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Criticism of the new draft version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders is already starting to fly. Right on cue. An editorial in Lancet points out the failure of the latest draft version to consider and generally exclude bereavement prior to the diagnosis of a major depressive disorder.
“In the draft version of DSM-5, however, there is no such exclusion for bereavement, which means that feelings of deep sadness, loss, sleeplessness, crying, inability to concentrate, tiredness, and no appetite, which continue for more than two weeks after the death of a loved one, could be diagnosed as depression, rather than as a normal grief reaction. Medicalizing grief, so that treatment is legitimized routinely with antidepressants, for example, is not only dangerously simplistic, but also flawed. The evidence base for treating recently bereaved people with standard antidepressant regimes is absent,” stated the editorial writers.
And the change in attitude toward grief may not end with the DSM. The World Health Organization’s Classification of Disease is currently debating whether or not to include a category on “prolonged grief disorder.” The report states, “Bereavement is associated with adverse health outcomes, both physical and mental, but interventions are best targeted at those at highest risk of developing a disorder or those who develop complicated grief or depression, rather than for all.”
So it seems that WHO is willing to recognize grief as a state of health, albeit uncomfortable and not without side effects. They do acknowledge that for some people the state of mind could become unhealthy and cause impairment. Nevertheless, grief is an important part of dealing with the cycle of life and to infer that medical attention, including drugs, may be a new normal for learning to deal with it, just puts us all at a disadvantage. Grief is necessary and should be a welcome part of learning to live without a loved one.
Source: MedicalNewsToday, Lancet
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