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J. Connor Barnhart, MD

Grief and Loss Treatment in San Francisco

Also known as: Grief, Bereavement, Prolonged Grief Disorder, Complicated Grief, Loss, Mourning

4 min readLast updated: 2026-02-20
Reviewed by J. Connor Barnhart, MD

Grief is the emotional, cognitive, and physical response to the loss of someone or something meaningful, most commonly the death of a loved one. While grief is a natural and expected part of the human experience, some individuals develop prolonged grief disorder (PGD), a condition recognized in the DSM-5-TR in which intense grief persists beyond culturally expected timeframes and significantly impairs daily functioning. PGD is estimated to affect approximately 4 to 15 percent of bereaved individuals.

At a Glance

  • Prolonged grief disorder affects an estimated 4 to 15 percent of bereaved individuals, with symptoms persisting beyond 12 months in adults[1]
  • Among individuals with prolonged grief disorder, approximately 75 percent have at least one comorbid psychiatric condition, most commonly depression, anxiety, or PTSD[1]
  • Prolonged grief disorder was added to the DSM-5-TR in March 2022 as a distinct diagnostic entity, separate from depression and PTSD[2]
  • Most bereaved individuals adapt adequately within 6 to 12 months, and grief itself is not a disorder but a natural response to loss[4]
  • Complicated grief therapy, a 16-session structured intervention, has demonstrated efficacy in randomized controlled trials for reducing prolonged grief symptoms[1]

Affected Anatomy

  • Central nervous system
  • Limbic system
  • Autonomic nervous system
  • Cardiovascular system
  • Immune system

What are the symptoms of Grief and Loss?

  • Intense yearning or longing for the deceased
  • Preoccupation with thoughts or memories of the person who died
  • Feelings of disbelief or difficulty accepting the death
  • Emotional numbness or difficulty experiencing positive emotions
  • Sense of identity disruption or feeling that part of oneself has died
  • Avoidance of reminders that the person is deceased
  • Intense emotional pain, sorrow, or pangs of grief
  • Difficulty reintegrating into relationships and one's usual activities
  • Social withdrawal or isolation
  • Sleep disturbances, including insomnia or hypersomnia
  • Changes in appetite or weight
  • Fatigue and decreased energy
  • Difficulty concentrating or making decisions
  • Somatic symptoms such as chest tightness, headaches, or nausea

When to See a Psychiatrist for Grief

  • Intense grief that does not lessen over time or worsens after months
  • Difficulty returning to daily activities, work, or relationships
  • Persistent feelings of guilt, numbness, or emotional detachment
  • Withdrawal from social connections or activities you previously valued
  • Grief accompanied by depression, anxiety, or thoughts of self-harm
  • Complicated grief involving traumatic loss or multiple concurrent losses

If any of these apply, consider reaching out to schedule a visit.

What causes Grief and Loss?

Causes

  • Death of a spouse, partner, or close family member
  • Death of a child or pregnancy loss
  • Loss of a close friend or significant relationship
  • Sudden or unexpected death, including accidents or medical emergencies
  • Traumatic deaths
  • Multiple losses occurring in a short period
  • Anticipatory grief during a loved one's terminal illness

Risk Factors

  • Loss of a spouse, child, or primary attachment figure
  • Sudden, unexpected, or violent circumstances of death
  • History of mood disorders, anxiety disorders, or prior trauma
  • Limited social support network
  • History of childhood adversity or prior complicated losses
  • Older age at the time of bereavement
  • Lower socioeconomic status
  • Ambivalent or conflicted relationship with the deceased

How It's Diagnosed

  • 1Clinical interview assessing grief symptom duration, intensity, and functional impairment
  • 2Application of DSM-5-TR diagnostic criteria for prolonged grief disorder
  • 3Screening questionnaires may be used
  • 4Assessment of comorbid psychiatric conditions
  • 5Medical evaluation to rule out physical health conditions contributing to symptoms

How is Grief and Loss treated?

