“It's been a year and it hurts as much as the day he died”
A year after a death, many people expect to feel lighter, and the people around them often expect it too. Instead the pain can feel as sharp as the first week, or the first anniversary can tear it open again. Some feel worse at a year than at three months, once the shock and the busyness have gone. What matters most is whether the pain has moved at all, what else was lost with the person, and whether life has narrowed around the absence.
What to check first
It helps to check what the year has held. A second loss, a house move, money trouble or caring for someone else can keep grief raw. ICD-11 uses at least six months after the death and DSM-5-TR at least twelve before calling grief prolonged, and both also ask how far daily life has been affected.
What could be going on
Prolonged grief disorder (ICD-11, DSM-5-TR): Fits if the longing fills most days a year on and life has narrowed around it, with little change since the start.
Grief (complicated, disenfranchised, anticipatory): Could be ordinary grief that still hits hard. Check whether the waves have spaced out, even if each one is as strong.
Secondary losses: Check whether new losses followed the death, such as money, a home or a role, and keep reopening it.
Major depression: Fits if low mood, self-blame and lost pleasure reach well beyond the person who died.
Experiential avoidance: Check whether you have kept away from every reminder all year, so the pain is seldom let near.
Growing around grief (Tonkin): Could be that the pain stays the same size while a few new things have come into your days.
Telling them apart
Prolonged grief disorder (ICD-11, DSM-5-TR): The longing or preoccupation is present most days a year on, with little change since the start. It tends to come with disbelief, numbness, feeling that life has no point without him, or struggling to take up plans. Work, friends and home life may have shrunk around it.
Grief (complicated, disenfranchised, anticipatory): The pain may still be strong and yet come and go more than it did. Good hours appear, then a date, a song or a smell brings it all back. Over the year the waves may have spaced out even if each one hits as hard.
Secondary losses: Much of the hurt may come from what went with him: income, a home, a role as carer or partner, the friends who drifted off. Each new practical loss can reopen the first. The grief may stay raw because the losses keep coming.
Major depression: Low mood may have spread past the loss into everything, with self-blame, poor sleep and little pleasure even in things that never involved him. Good memories may bring no comfort. The heaviness tends to stay put through the day.
Experiential avoidance: The person may have kept away from photos, places and talk of the death all year. The pain stays at full strength partly because it is seldom let near. When a reminder gets through, it can feel like day one.
Growing around grief (Tonkin): The grief itself may be the same size, while the life around it has grown a little: new routines, people, small plans. From inside, this can feel like no change at all. It shows more in how the days are spent than in the pain.
Questions to carry
- On the worst day this month, what set it off, or did it come from nowhere?
- What have I let myself do this year that I wasn't doing before he died?
Also said as
- a year on and grief is no better
- why does grief not get easier after a year
- first anniversary and still devastated
- it's been 12 months and i'm still not okay
- grief worse after one year
- my wife died a year ago and the pain is the same