DSM5 in Distress

The DSM's impact on mental health practice and research

Lancet Rejects Grief As a Mental Disorder

Will DSM 5 Finally Drop This Terrible Idea

The Lancet is probably the most prestigious medical journal in the world. When it speaks, people listen. The New York Times is probably the most prestigious newspaper in the world. Again, when it speaks, people usually listen. The Lancet and The New York Times have both spoken on the DSM-5 foolishness of turning grief into a mental disorder. Will DSM-5 finally listen?

Here are some selected quotes from today's wonderful Lancet editorial
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60248-7/fulltext

"Previous DSM editions have highlighted the need to consider, and usually exclude, bereavement before diagnosis of a major depressive disorder. In the draft version of DSM-5 , however, there is no such exclusion for bereavement, which means that feelings of deep sadness, loss, sleeplessness, crying, inability to concentrate, tiredness, and no appetite, which continue for more than 2 weeks after the death of a loved one, could be diagnosed as depression, rather than as a normal grief reaction."

Find a Therapist

Search for a mental health professional near you.

"Medicalising grief, so that treatment is legitimized routinely with antidepressants, for example, is not only dangerously simplistic, but also flawed. The evidence base for treating recently bereaved people with standard antidepressant regimens is absent. In many people, grief may be a necessary response to bereavement that should not be suppressed or eliminated."

"Building a life without the loved person who died cannot be expected to be quick, easy, or straightforward. Life cannot, nor should not, continue as normal. In a sense, a new life has to be created, and lived with".

"For those who are grieving, doctors would do better to offer time, compassion, remembrance, and empathy, than pills".

Our society has already gone way too far in medicalising the human condition. What is needed now is a push back to reverse rampant over-diagnosis and over-medication. Instead, DSM-5  seems bent on stubbornly including more and more of life's expectable heartaches, difficulties, anxieties, and disappointments within a rubric of mental disorder so broad as to become meaningless. If DSM-5  remains completely tone deaf and intransigent, it simply will not be used.

 

Allen Frances, M.D., was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.

more...

Subscribe to DSM5 in Distress

Current Issue

Just Say It

When and how should we open up to loved ones?