When my mother died over a dozen years ago, I remember my dad telling me his doctor had prescribed an anti-depressant for him. I don’t remember if my dad even filled it, but his reaction—which I shared—was that it seemed absurd to prescribe an anti-depressant for something so thoroughly normal and expected in his situation as grief.
In Good Grief! Psychiatry’s Struggle to Define Mental Illness Goes Awry, TIME health writer, Maia Szalavitz, writes about the upcoming DSM-5 including a provision to classify grief as depression. Not only would that make grief not good—it would make it pathological. For anyone who doesn’t know, The DSM is the Diagnostic and Statistical Manual, sort of the bible of diagnosing mental illnesses. If you get therapy or medication for any psychological issue, you can bet there’s a numerical code and diagnostic criteria for it that came from the DSM. While it’s an important tool in the diagnosis and treatment of mental illness, mental illness criteria are notoriously controversial, so the DSM has undergone many revisions, including this upcoming 5th edition.
Grief is a miserable experience, no doubt about it, but is it really a disorder? As one who has been been tagged with a code from that manual (I won’t say which one just yet), I take it sort of personally when it looks like normal human experience is getting classified as a disorder. For one thing, no matter how much we might wish it were otherwise, mental illness is stigmatized, so once you get a code from the book, there tends to be some sense of “broken” or “crazy” that you either feel, or get treated as by anyone who knows you’ve been diagnosed. It doesn’t really matter if you even agree with the diagnosis – it’s a ball and chain that you’re stuck with. For another, these diagnoses often lead to treatment consequences, which means pharmaceutical interests have a financial incentive to lobby for inclusion of conditions that make money – say…something that might get a prescription of an anti-depressant – and exclusion of conditions for which there’s not known treatment or cure that can be sold in drug form. I have a hard time seeing a benign intent to categorizing a standard human reaction to profound loss as a mental illness. It seems to me like a case of inventing a diagnosis to increase the marketability of existing drugs, rather than new diagnostic criteria that will help people who weren’t being helped before.
What do you think? If you could take a pill that might improve unpleasant negative emotions or thoughts you’re having, would you want that, even if meant classifying those feelings as a mental illness? Do you think this is a pharmaceutical conspiracy of sorts, or just coincidence when new conditions are written into the DSM that some doctors are already writing “off label” prescriptions in cases like grief? Do you think grief could qualify as worthy of a clinical depression diagnosis in some cases, but not others?
This post originally appeared on The Good Men Project and has been republished with full permission
Marcus Williams writes what he knows, which is a lot about a little and not much about everything else.
Do you think you can be or should be medicated through grief?
Comments
78 Comments so far
My mother died seven weeks ago. I’m grieving, I don’t sleep, I have flash back to the day she died, and I feel guilty for experiencing pleasure. My doctor in conjunction with grief counseling has prescribed me an anti depressant to help me to sleep and deal with my grief.
Perhaps grief need not be a pathological disorder, but grief induced trauma and depression is worth recognizing.
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Fear. And it was also the most crippling and ectsrudtive aspect of my grief. I went from being fearless to fearing EVERYTHING. It took me a long time to figure out how to live in God’s promises, again. But I think I’m there. It’s been three and a half years.
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call me crazy, but wouldn’t NOT grieving be more of a cause for concern? would be fascinated to see where the funding for DSM-5 is coming from … or is natural suspicion now classed as paranoia (and is there a pill for that)? xt
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I think that if the person is experiancing grief, but is still able to function then no they should not be automatically given pills and treatments. However if they are losing their ability to be able to the basics of life after a period of time, then whatever treatment is necessary to get back on track should be avilable for them to choose. Sometimes these things dont just “sort themselves out”. Once your brain gets in a pattern for a long time of depression/Greif it can be hard to interupt it and crawl back out.
As someone whos been there and tried not to take them, ultimately I found that I wished I had done something earlier, as I was putting myself through additional pain.
But these should always be options and not enforced on everyone. No one needs the same treatment, we are all different in what helps in the end.
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OK. Grief might be debilitating and might require professional assistance (sometimes maybe even in the form of drugs) BUT it is not a “mental illness.”
When my brother died, a friend said to me, “I think you’re depressed.” But my perception of depression is that it is due to chemical inbalances and various other things I probably don’t understand because I’m not a doctor. Grief can be debilitating and very sad, but it has an ultimate solution: if the person you are grieving were to return, you would not grieve anymore.
