Grief that does not lift: when to see a clinical psychologist
Grief that does not lift after many months, or that stops you managing daily life, is worth taking seriously rather than waiting out. Most people move through grief gradually. When pain stays sharp, constant and unchanging for six months or more, a clinical psychologist can help you understand what is happening and work through it.
What ordinary grief looks like
Losing someone close brings pain that comes in waves rather than along a straight line. In the weeks after a death, most people feel shock, sadness, anger, guilt or numbness, sometimes within the same afternoon. Sleep and appetite often suffer. Concentration can go missing for weeks at a time. This pattern usually softens over the following months, even if it never disappears completely. Anniversaries, birthdays and small reminders can still bring grief back sharply years later, and that is ordinary too. Ordinary grief tends to move, even slowly, rather than staying fixed at its original intensity.
When grief becomes prolonged
For some people, grief does not soften with time. The loss stays as raw and consuming as it was in the first weeks, month after month. Daily tasks, work, relationships and plans for the future stay on hold. This pattern has a clinical name, prolonged grief disorder. The ICD-11 definition used in the UK applies it when intense grief has lasted at least six months after a death, longer than would usually be expected, and shapes most of a person’s day. The American DSM-5-TR uses twelve months instead. It is distinct from depression or anxiety, though the three can occur together, and it responds to specific psychological treatment rather than resolving on its own.
Signs it may be time to get help
A few signs suggest grief has moved beyond what time alone is likely to resolve:
- Longing for the person who died dominates most of each day, six months or more after the loss
- Avoiding reminders of the person, or being unable to accept the loss as real
- Difficulty recalling positive memories, or feeling that part of yourself died with them
- Struggling to trust, plan or engage with people and activities that mattered before
- Grief that has started to affect work, sleep, physical health or close relationships
Any one of these on its own is not unusual in early grief. Several together, persisting six months or more after the loss, are worth discussing with a clinical psychologist.
How a clinical psychologist can help
A clinical psychologist can assess whether what you are experiencing fits the pattern of prolonged grief, depression, post-traumatic stress, or a combination, since treatment differs depending on which is at play. Assessment involves talking through the loss, its circumstances and how grief has affected your life since, without any assumption about what you should be feeling by now or how quickly you should have moved past it.
Approaches used
Treatment for prolonged grief usually draws on approaches with a trauma-informed, cognitive behavioural basis, adapted specifically for grief. Where a loss was sudden or traumatic, trauma-focused CBT or EMDR may be used alongside grief-specific work. Where anxiety or low mood sit alongside the grief, CBT or acceptance and commitment therapy can address those directly. NICE guidance recognises trauma-focused approaches for post-traumatic stress following bereavement, and a psychologist will explain which approach fits your situation before starting any course of treatment.
What sessions involve online
Sessions take place by video call, at a set time each week, in a private space of your choosing. Early sessions focus on understanding the loss and how grief is currently affecting your life, including sleep, work and close relationships. Later sessions work through specific memories, avoided situations or unhelpful patterns of thinking that keep grief from easing, at a pace agreed with you throughout. Nothing is rushed, and the structure of each session is explained before it begins.
Clinical psychologists for Greenwich and south east London
We are clinical psychologists for Greenwich and south east London, working online with adults. Sessions run by video call, so where you live matters less than finding a time each week that works around your routine.
When to seek help sooner
If grief has brought thoughts of not wanting to be here, or of harming yourself, that is a reason to seek help without waiting for a pattern to become clearer. If you are having thoughts of harming yourself or ending your life, please don’t wait for a therapy appointment. We are not a crisis service. If you need urgent help, call NHS 111 (option 2), contact your GP, or call Samaritans free on 116 123, any time. In an emergency, call 999. Grief that feels unmanageable does not need to fit a specific clinical description before it is taken seriously.
Questions people ask
How long is grief supposed to last?
There is no fixed timescale. Most people find that the intensity of grief softens over the first year, even though sadness can return sharply around anniversaries or reminders for years afterwards. What matters is whether grief is gradually easing or staying just as intense and disruptive as it was at the start.
What is prolonged grief disorder?
It is a clinical term for grief that stays intense, consuming and disruptive to daily life long after a death. The ICD-11 definition used in the UK says at least six months, while the American DSM-5-TR uses twelve months. It involves persistent longing for the person who died, difficulty accepting the loss, and problems engaging with work, relationships or plans that mattered before.
Is prolonged grief the same as depression?
No, though the two can occur together and can look similar from the outside. Grief tends to centre specifically on the person who died and reminders of them, whereas depression often spreads more broadly across mood, energy and self-worth. A clinical psychologist can assess which pattern fits, or whether both are present.
Can grief therapy be done online?
Yes. Assessment and therapy for grief can be delivered by video call, at a regular weekly time, in a private space you choose. Many people find this easier to fit around work and caring responsibilities than travelling to an appointment.
What if my grief follows a sudden or traumatic death?
Sudden, violent or unexpected deaths can bring symptoms that overlap with post-traumatic stress, such as intrusive memories or avoidance of reminders. A clinical psychologist can assess for this alongside grief and use trauma-focused approaches where they are needed.
Do I need a diagnosis before contacting a psychologist?
No. An assessment with a clinical psychologist is how a pattern gets identified in the first place. You do not need to know in advance whether what you are experiencing fits a particular clinical term.
Our blog posts are written to share general information and ideas. They are not personal advice and don't replace an assessment with a qualified clinician who knows your situation. We can't accept responsibility for decisions made based on this content alone. If you would like support or are worried about your mental health, please speak to your GP or get in touch with us.
We are not a crisis service. If you need urgent help, call NHS 111 (option 2), contact your GP, or call Samaritans free on 116 123, any time. In an emergency, call 999.