wuddya think about this:
Psychiatric 'bible' may classify the bereaved as mentally ill: Journal
By Sharon Kirkey, Postmedia News
One of the world's most influential medical journals is warning that normal human grief could soon be classified a mental illness and routinely treated with antidepressant drugs.
The Lancet, in a lead editorial published Thursday, says a proposed revision to psychiatry’s official manual of mental disorders that would allow doctors to diagnose the newly bereaved with major depression two weeks after the death of a loved one “is not only dangerously simplistic, but also flawed.”
“The evidence base for treating recently bereaved people with standard antidepressant regimens is absent,” the journal says.
“In many people, grief may be a necessary response to bereavement that should not be suppressed or eliminated.”
According to renowned U.S. psychiatrist Allen Frances: “This hits people where they live. Everyone who has lost a treasured loved one will run the risk of being called mentally ill.”
The proposal has become one of the most controversial issues in the rewriting of psychiatry’s “bible” of mental illness.
The current and fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, an influential book published by the American Psychiatric Association and used by doctors the world over, excludes people who have recently suffered a loss from being diagnosed with a major depressive disorder unless his or her symptoms are extremely severe or persist beyond two months. It’s known as the “bereavement exclusion”, the theory being that it’s normal for people to show symptoms of depression following the lost of a loved one.
But in the draft version of the next edition of the DSM, due out in 2013, “there is no such exclusion for bereavement” for a diagnosis of major depression, the Lancet notes — meaning that “feelings of deep sadness, loss, sleeplessness, crying, inability to concentrate, tiredness and no appetite, which continue for more than two weeks after the death of a loved one, could be diagnosed as depression, rather than as a normal grief reaction.”
Grief isn’t an illness, the journal says. It’s “part of being human” and time limits shouldn’t be placed on mourning.
It often take six months or the first anniversary of a death until grieving “can move into a less intense phase,” the authors write.
While depression or “prolonged grief disorder” occasionally develops and may need treatment, “most people who experience the death of someone they love do not need treatment by a psychiatrist or indeed by any doctor,” the Lancet argues.
Proponents of the move say that grief-related depression is like any other depression and that other major life stressors, such as the loss of a job or end of a marriage, aren’t excluded for a diagnosis of major depression. Removing the bereavement exclusion would enable people to get help sooner, they say.
Frances, a professor emeritus at Duke University who chaired the task force that wrote the current edition of the psychiatric manual, begs to differ. He said it’s impossible in the short run to distinguish grief from depression unless the symptoms are severe — for example, if the bereaved person is suicidal, or falsely believes, ‘It’s my fault the person died’, or if they’re markedly impaired and have had major depression before.
When the depression is clear cut, Frances says the current DSM is clear: “Make the diagnosis as soon as you can and start treatment.”
But most grief is different, he said.
“It’s a terrible life catastrophe, but it’s not a mental illness. The price of loving and attachment is that you feel devastated and this should not be medicalized.”
He and others worry that if the grief exclusion is dropped from the manual vast numbers of people would be misdiagnosed as mentally ill and prescribed antidepressants, exposing them to potentially serious side effects with no benefit.
“Drug companies will jump on this as a vast new market,” Frances said. “Grieving people will spend seven minutes with a primary care doctor and be given medication for normal grief. It makes no sense.”Read more: http://www.canada.com/health/Psychia...#ixzz1mb7dOpA1