I offer several approaches for grief and loss:

Psychodynamic Therapy

Psychodynamic therapy is an evidence-supported form of talk therapy rooted in longstanding psychoanalytic theory about how unconscious thoughts, past ...

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Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a structured, evidence-based form of psychotherapy that focuses on identifying and modifying unhelpful patterns ...

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Psychotherapy

Psychotherapy, also called talk therapy, refers to a variety of treatment approaches that aim to help a person identify and change troubling emotions,...

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Medication Management

Medication management refers to the ongoing, physician-supervised process of prescribing, monitoring, and adjusting psychiatric medications to treat m...

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Lifestyle Optimization

Lifestyle optimization is an evidence-based approach to mental health that uses individually tailored behavioral interventions – including sleep hygie...

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Prognosis and Recovery

  • Most bereaved individuals experience a gradual reduction in acute grief symptoms within 6 to 12 months
  • Grief is not a linear process, and individuals may experience fluctuations in symptom intensity over time
  • Approximately 4 to 15 percent of bereaved individuals develop prolonged grief disorder requiring targeted intervention
  • Therapy has shown significant symptom improvement in clinical trials
  • Comorbid conditions such as depression and PTSD may require separate or concurrent treatment
  • Early identification and intervention for at-risk individuals is associated with better long-term outcomes

Frequently Asked Questions

Grief is a natural emotional response to the loss of someone or something meaningful. Most people experience intense emotions that gradually ease over time. Grief may become prolonged grief disorder when intense symptoms persist beyond 12 months, cause significant functional impairment, and exceed expected cultural norms for mourning.
Prolonged grief disorder symptoms include intense yearning for the deceased, preoccupation with the death, emotional numbness, identity disruption, and difficulty reintegrating into daily life. Physical symptoms such as fatigue, sleep disturbances, and appetite changes are also common.
Risk factors for developing complicated grief include the sudden or violent death of a loved one, loss of a spouse or child, limited social support, a history of mood disorders or prior trauma, and a dependent attachment style with the deceased. Multiple losses in a short period may also increase risk.
See a psychiatrist if grief persists intensely beyond several months, interferes with daily functioning, or is accompanied by depression or anxiety. Professional support can help you process loss while maintaining your mental health.
Psychotherapy has been studied and shown to be helpful with recovery from prolonged grief. Support groups, grief counseling, and mindfulness-based approaches may also help. Treatment for comorbid depression or anxiety may be recommended alongside grief-specific therapy.
Most bereaved individuals experience a gradual lessening of acute grief within 6 to 12 months, though the process is not linear and grief may resurface at significant moments. Approximately 4 to 15 percent of bereaved individuals develop prolonged grief disorder, which typically requires professional intervention for improvement.
Helpful coping strategies include maintaining social connections and accepting support from others, engaging in regular physical activity, practicing mindfulness or relaxation techniques, maintaining consistent sleep routines, and giving yourself permission to grieve without judgment. Bereavement support groups can also reduce feelings of isolation.
Dr. Barnhart uses talk therapy to help patients process loss at their own pace. He creates a supportive space to explore the meaning of loss while monitoring for complications like depression that may benefit from additional treatment.

Your Practitioner

J. Connor Barnhart

J. Connor Barnhart, MD

Dr. J. Connor Barnhart is a board-certified psychiatrist and psychotherapist practicing in San Francisco. He completed his psychiatry residency at UCSF, where he trained in the Bipolar, LGBT, and Women's Mental Health specialty clinics and developed focused expertise in integrative psychiatry through a year-long rotation at the UCSF Osher Center. He attended medical school at the University of Pennsylvania's Perelman School of Medicine and graduated from Brown University with honors in Human Biology. His practice combines insight-oriented therapy, medication management, supplements, and lifestyle optimization to holistically address the root causes of mental health challenges including depression, anxiety, and difficulties with focus.

Medically reviewed by J. Connor Barnhart, MD · Last reviewed: 2026-06-03