By David Joel Miller.
Should bereavement, grief, the loss of a loved one be a mental illness?
How we see the death of a loved one is a real problem for our society. Loss of a loved one is for many people the most traumatic event in their life. Grief and loss is an important topic. There are a gazillion books on the subject and plenty of therapists who say they specialize in “grief work.” We know that the closer the person is to you the worse the loss.
But is bereavement, grief, the loss of a person, loved one or relationship a mental illness? Should it be?
Death and dying are something we don’t like to look at if we can avoid it. Most people die in hospitals behind closed doors. We consider death like birth a part of a human condition. It doesn’t seem right to make every emotion, happy or sad, suspect as being unacceptable. Should mental health help people avoid feelings or face them?
Professionals are just as confused about this as anyone else. Up till now we specifically excluded grief as a diagnosable mental illness. This is a controversial issue among psychiatrists and therapists.
When someone dies do you get depressed? Should you? Bereavement is specifically excluded from the criteria of Major Depressive Disorder. So if you get depressed because your favorite T. V. show was canceled you can be treated for Major Depression but is a family member dies it is not by definition a mental illness.
In the revision of the DSM, as we move to the DSM-5 in the middle of 2013, the professional community is trying to find a solution to the whole grief and bereavement problem. So far there is not much agreement.
Sometimes professionals get around this in various ways. They wait a while and then say this is going on too long and then give the diagnosis of Major Depression anyway. There are some professionals that say that we should just delete the exclusion. Depression is depression they say. So let everybody be depressed if they want to.
The contrary to that is that including people who are depressed because of bereavement may be enlarging the category, increasing the number of people who get treated for depression and making a normal human reaction to loss into a mental illness.
Some people want to exclude bereavement for the first year. If you are sad more than a year after the death of a loved one maybe we would want to offer you counseling. Depending on how sad you were, is it really depression?
Currently, Grief is included as a V code. V codes are those things listed in the back of the book like parents and children who can’t get along that are sometimes treated but we don’t specifically count these as a mental illness. (In the DSM-5 the V codes became Z codes.)
I wrote in a previous post about the movement, coming from outside the APA, to add a new disorder called “Complex grief” as if this is somehow different from regular grief.
So how do you deal with grief? Is it normal or a mental illness?
See also: Bereavement, grief, and loss
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