Psychiatrists to brand grief lasting longer than two weeks a mental illness

[The Straight Story]

THE grieving process is in danger of being branded a medical condition if a mourner feels sad for more than two weeks and consults a GP, according to an international authority on death and dying.

At present, mourners can feel sad for two months before being told they have a mental disorder, says Professor Dale Larson. Decades ago, a diagnosis could be made after a year.

In a keynote address at an Australian Psychological Society conference in Melbourne on Saturday, Prof Larson will express his anger about the American Psychiatric Association's new diagnostic manual, DSM 5, which is used in many countries including Australia and New Zealand.

The manual, to be published in May, allows a diagnosis of depression after two weeks of grieving.

According to Prof Larson, the manual undermines the legitimate feelings of the mourner and the help available from family, support groups, clerics and professional counsellors.

http://www.news.com.au/lifestyle/health-fitness/psychiatrists-to-brand-grief-lasting-longer-than-two-weeks-a-mental-illness/story-fneuzlbd-1226583559397

[MadHound]

1. That way they can charge you the big bucks to put you on those happy pills,

You know, the ones that increase your chances of committing suicide.

Idiots, absolute idiots.

[pediatricmedic]

7. That is not how the pills work

There is generally a two to three week time before you see a therapeutic effect from the pills. During that time, you start to have more energy and feel less lethargic. If you have suicidal ideation and a plan, you now have more energy to carry those plans out. The desire to commit suicide is pre-existing before the medication is even started.

Any clinician worth their salt will be asking about suicidal ideation and plans before prescribing these pills.

Given the time it takes to see a therapeutic effect, these pills will not be prescribed for short duration events.

[nebenaube]

34. I beg to differ

That's possible but not the rule.

[elias7]

129. That's a fact, not an opinion

What rule are you referring to?

[pnwmom]

64. But grief after the death of someone close is rarely a "short duration event."

That doesn't mean it's pathological, or should be treated with drugs.

[SwissTony]

125. Two years ago, my sister and I were talking about the death of my brother who died in 1974....

aged 13. We both started to tear up.

It never goes away.

Neither she nor I have felt that as a form of depression and the idea of being some drug therapy for our "condition" is ridiculous. It's just human nature.

I'm sure many on this board will have had similar experiences (unfortunately).

[pnwmom]

126. Yes. My mother, many decades later, can still feel that way about a baby she lost.

But she isn't depressed or in need of medication.

[Th1onein]

95. I'm glad you think you know how these pills "work...."

But I think you are totally wrong about this.

I lost my son to cystic fibrosis over 14 years ago. I STILL mourn him. I love him and always will, until the day that I die. And I will grieve for him for the rest of my life. Who do these people think they are to label those feelings as a mental illness?

I have taken these "pills" previously. I had an adverse reaction to them--akathisia. Akathisia, it is thought, is the state that actually leads people to want to kill themselves and act out violently towards others. I was lucky enough to know what was happening to me and lucky enough to have it happen early on in the course of my "treatment" with these pills, so that I could get off of them, and simply wait out their effects. Some people are not so lucky.

I am absolutely against arming anyone, even the police, even the military, so I'm far from a "gun nut," but I believe that the reason for the increase in these mass killings--rampage killings, like Columbine, Aurora, etc.-- is the adverse effects of these drugs.

And, now, these people who stand to profit enormously from the sale of these pills, and who are even now, administering these drugs to our most helpless --children-- DESPITE the danger, want to label anyone who is mourning for more than two weeks as mentally ill, so that they can administer these drugs to them, as well?

I think not.

[davidthegnome]

97. I am sorry for your loss.

Those words are so inadequate. From one parent to another, I can only imagine your pain. I have a son I have not seen for a long time, but some day maybe I'll be able to. To know that he was gone would devastate me utterly.

I'm taking those pills. An SSRI, particularly, due to a diagnosis (fourteen years ago) of PTSD. I've definitely had my ups and downs with them, and the side effects can be ugly... but I never had anything like what you describe happen to me. I am so sorry you had to suffer through that. I know what it's like to suffer in silence, alone inside your head, when everything seems so dark, so hopeless, so agonizing. When pouring milk over your cereal in the morning seems like climbing a mighty big mountain...

Two weeks for a diagnosis of some form of mental illness... as a result of grief... is bizarre. It is completely and utterly inexcusable and a symptom of a psychiatric industry gone absolutely frigging bonkers. Some solutions only add to the problems they claim to be trying to solve. Some solutions are so far from practical, so far from positive, that it's absurd that any thinking person can take them seriously.

This is one of those "solutions". No one has a right to determine what is a "healthy amount of time" to grieve. It sickens me.

[Th1onein]

113. Thank you, davidthegnome. I hope you know that I am not saying that some people

do benefit from these drugs. The problem is that so many are not followed closely and when the adverse effects happen, well......you have an Aurora-like event. It's just a tragedy all around. And, now, with these new "rules," it looks like there's going to be even more of these little pills handed out. I dread seeing the headlines.

[treestar]

44. Don't agree about the suicide, but do agree about selling the pills

Traditionally the mourning period was one year - that seems a lot more reasonable to me. People are supposed to be over it in two weeks? No way. There's every first holiday, birthday, without them, etc.

[pnwmom]

65. I agree. The "traditional mourning period" reflects reality.

Even as a child, when I lost a grandmother, I remember realizing one day that I could finally think about her and not cry -- and that was about a year after her death.

For the death of a spouse or a child, I'd imagine natural grief could be even longer. That doesn't mean it should be medicated away.

[treestar]

90. Exactly, grief is not depression and needs no medication

If the grieving person has a sense they cannot cope with the grief, then some medication might help. Depression is when you feel you can't handle things.

