When Grief Becomes a Mental Illness

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According to a study conducted by the National Institute of Mental Health, an estimated 26 percent of Americans live with some type of mental illness. (Read Utne’s coverage of America’s mental health crisis here.) The Diagnostic and Statistical Manual of Mental Disorders–or more commonly the DSM–dictates how the entire body of medical professionals diagnose mental illnesses. Thus, changes to the manual affect the lives of thousands of people. The fifth version of the DSM is due out in 2013, and the expected changes to the psychological definition of grief, reports Scientific American, are evoking intense controversy

Specifically, the DSM-V would change our understanding of grief in two important ways. First, the manual introduces a new diagnosis dubbed “complicated grief disorder,” which entails “powerful pining for the deceased, great difficulty moving on, a sense that life is meaningless, and bitterness or anger about the loss” past six months after the death. More controversially, the new version of the DSM will allow depression therapy as early as the first few weeks after experiencing a loss. (Currently, doctors and psychologists must wait until two months have passed since the death.)

Eventually we all suffer crippling grief; it’s a universal facet of the human condition. Then most of us overcome that grief. The proposed changes to the DSM-V make it easier for typical grief to be conflated with depression or diagnosed as abnormal.

Critics of the DSM change worry that grief will be overdiagnosed and exploited by pharmaceutical companies. “There will be vitriolic debates when the public fully appreciates the fact that the DSM is pathologizing the death of a loved one within two weeks,” grief researcher Holly G. Prigerson told Scientific American. On the other hand, professionals like Kenneth S. Kendler of the DSM-V Mood Disorder Work Group, who claim that “on the basis of scientific evidence, [mourners are] just like anybody else with depression,” argue withholding depression treatment is professionally unfair.

The article concludes: “In many ways, parsing the differences between normal grief, complicated grief and depression reflects the fundamental dilemma of psychiatry: Mental disorders are diagnosed using subjective criteria and are usually an extension of a normal state.” Those probably aren’t very reassuring words to someone on the precipice of despair.

Source: Scientific American

Image by e3000, licensed under Creative Commons.

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