Diagnosis: Grief?

June 18, 2016

I would like to note that I am not a mental health or medical professional. I have an interest in psychology (I minored in it) and I love to do research, in general.

In late March, a proposal to include a disorder called “Complicated Grief” to the fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-V) made news. The DSM is the tool used by medical practitioners to assist them in diagnosing psychiatric disorders. Currently, there is a “Bereavement Exclusion” in the diagnosis of Major Depressive Disorder (MDD), which indicates to the diagnostician that if a patient has suffered a recent loss, a diagnosis of MDD should be excluded. The concern is that a person with MDD who had not been diagnosed prior to the loss might not be diagnosed and only treated for their grief, and not for their depression. Like many other illnesses, the sooner someone who has MDD is diagnosed, the sooner treatment and healing can begin, and the more successful that treatment will likely be. The other concern from a clinician’s standpoint is that the severe symptoms of grief, if suffered for an extended period of time, could be ignored or ascribed to some other disorder. Studies have found, for instance, that grief does not respond well to traditional antidepressant therapy. These concerns seem to make sense, on the surface. But, in a time when it seems that everything is a “disorder”, and prescriptions for psychiatric medications have increased four-fold in the last ten years, one must consider what the benefit is to create yet another disorder for something that everyone experiences in their own way and on their own timetable.

The article in Slate posed this very question of whether or not it was wise to stigmatize grief—an experience that is truly universal. Everyone will lose a loved one or friend at some point in time in his or her life. And he or she will grieve (unless they are incapable of feeling emotions, and that in itself would indicate a mental disorder!).

So what makes grief go from ordinary mourning and bereavement to “complicated”? The full criteria can be found here, but, in a nutshell, there are a few criteria, aside from the amount of time (more than a year has passed since the death) that distinguish “complicated” grief, from plain, old, garden-variety grief: the bereaved has more bad days than good, the feelings and symptoms of grief interfere with normal functioning, and the bereaved feels life is meaningless and wishes to die in order to be with the deceased. These things seem fairly reasonable as a cause for concern, right?

If you’re a bereaved parent, that may not seem reasonable to you at all. As a bereaved parent myself, I’ll explain why.

What if you didn’t start to experience these things until a year after the death? My son died in February of 2010 from complications due to CHD. He was 10 days shy of four months old. It was traumatic and shocking, even though we knew he was very sick. I was numb for nearly a year. I had two other children and responsibilities to take care of. I also had a health issue of my own 9 months after he died. I didn’t have time to really grieve him, and I didn’t appear to be able to, anyway. A year later, I began to fall apart. My brain was finally ready to process what had happened. There were more bad days than good. And what parent hasn’t wished for just a moment to be with their deceased child—even if it meant dying?

I could have been diagnosed with complicated grief. But what I really had was delayed grief. And I sought out help, because it was becoming a problem for me. After three months of therapy, I was ready to start remembering my son more than I mourned him.

I am concerned about people who are only processing the death of their loved one in their own way and their own time being treated as though they have a disorder rather than just being given the tools to learn how to grieve and remember in a constructive way. Slapping a label on a person who has sought out counseling or treatment for grief seems, in many ways, counterproductive, especially for grieving parents, who already feel stigmatized for having experienced something so “unnatural”. Grief is a lifelong journey and the manner in which it unfolds is as unique as the individual who experiences it.

What do you think? I would love to read your comments and to answer any questions you may have based on my research. There was much I was unable to include here for fear of boring our dear readers, and would love to discuss it further!

  • Rachel Kain works in IT to make ends meet, but her real passions are writing, music, food, and yoga. She blogs about motherhood, CHD, child loss, and anything else that interests her at Writers Write. Follow her on Twitter: @rjkain

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