[markpkessinger]

103. Grief can indeed trigger a major depression . . .

I speak from experience. In 2000, I lost both parents to lung cancer, 12 days apart: Mom on December 13, dad on Christmas day. Both died at home, as was their wish. During their last two months, I was their primary care giver, with significant assistance from my four siblings and from the hospice nurses that visited, at first 3 times a week, and then on a daily basis as we got closer to the end. My siblings and I were all present with both parents when each of them passed. I could not function at a remotely normal level for nearly two years afterwards, and it was a full three years before I got back to feeling fully back to normal. I received counseling, but no medication. (Indeed, my therapist said I was exhibiting signs of post-traumatic stress syndrome.) About nine months after my parents died, I wound up losing a job because I couldn't function at an acceptable level. I was failing to respond to emails, missing deadlines, going into work and keeping my door shut all day long, and yet somehow I wasn't even aware of my lack of functioning. I was in a complete fog.

One of my sisters, then a high school English teacher, was having a similarly hard time and, like me, thought she was functioning just fine. In her case, a very sensitive and observant principal, whose own wife had gone through something similar, realized what was happening, and one day pulled her out of class and told her she was, from that day through the remainder of the academic year, placed on medical leave. He also got her in touch with a very good psychotherapist, who, in consultation with a psychiatrist, did indeed place her on an anti-depressant regimen, which she remained on for a couple of years. It helped her immensely.

I would urge caution before presuming to declare what grief "is" or "isn't." The grieving process is unique to every person, and some may indeed need some help in getting through it.

[davidthegnome]

110. Yes, it can.

In theory, there are quite a large number of things that can trigger any kind of mental illness, including depression. My thinking is that the label is given too easily, too quickly, without enough study, without enough consideration.

I was fourteen when I was diagnosed with PTSD (this was fourteen years ago now) and it took less than an hour. A nice man in an expensive looking suit asked me what was going on in my life and how I felt about it. He seemed considerate and kind. He pulled out his pen and wrote a prescription for zoloft, telling me that it was non habit forming and that the side effects would be mild. I have no idea what the price was, but I know that, today, an hour meeting with a psychiatrist in the town I grew up in costs 300 dollars or more. Three hundred dollars. For one hour of someone's time. I'm rather cynical when it comes to psychiatry in general, because true therapy, psycho-analysis... was not used with me. There was no dedication from any staff, no true follow up or real lasting concern about what happened to me, or how I reacted to the medications. It was, "Take this and go home. See me in a few months. If you can afford to."

It took less than an hour to determine that I was a good candidate for a powerful, mind-altering drug that I have struggled with ever since. I couldn't begin to describe, in just a few paragraphs, how much I've come to hate it and rely on it. It helps treat the symptoms - but it creates it's own issues via side effects. For instance, unless I am severely and completely emotionally overwhelmed in a very brief period of time (which rarely happens) I cannot bring myself to cry. This is not a good thing.

Anyhow, back to the topic at hand... do you think two weeks of grieving is enough to determine whether someone is mentally ill? Do you think one hour is enough? I'm assuming we're both well aware of the diagnostic criteria.

There is a difference between grief and mental illness. Grief is a natural way of letting go of friends, family, pets, loved ones. Mental illness is generally described as a chemical imbalance within the brain.

Psychiatric medications can help, they can help a lot. At the right time, when used short term. In the long term though, they can be devastating. I know. I am one of those people that slipped through the cracks.

[treestar]

145. Yes there is a difference

between mental illness and normal emotions. The pharma industry would love very negative emotion to be treatable with pills.

[pnwmom]

121. Yes it can. I think what people were objecting to was the idea that grief lasting more

than a couple weeks meant something was wrong.

[msanthrope]

139. No--you AREN'T supposed to be over it. That's what this designation says--some people cannot

function after two weeks, and these people can and should benefit from mental health therapy--they should benefit from extended leave, therapy, therapeutic assistance, and in severe cases, drugs and disability.

This is an additional code for people to get help.

[Sekhmets Daughter]

52. It's all about the shareholder value...

I would call them much worse than idiots...Doctors who bow to the will of the pharmaceutical companies are being criminally negligent!

[msanthrope]

138. I think that's a facile way of regarding this--family leave, therapy, therapeutic assistance,

are all benefits that can be justified using this code....

This is a positive--it's admitting that the normal grief process does take more than two weeks and people are entitled to benefit from their insurance companies. They are entitled to more leave, and therapy. They are entitled to mental health care.

[green for victory]

2. and that means...

More Drugs! In the middle of a Drug War!

this is Insanity on Display

So- you kill yourself because of the drugs you will now be prescribed because you are mentally ill due to depression, you won't be depressed anymore. Does that count as a "success"?

[TexasBushwhacker]

50. Children, adolescents and young adults

It's right there in the first sentence.

[adigal]

98. This is not helpful, many people take anti-depressants safely

I bet you more people die from that dangerous drug, aspirin, every year. Sensationalism, don't give it merit.

[steve2470]

131. agreed about the overall safety of antidepressants nt

[WinkyDink]

3. That should be "Two weeks or as soon as a TV reporter sticks a mic in your face."

[Jackpine Radical]

4. Two points:

1) It is a travesty to turn ordinary grief into a mental disorder.

2) This travesty is inspired by our for-profit health care system, which will not reimburse a therapist for treating a problem such as grief without a diagnosis.

The reality is that grief is not a mental disorder, but therapy is often very effective in helping people go through the grieving process. Medications may or not be warranted in a given case (imhpo usually not), but that should be decided on a case-by-case basis, and generally only in combination with talk therapy.

Edited to add: This is another outgrowth of our culture's crazy insistence on trying to force emotional issues into a medical "mental health" model, and for only paying for treatments that are at least nominally aimed at "diseases."

[Flying Dream Blues]

11. This

You've got to have a "diagnosis" in order for your insurance to pay for therapy and/or meds. I agree that both are often useful for people going through the trauma and loss of grief.

[pinboy3niner]

18. +1

Ordinary grief is a far different thing from the grief that is a component of PTSD. Most trauma survivors probably would be happy to have sadness that lasted only a couple of weeks or slightly longer.

[sibelian]

20. I entirely agree.

I also think the idea that happiness is an indicator of good mental health is screwy.

[siligut]

115. You said it

So I don't have to, thanks.

