Free consult
A 15-minute phone call to decide whether psychiatric care fits what is happening, or whether what you need is room. No card required.
§ 01 Grief and bereavement psychiatry
Some losses need room. Some need more.
Most grief does not belong in a psychiatric office, and I will tell you so. But when mourning gets tangled with broken sleep, panic, depression, or a grief that has stopped moving, careful psychiatric care can give you back the strength to carry what you are carrying. Telehealth, for adults across Washington.
No card required for the consultation request. We use the call to decide whether medication management is the right next step.
At a glance
Grief and bereavement psychiatry here means private telehealth evaluation and medication management for Washington adults when loss is tangled with insomnia, anxiety, depression, traumatic stress, guilt, numbness, or impaired functioning. Grief itself is not a disorder, and medication does not erase loss. The work is telling mourning that needs room apart from suffering that deserves treatment, and treating only the second.
§ 02 The distinction that guides everything
Grief is not a disease.
It is the cost of having loved something that could be lost. The clinical question is never "are you grieving correctly?" It is whether something else has grown around the grief.
Needs room, not prescriptions
Mourning that is moving.
Waves of sorrow that come and go. Crying at the song, the smell, the anniversary. Telling the story again. Anger, longing, even relief, sometimes within the same hour. Sleep that suffers for a while and slowly mends.
- The pain changes shape over weeks and months, even if slowly.
- Moments of ordinary life, meals, work, laughter, keep breaking through.
- What helps most is people, ritual, time, and being allowed to grieve.
Deserves evaluation and treatment
Suffering that has settled in.
Sometimes depression moves in on top of the mourning. Sometimes the grief itself freezes: months or years on, the longing and preoccupation remain so consuming that life cannot restart. Clinicians call that prolonged grief; it is real, and it responds to treatment.
- Sleep wrecked for weeks; panic attacks; a body that cannot stand down.
- Worthlessness, guilt far beyond the loss, or thoughts of not wanting to be here.
- Numbness so complete that nothing, not even the grief, gets through.
If you are on the left side of this line, I will say so, plainly and without charging you for six visits to hear it. The free consultation exists for exactly this question.
§ 03 What this care is
Care around the grief, not instead of it.
The evaluation looks at the loss and everything that has grown around it: sleep, appetite, panic, traumatic reminders, guilt, numbness, depression, how you are functioning, what medications you already take, and what kind of loss this was, expected or sudden, peaceful or violent, recent or long ago but never settled.
If treatment makes sense, it is aimed at named targets: the insomnia, the panic, the depressive collapse. Never at the love, the memory, or the mourning itself. Those are yours, and they are not symptoms.
This is a private cash-pay practice for adults physically located in Washington State. I do not accept or bill insurance. Superbills are available for possible out-of-network reimbursement when applicable.
$250 intake
A 60-minute psychiatric evaluation: the loss, its context, your history, medication review, and an initial plan if one is warranted.
$150 follow-up
Thirty-minute follow-ups reviewing sleep, mood, anxiety, functioning, side effects, and whether treatment is still needed.
§ 04 When people reach out
Usually, it is the nights.
Grief tends to be survivable in daylight, with people around. The calls I get are about what happens after the casseroles stop and the house goes quiet.
The nights
Lying awake replaying the last days, or waking at three with the dread already running. Nightmares, or the worse mornings: the few seconds of forgetting, then remembering again.
The body
Chest tightness, panic out of nowhere, exhaustion that sleep does not fix, a startle response that treats the doorbell like a threat. Loss lives in the body longer than anyone warns you.
The fog
Numbness, autopilot, watching your own life from a distance. Months in, people say you seem fine. You are not fine; you are absent, and you know it.
The hard losses
Sudden death, suicide loss, medical trauma, a battle buddy, a child. Losses with violence or guilt stitched into them, where mourning and traumatic stress arrive tangled together.
§ 05 Medication, honestly
What it can do. What it cannot.
I would rather you know both sides before the first visit than be sold one side and disappointed later.
Medication can help with
- Sleep that has been broken for weeks, using non-controlled options only.
- Panic, physiological alarm, and a nervous system that will not stand down.
- Depression that has moved in on top of the mourning: the collapse of energy, appetite, and worth.
- Nightmares and trauma physiology after sudden or violent loss.
Medication will not
- Erase the loss, or make it hurt less than it should.
- Dull your love, your memories, or your connection to the person.
- Replace mourning, therapy, ritual, faith, family, or community.
- Put grief on a schedule. There is no correct timeline, and I will not impose one.
§ 06 What this is not
Grief deserves clear boundaries.
Not crisis care
If you are in acute danger or thinking of harming yourself or someone else, call 988, 911, or go to the nearest emergency department.
Not grief erasure
Medication does not remove love, memory, longing, anger, or the human work of mourning, and it is never prescribed here with that aim.
Not therapy replacement
Medication can support grief therapy, ritual, family, peer, spiritual, and community support, but it does not replace any of them.
Not controlled substances
I do not prescribe controlled substances: no stimulants, no benzodiazepines, no controlled sleep medications. That prescribing is not part of this practice.
§ 07 Related paths
Depression care
When the heaviness has detached from the loss and become its own weather, the depression page describes that work.
Explore depression careTrauma and PTSD
Sudden, violent, medical, or military loss can leave threat physiology tangled with the mourning. Both need attention.
Explore trauma careAdjustment
When the loss is one part of a larger upheaval, service ending, illness, a life restructured, the wider frame may fit better.
Explore adjustment careFrom the journal
On veteran trauma and complex grief: why losses from service years surface decades later, and what telehealth care can offer.
Read the essay§ 08 Questions
Is grief a psychiatric disorder?
No. Grief is the human response to losing someone or something that mattered, and most grief needs room, ritual, and people rather than a prescription. Psychiatric care earns a place when grief is tangled with severe insomnia, panic, depression, traumatic stress, or a grief that has stayed frozen and disabling long past the early months.
Will medication take away grief?
No, and I would not want it to. Medication does not erase loss, dull love, or replace mourning, therapy, ritual, family, or community. What it can do is reduce specific burdens, broken sleep, physiological panic, depressive collapse, so the grief itself becomes carryable.
When does grief become something to treat?
Two patterns deserve evaluation. The first is grief plus something else: major depression, severe insomnia, panic, or traumatic stress riding on top of the mourning. The second is grief that has stopped moving, when months or years on, the longing and preoccupation remain so consuming that life cannot restart. Both are treatable; neither means you loved wrongly.
Can you coordinate with my therapist or primary care clinician?
Yes, with your permission. Grief care works best when medication management is one part of a broader circle that includes therapy, family, community, and whatever ritual or faith holds you.
What is the first step?
Request a free 15-minute phone consultation. No card is required for that call, and we use it to decide together whether a full psychiatric evaluation makes sense.
You do not have to know which side of the line you are on.
That is what the fifteen minutes are for. Free, by phone, no card, and an honest answer either way.
Book a free 15-minute consultation