You may never have heard of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association’s diagnostic guidebook. The fifth edition is currently in draft form and scheduled for publication in May. It was first issued in 1952 and the fifth edition will be the first update since 2000. (When I was a mental health worker in the 1980s, DSM-III was being used.)
DSM-5 has been in the news recently because of the way it plans to reclassify grief. Previous versions of the manual have excluded grief as a depressive condition. Meaning if you went to your doctor and reported feelings of deep sadness and loss, insomnia, inability to concentrate or loss of appetite that lasted longer than two weeks, your doctor would find out if you had lost someone close to you.
Sure, your doctor might have prescribed something to help you sleep. My dad’s doctor did for him after my mom died. But by making grief an extenuating circumstance in diagnostic terms, the manual signified grief as a normal part of life. No more, if DSM-5 proceeds without further edits. You could very well be diagnosed as depressed for having a completely normal response to a loss, and prescribed antidepressants when the best healing agent is simply time.
If there’s one thing I’ve learned about grief, it’s that it’s not linear. It won’t be resolved in two or three or six months, much less two weeks. The respected medical journal The Lancet said it beautifully. “Building a life without the loved person who died cannot be expected to be quick, easy, or straightforward. Life cannot, nor should not, continue as normal. In a sense, a new life has to be created, and lived with.”
I trust doctors will continue to use their common sense, no matter what the final DSM-5 looks like. But as Allen Frances, M.D., wrote in Psychology Today, “If DSM-5 remains completely tone deaf and intransigent, it simply will not be used.”
Grief is a part of life, like love or joy or pain. It is not a disorder, and treating it as though it were is a big mistake.
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