I would add, this may also be an attempt to tell people what their feelings should be.

[steve2470]

118. I agree

I think doctors and other health care providers need to actively guard against the conflation of major depression with grief. As I said in a post downthread, if someone is unable to function due to MDD symptoms, diagnose and treat that, NOT the grief.

[sibelian]

135. +1

[msanthrope]

142. Point #2 is the Winnah!!!! You don't get medical leave, therapy, disability, without a diagnosis or

code. And many people might shy away from being labelled 'depressive.'

I hope this expands mental health therapy for those people who cannot get back to 'functioning' after two weeks.

[OceanEcosystem]

5. Oh, come on.

It's perfectly normal of people to feel emotional pain and grief for MUCH LONGER than two weeks after the loss of a loved one.

[Samjm]

6. 2 weeks?

Yeah, tell that to my cousin who lost her 2.5 yr old son to a very virulent brain tumor (6 weeks from diagnosis till death). She's finally somewhat functioning again a year later.

[R B Garr]

21. A year is what I had learned it takes just to get over the shock

One year is also the time limit that it takes to get over all the first anniversaries without the loved one such as birthdays, Xmas, etc. Two weeks is nothing. You still think they're going to be walking through the door or calling you or doing the things they always did.

[OldEurope]

41. This is what I learned!

A year at least!

[markpkessinger]

109. There is no set time period...

...It depends on many, many things. After losing both of my parents to lung cancer in 2000, just 12 days apart, it took me nearly two years to begin functioning at a remotely normal level, and closer to three before I really felt like myself again.

[WinkyDink]

75. My question is: Where did they pull this length of time from, besides their arses?

[elehhhhna]

111. Well, if they picked "one week" or "five business days"

it would look shady?

[malaise]

8. Big pharma has drugs to sell

Get over your grief or get that prescription.

The fuckers are the ones who need medication.

[OhioChick]

27. +1000 n/t

[sibelian]

9. Well, there it is.

I did wonder, but now I'm sure.

[VenusRising]

10. They would lock me in an institution, then.

It's been three years, and I still have feelings of sadness about losing my husband. I still see a therapist for grief counseling. I'm not sad every day, but I have my moments.

[Flying Dream Blues]

14. I totally understand.

I remember even though I was much better, the fog of sadness didn't really lift until about the 5th year after I lost my son. I also went to grief counseling regularly. I'm glad you are feeling better; it really does take time.

[VenusRising]

17. I'm sorry about your son.

Losing those that are so close to our hearts is devastating.

[pipi_k]

93. It does take time...

and it never really stops, IMO.

I lost a child 38 years ago. I was still actively grieving 7 years later.

And even now, while the pain isn't as sharp, there is a place in my heart where the pain still lives, poised to leap out when I least expect it.

It took me over five years to mourn my father's death.

My younger brother died two years ago this month. It hurts so much I can't cry even though I feel like I want to...

It seems like grief gets harder to deal with the older I get.

Or maybe it's the losses piled on losses piled on losses...

I'm so sorry about the loss of your son.

[vankuria]

134. So very sorry for your loses...

I think someone would be mentally ill if they didn't feel the sadness of loss. Especially if it's a child, I can only try to imagine the pain. I lost my Mom who I was exceptionally close with, it'll be 2 years in May, and I still mourn for her loss. I will always miss her and wish she was here. It doesn't mean I'm mentally ill, just that I miss her and love her so much.

I wish these so called "experts" would shut up and quit telling people what's "normal" and what there supposed to feel.

[The Straight Story]

15. Been 8 years since we lost mom

Two nights ago had a dream she was here and alive somehow. I was so happy. A dog I had lost came home as well.

I asked someone in my dream how this could be. I knew mom had died and we cremated her but here she was. I then asked myself what if this was all it dream because it was wonderful and I was so happy. But it couldn't be a dream because here I was, etc.

Then I woke up. It was like losing her all over again.

Such dreams happen about once a month. Other dreams she is in and she and I both know she is dead and that it is just a dream. Some don't 'feel' real at all. But some, like this one, felt absolutely real.

Still miss her but don't dwell on it all that much usually. But I can't control those dreams.

[VenusRising]

19. I've had those dreams where it felt like he was right in front of me.

I hate waking up from those. I want to stay there with him forever.

[CrispyQ]

119. ...

A heartfelt acknowledgement to you & those who responded to your post.

[Kalidurga]

12. I don't know the absolute of when is too much time to grieve.

I know of someone I used to work with that has held on to grief for over 20 years. I think that is too much time and should have been treated a long long time ago. I also think it matters how a person is grieving to say when is too much time. If a person is grieving in a destructive way i.e. with alcohol, gambling, dangerous behavior, overeating, lashing out, etc, then intervention should be done as soon as possible. Two weeks might actually be a good time to intervene. But, if a person is just taking a little longer to be happy again, two weeks is probably way too soon to ask for someone to just go back to normal. But, I would expect significant improvement in someone's mood after 2 month's like they can laugh at jokes again and get up and going a lot easier. I still wouldn't expect a person to be completely through the grief process. I am not even convinced it should be over in a year, but things should be improved to the point that life is going on and the person isn't going into bouts of depression over ever reminder of the trauma.

I think it's a very individual thing and I think it is going to be in direct proportion to the loss and the circumstances of the loss. Sudden death seems to be one of the harder things to deal with especially when it's occurs somewhere that is considered safe. I am thinking of all the mass murders we have heard about from Arizona on to Sandy Hook. I really wouldn't expect the people who lost someone there or even those that have been injured or those who were there but survived and without injury to just be able to go back to a normal state of mind in just two weeks. I wouldn't even expect them to be completely right in a year. I would expect a lot of improvement though.

I think grief is too personal and too complicated to put on a time line. I do think that if people are concerned about an individual in the grieving process they should ask that person to seek help in a very gentle way. And very gently try to figure out what is going on and asses how it's affecting that person's day to day life. But, to label someone with a mental illness after two weeks without a complete history and assessment of the entire situation seems a bit wrong.

