New manual defines grieving as depression

Coping with the loss of a loved one can soon be part of the medical diagnosis of depression.

The fifth edition of the Diagnostic and Statistical Manual for mental disorders will include bereavement as a sign of depression.

Mental health professionals will be able to diagnose and medicate people who are experiencing the loss of a loved one as long as they meet an additional five of the 10 criteria listed in the DSM.

Recommendations for the fifth edition, which will be released in May 2013, include changes for more than a dozen disorders, including autism and depression.

The changes are published on the manual’s website and were determined by a report completed by two psychiatric professors.

Since then, critics of the change in depression’s definition have said it will over-medicalize a natural part of life and, as a result, over-diagnose people.

The answer to whether grieving should be a condition is not so simple, Bloomington therapist Carole Suzanne Holton said.

Holton said she probably would not diagnose someone with depression if he or she was grieving because of the loss of a loved one, but said she thinks talking to someone other than friends and family is sometimes necessary for people to recover and move on.

“My opinion is that grieving is something we all do, hopefully,” she said. “Some people really need to talk to somebody about it. So it probably should be in the DSM. So it’s a struggle that way.”

Insurance is also another issue, she said. If the diagnosis isn’t in the DSM, people won’t be able to receive medication or treatment.

“This is the real problem it comes down to,” Holton said.

Margaret Squires, a licensed psychologist in Bloomington, said clinicians need to be careful when using labels to diagnose patients so they don’t treat the label rather than the person.

“The important point is that clinicians must be careful and thoughtful in deciding what to do,” she said. 

Using labels leads to prescriptions, as in the case of Ball State University junior Andrew Carson, whose doctor diagnosed him with generalized anxiety disorder and mild depression when he was in high school.

Carson was prescribed Zoloft and Abilify, two medications that are used as a treatment for depression.

“The medicine had affected my sleeping patterns and my moods, but not in a way that I thought was actually helping my original symptoms,” Carson said.

Carson has been off the medication for six months and said he now feels that he was misdiagnosed.

“My original diagnosis of ‘general anxiety’ may have just been a growing pain,” he said. “I will certainly be more suspicious of the way doctors diagnose me in the future.”

Squires said the change in the manual could lead to a rise in the over-medication of grief.

“Inappropriate treatment will result,” she said. “If they take the time to know their clients and modify their treatment approach when needed, then the best results can be achieved.”