Grieving to be labelled mental illness

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LABEL IT: Psychiatrists have developed a new diagnosis for people struggling to cope after the death of a loved one; adjustment disorder related to bereavement.
Relevant offersPeople suffering from long-term grief after the death of a loved one will soon have their condition officially labelled a mental disorder.

Many psychiatrists have argued grief should not be labelled as a mental condition because it is a natural phenomenon which everyone experiences.

However, the next edition of the industry's so-called bible, the Diagnostic and Statistical Manual of Mental Disorders, will include a new diagnosis for people still struggling to cope a year or more after a loved one dies.

The condition will be officially known as adjustment disorder related to bereavement.

University of New South Wales psychology professor Richard Bryant, who is on the manual's review committee, said 10 to 15 per cent of people have a persistent grief reaction which can last up to 40 years.

Those most likely to mourn for more than a year include people who lose a child or suffer a loss through suicide and unexpected death such as a road accident or homicide.

"People have said it's not right to medicinise grief which has personal and culturally specific responses and psychiatry is butting in where it doesn't belong," Prof Bryant told AAP.

"The alternative view is that all of the above is true but we know after a traumatic event a proportion of people will have negative psychological reactions that will affect them.

"Having a diagnosis means we can identify people through formal screening programs and facilitate people to getting directed to appropriate treatments like cognitive behaviour therapy."

Prof Bryant, who is also the director of the traumatic stress clinic at Sydney's Westmead Hospital, said people with long-term grief tended to be "stuck in the past" and unable to move on with their lives.

"For most people after six months the pain starts to ease and for those who it doesn't they will have a long-term problem," he said.

"They are going to be more likely to abuse substances, have mental health problems, heart conditions and engage in poor health behaviour like smoking and drinking."

Often people who are struggling to cope with grief are prescribed anti-depressants and offered counselling.

But Prof Bryant said these were unlikely to be solutions for people with long-term grief.

"The reaction is about yearning and missing and longing and is distinct from anxiety and depression and is not responsive to treatment for depression," he said.

"So, medication is not going to help it.

"It is psychotherapy programs which are different from the normal grief work programs and counsellors that are best."

Prof Bryant is due to discuss the new diagnosis for long-term grief at a forum hosted by the University of Melbourne's Australian Centre for Post-traumatic Mental Health on August 12.

The next edition of the Diagnostic and Statistical Manual of Mental Disorders is due to be published by the American Psychiatric Association in 2013.

http://www.stuff.co.nz/life-style/537080...al-illness


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Redefining process of mourning - Proposal would label grief a mental disorder


Human grief could soon be diagnosed as a mental disorder under a proposal critics fear could lead to mood-altering pills being pushed for “mourning.”


Psychiatrists charged with revising the official “bible” of mental illness are recommending changes that would make it easier for doctors to diagnose major depression in the newly bereaved.

Instead of having to wait months, the diagnosis could be made two weeks after the loss of a loved one.

The current edition of the Diagnostic and Statistical Manual of Mental Disorders – an influential tome used the world over – excludes people who have recently suffered a loss from being diagnosed with a major depressive disorder unless his or her symptoms persist beyond two months. It’s known as the “grief exclusion,” the theory being that “normal” grief shouldn’t be labelled a mental disorder.

But in what critics have called a potentially disastrous suggestion tucked among the proposed changes to the manual, “grief exclusion” would be eliminated from the DSM.

Proponents argue that major depression is major depression, that it makes little difference whether it comes on after the loss of a loved one, the loss of a job, the loss of a marriage or any other major life stressor. Eliminating “grief exclusion” would help people get treatment sooner than they otherwise would.

But critics fear that those experiencing completely expectable symptoms of grief would be labelled mentally “sick.” Dr. Allen Frances says the proposal would pathologize a normal human emotion and could bring on even wider prescribing of moodaltering pills.