I feel like it does not do the mentally ill or the grieving any favours to lump t
them together – but that’s not to say that the symptoms of grief and depression might APPEAR the same.
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While grief may be a normal part of life, it can be overwhelming and crushing. I believe counselling is a good process that helps you through the grief and provides an audience for all those things you can’t say to family and friends, particularly if they are sharing your grief or if they have tired of it – and that, in my experience doesn’t take long to happen.
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I am wondering, if mammamia intends to provide any kind of follow up to this article, perhaps from a professionals perspective. Clearly, the author and many commenting have no idea about what anti-depressants do, some education for your readers would be the most responsible course of action, otherwise I am left feeling your site stigmatises mental illness and anti-depressants, as the author does. I feel it is quite dangerous to publish this article, without some professional medical advice aswell, this article could well deter some from seeking help they desperately need, because the author insists grief is ‘normal’ and something they just need to work through. I nsincerly hope no one suicidal following a loss has read this, they could very easily come away with the wrong message.
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For many people, naming their mental illness is a relief, because it externalizes their problem – e.g., The Depression is making me feel ___. It gives them a sense of control over their situation. Surely for many people during a period of extended grief, a sense of control is one of the things missing in life??
I think that the important thing to do in this situation is distinguish chronic grief from the normal grieving process. Normal grief should (in my opinion) be thought of as a mental illness, treatable with counseling and recognized as an illness by workplaces and the government, but should be separate from chronic grief – where people become stuck in their depressive states.
We have a clinical diagnosis for post-natal depression – and this has reduced stigma and lasting judgments about the person who is suffering from this – surely grief is as worthy of diagnosis??
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I think grief comes in many shapes and size and no one knows how it will hit them and it can manifest in many different ways. Perhaps physical, perhaps mental.
The day after my mother died, my father took himself of to the GP with a racing heart – no previous heart conditions so he did the righ thing. It was most likely the stress of the event and he was given beta-blockers which sorted him out. So you could say that his grief became physiological.
Grief is personal and we don’t know how far that black hole we might fall.
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I’m so sick of the pathologising of normal human emotions!! Of course grief is not a mental illness – it’s a necessary process that one must go through in order to effectively process the loss of a love one. After my sister died suddenly four years ago, a bereavement counsellor I saw said to me ‘Grief is not something you can get around. It’s something you have to go THROUGH’. She was so right…
There is such a ridiculous emphasis on happiness these days, as though experiencing anything other than complete happiness at any given time is somehow abnormal.
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I think grief is a mental illness. My boyfriend died ten years ago and I have huge blackouts about the whole of the rest of 2002, I literally have no idea what I did for most of that year. It was the natural way for my brain to cope with something so overwhelming. I dont think there should be a stigma around it though, mental illness is just as natural as grieving and can happen to anyone. I don’t think it is the same as depression though. It is usually linked to a specific event whereas depression for many people can be much more generalised. That’s why I don’t think antidepressants are the answer.
I was prescribed some antidepressants but they gave me horrendous heart palpitations so I only took them the one time, but I think if they hadn’t I would have become addicted to them as a crutch when really it was only time that was going to actually help me.
I just think they are designed to treat different things and that they would need to develop some anti-grief medications for this to work.
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Anti-depressants are not addictive.
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The trouble is that our society is very intolerant of grief. You are expected to get on, quick smart and not be troubled by messy, wrenching grief. I learnt that when my grandson died. It was hard enough for me but unbearable for my daughter. When people got sick of her grief, and they did quite early on, I wanted to rip their throats out. The whole experience has made my family very isolated. if you are not allowed to grieve fully and openly you lose your points of reference with other humans.
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Mary – thank you for your comments, particularly the feeling of wanting to ‘reap their throats out,’ at peoples intolerance to grief, my feeling exactly. Take care.
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I completely understand! Grief is normal and also very personal. There is no right or wrong way to grieve, I learnt that first had. Sorry that you lost your grandson, that must have been just awful for you and your family.