[undeterred]

13. Shallowness: the new normal

[sibelian]

16. When did sadness itself become an ILLNESS?

Depression used to be the chronic inability to feel happiness, and in fact, an inability to feel "properly" sad. This has somehow been allowed to overlap with ordinary emotional states.

I really think this is just grotesque. Who are psychiatrists to tell anyone how to feel?

[reformist2]

25. Since we became a Brave New World. Sometime after 1984, coincidentally...

[sibelian]

29. It's so HIDEOUS.

I read Brave New World again recently. I read it in high school for English and wasn't particularly struck by it as anything other than a fairly interesting set of metaphors, this time round I read at 42 and went "AAAAAAAAAAAAAAAAAAAAAAHHHH! OH MY GOD, HE WAS RIGHT..."

[reformist2]

35. I find BNW much more disturbing than 1984, because people do it to themselves.

I understand that the pain of negative feelings is sometimes so awful, that people will take anything to make it go away. I get that. The only problem is, when you take away all the negative emotions, I don't think you can truly have any positive ones, either.

[sibelian]

46. I agree wholeheartedly.

Particularly in light of recent experiences (last year or so) in trying overcome "depression" and finally letting go of antidepressants. All my "depression" came from silly ideas about myself and the world I was living in.

I do also think BNW turned out to be far more plausible and vastly more sinister than 1984, I now realise later on in life that it was touching on something considerably more fundamental than my 14 year old self understood...

[snooper2]

120. about the same time schools banned dodge ball

[sibelian]

128. :)

[undeterred]

22. Grief is a social process

and the one thing our society does not have ways of doing is allowing people to grieve for an extended period of time. When someone dies, everyone tends to show up and express condolences for the first week or two, and then everyone becomes scarce. People even avoid the bereaved or treat them like they are fragile.

I had a friend who lost her husband. She had been married to him for a couple of years and lost him to cancer. It was her second marriage and it was a very happy marriage. For reasons I don't remember I missed going to the wake and funeral, but I called her to express condolences and then I invited her to go to dinner about two months after his death.

Well we ended up spending the entire evening together. She brought out all the pictures of them and she talked about him for hours. She didn't cry. She just talked and talked and I listened. I had been feeling guilty about not being there for the wake and the funeral, but then I realized that she really needed me right now just to sit and listen. And it wasn't hard at all. I don't think she even noticed who was there the first few days after he passed. And a few months out, she felt like people were avoiding her.

After that I often thought there should be a signup sheet at the wake or funeral. Instead of everybody expressing their condolences the first week.... everyone call the person and make sure someone is giving them a shoulder to cry on during that whole first year without them even asking for it. That is the way to have a healthy grieving experience.

[The Straight Story]

31. Have to agree with you

When mom died it hit me terribly hard. I had just moved into the house next door to her after not seeing here a lot over the years (since I lived all over Ohio and California) and we were enjoying each other. 3 months later she was in the hospital and died not long after that. Had my dream job, house, car, married and wonderful daughter, and things were all good.

My brother/sister/dad/nieces/etc all seemed to pretty much get over it after the funeral. I was still devastated. Their advice 'just get over it, she is in a better place, drink some green herbal tea, quit thinking about it, etc'.

My first mother's day without her I made a video tribute to her which I eventually put online. My x was mad at me for not doing more for her that mother's day. My family told me I shouldn't dwell on it, etc.

Now years later I am much better and some of them are now having problems from burying it all. I get upset a little on the anniversary of her death (new year's eve) but pretty much I went through grief stages, got counseling, and worked through it over time - but the people closest to me made me feel bad about it.

All this was compounded with mom's best friend dying a few months later and my first x dying shortly after that and me finding my kids after 10 years.

Grief can be a lonely hell hole when people try to get you to suppress it because they are feeling it differently than you and do not try to understand (and with one exception they are all rabid rw christian fundies....whose answer to everything is suck it up and bury things)

[undeterred]

37. Grief is work.

And if you don't do it right away, you'll have to do it later. I think that's true whether you are grieving the breakup of a relationship or the loss of a spouse or a parent. Your brain needs to process these things. It cannot be done in a week.

When my father died suddenly I actually had a doctor who prescribed spending a lot of time thinking about my father. I love him for that - its exactly what a doctor should say. And he was right.

[Cleita]

23. They must be right wingers. Only right wingers have no feelings and

think that people can get over the loss of loved ones in two week.

Disgusting!

[Demeter]

79. Or psychopaths

oh, same thing, sorry....

[reformist2]

24. Sounds like it's designed to match a typical employee's vacation time. Hmm...

[Nite Owl]

26. It's been almost

18yrs since I lost my husband and I still have bad days. I don't think I ever worked through it as my kids were young and I had to bury it all. It's different for every person.

[cbayer]

28. Just to be a devil's advocate here for a moment...

The problem previously was that people experiencing grief were excluded from receiving a diagnosis of Major Depression. While highly controversial, this may allow those who have developed symptoms that exceed what one might expect for normal grieving to be given a diagnosis. That may give them insurance coverage that they might have been denied without a diagnosis.

[sibelian]

32. What's "normal grieving", cbayer?

How does one go about establishing a benchmark for how important someone should be to you, and thus how long it takes you to honour their death?

As far as I'm concerned this whole idea comes from the referral to grief as a "process". It's awful, like human emotions are cans of corned beef coming off a conveyor belt...

[cbayer]

48. Normal grieving is variable, but shares many "symptoms" with major depression.

However, if normal grieving becomes life threatening, there may be a need for intervention.

It's not about setting benchmarks for the importance of the lost individual or the time frame for mourning a loss, but about the severity of the "symptoms".

[sibelian]

54. Why have you put inverted commas around symptoms?

I'm sorry but I'm going to push you on this - do you regard the emotional consequences of death as pathological or not? I can't see a "segueing" into "pathology" ever really being a meaningful way of describing grief, if that's what you're suggesting.

