.
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Prolonged or complicated grief is not a sign of weakness or of loving “too much”. It means the grief needs extra support to move.
What makes grief harder to move through
Some losses and situations raise the chance grief gets stuck.
Anyone can develop prolonged grief. Research points to some situations that make it more likely. Knowing them can help you reach for support early.
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Grief is more likely to become prolonged after a sudden, unnatural or violent death, such as suicide, an accident or homicide. Deaths in an intensive care unit, rather than at home, are also linked with higher risk.
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Losing a child or a spouse or partner is linked with a higher risk of prolonged grief. So is being very close to, or depending heavily on, the person who died.
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A lack of social support raises the risk of problems coping after a loss. Bereavement groups and peer support can reduce the isolation that makes prolonged grief more likely.
Small ways to build support
- Tell one person how you are really doing
- Join a grief group for your kind of loss
- Say yes to one invitation a week
- Ask a faith or community group about bereavement support
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A history of depression, very high grief before the death, an anxious attachment style, and coping by thinking about the loss over and over are all linked with more difficult grief.
People who feel little control over their lives, or have low self-esteem, may also find an unexpected loss harder to move through.
Grief, depression and trauma
They can overlap, but they are not the same.
Prolonged grief, depression and trauma can look alike and can happen together. Knowing the differences can help you explain what you are feeling to a professional.
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Grief and depression can share sleep problems, guilt and loss of interest. In grief, painful feelings tend to come and go in waves, the main feeling is often missing the person, and people usually keep their sense of self-worth.
When low mood stays heavy almost all the time, when you feel worthless, or when nothing brings even a moment of relief, it is worth talking to a professional.
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Traumatic grief is when you are processing a loss and trauma at the same time. It can follow a death in frightening or unpredictable circumstances.
You may have upsetting images, nightmares or flashbacks, especially if you witnessed the death or found your loved one.
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Guilt about something said or unsaid, or about not preventing the loss, is a common part of grief. When guilt and “what ifs” feel overwhelming, talking to a counselor can help.
Help that works
Talk therapies made for grief, and groups that ease loneliness.
The good news is that prolonged grief responds to help. Therapies designed for grief help people accept the loss, face painful reminders gently, and slowly rebuild a life with meaning.
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Prolonged grief therapy helps people accept the reality of the loss and work toward goals and satisfaction in a world without the person. It is often given in about 16 sessions.
In a 2005 trial, 51% of people with complicated grief improved with this kind of therapy, compared with 28% who had a standard therapy for depression.
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Cognitive behavioral therapy (CBT) teaches skills to change unhelpful thoughts and behaviors linked to grief. CBT-based treatments have been shown to reduce prolonged grief symptoms.
Research also suggests CBT can help children and teens with prolonged grief, and CBT for insomnia can help with grief-related sleep problems.
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Other approaches include telling the story of the loss (narrative disclosure) and working on avoidance of painful reminders. Done gently with a trained therapist, this can loosen grief’s grip.
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Bereavement support groups and peer support offer connection, which can reduce the isolation that raises the risk of prolonged grief.
Where groups meet
- Faith communities
- Hospices and hospitals
- Online, for people who can’t get to a group
- Organizations for a specific kind of loss, like suicide or the death of a child
Small steps you can take
Gentle things to try alongside professional help.
Self-help is not a replacement for professional care when grief is stuck. But small, steady steps can support your healing.
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Healthy grieving moves back and forth between facing the loss and rebuilding daily life. If you spend almost all your time in one, gently make a little room for the other.
Ideas
- Set aside a short time each day to remember them
- Plan one small, ordinary activity each day
- Notice when you avoid all reminders, or can think of nothing else
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Setting small targets you can easily reach, and focusing on what you can influence, can help. Trying to do everything at once can make grief harder.
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Regular exercise can lift your mood and help you sleep, and regular meals keep your energy steady.
Using alcohol, cigarettes, gambling or drugs to cope can make grief and mental health worse.
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Talking about how you feel with a friend, family member or counselor can help. Believing you are alone tends to make grief harder.
Ideas
- Message one person today
- Join a group, even just to listen at first
- Spend time with people who loved the person too
Supporting someone whose grief feels stuck
Patience, presence and a gentle nudge toward help.
It can be painful to watch someone you love stay deep in grief for a long time. Your steady presence matters, and so does gently encouraging professional help.
What can help
- Avoid telling them to “move on” or “get over it”
- Help them find a grief counselor or group, and offer to go along
- Keep inviting them to small, low-pressure activities
- Listen, and say their loved one’s name
- Look after your own wellbeing too
When and where to get help
You don’t need to wait a year to ask for help.
If grief is making it hard to get through the day, a professional can help now. You don’t need a label first.
Places to start
- A grief counselor or therapist trained in prolonged grief
- A bereavement support group
- Your doctor or clinical provider
- Your workplace Employee Assistance Program (EAP), if you have one
📝 Worksheets for this guide
Fill these in privately in the app. Your answers stay on your phone.
Sources
- NHS (UK National Health Service) (2026). Grief after bereavement or loss
- Cleveland Clinic (2023). Grief
- Centers for Disease Control and Prevention (CDC). Sadness and Depression (How Right Now)
- American Psychiatric Association. Prolonged Grief Disorder
- Mayo Clinic. Suicide grief
- Peer-reviewed research (PubMed) (1999). The dual process model of coping with bereavement: rationale and description (Stroebe & Schut, Death Studies)
- Peer-reviewed research (PubMed) (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis (Journal of Affective Disorders)
- National Cancer Institute (NCI), National Institutes of Health. Grief, Bereavement, and Coping With Loss (PDQ®) – Patient Version
- Hospice Foundation of America. Research on grief and grieving
- Peer-reviewed research (PubMed) (2005). Treatment of complicated grief: a randomized controlled trial (Shear et al., JAMA)
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.
