Prolonged grief

What it is

Grief is not an illness. Mourning the people we love is among the most human things we do, and cultures across Africa surround it with ritual, community and faith for good reason. Most bereaved people, in time, find a way to carry the loss and re-enter life.

For some, grief does not change shape. Prolonged grief disorder, added to the DSM-5-TR in 2022, describes intense yearning or preoccupation with the person who died that persists at least a year after the death (six months in children), accompanied by identity disruption (“part of me died with them”), disbelief, avoidance of reminders, intense pain, numbness, loneliness, and inability to rejoin life, to a degree that exceeds cultural and religious norms. The last clause matters: extended mourning that your community recognises as normal is not a disorder.

What it can feel like

Time stops at the death. Years later, the bedroom is untouched, the phone number still dialled, every conversation circles back. Joy feels like betrayal of the dead. Some survivors avoid every reminder; others cannot leave them. The bereaved person often knows something is stuck, and feels ashamed that faith and family have not been enough. This is a recognised condition, and it is treatable; it says nothing about the depth of their love or the sincerity of their faith.

How common is it and who is at risk

Around one in ten bereaved adults develops prolonged grief, with higher rates after the loss of a child or spouse, sudden or violent deaths (accidents, homicide, suicide), and deaths where the body was never recovered or rituals could not be completed, a wound familiar after disasters and conflict.

How it is diagnosed

A clinician makes the diagnosis through a careful, compassionate conversation, looking for intense yearning or preoccupation with the person who died that persists beyond a year (six months in children), along with the stuck quality of the grief and its effect on daily life. Crucially, the clinician weighs this against what the person's own culture and faith consider normal mourning, since extended grieving that a community recognises as expected is not a disorder. They also check for depression and PTSD, which can occur alongside it.

How it is treated

The best-evidenced treatment is grief-focused psychotherapy, a structured approach that helps the mourner revisit the loss safely, address the stuck points (guilt, unanswered questions, avoided places), and rebuild a life in which the dead remain loved but the living person continues. Trials show it outperforms both standard depression treatment and antidepressants alone for grief outcomes. Community, ritual and faith are allies of this work, not rivals to it. Antidepressants may be added when depression co-occurs.

Prolonged grief in the African context

Across Africa, grief is held by ritual, community, and faith, and these are powerful protectors, not problems. The diagnosis deliberately allows for this: extended mourning that your community recognises as normal is not a disorder. What raises concern is grief that stays frozen and cuts a person off from life long after their own traditions would expect some healing to have begun. Where death came suddenly or violently, or where burial rites and mourning could not be completed, as happens with disasters, conflict, or a body never recovered, grief is more likely to become stuck. Faith and family are allies of recovery, and professional help works alongside them.

Helping someone

If someone you love is locked in grief long after a loss, your steady presence helps.

• Be patient and try not to push them to move on, while gently staying connected to life with them.
• Let them speak of the person who died, and remember important dates with them.
• Avoid judging their grief against your own timetable, and do not treat faith or ritual as a substitute for needed care.
• Encourage grief-focused professional help where grief stays stuck, and offer to help find it. Our find a therapist page can help.
• Take any mention of self-harm seriously, and look after yourself too.