In the absence of a diagnosed co-morbidity like actual major depressive disorder I don't see how you can arbitrarily draw a line between "pathological" and "non-pathological" emotions around a life altering event like death. I see that those considering ending their own lives rather than continuing with grief might need help, but I don't see that delegitimising the cause of those emotions by conflating them with mood disorders is actually helping. And I really can't see how you can divorce such emotions from their cause, which is the significance of the lost person to the grieving individual, without delegitimising them and thus causing more stress to the grieving individual...

(Anyway, I imagine if you're talking about people driven to suicidal ideas as a result of loss we're getting away from the subject of the OP, somewhat...)

[cbayer]

59. Because symptoms are associated with illness, but these same things may

be experienced during a period of grief and are not symptoms of illness at all, but expected.

It is a fact that some grieving can become pathological. Someone might become suicidal, stop eating to the point that they are in danger, begin using drugs or alcohol in a way that puts their lives at risk. The rates of death of a surviving spouse in the first year after their loss is very high. Some people may even develop psychosis which could place them, and even others, at risk.

I think you have missed the original point. If someone develops symptoms severe enough to qualify for a diagnosis of depressive disorder during a period of grief, they were previously excluded from receiving that diagnosis. That might lock them out of life saving treatment.

Nothing about this side of the argument delegitimizes the cause or divorces the syndrome from the trigger.

Although I understand why this is controversial, I believe the intent was to provide a way for those that have become seriously ill as a result of a loss, a pathway to what may be life saving treatment.

[sibelian]

123. So - a safety net for people *actually* suffering from major depressive disorder...?

Perhaps not a bad idea in principle, but how does establishing an arbitrary time limit for grief help with this?

What you're describing clearly should be a solvable quandary, but the two week limit for grieving is a horrible solution. These new diagnostic guidelines will start to subject people undergoing ordinary emotional reactions to the same stigma that other people with genuine mental health problems already face. Why can't the exclusion from a diagnosis of genuine major depressive disorder in these cases simply be managed better? You detail some effects of grief and/or depressive disorder that are threatening to life - why can't these effects themselves be taken as sufficient to validate a diagnosis in cases where actual mental illness has resulted from grief? Why must ordinary human behaviour be re-classified and our perceptions of it distorted?

I believe that your position is very well-intentioned, cbayer, for which I respect you, but it seems to me that this solution is like using a sledgehammer to fix a music box.

[cbayer]

136. Perhaps you misread. This doesn't set an arbitrary time limit for grief at all.

The headline is misleading. The idea here is not to automatically move people from the category of grieving to depression after a certain amount of time, but to allow people to receive a diagnosis of depression at any time (after 2 weeks) if they develop significant illness during a period of grief.

Nowhere does this say there is a two week limit on grieving. That would be absurd.

[OldDem2012]

30. Well, I guess I've been mentally ill three times in my lifetime following the passing of....

....my sister in 1980, my mom in 1996, and my dad in 2009.

Who gives these idiots the right to put a time limit on grief?

[sibelian]

33. I want rid of the term "grieving process".

How is grieving a "process"?

[reformist2]

38. The language is designed to make us think of ourselves as little automatons.

Two weeks grieving, that should be enough time to be fully healed... Now back to work!

[Sunlei]

36. oh great, so when do the new 'private for profit' mental hospitals start grabbing federal money?

and state money.

[appleannie1]

39. I must have been mentally ill for years after my son died. You don't get over something

like that in 2 weeks unless you are a sociapath or totally uncaring person to start with.

[HockeyMom]

40. I am sure the familes of Sandy Hook,

Aurora, Columbine, etc., plus the families of 9/11 victims, are all still grieving. Mentally insane? While they will get on with their lives, they will NEVER stop grieving the loss of a loved one especially by an act of violence.

[appleannie1]

87. I agree fully and losing a child changes a person. I think if anyone is mentally ill

it is the nut that thinks a person should stop grieving the loss of a loved one in 2 short weeks.

[adigal]

99. I think about that poor woman on Staten Island, whose two babies

We're swept away from her during Hurricane Sandy. I would NEVER get over something like that. God, what asshat came up with this two week BS?

[LadyHawkAZ]

104. My best friend died in 2004

He was the closest person in the world to me, and it took me five years to finally let him go. Two weeks is ridiculous.

[Tierra_y_Libertad]

42. That gives new meaning to the phrase, "Physician heal thyself."

Does the same diagnosis apply to sad, happy, restless, amazed, frightened, carefree, passive, aggressive, kind, mean, gentle, generous, etc, etc, etc.?

[Matariki]

43. I HATE this about our culture - this is absolutely souless

It's just a way to push pills on people so they can 'function'. Because being a 'productive' worker means not having any pesky emotions beyond the desire to have things.

I'm reminded of a friend of mine from Ethiopia telling me that in that culture when a close family member or spouse dies that the grieving process is expected to last for up to a year - and that grieving process is supported by the community. And that just seemed much more human and psychologically healthy to me.

Even in Eurpean culture in the past the mourning period for a spouse was an official 2 1/2 years - which was shortened to a year after the 1950s

What the hell is wrong with us and our 'move on' culture?

[LadyHawkAZ]

45. What could po$$ibly have brought thi$ $illine$$ on?

I'm $ure they have $ome perfectly valid rea$on for pre$enting an "acceptable" timeframe for grief, but I'm not $ure what it could be. Any idea$?

[green for victory]

56. hilariou$

[HiPointDem]

82. ye$$$$$$$$$$$$$ my preciou$$$$$$$$$$

[Ron Obvious]

47. Amazing...

Same thing happened to a neighbour who last her husband to cancer. She was strongly encouraged to take anti-depressants and then became virtually unemployable because they showed up on her pre-employment drug tests.

Sick.

[sibelian]

53. That is NIGHTMARISH.

There are no words...

[TexasBushwhacker]

49. AND CONSULTS A GP

Did anyone bother to read the article?

[Union Scribe]

66. No, they just read the headline

and went on their woo woo anti-medical profession rants.

[sibelian]

67. Slightly disengenuous as the ARTICLE ITSELF contains the "woo woo" observation

that this strategy is a bonanza for pharmaceutical companies.

