The chair across the dinner table is empty, but you still set a place sometimes before catching yourself. Songs come on the radio that stop you mid-breath. Friends tell you that time heals, but the months keep passing and the weight hasn’t lifted—if anything, it’s settled deeper, becoming part of the architecture of your days. Grief is one of the most universal human experiences, yet when it refuses to loosen its grip, it can feel like the loneliest journey in the world. If you’re carrying a loss that has become too heavy to bear, you’re far from alone.
When Grief Becomes Something More
Grief is not a disorder. It is a natural, necessary response to loss—a testament to the depth of our connections. But for some people, grief crosses a threshold from the painful-but-functional process of mourning into something that fundamentally disrupts their ability to engage with life. Clinicians now recognize this as Prolonged Grief Disorder, a condition added to the DSM-5-TR in 2022, characterized by intense longing for the deceased, difficulty accepting the death, emotional numbness, a sense that life has lost its meaning, and significant impairment in daily functioning persisting beyond 12 months.
The distinction between normal grief and prolonged grief isn’t about a timeline or a checklist—it’s about whether the grief has become a place you’re trapped in rather than a process you’re moving through. Normal grief ebbs and flows, with moments of intense pain gradually interspersed with memories that bring warmth rather than only anguish. Prolonged grief feels frozen, as if you’re reliving the initial devastation without the gradual integration that allows most people to carry their loss forward into a meaningful life.
Here in Orange County, the cultural expectation to “make every moment count” can make grief feel especially isolating. Surrounded by wellness gurus and social media highlight reels, many bereaved individuals describe feeling pressure to move on faster than their hearts allow, leading to suppressed grief that eventually manifests as depression, anxiety, or physical illness.
The Neuroscience of Stalled Grief
Why does grief become stuck for some people? Research from Columbia University and elsewhere has begun to illuminate the neural mechanisms involved. Brain imaging studies show that in prolonged grief, the nucleus accumbens—a region associated with reward and attachment—remains hyperactive when exposed to reminders of the deceased, essentially keeping the brain in a state of perpetual yearning. At the same time, the prefrontal cortex, which helps us process and adapt to new realities, shows reduced activity.
This neurological pattern creates a painful loop: the brain keeps seeking the person who is gone while simultaneously struggling to update its internal model of the world to reflect their absence. It’s not a failure of character or effort—it’s a brain stuck in a pattern it can’t find its way out of. Traditional grief therapy helps many people, but for those whose neural patterns have become deeply entrenched, talk therapy alone may not provide enough leverage to break the cycle.
How Ketamine May Help Process Grief
Ketamine’s therapeutic potential for grief lies in the same mechanisms that make it effective for treatment-resistant depression: its rapid promotion of neuroplasticity. By increasing BDNF and stimulating new synaptic connections, ketamine therapy may help the brain reorganize itself around the reality of loss rather than remaining stuck in the loop of searching and yearning.
During ketamine sessions, patients frequently describe experiences that are particularly relevant to grief processing. The temporary dissolution of rigid thought patterns allows some patients to access emotions they’ve been avoiding—not in a re-traumatizing way, but from a place of safety and psychological distance. Others report a deep sense of profound peace and connection or transcendence that provides comfort around existential questions about death and meaning. While these subjective experiences are deeply personal and often spiritual, they align with research suggesting that ketamine’s effects on the default mode network may facilitate new perspectives on fixed thought patterns, including those associated with prolonged grief. These insights are most powerful when actively integrated into lasting behavioral and emotional change after each session.
Robert, a 58-year-old retired first responder from Laguna Beach, lost his wife of 32 years to cancer. Eighteen months later, he could barely function: “I wasn’t suicidal, but I’d stopped living. I ate because I had to, slept when exhaustion won, and spent most of my days in the garage where her car used to be parked. My daughter finally convinced me to try ketamine therapy after seeing some TikToks on mental health. During my second infusion, I had this experience of sitting with Elizabeth—not literally, but it felt deeply real—and she was at peace. When I came out of it, I sobbed for an hour. But it was different from my usual grief. It was release, not despair. Something unlocked that day, and while I still miss her every single day, I started being able to live again.”
Grief Is Not Depression—But They Often Travel Together
An important clinical distinction is that grief and depression, while frequently coexisting, are different conditions with different treatment considerations. Grief centers on the loss of a specific person and is marked by waves of longing, memories, and sadness specifically connected to that absence. Depression is a more pervasive state affecting overall mood, self-worth, and the ability to experience pleasure from anything.
