Wednesday, 25 January 2012

Should grief be categorised as depression?

There is a guide to bereavement in the United States of America called the Diagnostic and Statistical Manual of Mental Disorders or DSM for short.  This manual is designed to help doctors diagnose when someone has depression and give guidance to help them treat it. 

The DSM currently excludes bereavement as a form of depression, but the American Psychiatric Association is proposing that the fifth edition no longer excludes bereavement as a form of depression.

There is going to be a lot of debate between practitioners and researchers over the coming months and I'm sure both sides will have good reasons to have bereavement within or without a classification of depression.  Here's what I think.

Bereavement, or grief by any other term, often includes depressive symptoms such as sadness, difficulty sleeping, decreased appetite, fatigue, less interest or pleasure in usual activities.  This is normal, it would be weird if people did not experience these symptoms after they loose someone they love.

People move through the various stages of grief in their own time; with sadness and depression one of the normal aspects of bereavement.  Most people move through this without any specific help required, and only if they get stuck might then need professional help and possibly treatment for depression.

If the whole process of bereavement is classified as depression then it may be seen as something which is abnormal, which most people can cope with; this is basically unhealthy and would likely result in less understanding of grief.

However, if those who are bereaved were allowed to reach out for help when they feel uncontrollably depressed then this might be useful.  I know people who get stuck in the depressive stage of grief and need some additional support; perhaps this would be easier to access if it was diagnosed quickly.

As you can see I am conflicted.  I am 99% sure that grief and bereavement should not be categorised as depression but seen as a very normal and necessary part of life.  But 1% of me would like to see more support for the bereaved and if depression diagnoses would help then that might just be a good thing.

What do you think?

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