Should grief be classified as a mental illness? Editors from The Lancet, a highly regarded medical journal, argue no.
The recently published editorial warned against prescribing antidepressants to treat grief, arguing that "medicalising" a normal human emotion is "not only dangerously simplistic, but also flawed".
The warning has been prompted by the release of the draft version of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In this upcoming edition of the 'psychiatrist's bible' there is no exclusion for bereavement in the diagnosis of a major depressive disorder.
This means that "feelings of deep sadness, loss, sleeplessness, crying, inability to concentrate, tiredness, and no appetite, which continue for more than 2 weeks after the death of a loved one, could be diagnosed as depression, rather than as a normal grief reaction."
Dr Astrid James, deputy editor of The Lancet, said it seemed "far too early" to classify someone as mentally ill two weeks after the death of a loved one.
"We need to be careful not to overmedicalise experiences that are part of normal living, and to make sure we allow people to grieve rather than try and suppress it or treat it," she added.
Previous editions of the DSM editions have highlighted the need to consider, and usually exclude, bereavement before a major depressive disorder is diagnosed.
View related article: Grief: coping after someone has died
Australian psychiatrists contribute to the DSM and use it as their standard for diagnosis. The manual is also of great influence around the world, although the World Health Organisation has a diagnostic manual called ICD-10 that lays down criteria for mental illness diagnoses which has significant differences.
The editorial claimed that doctors "would do better to offer time, compassion, remembrance and empathy", than diagnose pills.
It concludes: "Grief is not an illness; it is more usefully thought of as part of being human and a normal response to death of a loved one.
To find out more about grief visit The Australian Centre for Grief and Bereavement website at www.grief.org.au or phone 1300 664 786 within Australia.
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