Many grieving individuals develop depression alongside their grief, and the combination can be particularly debilitating. Ketamine therapy may address the depressive component directly through its antidepressant mechanisms while the neuroplastic changes it promotes create space for the grief to be processed rather than suppressed. This dual benefit makes it an especially compelling option for people whose grief has become entangled with depression.
At OC Ketamine Therapy, Dr. Seif’s approach to grief-related treatment includes careful assessment of both the grief itself and any coexisting depression, ensuring that the treatment protocol addresses the full picture rather than treating one aspect while neglecting the other.
The Role of Integration in Grief Work
For grief specifically, integration—the process of incorporating insights from ketamine sessions into daily life—is perhaps even more important than for other conditions. The emotions and experiences that emerge during grief-focused ketamine sessions can be powerful, and understanding how integration transforms those experiences into lasting change maximizes their therapeutic value.
Journaling immediately after sessions helps capture the texture of the experience before it fades. Working with a grief-informed therapist who can help you make sense of what emerged during treatment provides professional support for the integration process. Pairing this with grounding techniques between sessions can help you stay connected to your body and the present moment as new emotions surface. Some patients find that creative expression—writing letters to the deceased, creating art, or compiling meaningful photographs—provides an outlet for emotions that ketamine helps access.
The goal of integration in grief work isn’t to stop missing the person you’ve lost. It’s to help your brain move from a place of stuck disconnection and frozen anguish to one where you can carry your love and your loss forward while still engaging meaningfully with the life that continues around you. And if all of this feels too big, Dr. Seif will be there to provide a safe space and guide you through the process.
Finding Your Way Through
Grief is not something to overcome—it’s something to integrate. If conventional approaches haven’t helped you find your footing after loss, ketamine therapy may offer the neuroplastic shift your brain needs to begin processing rather than circling. Our compassionate team at OC Ketamine Therapy in Newport Beach treats grief with the seriousness, sensitivity, and clinical expertise it deserves. Schedule a discovery call to explore how we can support your journey through loss and toward healing.
References
O’Connor, M. F., Wellisch, D. K., Stanton, A. L., et al. (2008). Craving love? Enduring grief activates brain’s reward center. NeuroImage, 42(2), 969–972. https://doi.org/10.1016/j.neuroimage.2008.04.256
Prigerson, H. G., Kakarala, S., Gang, J., & Maciejewski, P. K. (2021). History and status of prolonged grief disorder as a psychiatric diagnosis. Annual Review of Clinical Psychology, 17, 109–126. https://doi.org/10.1146/annurev-clinpsy-081219-093600
Zanos, P., & Gould, T. D. (2018). Mechanisms of ketamine action as an antidepressant. Molecular Psychiatry, 23(4), 801–811. https://doi.org/10.1038/mp.2017.255
Duman, R. S., & Aghajanian, G. K. (2012). Synaptic dysfunction in depression: Potential therapeutic targets. Science, 338(6103), 68–72. https://doi.org/10.1126/science.1222939
About Dr. Dina Seif
Dina Seif, MD, believes that with the right mindset and support, every one of us has the potential to transform and heal our minds. She specializes in creating a personalized plan for each patient and is committed to providing a supportive healing environment for your journey.
Dr. Seif is a member of the American Society of Ketamine Physicians and was recognized as a Physician of Excellence by the Orange County Medical Association. Dr. Seif has 15+ years of experience with ketamine in the emergency setting and founded one of the first ketamine practices in Orange County in 2019. She has administered thousands of infusions and cared for hundreds of patients from around the world, bringing deep clinical experience to those struggling with severe depression and guiding them toward renewed hope and well-being.
Dr. Seif is board-certified in Emergency Medicine. She is a graduate of the University of California, Irvine, where she attended college, medical school, and business school.
After an internship in Internal Medicine at St. Vincent’s Medical Center in New York, she returned to California for Emergency Medicine residency at LAC+USC Medical Center where she also completed a fellowship in Emergency Ultrasound and was a Professor of Clinical Emergency Medicine at Keck School of Medicine of USC for 5 years.
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. If you are experiencing a mental health crisis or having thoughts of self-harm, please call 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room immediately. The information provided here is not intended to diagnose, treat, cure, or prevent any disease or condition. Always consult with a qualified healthcare provider before starting any new treatment or making changes to existing treatment plans. Individual results may vary, and what works for one person may not work for another.