If the sadness doesn't subside

Mourning is never complete when a loved one dies. Over time, however, it pushes itself more and more into the background. Space is then created again for everyday life, joy and new things. The pain flares up again years later in a few moments. For example on the anniversary of death, on birthdays, but maybe also on an ordinary afternoon. For some people, however, the grief retains its force.

Then it may be that a so-called persistent grief disorder has developed. The boundary between a normal grief reaction and this illness is fluid: “A persistent grief disorder consists of symptoms that occur with very acute grief, but which do not improve over time. We're talking about six to twelve months here," says Rita Rosner from the Catholic University of Eichstätt-Ingolstadt. The holder of the Chair of Clinical and Biological Psychology researches persistent grief disorders.

According to Rosner, a sign of such a grief disorder can be that the grief severely restricts those affected in their everyday life even after this time - they cannot work or go to school. You are more likely to develop this disorder if the loss is sudden and unexpected. And if it is a close relationship such as a partner, a parent or your own child. "After the loss, a lack of social support can be a factor," says psychotherapist Rosner.

In 2019, the World Health Organization (WHO) decided to recognize the persistent grieving disorder as a disease, i.e. to include it in the International Catalog of Classified Diseases (ICD).

Thus, intense emotional pain is an important feature. It can take different forms: sadness, anger, guilt, extreme longing or even emotional numbness.

Rosner advises anyone who notices these signs to see a psychotherapist. Only she also says: "Since the waiting times in Germany are currently more than five months, it can also make sense to visit self-help groups or accept special counseling offers before the appointment."

A persistent grief disorder is usually diagnosed through a conversation. "But it can also be the case that mourners develop other disorders, such as depression or anxiety disorders," says Rosner.

The fact that the grief disorder itself is now classified as an illness has the advantage that those affected can get help earlier and better. Because many with a persistent grieving disorder had previously been misdiagnosed. “So it often happened that they were treated with antidepressants or various tranquilizers. Today we know that such pharmacological treatment is rarely helpful,” says Rosner.

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