Controversial New Diagnosis: Prolonged Grief Disorder

Critics abound, but decision opens new pathways for people who meet diagnosis criteria
By Mike L. Ford,  Newser Staff
Posted Mar 26, 2022 4:05 PM CDT
For Some, Intense Grief Is Now a Mental Disorder
   (AP Photo/American Psychiatric Association)

Debate will continue in the psychiatric community, but the decision is official: The latest edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5-TR, includes an entry for prolonged grief disorder. Per an APA release, the new disorder is one in which "the duration of the person’s bereavement exceeds expected social, cultural, or religious norms and the symptoms are not better explained by another mental disorder." The New York Times reports the decision "means that clinicians can now bill insurance companies for treating people for the condition" and should stimulate new funding for research into treatments and therapies.

According to Holly Prigerson, a pioneer in the field and lead author of a key study that validated criteria for the condition, PGD applies to 4% of bereaved individuals who remain "stuck and miserable" long after grief symptoms typically ease. Prigerson’s research determined the disorder could be identified six months post-death, but the APA pushed that out to a year to be more conservative. Axios quotes the APA’s Saul Levin as saying the disorder’s inclusion will provide "an understanding of what normal grief looks like and what might indicate a long-term problem." Critics abound, many of whom say grief is not a mental illness but an innately human experience.

Others warn about false-positive diagnoses, the ascendancy of Big Pharma, and an inherent motive for clinicians to categorize patients for reimbursement purposes. Everyone involved agrees that grief is as individualized as it is natural, and not everyone is shoveling pharmaceuticals at the problem. Dr. M. Katherine Shear of Columbia University applied PTSD-type methods in her 16-week psychotherapy program for PGD, which influenced the APA’s final decision. Reflecting on her experience in Shear's program, which allowed her to come to accept her brother's sudden death, one patient who had suffered three years of prolonged grief told the Times, "Am I ashamed or embarrassed? Do I feel pathological? No. I needed professional help." (More DSM-5 stories.)

Get the news faster.
Tap to install our app.
Install the Newser News app
in two easy steps:
1. Tap in your navigation bar.
2. Tap to Add to Home Screen.