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Published February 26, 2012, 10:12 PM

Psychiatry debates whether grief qualifies as an illness

The pain of losing a loved one can be a searing, gut-wrenching hurt and a long-lasting blow to a person’s mood, concentration and ability to function. But is grief the same as depression?

By: By Melissa Healy, INFORUM

The pain of losing a loved one can be a searing, gut-wrenching hurt and a long-lasting blow to a person’s mood, concentration and ability to function. But is grief the same as depression?

That’s a lively debate right now, as the psychiatric profession considers a key change in the forthcoming rewrite of its diagnostic “bible.” That proposed modification would allow mental health providers to label the psychic pain of bereavement a mood disorder and act quickly to treat it, in some cases, with medication. With the Diagnostic and Statistical Manual’s fifth edition set for completion by the end of this year, the editors of the British journal The Lancet have come out in strong opposition to the new language.

“Grief is not an illness. It is more usefully thought of as part of being human, and a normal response to the death of a loved one,” writes the editor of The Lancet.

The change under consideration would expunge any reference to the passage of time since a loved one’s death before a diagnosis of depression could be considered. The current edition of the diagnostic manual states that if a patient’s low mood and energy, sleep difficulties and appetite changes persist for more than two months following bereavement, a diagnosis of depression might be considered.

“Putting a time frame on grief is inappropriate,” The Lancet’s lead editorial states simply. And in a “Perspectives” essay also published Thursday in Lancet, Harvard University medical anthropologist Dr. Arthur Kleinman agrees, eloquently exploring what’s at stake.

“Is grief something we can or should no longer tolerate?” asks Kleinman, who describes his own grief after his wife of 46 years died last March from Alzheimer’s disease. “Is this existential source of suffering like any dental or back pain, unwanted and unneeded?”

Kleinman calls the current two-month time period allowed for grief a “shockingly short expectation” that no religion or society would support.

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