Do I Have Prolonged Grief Disorder? Understanding Intense Grief Beyond the Diagnosis

You're lying awake at 2 a.m. again, scrolling through photos of someone you love who died. Maybe it's been two years, maybe five. Your family keeps saying "you should be over this by now," and your friends have stopped asking how you're doing. You wonder if something is wrong with you. You've Googled "still grieving after years" and "why can't I move on from grief," and now you're here, asking yourself: Do I have Prolonged Grief Disorder?

Here's what I want you to know right away: Your grief isn't broken. You aren't broken. And whether or not you fit into a diagnosis, your experience deserves to be honoured, not pathologized.

I'm a grief and loss therapist in Surrey, Coquitlam, Greater Vancouver, and online, and I work primarily with BIPOC and LGBTQ+ folks. I'm trained in Prolonged Grief Disorder Therapy from the Center for Prolonged Grief, and I want to have an honest conversation with you about what this diagnosis means, what it doesn't mean, and how to know if you need support.

What is Prolonged Grief Disorder and how did it become a diagnosis?

Prolonged Grief Disorder (PGD) was added to the DSM-5-TR in 2022 and the ICD-11, making it one of the newest mental health diagnoses. The clinical criteria say that if you're experiencing intense grief for more than 12 months after a death (6 months for children), along with significant distress and impairment in daily functioning, you might meet the diagnosis.

The DSM lists specific symptoms like:

• Intense longing or yearning for the person who died

• Preoccupation with thoughts or memories of them

• Identity disruption (feeling like part of you died too)

• Marked sense of disbelief about the death

• Avoidance of reminders of the loss

• Intense emotional pain (anger, guilt, or numbness)

• Difficulty re-engaging with life

• Feeling that life is meaningless

  
  

But here's where I want to slow down with you. The inclusion of PGD in the DSM was controversial. Many grief researchers and therapists worry that we're taking a normal human response to loss and turning it into a mental illness. Grief isn't a disorder. It's what happens when we love someone and they die. For most people, grief naturally changes over time without professional help. The pain becomes less sharp, life starts to hold meaning again, and you learn to carry the loss alongside living.

The problem with diagnoses like this is they can make you feel like you're failing at grief. They set arbitrary timelines on how long you "should" hurt. And they don't account for the reality that some losses are harder to integrate, some relationships were more central to who you are, and some communities don't get the same space to grieve.

Why does my grief still feel so intense after all this time?

If you're a BIPOC person, you might be carrying grief that your white colleagues or friends don't understand. Maybe you're grieving someone who died from systemic racism, medical neglect, or violence. Maybe you're grieving while also experiencing ongoing racial trauma. Maybe your cultural practices around death and remembrance span years, not months, and Western timelines feel violent to your healing.

Disenfranchised grief can make everything more complicated. When your relationship isn't legally recognized, when you can't take bereavement leave, when people don't even know the person who died was central to your life, the grief becomes layered with invisibility and isolation. You're not just grieving the loss. You're grieving without witness, without permission, without the rituals and support that others receive automatically.

I've sat with trans clients whose grief over losing a parent was tangled up with the parent's rejection of their identity. The longing wasn't just for the parent who died, but for the parent who could have loved them fully. That kind of grief doesn't follow a linear path. And if you've lost a child, the grief carries its own particular weight. Children aren't supposed to die before their parents. It goes against the expected order of life, against every instinct and hope you had for the future. The dreams you held, the person they were becoming, the life they should have lived – all of it gone. This kind of loss can feel impossible to reconcile because it violates something fundamental about how we believe the world should work. There's no timeline that makes sense for this grief, no milestone that signals you're "better." You're learning to carry an unbearable weight, and that takes however long it takes.

Key things to understand about intense, lasting grief:

• Grief doesn't operate on a schedule, no matter what the DSM says

• Cultural and systemic factors deeply impact how you experience and express grief

• You can feel intense pain AND still have moments of joy, connection, and meaning

• Grief changes, but it doesn't disappear, and that's okay

• Sometimes grief is intense because the relationship was complicated, not just because it was loving

• Marginalized folks often grieve with less support, recognition, and safety

  
  

When does grief become something that needs professional support?

