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Advances in health and medicine.
Marjorie Bekaert Thomas
Advances in health and medicine.
Mental Health Channel
Reported February 21, 2007

How Much Grief is Too Much?

By Betsy Lievense, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- Losing a loved one can be a painful experience, but how much grief is too much? A new study reveals people who experience yearning, anger or depression more than six months after a loved one dies of natural causes may want to seek professional help.

Physicians and mental health professionals currently use the stage theory of grief as a tool to help them identify patients with prolonged grief disorder. The stage theory of grief suggests people pass through five stages of bereavement before coming to terms with their loss. These stages include disbelief, yearning, anger, depression and acceptance.

Researchers at Yale University in New Haven, Conn., put the stage theory of grief to the test when they observed 233 subjects who lost family members to terminal illnesses, like cancer or other natural causes, as opposed to tragic events.

Researchers found most people experienced acceptance first, a feeling that increased for up to 24 months after death. Disbelief decreased in participants one month after their loss, and yearning decreased after four months. Researchers found anger began to subside in participants after five months, while depression did not decrease until six months after the death of the loved one.

"Kinship relationship is very significantly related to the level of a person's grief, and parents are almost always the most severely affected," Holly G. Prigerson, Ph.D., an associate research professor at Harvard Medical School in Boston, told Ivanhoe. "We found if family members knew about the possibility of death more than six months before it occurred, they experienced lower levels of disbelief and higher levels of acceptance."

Based on the findings of the study, Dr. Prigerson advises health care professionals to warn family members about the possibility of a patient's impending death, as it could prepare them for loss and aid in the coping process. She also said people who experience negative symptoms like pining, yearning and longing more than six months after the death of a loved one should consider professional help.

"It's useful to know [the average grief progression] because one of the most common questions I get asked is as a research expert is, 'Is my grief normal?'" said Dr. Prigerson. "This study provides a benchmark for what's normal and what isn't."

Dr. Prigerson said the study could affect the way physicians diagnose prolonged grief disorder in patients who experience natural loss since the key factor in diagnosis appears to be negative symptoms like yearning as opposed to general sadness.

This article was reported by, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: /newsalert/.

SOURCE: Ivanhoe interview with Holly G. Prigerson, Ph.D.; The Journal of the American Medical Association, 2007;297:716-723

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