[Union Scribe]

70. No, disingenuous is using a move to give doctors

more options in treating their patients to thrust forward people's closet Scientology routines judging/mocking those who use and prescribe medications. (Just like the last time this fauxrage came up here. It isn't a new idea.)

[sibelian]

71. What on earth are you talking about

and how does it relate in any way to the subject of the OP?

[Union Scribe]

72. Do try to keep up

if you're going to reply to me. Read the thread, or at least the first bloody reply.

"That way they can charge you the big bucks to put you on those happy pills..."

[sibelian]

73. No, please explain yourself.

don't dodge about and play silly games, what does anything you have said have to do with the OP? What's it got to do with Scientology?

[Union Scribe]

76. What is so difficult for you to grasp?

1. This is not a new move by the psychiatric community.
2. It has been discussed here before.
3. Then, as now, posters jump past the point of the move--to grant patients more access to care by altering diagnostic guidelines--in order to condemn psychiatry and medical science as a profit-driven fraud.
4. Who else does that? Scientologists. In fact, in the last DU thread about this, there was a good lot of copypasta right from the cult's own websites "proving" how bad psychiatric treatments are.

I literally don't know how to make that more simple for you.

[Posteritatis]

81. You might have to chip it down to monosyllables.

Lots of people on this site probably can't handle more nuance than that, especially given the often vile and almost-always kneejerky attitudes DUers as a whole have on subjects of mental health.

[sibelian]

86. You might have to read the article...

And then come back and observe Union Scribe's behaviour a little more dispassionately.

[sibelian]

85. Thank you.

1. This is not a new move by the psychiatric community.

This observation, while entirely true, does not, in and of itself make the move a useful thing to do.

2. It has been discussed here before.

That's clearly of no consequence whatsoever. What is the thread limit per topic on DU?

3. Then, as now, posters jump past the point of the move--to grant patients more access to care by altering diagnostic guidelines--in order to condemn psychiatry and medical science as a profit-driven fraud.

(head-desk)

"to grant patients more access to care by altering diagnostic guidelines"

.....they only become "patients" because the diagnostic guidelines have been moved.

What is your position, that all the people who grieved longer than 2 weeks prior to this idea were secretly mentally ill and, GASP, nobody ever knew?

Are you seriously suggesting that unhappiness is an illness?

"in order to condemn psychiatry and medical science as a profit-driven fraud"

Well, that's a little bit peculiar given that, in the article, the main antagonist to the proposition is a psychiatrist. But of course, having read the article (presumably before condemning everyone else in the thread for not reading it) you'd know that. So I suppose the question I have to ask you is - why do you think he's a Scientologist? Is he undercover? Is he a secret agent man?

4. Who else does that? Scientologists. In fact, in the last DU thread about this, there was a good lot of copypasta right from the cult's own websites "proving" how bad psychiatric treatments are.

I literally don't know how to make that more simple for you.

Well, it's certainly simple.

[davidthegnome]

114. You are assuming...

that the intent is noble. From experience, I tend to think the opposite. There is a reason we have this "woo-woo anti-medical profession attitude". At least, in the case of those of us who speak from experience, who have personally had dealings with our system of medicine and those who practice it - particularly as it regards mental health.

I'm not even close to being a Scientologist. I consider this move to be motivated by profit - and will continue to consider it so until it is demonstrated that the motive IS in fact, to help patients. The fact that this will make it easier for some patients to get their medication is a good thing, but it is but one aspect of this move - but one result. Another result is that prescriptions can be more easily given to ANYONE. Another result is that people who are sad from the loss of a loved one, who are grieving in a normal way over a period of time... could be considered to be mentally ill and given powerful, mind-altering drugs.

It's not nearly as simple as you're suggesting.

[LadyHawkAZ]

105. I consulted my GP when I was grieving

He put me on tranquilizers. Somehow between us we managed to get me through it without me being diagnosed as mentally ill.

I'm sorry but I don't see how this helps.

[MADem]

51. Good "grief," pardon the pun. Some things are just part of living, not something to be "cured."

A parent or other close loved one dies, and any feelings of upset past a magical two weeks are a "problem?"

Oh, I know your granny raised you up, but it's been ten days now--you don't start perking up soon and we'll have to send you for a cure!

[Apophis]

55. Wow. Really?

Did the drug companies push this?

[gollygee]

57. My guess is that private insurance companies require a diagnosis

so they're making one so they can treat people for something that doesn't require a diagnosis for any reason other than to make it possible for people to have services.

[SoCalDem]

58. For some , grief NEVER ends..

It just becomes a "passenger" through life, with some days being okay and others not so much.

There are triggers all around, and depending on the depth of love, the grief can come any time..

I don't see that as mental illness....just as being a caring, feeling human.

No one is truly dead, until all who knew them are also gone..

[Raine]

89. EXACTLY. nt

[AceWheeler]

60. Mental "illness"

As a retired clinical psychologist, one who doesn't like the DSM but who had, at times, to use it, and one who helped more than one person who was dealing with grief in multiple contexts, I know about many of the issues involved here.

A substantial number of folks, including Larsen, prefer to focus on the health care industry (including care providers, insurance companies, and pharaceuticals).

I don't see that much attention to the grieving person. It seems there is a tendency to take the objective perspective (e.g., the social labeling of a person), rather than the subjective experience (there are, indeed, people who feel bad, sometimes don't know why, and sometimes seek help).

There are many ways to deal with grief, psychotherapy and medication (yes, the research indicates that medication alone is often insufficient, AND many benefit from therapy without medication) being but one. I know, and probably most here know from personal experience, what is involved when we grieve. I know that some benefit from outside help, from friends and family, religious figures, and psychotherapists, to name a few.

When, as does happen, psychotherapy (possibly plus medication) is of benefit, heretofor, it was not covered under mental health provisions of medical insurance. Simple bereavement did not qualify for third-party payments. Depression does/did qualify, but it had to go on too long to be diagnosed for those in grief.

