reprinted from Healthcare Chaplaincy Today, Issue 70, February 2013
Grief. What’s Normal?
The American Psychiatric Association is about to publish its long-awaited 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Much controversy has swirled around this decade-long overhaul of the “bible” that psychiatrists use to diagnose patients, including the decision to equate normal grief with clinical depression.
We view this subject as so important because our chaplains deal with grief all the time.
“That proposed modification,” writes the Los Angeles Times, “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.”
The editors of the British medical journal, The Lancet, have come out in strong opposition to the new language, calling grief a natural and healthy response to loss, not a pathological state.
“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.”
Writing in PlainViews®, HealthCare Chaplaincy’s online journal for professional chaplains, Dr. Joanne Cacciatore, founder of the Center for Loss and Trauma, agrees: “The DSM-5 change increases the likelihood that grief will be misdiagnosed as Major Depressive Disorder in the most vulnerable of all populations, and that bereaved parents and other grievers will be prescribed medication for symptoms which are actually a normative response.”
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. An earlier edition of the manual had established a year as the period during which mourning should not be confused with depression.
“Putting a time frame on grief is inappropriate,” The Lancet’s editorial states.
Professional chaplains are trained to help people cope with their grief, walking with them through the many stages of their sorrow. The settings are many:
Professional chaplains know that grief is not an illness nor is it a mental disorder. It is a natural, painful part of life that challenges one to relearn the world without the one they loved. Chaplaincy care is an essential part of care to persons in grief. END
This article speaks to my heart and soul as I (as well as my children) have experienced deep raw grief and know that 95% of the clinicians in the “psychiatric industry” succumb to the powers of the pharmaceutical companies and regulations of the insurance companies. Agreeing that there are people in our world that have complicated grief along with mental and/or emotional illness I support pharmaceuticals when needed. What I don’t support are the fine lines and gray areas in which people can be misdiagnosed and put on unnecessary medications. I love what I do because it has been proven to me that often times, grief (of any kind) can be relieved, reconciled and recovered with love, compassion, a non-judgmental safe place to process, encouragement, and honoring with a bucket of tools and coping skills.