Tag Archives: depression

Is Grief An Illness?

Clinicians have been arguing whether grief is an illness for decades. The latest round in the debate is over whether what’s known as the “grief exclusion” should be taken out of the criterion for major depression in DSM-5, the upcoming edition of the diagnostic manual used by mental health professionals. In the current edition, the grief exclusion states that someone who was bereaved within the last two months is not eligible for a diagnosis of major depression. (Bereavement also makes an appearance as a “V code” in the section in the back of the manual for disorders that are not reimburseable by insurance.)  In an Op-Ed in the New York Times, Allen Frances, a professor emeritus of psychiatry at Duke University who has become a vocal critic of DSM-5, warned that eliminating the grief exclusion would lead to the ”wholesale medicalization of normal emotion.” The doctors in charge of the decision  responded that “most bereaved individuals do not develop major depression, although they may feel terrible sadness. Major depression—the clinical syndrome—is quite different from feeling sad and blue. It also involves marked, peristent changes in function like sleep, appetite and cognition, and sometimes suicidal thinking. ” This confusion is common, but perhaps even more so in the case of bereavement. Ever since Kübler-Ross made depression one of her five stages, people see it as a normal reaction to grief. Let’s hope that the Mood Disorders Work Group for DSM-5 can help clarify the distinction.