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Monday, March 21, 2022

"Prolonged grief disorder?"

Back in 2012, I posted about a proposed amendment to the Diagnostic & Statistical Manual (DSM -- used by psychiatrists & psychologists to diagnose and treat mental disorders), which would allow patients grieving a loss to be diagnosed as "clinically depressed" within just TWO WEEKS.  (The previous time frame was two months, and previous to that, a full year.) 

"In other words," I wrote, "after two weeks, grief could be classified as abnormal behaviour. You could be categorized as mentally ill if you're not deemed to be sufficiently "over" the death of a loved one. After just TWO WEEKS." 

Fast forward 10 years.  "How Long Should It Take to Grieve? Psychiatry Has Come Up With an Answer," read a headline in the New York Times this past weekend. The latest edition of the DSM now includes a new diagnosis for "prolonged grief disorder," which would apply to those (an estimated 4% of grieving people) who are "incapacitated, pining and ruminating a year after a loss, and unable to return to previous activities." Its inclusion in the DSM also means that "clinicians can now bill insurance companies for treating people for the condition," the article says.

...critics of the idea have argued vigorously against categorizing grief as a mental disorder, saying that the designation risks pathologizing a fundamental aspect of the human experience.

They warn that there will be false positives — grieving people told by doctors that they have mental illnesses when they are actually emerging, slowly but naturally, from their losses.

And they fear grief will be seen as a growth market by drug companies that will try to persuade the public that they need medical treatment to emerge from mourning.

As in 2012, Dr. Joanne Cacciatore is speaking out: 

“I completely, utterly disagree that grief is a mental illness,” said Joanne Cacciatore, an associate professor of social work at Arizona State University who has published widely on grief, and who operates the Selah Carefarm, a retreat for bereaved people.
“When someone who is a quote-unquote expert tells us we are disordered and we are feeling very vulnerable and feeling overwhelmed, we no longer trust ourselves and our emotions,” Dr. Cacciatore said. “To me, that is an incredibly dangerous move, and short sighted.”

As I said when I flagged this article on Facebook, if they've found some new approaches to therapy that have proven helpful to some people (and if you read the article, it sounds like they have), well, fine. But I reject the idea that there's a prescribed length of time that it's acceptable to grieve, that "prolonged" (by whose standards?) grief is a disorder or mental illness. 

Grief needs to be normalized, not pathologized.

Read the whole article (the comments are interesting too). Your thoughts? 

You can find more of this week's #MicroblogMondays posts here.

3 comments:

  1. There is no time limit to grief. I am in mourning right now. It's been a month. I'm not crying everyday, but the pain is still there. It has lessened but it feels very much real to me.

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  2. I've been thinking about this a lot, which is why I haven't responded earlier. If I get my thoughts straight, I might post them.

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  3. Same with Mali. This is a tough one.

    Perhaps there is such a thing as a healthy grieving process, in which there is a sense of processing -- not necessarily right away, but at least some baby steps over time.

    And while I wouldn't call grief a mental illness, I could accept that getting stuck in grief -- no longer processing it -- can have the same impact as other mental health challenges like depression, and sufferers would benefit from a diagnosis in order to get treatment.

    Much to unpack. The human psyche in all its variations and permutations does not fit into boxes.

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