In one of our SOCIUS salons, “Healthy Sick People,” a participant reported that her son had died six years ago and spoke of grief as a chronic illness. As a grief counsellor and co-initiator of our SOCIUS salons on the topic of chronic illness and work, I had already thought about this very issue.

Grief is one of the deepest and most complex human experiences. We all face loss in the course of our lives, and each of us grieves in our own unique way. Nevertheless, there is also a similar experience among mourners; it is not without reason that bereavement groups are places where a sense of connection develops despite such different losses.

But what if grief is not just a temporary feeling? What if it develops into a long-lasting, chronic condition?

Grief as a constant companion

For several years now, there has also been an official diagnosis: the Prolonged grief disorder (PGD).

According to the International Statistical Classification of Diseases and Related Health Problems (ICD-11), i.e. the international classification of mental disorders, persistent grief disorder can be diagnosed after just six months of mourning. However, other symptoms must also be present, such as a pronounced longing for the deceased person, accompanied by intense emotional pain such as sadness, feelings of guilt, anger, denial, difficulty accepting death, feeling of having lost a part of oneself, inability to experience positive moods, emotional numbness, difficulty engaging in social and other activities. And the grief reaction exceeds the expected social, cultural or religious norms for the individual's culture and context. (Source: German Children's Hospice Association.)

According to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Persistent grief disorder is only diagnosed after more than a year of persistent grief. Here, too, it must be accompanied by a strong longing for the deceased person and a kind of obsession with the deceased person, which is accompanied by severe suffering and functional impairments.

The diagnostic options are not without controversy. On the one hand, they can facilitate access to professional help and ensure that costs are covered by health insurance companies, but on the other hand, they carry the risk of further stigmatising those who are grieving.

Experienced grief counsellors know, as do those affected, that the grieving process often takes much longer than a year, sometimes a lifetime, and that, above all, the way we deal with it changes. (See also Good grief – Aeternitas e.V.)

So we know that grief comes in waves, and that these waves also change. The question “Are you still grieving?” can be answered without any diagnosis with “Yes, my loved one is still dead,” and may cause some people to flinch a little at the inherent truth.

If grief is the price of love, and love remains, then grief also remains. Without becoming an illness, but rather an integral part of life. 

Other official diagnoses that indicate chronic conditions related to grief include adjustment disorder, post-traumatic stress disorder (PTSD) and depression.

Grief can, of course, also physical symptoms trigger, such as exhaustion, sleep disorders, chronic pain or digestive problems. These symptoms can persist over the long term and resemble a chronic illness.

Neurobiological studies show that grief can affect the brain in a similar way to chronic stress or depression. The limbic system (responsible for emotions) and the reward system in particular are heavily impacted by grief processes, which can lead to a kind of neurological „exhaustion“. Here you can read an interesting article on this topic or listen to a podcast.

Grief in work contexts and organisations

However, people who experience prolonged grief often encounter difficulties in the workplace, especially when there are no support structures in place. Many report a decline in performance, cognitive impairments or the feeling that they cannot fully reintegrate. In some cases, this can manifest itself in a kind of „permanent exclusion“, much like other chronic illnesses.

There are people who describe their grief as a „lifelong illness“ that cannot simply be „cured,“ even without having an ICD-11 diagnosis or disorder. And similar to chronic illnesses, grief can also be or become invisible; there are good and bad phases, and social support and adjustments in the work and living environment play a major role in coping.

It is not only in our culture that there is often little room for grief. After a certain period of time, people are expected to „function“ again. This expectation can put pressure on mourners to suppress their feelings rather than integrating them into their everyday lives.

But grief is not linear. Its wave-like nature is sometimes gentle, sometimes it crashes over the bereaved with the force of a tsunami. There is no „right“ or „wrong“ way to grieve, and there is no timetable that must be followed.

Acceptance as the key

Both chronic illnesses and grief have something to do with acceptance. It is not about „getting rid of“ them, but learning to live with them, integrating them and giving them space.

A gentler view of the world

In a world that is often characterised by harshness and polarisation, we need more than ever a gentler, more accepting view – of grief, of illness, of everything that does not simply disappear but continues with us.

How can we become gentler?

Gentleness and acceptance arise in small, everyday encounters. In the way we listen to each other. In how we don't immediately want to „get rid“ of grief, pain or illness, but “simply” endure them.

This is precisely what our SOCIUS salons are for – as places for meeting, exchanging ideas and listening.