A change in the official psychiatric guidelines for depression has raised fears that grief over the death of a loved one could to be classified as clinical depression.
The change is contained in new revisions to the DSM-5, a set of standards used to categorize mental illness, and it eliminates the bereavement exclusion, which exempts grieving people from diagnoses of depression for two months unless the symptoms are self-destructive. Now under the changes, depression could be diagnosed more easily just two weeks after a death.
The bereavement exclusion separated the normal responses from the more severe ones, like worthlessness and suicidal impulses. The bereavement exclusion’s removal was announced on December 1, by the American Psychiatric Association, citing that worries of pathologized grief are overblown. They argue that though not all grieving is depressive, grief-related depression isn’t that different from normal depression. As a result, they say the exclusion made it difficult for clinicians to deal with bereaved patients, who legitimately needed help.
The Diagnostic and Statistical Manual of Mental Disorders represents American psychiatrists’ tool for deciding between normalcy and metal disorders. It was first drafted in 1952. The latest changes developed over the last seven years and were recently approved. New conditions include hoarding, severe pre-menstrual syndrome, binge eating, temper tantrums, and everyday forgetting for elderly patients. Critics state that this represents a tendency in modern psychiatry to medicalize the normal range of human emotions.
Editorials opposing the decision have appeared in medical journals like The Lancet and the New England Journal of Medicine.
“Living with grief” by The Lancet, 18 February 2012, The Lancet.
“Grief, Depression, and the DSM-5” by Richard A. Friedman, M.D., 17 May 2012, New England Journal of Medicine.