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Should grief be treated as depression?
The proposed new depression diagnosis would no longer exclude bereavement grief from its definition.
Fri, Jan 27 2012 at 8:00 AM
Sad doggie

Photo: julka76/sxc.hu

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?

The opinions expressed by MNN Bloggers and those providing comments are theirs alone, and do not reflect the opinions of MNN.com. While we have reviewed their content to make sure it complies with our Terms and Conditions, MNN is not responsible for the accuracy of any of their information.

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Comments: 2
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anonymous
Jane Jan 27 2012 at 12:15 PM
I disagree that grief should be treated as depression. Grief is a natural emotion, that stems from our love for, for instance, our parents. When they pass away, there is a natural process of grieving which goes through certain steps. At the end of the grieving period, most people are healed and can move on, if always saddened by the loss. Now for some people, grieving can become depression, and I would welcome more awareness of this. Spouses should be aware of subtle signs that it's not just sadness,
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and parents with children too, and other family members. I would be concerned with the change because most people are going to suffer grief in their lifetime, and 1) they shouldn't be pigeonholed as "having a psychiatric illness" for grieving - thus giving their insurance company a reason to increase premiums, or their HR department to make a note on their file, or anything that could begin deleterious to their future. For 2) it opens the door to granting medication or suggesting medication as soon as a person is bereaved, when they actually *need* to process the grief, rather than have it numbed by drugs. I lost both of my parents 5 and 6 years ago respectively, and it was very hard, and at one point there was depression involved, but to say I was always depressed would be wrong, and I wouldn't like to have myself "labelled" as depressed when during the most of the grieving process, I was actually just "sad".
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jsavedge's picture
Jenn Savedge Jan 27 2012 at 2:30 PM
Thanks for your comments Jane. I agree with you that grief is a natural emotion and that it shouldn't necessarily be labelled as depression. But in the scenario I'm thinking of, a relative of mine lost her spouse. Her grief was intense, affecting her work, eating, sleeping, and relationships. After 6 months, she was still in terrible pain and many people suggested counseling, but bc her "depression" stemmed from "grief" the counseling was not covered under her insurance. So she could afford
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to go. Did she eventually recover? Yes. But honestly many years later it is still touch and go for her. I think she would have greatly benefited from therapy to help her in her healing process. Not everyone who suffers grief will also suffer from depression, but I think excluding grief from the depression does more harm than good.
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