Should grieving for a loved one be considered clinical depression by psychiatrists?
An editorial in the Lancet, one of the world’s most influential medical journals, says no, according to Canada.com.
If “normal human grief” becomes classified as a mental illness – as a proposed revision to the manual governing psychiatry would – antidepressant drugs could be prescribed much more widely, the editorial points out.
It says the proposal to remove a section known as the “bereavement exclusion” from the diagnosis of depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM), to be published by the American Psychiatric Association in 2013, “is not only dangerously simplistic, but also flawed,” reporter Sharon Kirby writes.
“The evidence base for treating recently bereaved people with standard antidepressant regimens is absent,” the editorial says.
Under the current thinking, a person would have to have persistent symptoms for two months before being considered depressed.
If the proposal is adopted, “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,” the editorial says.
Most people who go through the death of a loved one do not need treatment, the authors say.
But those in favour of the change tell Ms. Kirby that “it’s impossible in the short run to distinguish grief from depression unless the symptoms are severe – for example, if the bereaved person is suicidal, or falsely believes, ‘It’s my fault the person died,’ or if they’re markedly impaired and have had major depression before.”
Is grief a normal emotion we all experience? Or can it evolve into mental illness?