“Normal” Bereavement

There was a nice article in the Lancet last month.  The article posed the question: “When should grief be classified as a mental illness?”

The author criticized the APA’s draft version of DSM-5 for blurring the distinction and for making it more likely that people in bereavement will be “diagnosed” as depressed and, of course, “treated” with prescription drugs.

There has been a good deal of criticism against the APA on this issue, and it is likely that the final version of DSM-5 will reflect some retreat in this matter.

The problem is not new, however.  DSM-III included “uncomplicated bereavement” (V62-82) as a V code (i.e. “conditions not attributable to a mental disorder.”)  V62-82 occurs also in DSM-IV, but without the word “uncomplicated.”  What is noteworthy, however, is that in DSM-IV, a list is provided of “symptoms” that can be used to distinguish a normal bereavement from major depression.  The APA’s agenda is clear and has always been clear:  to pathologize for their own profit, and for the profit of pharmaceutical companies, as much of human existence as possible.  There is clear and steady progression in this regard from DSM-III to DSM-IV and now to the draft DSM-5.

There are no mental disorders.  There are people with problems, one of which is the loss of loved ones.  These human problems are not helped by drug-taking.  Bereavement in particular should not be addressed in this way.  Attempts to smother the feelings of loss and despondency with chemicals are always counter-productive.

  • Nanu Grewal

    “on the few occasions I’ve gone to conferences I have usually found my own daydreams more interesting than the lectures.”For that line alone, this blog is a great thing…On a serious note, the belief that true friends offering time and support is the most valuable therapeutic resource. However, in my practice (as a General Medical practitioner), two problems are seen: 1) some unfortunate people have significant problems in their psycho-behavioural constitution that need talking through – but have no such friends, 2) Sometimes a chronically well-meaning friend can swerve a healthy course of improvement into a dangerous siding. The folie-a-deux scenario looms, and between the helper and the helped there may be no one to call for a time-out.

  • Nanu Grewal

    ahh, my comment was supposed to be attached to the “intrusive thoughts” entry

  • Phil_Hickey


    Thanks for coming back.  You make a very good point.  There are times when a person needs to talk to a professional helper.  Counselors used to fill this role nicely, but at least here in the U.S. they’ve been “swallowed” by the mental health system, and most of them promote the spurious illness notion.  There are still some independent thinkers, of course, but they’re becoming harder to find.  There are also social workers who can be helpful.  But bio-pharma psychiatry rules, and the specter of malpractice litigation makes cowards of us all.