One day, in the summer of 2008, I was traveling on a train back to London when I got a call that suddenly changed everything. I was told my boyfriend Richard was in hospital; he had attempted to take his own life from him. He died seven days later. We were both twenty-year-old university students at the time.
Death is one of the few certainties in life and yet we’re never prepared for it, least of all at that age and my grief tore me apart. His death of him by suicide also added a layer to the pain of my grief and the stigma and shame around suicide still exists to this day, over 13 years since Richard’s death of him.
I felt a lot of shame after his death and what followed was almost a decade of avoidance, emotional numbing and pretending it never happened. It was only after eight years that I sought help through therapy to talk about what had happened and process my grief. It was important to me to tell this story and publish my book Totally Fine (and other lies I’ve told myself) because I felt a lot of shame for how long I was impacted by my grief. What I didn’t know, until now, was that perhaps I could have had a condition called “prolonged grief disorder”.
In the US, the Diagnostic and Statistical Manual of Mental Disorders (the DSM) – which is the psychiatric bible when it comes to defining and diagnosing disorders – this month added “prolonged grief disorder”. The terminology has been over a decade in the making and looks at how relief can impact depression.
In the UK, we don’t have an equivalent to the DSM, but we look to the World Health Organization’s International Classification of Diseases (the ICD) and in 2018, it introduced prolonged grief disorder, describing it as “a persistent and pervasive longing for, or concern with the deceased that lasts at least six months after loss.”
Symptoms of prolonged grief disorder can include emotional numbing, avoidance, difficulty with moving on with your life and extreme loneliness. Looking back, I relate to a lot of these symptoms. If I’d had the language for it, I could have sought out help earlier. Instead, I felt shame and like there was something wrong with me.
Prolonged grief disorder is more likely to happen when the nature of death is violent and sudden, such as suicide, and when it’s the loss of a romantic partner or child. I haven’t been diagnosed with prolonged grief disorder, and I’ll never know if I had it, but I do identify with its symptoms. There is no denying that my grief impacted my mental health for a long time and held me back from functioning and living well.
The classification of “prolonged grief disorder” has brought it’s controversies however – as there’s an argument that we run the risk of medicalizing and pathologizing grief and perhaps it’s insulting to medically “diagnose” those grieving. I agree there is no such thing as “grieving for too long” and there is no “normal” when it comes to grief, but giving language to an experience can help us feel less alone. The definition, which 10 per cent of those bereaved can suffer from, can encourage us to seek help.
It’s good that grief and how it can affect us is being given more attention. Statistics show that nine per cent of people affected by suicide will also attempt to take their own life and eight per cent will drop out of work. The Government are increasing support to those bereaved by suicide, which is a much-needed step in the right direction, but we also need to think about longer-term support for those who may be experiencing “prolonged grief disorder”.
There is no normal way to grieve and grief isn’t something you get over, but something you learn to live with. I’m not over Richard’s death, but I’m able to be at peace with it since seeking help. Having the language that acknowledges how much grief impacts us, which can increase attention and investment in support services, can only be a good thing.
Tiffany Philippou is a freelance journalist. Her book Totally Fine (and other lies I’ve told myself) is out now