Speaking from experience, I can tell you that when someone you love passes away, it can utterly and completely knock the wind out of you. A loved one's death leaves you sad-beyond-sad, to the point where it affects your sleeping, eating, relationships and work. It's depression. But until now, "bereavement grief" has been specifically excluded from the definition of depression. That may change soon.


You probably know from the recent uproar over the proposed changes to the definition of autism that the American Psychiatric Association is taking a look at many diagnosis definitions as it revises the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, or DSM, for the first time since since 1994. The DSM is the standard diagnostic reference for the mental health field, essentially determining who gets what treatment and for how long.  


Under the current definition of depression, diagnosis requires that a person exhibit at least five of nine symptoms — which include sleeping problems, a feeling of worthlessness and a loss of concentration — for two weeks or more. Bereavement grieving — the type experienced after the loss of a loved one — is specifically excluded from this definition. The proposed new definition of depression would no longer include this exclusion. Thus grief would now, diagnostically speaking, be considered a form of depression.


I would argue that this is a good thing. The depression that accompanies grief, even though it may fade more quickly than traditional depression, is not something to be taken lightly. Those who experience this type of intense grief may need medical intervention, i.e. therapy and medication, for their depression. And without a diagnosis, this type of health care would not be covered.


I am not a mental health professional, and though many in the field agree, others do not. A new report, by psychiatric researchers from Columbia and New York Universities, argues that if the “bereavement exclusion” is eliminated, “there is the potential for considerable false-positive diagnosis and unnecessary treatment of grief-stricken persons.”  The concern here is that someone who is experiencing normal grief will turn to medication rather than deal with the loss. And the drugs for depression can have very real and very intense side effects, including low sex drive and sleeping problems.


Do you think grief should be considered — and treated — like depression?

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