Psychiatric Care for Grief and Loss

Grief is a natural response to the death of someone close, or to other losses, and it has no set timeline. For some people, grief stays intense and interferes with daily life long after the loss, a condition now recognized as prolonged grief disorder. Loss can also bring on depression, anxiety, or trauma symptoms, especially after a sudden or violent death.

How our physicians help

Our physicians do not try to hurry grief or treat a natural response to loss as an illness. We take time to understand the loss and how you are coping, and look for depression, anxiety, trauma, or sleep problems that may need treatment. Care centers on psychotherapy, with medication only when a co-occurring condition calls for it, and with close involvement of parents for children and teens.

When adult grief needs more support

Grief usually softens with time, even though the loss stays with you. These signs suggest it may have become stuck:

• Longing for the person that crowds out most of your day
• Struggling to believe the death happened, long after it did
• Avoiding places, photos or people that bring the loss to mind
• Feeling that part of you died too
• Drinking or using substances to dull the pain

Grief in children and teens

A child may grieve the same loss again at each new stage of growing up, so signs can appear long after the death. Watch for:

• Younger children acting younger than their age, such as new bedwetting or clinging
• Fear that another family member will die
• Trying to act fine in order to protect a parent
• Teens pulling away from friends, showing new anger or taking new risks

How our physicians evaluate grief

Your physician asks about the loss, the relationship, what your days look like now and who supports you.

Prolonged grief disorder is usually considered when intense longing and trouble functioning last at least a year after a death in adults, or about six months in children and teens. That window is a guide for doctors. It is not a deadline for your grief.

Trauma can look similar. It tends to center on fear and unwanted images of what happened, while prolonged grief centers on missing the person. Each calls for a different approach.

Treatment options for grief

Most grieving people do not need psychiatric treatment. Family, friends, faith communities and grief groups are often enough. When they are not, therapy can help, though turning toward painful memories is hard at first. Options include:

• Prolonged grief therapy is a structured talk therapy made for this condition. It helps you face the story of the loss and rebuild goals, while keeping a bond with the person who died.
• Cognitive behavioral therapy (CBT) can ease guilt, self-blame and thoughts that keep circling.
• After a traumatic death, trauma-focused therapy may fit better, and a version is used with children and teens.
• Medication does not treat grief itself, though it can help if depression or anxiety has joined the grief.

Helping someone who is grieving

Say the name of the person who died, and share a memory. Offer specific help, such as a meal or a ride. Stay in touch after the first few weeks, when others stop calling, and remember anniversaries.

Loss can bring thoughts of not wanting to go on, or of wanting to be with the person who died. Please tell someone. If you have those thoughts or are in crisis, call or text 988 (the Suicide & Crisis Lifeline) or call 911. We are not an emergency service. Grief this heavy can ease with support, even when that is hard to believe.

Find your doctor for grief and loss →