Here's the real question underneath "Do I have Prolonged Grief Disorder?" What you're actually asking is: Is my grief getting in the way of living the life I want to live? Do I need help?

You might benefit from working with a grief therapist if:

• You're unable to engage in daily activities (work, relationships, self-care) in ways that matter to you

• You feel completely stuck and unable to imagine any kind of future

• You're having thoughts of wanting to die in order to be with the person who died

• Your grief is all-consuming with no moments of relief or connection

• You feel totally alone in your experience

• You're using substances or behaviours to avoid feeling the pain

  
  

But even if you don't check all those boxes, you can still benefit from support. Therapy isn't just for people in crisis. It's for anyone who wants a space to be honest about how hard this is, to explore what this loss means, and to find ways to honour both your grief and your life.

I want to name something important: Most of my clients who come to me years into their grief don't fit neatly into the PGD diagnosis because they haven't lost all meaning or connection. They're still showing up for their lives. They laugh with friends, they find beauty in small moments, they feel connected to the person who died through memory and ritual. What they need isn't to be "fixed." They need someone to walk alongside them who understands that grief and life coexist, that cultural context matters, and that healing doesn't mean forgetting.

How can I honour my grief while also living my life?

This isn't about choosing between grief and life. It's about making space for both. You don't have to "get over" your loss to live fully. You don't have to stop loving or remembering to move forward.

What helps:

• Finding communities or spaces where your grief is welcomed, not rushed

• Engaging in cultural or spiritual practices that honour ongoing connection

• Creating rituals that feel meaningful to you (lighting candles, speaking their name, visiting places that hold memory)

• Allowing yourself to feel the full range of emotions without judgment

• Connecting with others who understand the specific context of your loss

• Exploring what it means to carry this person with you as you live

  
  

For BIPOC and LGBTQ+ folks, this often means rejecting the dominant narrative that grief should be private, quick, and quiet. Your grief might be communal. It might be loud. It might be political. It might be ongoing. All of that is okay.

Looking Ahead: You Don't Have to Grieve Alone

Whether or not you have Prolonged Grief Disorder isn't the most important question. What matters is whether you feel supported, whether you have space to be honest about your pain, and whether you're able to hold both your grief and your life.

I'm here in Surrey, Coquitlam, Greater Vancouver, and online to walk alongside you. As a therapist trained in Prolonged Grief Disorder therapy, I understand the clinical framework, but I also know that you're not a checklist of symptoms. You're a whole person with a specific cultural context, a unique relationship to the person who died, and your own timeline for healing.

Grief isn't something to fix. It's something to honour. And you deserve support that sees you fully, in all your complexity and all your humanity.

If any of this feels true to your experience, I'd love to connect with you. You can book a free consultation to see if working together feels right. There's no pressure, no judgment, just an invitation to not carry this alone anymore.

Frequently Asked Questions

How long is "normal" grief supposed to last? There's no such thing as a normal timeline for grief. While the DSM sets 12 months as a marker for Prolonged Grief Disorder, grief doesn't follow a schedule. Cultural practices, the nature of your relationship, your support system, and your own processing all influence how long intense grief lasts. Many people experience waves of grief for years, and that's completely normal.

Will I ever stop missing the person who died? No, and you don't have to. Missing someone isn't a problem to solve. Over time, the missing might feel different, less sharp, more tender, but the love and longing don't disappear. Healing doesn't mean forgetting or not missing them.

Is therapy going to try to make me "get over" my grief? Not with the right therapist. Good grief therapy honours your ongoing connection to the person who died while helping you find ways to live fully. The goal isn't to erase grief but to help you carry it in a way that doesn't consume everything.

What if my culture has different beliefs about death and grief? Your cultural beliefs and practices are essential to your healing. A culturally responsive grief therapist will honour and integrate your traditions, whether that's ancestor veneration, specific mourning periods, communal grieving practices, or ongoing rituals of connection. Western psychology doesn't hold all the answers about grief.

Can I have Prolonged Grief Disorder if I still have good days? Yes. Grief isn't all or nothing. You can have intense, lasting grief and still experience joy, connection, and meaning. The coexistence of grief and life is normal and healthy.