“This is a disaster,” says Frances, a renowned U.S. psychiatrist who chaired the task force that wrote the current edition of the DSM, which is now undergoing its fifth revision. “Say you lose someone you love and two weeks later you feel sad, can’t sleep well, and have reduced interest, appetite, and energy. These five symptoms are completely typical of normal grieving, but DSM-5 would instead label you with a mental disorder.”

http://www.cchrint.org/2011/04/18/psychi...-disorder/


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In your first post the time period referred to is one year after the death.

In your second post there is reference to two months and two weeks.

And this is why I'm not a big fan of psychology. It already stinks due to the fact that most people that decide to major in psychology are pretentious a**holes. Not all of them, but just enough to suggest that psychology attracts morons.

Makes sense to me grieving is normal but when it goes on far longer than it should and is interfering with someones ability to function it should certainly be acknowledged as a mental illness. But I am confused about how this is new, I thought they already had this disorder in the DSM.

Though I do not necessarily agree with using anti-depressants for this, but yeah according to the logic in the OP PTSD should not be considered a mental illness either.

I have a family member that has been grieving for maybe 60 years.

I think the duration shouldn't matter, but the person's ability to cope should. I disagree with the offered diagnosis.

It all depends on where the issue of "clinical significance" gets put.

Grief for the death of a loved one, for example, is not clinically significant. It is typical, it is transient and it can be accommodated.

But death of a loved one can trigger major, clinically significant depression. A person who is suicidal after the death of a spouse should not be left untreated simply because the person is still within a grief exclusion.

At some point we have to stand back and acknowledge that the DSM is a tool, but it does not stand as a substitute for the training, experience and judgement of individuals. The insurance-pharmacy-medical-industrial complex has fetishized checklist diagnosis and it is high time that we started to undercut that.

I agree, visagrunt.

As with ANY "disorder," it isn't about whether the terms used to describe the disorder are terms we use to describe ordinary human conditions. It's about whether the experience of the person involved is OUT of the ordinary. It doesn't seem very helpful to me to discuss whether this is a "legitimate disorder" without actually looking at how, specifically, the disorder is defined.

That said, here is the proposed DSM-V entry:

personally, my objection is that I don't see why it has to take a year to see if one's bereavement has clinical symptoms.

To diagnose greif is another way to prove whoever decided it is completely emotionless to the point where typical human behavior is unacceptable. Would I still grieve if the person I love dies 20 years after it happens? Of course. It's almost like love is nonexistent to the "experts." All the symtoms listed are normal, I have felt them before when someone I love tried to kill themselves but survived. Does that mean I have yet another mental disorder? No.

What are they supposed to do? Feel happy?

People grieve in different ways, with differing intensity and for different durations. However, the proposed criteria outlined above in MrXxx's post relate to a degree, severity and duration of grieving which is abnormal, and has to be clinically significant and pervasive for a diagnosis.

As a student, and now ordained, minister I reckon I have conducted about 85 funerals over the past 3 years or so. Assuming an average of 4 close family members I come into contact with, that's 340 recently bereaved people I have spent time with. Of those, I can think of only one whose response to the death was unusual and, some 4 months after the death, the last time I had contact with the family, was becoming more severe in its intensity and expression. At that time she would likely have met some of the proposed criteria posted above by MrXxx, but not nearly enough for a diagnosis. It is possible that over the next few months she would have better able to adjust to the fact of her, elderly, mother's death, but it is also possible that she became less able to deal with it, and return to normal routines and patterns of living. I don't believe she was depressed. I provided details of grief counselling services, but she refused to go herself, instead insisting that her father needed the counselling. He didn't. His grief was normal and he slowly was returning to some of his old routines, and making new routines for himself as an elderly widower.

People grieve, people find ways of coping, of finding a new identity and a way to be after the death of a loved one. This Bereavement Related Disorder is about people who aren't able to do that, who can't even begin to do that after a lengthy period of time, and who are unable to function because of that.

Actually, the thread title is quite misleading, I think. What is being described in the proposed criteria isn't grieving. It's something else. Bereavement related, yes, but not grief as it is normally understood and experienced.