When Grief Becomes a Mental Illness — Mind and Body — Utne Reader

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When Grief Becomes a Mental Illness

7/8/2011 2:06:47 PM

by Will Wlizlo

Tags: grief, mourning, dsm-v, psychology, depression, Scientific American, mind

and body, Will Wlizlo

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 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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