This change in the DSM will actually benefit grieving individuals who seek psychotherpy to deal with their grief and want to use their health insurance to cover some of the cost. I do NOT know if this is the motivation for the change in the DSM, but I do know that it is an issue that is addressed by this change.

So there is moreat play here than simply a change into the diagnostic criteria, especially when we include the person seeking help to deal with his/her distress. The issue is even larger than the DSM. It has to do with health care coverage. Our current system relies on a medical model that includes assesssment, diagnosis, prognosis and course of treatment.

How this came about regarding physical ailments is clear and relatively noncontroversial. Many, including me, object to using it when it comes to mental issues. But rather than attacking the DSM, I think they should focus on the larger context and work to remedy that.

Unfortunately, attitudes and biases regarding mental issues (as compared to physical issues) often obstruct efforts to change how we view and deal with human distress and dysfunction. Anthropologists, sociologists, and social and clinical psychologists, have repeatedly examined socio-cultural issues and the alternatives which may be of greater benefit. They have observed ways in which I current treatments can actually prolong and/or magnify negative mental states. But as we've seen here in the US, change does not often come easily, espeically given the socio-cultural forces that resist it.

I, for one, have not given up.

[Tree-Hugger]

61. I guess I am mentally ill

It's been nearly 3 years since my miscarriage and I still experience grief. As if miscarriage and the grief around it wasn't enough of a social stigma. Bereaved parents are already expected to "get over it" quickly. Now we get placed into a 2 week time frame. Nice.

[Arctic Dave]

62. What if it last eleven years?

Fuck, how many jack offs still have "never forget" bullshit on their walls or vehicles.

[winter is coming]

63. This is ridiculously simplistic.

Our relationships aren't one-size-fits-all, so why should our grief be? Two weeks after the sudden death of someone close to me, I was no longer crying constantly, but was still pretty close to tears most of the time. It took me far less time to stop crying constantly when I lost someone else equally dear to me, but I'd been mourning her, intensely but intermittently, throughout a harrowing decline.

When I lost yet another person, a friend I had conflicting feelings about, I wasn't very weepy or sad at the time, nor at the funeral service (which described this person in terms so unlike him that I felt like checking the program to see if I was in the right church), yet I do miss him deeply, perhaps more now than I did at first. I don't think I truly started mourning him until months after his death, after having a dream where he behaved not like the paragon portrayed at his funeral, but like the jerk he sometimes was.

Also, it's not like we grieve for X amount of time and then it's done. We occasionally stumble across it again and fall into a hole nearly as intense as the initial loss, but the feelings don't last nearly so long. And what we do to get through grief is also individual. I've known people who derived great comfort from funerals and others who felt they were a gauntlet.

[murray hill farm]

68. No need to hyper react to this.....

What we are talking about here is those first two horrible months that are akin to the darkest, dark night of the soul. Antidepressants and anxiety medication for that time just gives a little relief of that horrible, existential pain and what this diagnosis does is give the patient that relief and and to have help from insurance to recieve it. This is not a bad thing.

[Posteritatis]

77. Yep, on top of the various non-pharmaceutical forms of assistance as well

Someone might need medication; they might also just need counseling.

There's no shame - none whatsoever - in either of those.

[Union Scribe]

78. Quite right.

It's too bad that getting help is seen by some as being "shallow" etc.

[Posteritatis]

80. Yeah, that attitude's kept several of my friends from being treated for things

Very nearly killed one this year, as a bunch of her 'friends' went full-on "all psychology is evil," parroting lots of the points in this thread and pressuring her into going off her medications for a particularly badly-swinging variety of bipolar disorder. She's been back on them for a few weeks, but some of those ignorant fucksticks are still hassling her now and then.

That sort of thing makes me cranky enough at the best of times. The fact that I was accosted in the street by actual Scientologists earlier this week isn't helping..

[Union Scribe]

83. Yep, a stigma that lives on

It certainly does die hard, even on the more enlightened side of the aisle! My best to you and your friend

[msanthrope]

137. Precisely--perhaps a 'grief-based' diagnosis will allow some people who don't want to be labeled

'depressed' to get some help. And I don't mean just drugs--I mean leave, and therapy, and assistance.

Rather than limiting a person's time period of grief, I think having an insurance code/diagnosis like this is a statement that 'normal grief' does take more than two weeks....often one cannot go back to work, cannot resume normal function. This code is a help, a way of allowing a practitioner to get more help for their patient.

[steve2470]

144. that's my idea in this post

http://www.democraticunderground.com/10022418312#post132

[Honeycombe8]

69. That way they get to prescribe medication longer, or start earlier? nt

[Posteritatis]

74. I wonder if there'd be a benefit to thinking of that as an 'injury' rather than an 'illness'

Framing it as an illness, as this thread suggests, draws out all the people who think there's some kind of monolithic Generic Insanity that constitutes mental illness, or think mental health treatment is nothing more than "happy pills," or any of a number of other forms of astounding, stigmatizing ignorance. Just as something can happen to damage a person's body for a time, things can happen that do the same thing to a person's mental state. There's no point in claiming otherwise, and no shame in admitting that happens to just about everyone.

If something happens to me physically that leaves my ability to function impaired for weeks, that's a problem and there are usually things that can be looked at or otherwise done to try to help fix that. I don't feel bad about seeking medical attention for something like that, nor should I.

Leaving aside the "suck it up and move on" crowd - to which I can only say "go fuck yourself" - I don't see why it should be any different when something devastates someone emotionally. Is the friend of mine who's a mess because of a nasty divorce somehow less of a person because she's seeking help about it due to trouble adjusting? Is a sufferer of PTSD, particularly considering the fact that there's a lot of things that can bring that about, not just the narrow list that comes to mind for most people?

Or does it not count as something worth helping people over if they've "merely" had a loved one die and are having trouble adjusting to that?

[Turbineguy]

84. Traditional mourning is one year.

But it's never a bad time to throw out 100,000 years of learning.

I guess.

