Mourning Should Not Be “Medicalized”

Posted on December 31, 2012


Back at the beginning of December, we looked at some of the upcoming changes to the DSM-5 and what impacts they could have on patients with certain diagnoses… and now, there may be an impact for those who do not have any diagnosis.  Not yet, anyway, but the American Psychiatric Association is working on that.

In the past, people who had just lost their loved ones were “bereaved,” and this was not an illness to be diagnosed; it was a natural reaction to that deep, intense loss.  Everyone grieved a little differently, in manner, intensity or length, but their grief was understood and accepted.  Time was, the DSM advised against diagnosing depression in patients whose distress is “better accounted for by bereavement.”

Well, you no longer have to suffer when your loved one passes.  Thanks to the American Psychiatric Association and their latest edition of the DSM-5, the advice to leave the bereaved to the course of nature was dropped.  Bring on the antidepressants!

There are a couple of revolting aspects to this.  First, it implies that missing your loved one and feeling sad about their absence is a disorder that needs treating, or at least some kind of shallow ailment that would be best dissipated by drugs, rather than allowed to run its natural – and healing – course.  It’s disrespectful of people’s feelings, disrespectful of the memory of their loved ones, as if they aren’t worth mourning.  It’s patronizing, as if people are incapable of processing their own grief and loss.

Check out Peter Whoriskey’s excellent article in the Washington Post for the other really revolting aspect:  obvious conflict of interests, with big bucks to be made by Big Pharma and the medical community, and patient health and safety coming out on the short end of things.  As Whoriskey points out,

“The change in the handbook… was developed in large part by people affiliated with the pharmaceutical industry, an examination of financial disclosures shows.”

And:  “Drug companies have shown an interest in treating patients who have recently lost a loved one, having sponsored… at least three trials in which the bereaved were treated with antidepressants…”

And:  “The financial ties between the creators of the APA handbook and the industry far exceed limits recommended in 2009 by the Institute of Medicine, a branch of the National Academy of Sciences.”

This kind of link with for-profit drugmakers pretty much invalidates the recommendations of the DSM-5 as far as I am concerned.

And there is one more revolting fact to consider:  currently, 11% of all Americans over age 12 are on antidepressants.  Why?  Is our population really so ill and depressed, so unable to handle their own emotional states that more than one in ten actually needs to be medicated?  Or could it be that too many medical professionals are in the pharmaceutical industry’s pocket, and too many patients have allowed themselves to be diagnosed and medicated unnecessarily, trustfully following our care provider’s biased recommendations like credulous sheep?  And now, we are poised to add even more fleecy sheep to the antidepressant fold, in the form of people in mourning.

Enough is enough.  One cannot ignore the pharmaceutical connections of the drafters of this key diagnostic manual which “lists every psychiatric disorder recognized by the U.S. healthcare system.”  It has too large an impact on insurance payments, treatment decisions, diagnoses, and…  us.