We all lose people we love along the way. In most cases, the passage of time is enough to get us through the acute stages of sorrow, when every reminder of the loved one is like a knife to the heart. When each of my grandparents died, I was devastated and I missed them, but I was not consumed by longing for their return. They all died peacefully, at the end of long, full lives. Most of us, after a person we love passes on, can gradually accept that they are gone, experience joy again and find meaning in our favorite pursuits. But when my brother died, I got stuck. My grief became a trap.
For a long time, I resisted seeking help because I believed—I still believe—that my reaction to my brother’s death was a normal human reaction to a horrifying loss. The idea of branding my grief as abnormal –as something that needed treatment—was repellant to me. But was feeling suicidal normal for me? No. Definitely not. Did I want to go on feeling this way? Also, no.
The idea that grief can take two separate forms—one that resolves itself organically and one that endures—is at least as old as Sigmund Freud. In his 1917 book, Mourning and Melancholia, Freud wrote that grief resulted in one of two conditions. Mourning was a healthy form of grief over the loss of a loved one, a process of which one was consciously aware. Melancholia, on the other hand, was an unconscious, pathological form of grief that was difficult for the individual to understand and extended beyond the scope of the loss itself to other areas of life. Freud influenced grief research and treatment for decades to come.
Over the past decade, as neuroscientists grappled with what was happening in the brains of people who suffer long-term grief, they made a discovery. While PGD often contains some elements of PTSD, depression, and anxiety, it is most similar to addiction.6 Like addiction, prolonged grief tends to feature a conflict between craving and avoidance: Yearning for the deceased loved one alternates with an avoidance of painful memory triggers.