[Raine]

88. Just a way to get more people on more drugs and more money for big pharma. nt

[politicat]

91. There is a (not great) reason for this...

The American insurance industry requires coding to get treatment paid for. We shrinks have to eat, too.

Remember the Death Panel stuff, how Medicare made a code so doctors could actually get paid for having the end of life discussion? This is the same concept. We have to have something to put on the paperwork.

When a patient comes in after a death and can't sleep or is self-isolating or is having suicidal ideation or just needs to talk to an ally who is uninvolved in the family dynamics, waiting two months can be way, way too long.

Remember: psychologists do NOT have a prescription pad. We often work with psychiatrists (who do have prescribing privileges) but we are not giving out drugs. Our job is a lot more like a coach, sympathetic bartender, rehearsal coach and strategist. Often, when a patient is grieving, what zie needs is practical help -- how to handle other family members who are fighting over inheritance, or how to talk to the children left behind, or how to manage what used to be a two adult household on half the person hours.

I HATE the fact that everything has to be a syndrome or a disorder before the insurance companies will cough up their pittance, but I'm trying to help people, not running those damned corporations. Want to fix it? Fix the insurance industry and let me do my work instead of the freakin' paperwork.

[TexasBushwhacker]

96. And some insurance require a referral to see a specialist

Everyone responds to loss differently. If a person has been curled up in a ball for 2 weeks, not eating or bathing, I would think 2 weeks would be long enough for friends or family to say "Maybe you should see a doctor". Waiting until the person is circling the drain is unwise because if they decide to take antidepressants, it takes at least 3 to 4 weeks before you can notice much effect.

[sibelian]

124. Thank you, very clear headed response.

It does sound like this is primarily a bad fix to a stupid problem that shouldn't exist in the first place.

I salute your final paragraph!

[steve2470]

132. you are, of course correct

If they made the DSM-V code of V62.82 Bereavement reimbursable, it would solve the problem and not pathologize normal grieving.

[politicat]

146. Exactly!

I see no reason why a referral to a therapist, or sleep meds, or anxiety meds (panic attacks being an all too frequent side effect of bereavement and PAs hurt) aren't covered already. Because the least useful thing for a client is to make coping harder.

[limpyhobbler]

92. ridiculous

thanks for posting that.

[derby378]

94. And how many gun-control advocates would insist on that criteria in the US?

"Oh, your wife died three months ago, and you're still grieving for her. You poor thing. Now hand in your shotgun, you psychopath."

[ck4829]

100. Stop crying and get back to work!!1!

[patrice]

101. Soylent Green here we come! nt

[patrice]

102. OMG! The APA is fighting mental health-care insurance-coverage parity.

[CrispyQ]

106. Every day I read stories that I am certain are from The Onion.

I'm starting to check the link first, to verify if it is The Onion or some other satire site.

I have no words for the stupidity of this. What the fuck happened to common sense?

[green for victory]

116. Post 45 both asks and answers "What the F happened to common $en$e?"

45

No one should be surprised at this- we have the best Government that money can buy

Max Baucus had Single Payer advocates arrested at a hearing for a reason. And hey he got away with it, who can even remember that atrocious filthy act?

[markpkessinger]

108. Please be careful before declaring what grief "is" or "is not"

Grieving is unique to each person, and some folks may well need more help in dealing with it than others.

I speak from experience. In 2000, I lost both parents to lung cancer, 12 days apart: Mom on December 13, dad on Christmas day. Both died at home, as was their wish. During their last two months, I was their primary care giver, with significant assistance from my four siblings and from the hospice nurses that visited, at first 3 times a week, and then on a daily basis as we got closer to the end. My siblings and I were all present with both parents when each of them passed. I could not function at a remotely normal level for nearly two years afterwards, and it was a full three years before I got back to feeling fully back to normal. I received counseling, but no medication. (Indeed, my therapist said I was exhibiting signs of post-traumatic stress syndrome.) About nine months after my parents died, I wound up losing a job because I couldn't function at an acceptable level. I was failing to respond to emails, missing deadlines, going into work and keeping my door shut all day long, and yet somehow I wasn't even aware of my lack of functioning. I was in a complete fog.

One of my sisters, then a high school English teacher, was having a similarly hard time and, like me, thought she was functioning just fine. In her case, a very sensitive and observant principal, whose own wife had gone through something similar, realized what was happening, and one day pulled her out of class and told her she was, from that day through the remainder of the academic year (from mid-March through early June), placed on medical leave. He also got her in touch with a very good psychotherapist, who, in consultation with a psychiatrist, did indeed place her on an anti-depressant regimen, which she remained on for a couple of years. It helped her immensely, enabling her at least to function more normally again. She returned to work without further difficulty in September of the same year.

[elehhhhna]

112. So employers will have a fit -- because this means

people can go out on temp disablility -- maybe permanent? and possibly take family leave for their grieving.

[msanthrope]

140. Yes--it is an EXPANSION of benefits. Funny the woo crowd on this thread. nt

[steve2470]

117. I'm all for people getting treatment/relief but...

this strikes me as very misguided, to say the least.

If someone cannot stop crying, cannot get out of bed, cannot function, etc etc, maybe they are clinically depressed AND grieving. I have no problem with the diagnosis of MDD and treatment, but not the grief part.

[tavalon]

122. Jesus Christ on a trailer hitch!

Mourning takes whatever time it takes. Period.

[Jasana]

127. K&R all the way. NT

[tblue37]

130. This is just part of our coldhearted culture that wants

people back at work, being "useful" and not distracting others with their problems or pain.

[midnight]

133. But since every one is unique.... I suppose this new theory won't last to long...

[tarheelsunc]

141. I can see the cries from the NRA "They're out to label you mentally unstable and get your guns" eom

[felix_numinous]

143. They just want to sell drugs.

Screw them, unprofessional and unprecedented. This is insane.

[glinda]

147. Dope the public into submission.

[fadedrose]

148. I think these psychologists need to see a psychologist...nt

[Quantess]

149. 2 weeks? That's short.

Sorry for the pun, but that's nuts.