A magnolia bud opening in sunlight

Grief is not a problem to be solved. There's no right way to do it, no set number of months after which you "should" feel better. For most people, the pain of loss gradually softens over time. It never disappears, because it's the other side of love, but it becomes something we can integrate into our life.

For some people, though, it doesn't shift. Months or years pass and life still feels at a standstill. If this is you, or someone you love, it's not a sign of weakness, and it doesn't mean you're grieving the "wrong way." It may be that your grief has become stuck.

What is prolonged grief disorder?

Prolonged grief disorder (PGD) is a recognised condition, included in the ICD-11 and added to the DSM-5-TR in 2022. It's distinct from depression and from PTSD, although they can overlap. The diagnosis applies when, more than six months after a death (twelve months in the DSM), grief is still intense and interfering with daily life, often with a combination of:

  • A persistent yearning or longing for the person who died
  • Difficulty accepting the death, even when you know the facts
  • Feeling that part of yourself died too, or a sense of lost identity
  • Avoidance of reminders of the death, or avoidance of moving on from it, as if doing so would betray the person
  • Difficulty re-engaging with relationships, work, hobbies, or the future
  • Intense emotional pain, numbness, or a feeling that life has no meaning

You may have been told, kindly or not, "it's just been a long time." Time alone doesn't heal every loss, and being stuck isn't a character flaw.

Why does grief get stuck?

There's no single cause, but some patterns come up often. Reminders may feel unbearable, so we avoid them, and the avoidance stops us from taking in the reality of the loss. Or we may feel that moving forward means leaving the person behind, so we hold on tightly to the pain. Guilt, "what ifs," and rumination can keep us circling. In both cases, the loss hasn't been given the space it needs, and the life that continues hasn't been given a chance either.

It can help to think of grief as having two parts that both need attention. One is accepting the loss itself and the other is restoring life. In stuck grief, one part tends to take over. Healing involves moving between the two, gently and in your own time.

Who is more likely to be affected?

Anyone can develop prolonged grief, and research suggests roughly one in ten bereaved adults does, with higher rates in certain circumstances: a sudden, violent, or traumatic death, the loss of a child or partner, a very close or dependent relationship, limited support, and earlier losses or mental health difficulties.

What helps?

The good news is that there's a specific, evidence-based treatment for this. Prolonged Grief Disorder Therapy (PGDT) was developed at Columbia University's Center for Prolonged Grief and is a structured, roughly 16-session approach. I trained at Columbia in 2020, and I'm a co-author on a 2025 paper in The Cognitive Behaviour Therapist evaluating a PGDT pathway in a Devon, England NHS Talking Therapies service (part of the UK's publicly funded mental health care), one of the first UK evaluations in routine care.

In PGDT, we work together to:

  1. Build a shared understanding of your loss and where you feel stuck.
  2. Develop a short, low-effort daily grief monitoring practice.
  3. Approach the story of the death deliberately, and at a pace you can tolerate.
  4. Reconnect with what mattered to you before, and what might matter next.
  5. Address specific avoidance that's keeping the grief frozen.
  6. Plan for anniversaries, setbacks, and the long arc of carrying a loss.

It's structured, but tailored to the person and the loss. The aim isn't to "get over" your grief but to help you integrate the loss while living a life that's meaningful to you, with the love and the connection still intact.

Small things you can try in the meantime

These don't replace therapy, but many people find them a gentle way in:

  • Let all the feelings in. Anger, guilt, sadness, relief, and numbness are all welcome. Moving, writing, making, or walking can help feelings move through.
  • Build in some "buoyancy aids." What helps you stay afloat, even a little? A garden walk, a favourite song, the smell of a familiar perfume, a friend who doesn't need you to explain.
  • Gently notice grief and restoration. Make space for remembering, and plan one small thing that connects you to life this week, such as a walk or a meal with someone you trust.

When to reach out

It may be time to talk to someone if, six months or more after your loss, you're still finding it hard to function, if the longing feels as acute as ever, if you feel you can't imagine a future, or if you're avoiding reminders or life itself. Your GP (primary care doctor) is a good first step.

If you're having thoughts of not wanting to be here, or of joining the person who died, please don't wait. Contact your GP, call the Samaritans any time on 116 123, or call 999 if you're in immediate danger.

If you're supporting someone who is grieving

Your steady presence matters more than the perfect words. Listen, say the person's name, and try not to put pressure on their healing.

If you'd like to explore whether PGDT might be right for you, you're welcome to book a free 20-minute consultation or read more about Prolonged Grief Disorder Therapy. There's no expectation to commit to a full course.

This post is for general information and is not a substitute for professional diagnosis or treatment.