Is Grief a Disorder?
Last updated: Jan 26, 2012
No one argues that grief triggers dramatic changes in emotional state, sometimes including horrible sadness. But does that make it a mental disorder?
Clinicians are skirmishing over the question of whether bereavement (the usual grieving after the loss of a loved one) qualifies as a diagnosis, reports Benedict Carey in The New York Times. The American Psychiatric Association is reviewing changes to the latest edition of its diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). It hasn't been revised since 1994.
On one side are those who say that the current guidelines are sufficient. They say that the definition of depression as now written, which specifically excludes grief, is sufficient. They worry that if this exception is left out, as has been proposed, many of the 8 to 10 million grief-stricken individuals, a third of whom typically have depressive symptoms, will be pathologized -- and their natural feelings treated (often with medication) as if they had a disease.
Those on the other side argue that intensive grief can indeed be debilitating and feature depression, so why pretend it's not a disorder? They say labeling persistent symptoms will help sufferers get the help they need, and perhaps reimbursement for it.
Psychiatrists' wrangling over the question has broad implications, including what insurance companies will cover.
Other changes to the DSM would clarify the definitions of autism, eating disorders, body image disorders, and psychosis. So far, there's not much more agreement on many of those topics than there is on whether grief is normal -- or abnormal.