Death never happened before

She was old and ill, and the illness was debilitating and dehumanising. Her death was a blessing. But to her. Only to her.

A few months after the death, a doctor asked one of the daughters how they were managing.

Of course they not managing. This was not a manageable situation. Did he believe that this got better for anyone?

The doctor’s response was a snort of disbelief. Doctors should snort more; it’s very funny. At the time, the bereaved daughter thought to throw a chair at him, but agrees it’s definitely funny now.

A year after her mother died she cried for the first time and stayed in bed for ten months. Later, one of her friends told her that when the mother died, it seemed like the rest of the family did too. She’d gone and taken them with her.

Prolonged Grief Disorder (PGD) – sometimes still referred to as Complicated Grief – is painfully prevalent. I didn’t know this was a thing worth pursuing until I saw, at the very end of an article, the word “unrecognised.”

The Center for Complicated Grief at the Columbia School of Social Work suggests as many as 20 per cent of patients getting some kind of mental health help have unrecognised PGD.

How masked are these symptoms that you can fail to recognise it in so many people?

Suspecting that I and everyone in my family suffered or suffers from PGD, I’d like to go pick out my exceedingly high horse, tie a soapbox to it (but I don’t know if they still make them), and then get on top of that.

From there, I will shout and rant and wail about how obvious this condition should be in presentation.

What it pleases the world to call “normal grief” looks a lot like PGD, but lasts maybe a month or so before the pieces of life and routine start to fall into place. They go back to work, they go out, they get back to their tennis lessons.

In short, their life resumes. Doubtless they remember the deceased and think on them, but they are not manacled to their grief.

And this is where the PGD sufferers start to look very different.

They do not move on. Rather, they cling to every sensory surface that reminds them of the lost one. They live inside their loss – in the scent of the person’s room, in photographs and songs, they daydream about them being alive still.

We can see from this small sketch how many beloved – or feared – fictional characters may have had PGD: Heathcliff and his tormented grave vigil (we will not speak of the near-necromancy, I’m not qualified); Miss Havisham and her stopped-clock house; the skeletal Ralph Fiennes as Almásy telling his never-ending tale of love, death and treachery in The English Patient.

Not to be judgemental, but all those people seemed completely out of their minds.

Perhaps this is the problem with diagnosis?

This extreme display of grief looks not so much like something you can deal with in a neat multi-step programme, but with a straitjacket and a padded cell.

Why is it not depression? Delusion – some people just refuse to believe the person is dead? One peer-reviewed piece cheering for its inclusion in the DSM, suggested PGD was a likely diagnosis if no other diagnosis was a better fit.

As if grief wasn’t bad enough on its own, it has to compete for treatment space.

There was a popular misconception that this sort of affliction befell those with lots of unresolved issues and problems with the departed.

Happily, we now know that we can suffer when we lose someone with whom we had a really, really fulfilling, beautiful relationship. It’s refreshing to know that all disorders don’t have to be tied up in some amount of ugliness.

I’m also grateful for the shiny new name, even though it may take a while to really set in. Complicated grief sounds like a many-layered, problematic, hand-wringing sort of pain. It doesn’t sound like a pain or longing you could have in healthy relationship.

A dozen years ago, when my mother died, I called a friend and asked her – no drama at all – if anyone had ever died before. She too was facing the loss of a parent and was sensitive to my problem.

We agreed that it must not, in fact, have ever happened before. Surely no one had ever died. If other people knew about this dying, this never-coming-back of a person you love, surely someone would have figured out how to make it stop.

In lay terms, some grief is entirely simple. It just never ends.