Why can’t some brains get over a loss?

The alterations in brain networks related to reward could explain the persistence of grief in some people and clarify the differences between prolonged grief disorder (PDD) and depression and anxietyaccording to experts from the University of New South Wales (Australia)

For most people, the intense grief that follows the death of a loved one eventually subsides and daily life resumes. But for some, The pain does not decrease over time, a condition known as prolonged grief disorder (PDD). Thus, in this review published in the journal Trends in Neurosciences from Cell Pressresearchers examine knowledge about the neurobiology of PDD.

“Prolonged grief disorder It is the new trend in psychiatric diagnoses” says lead author Richard Bryant, a trauma researcher with extensive experience at the University of New South Wales in Australia. While grief has long been studied, PDD was not formally recognized until 2018.

The core experience of PDD resembles typical grief, with intense longing, longing and emotional pain. However, in approximately For one in 20 bereaved people, the pain persists and lasts more than six months after the loss. They may feel that life has lost its meaning, that part of their identity has disappeared, or that they cannot accept death, even though they know it has happened. “It’s not that it’s a different kind of grief,” Bryant says. “It’s just that the person is trapped in grief.”

To understand why some people remain stuck, Bryant and his colleagues turned to the neurobiology of prolonged grief, a field that is still in its infancy and often relies on research with small sample sizes and variable experimental designs, complicating comparisons between studies.

Much of the research in this field comes from neuroimaging studies, which ask grieving participants to recall or visualize reminders of the deceased during brain scans. In these studies, TDP has been repeatedly linked to changes in reward-related brain circuits. These regions include the nucleus accumbens and orbitofrontal cortex, involved in desire and motivation, as well as the amygdala and insula, which play a role in processing emotions. “It kind of fit with this notion that grief is characterized by a longing or longing for the deceased,” Bryant says.

Some of the neural patterns observed are not exclusive to prolonged grief. Similar changes are seen in depression and post-traumatic stress disorder. Since these conditions share traits such as rumination and emotional distress“It would be very strange if this overlap were not observed,” says Bryant. However, this presents a challenge for researchers, who must determine which brain changes are specific to PDD and whether the observed brain differences cause or are a consequence of prolonged grief.

Looking ahead, Bryant emphasizes the need to work with larger groups of grieving people over time to reveal how grief-related brain activity changes as some people recover while others do not. “I hope to raise awareness,” says Bryant. “To truly address prolonged grief, we need to recognize it as a disorder. “While we have treatments that can address it, we can’t do that if we can’t identify these people.”