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Grief may not be mental illness but for some of us (myself included), councelling/professional support is needed, and for others on top of this medical support may also be the best track to follow. What I think would help people in this situation is more understanding and support during bereavement by friends, neighours, colleagues and family. Understanding that we may not be overly concerned with the trivalities of life, the politics at work or whether the security gate is open or closed! My boss asked me four weeks after my mothers sudden and unexpected death ‘why was I still at work at 6.00pm, and concluded that I obviously wasn’t able to do my work if I was still there,’. I am sadden by my mothers lose and miss her greatly, that I expect and can actually deal with – it is the insensitivity of people around me that is harder to deal with and probably why I current seek some professional support. A little more understanding and compassion – would help us all.
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People don’t cope well with displays of raw emotion in others, hence the need to label grief as an illness. Yes some people need help with their grief, the the form of medication or counselling or whatever, but other people just need to be able to experience their grief to get through it and out the other side.
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I feel it is unfair to criticise people for taking drugs when going through grief. I lost somebody last year who I love and I really thought I was going to completely fall apart so had a helping hand from medication. I did not take them for long but I am glad I did. Why the judgement?
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I don’t feel the article is judging so much as posing a question.
I take an anti-depressant and may do for the rest of my life. My mother died over ten years ago and I buried that grief until it bubbled up and overwhelmed me and came out as anxiety etc. I needed medication so I could get some respite as my emotions were overwhelming me to the point I was finding life difficult to manage.
I do think Doctors and psychiatrists are too quick to give out medication. My Doctor immediately offered Valium to which I declined. The issue is people are not given the full picture of medications and there effect. Doctors have about 10 minutes maximum per patient and give a bandaid solution.
I think as a society we are quickly losing the ability to grieve. We apologise for crying, showing emotion or for not getting over something quickly enough. Everything is so fast paced that we no longer take the time to process what our body wants and needs to naturally do.
Grief is a process and we all deal with it very differently. Some will need a lot more supports than others. Some may be hit with multiple grief and medication is needed. Its a case by case bases.
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ABSOLUTELY there comes a time when grief does indeed become pathological and there needs to be intervention. That time is generally agreed (so my psychologists tell me) to be somewhere after the three year mark. “Normal” grieving lasts anywhere between 1-3 years. AFTER that – then yes, maybe you’re stuck,and you need further help and the label DOES become useful because it lets you GET the help you need, whether that help is in from of some sort of medication, or more likely in a combination of drug and talk therapies.
Let’s not forget that the whole DSM system was put in place originally so that mentally ill people could get HELP – regardless of how the money making institutions might abuse it, I personally am happy to have my DSM codes so I can get help instead of being locked away in an asylum with no hope of a life integrated into the rest of society.
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That’s really interesting about the 3 year mark. I went through grief recently and just came good pretty much around the 3 year mark. I wish I had known that earlier, I thought I was taking too long.
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I’m nearly at the 3 year mark, and I don’t think I’m there yet. Maybe it’s time for some help.
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iAmandaroseI think there is a certain beauty in grief. It crystallises and intensifies emotions and makes your really remember the deep love and affection you have for the loss you are grieving. It helps clarify who you are and what you believe.
All the grief I have had in my life defines who I am now and I wouldn’t Change it for the world.
I was rather impressed by a local G.P who sent my mother in law for counceling instead of prescribing a pill after her marriage break down. She told her it was situational depression( I.e a normal response to a depressing situation) and that pills would not help her deal with the loss of her marriage.
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I have no issues with the DSM’s proposal on removing the bereavement clause and giving grief a code. From a practical sense – which far outweighs the debate on whether we are “pathologicalising” grief -, is that access for assistance will improve for people who need it i.e. clinicians can diagnose depression earlier than 2 months (as stipulated in current version) and associated benefits of insurance coverage.
I am appalled also that article, whilst proclaiming that mental illness is stigmatised, does nothing further but to stigmatise it. Sigh.
Someone who is grieving and finding it debilitating shouldn’t feel a sense of shame, if they feel they need some help from a person who is in a position to do so. This is regardless of some arbitrary time that has or has not passed.
In other news, doctors have created the concept of “prediabetes”; it basically means millions of people with no signs of illness whatsoever will be “labelled” and forced to receive treatment which they don’t need (except for the minor point that it may actually save lives). I guess my point is, grief can trigger off a depressive episode as similarly, the baby blues can trigger off PND in some of the population. Let’s leave it to the experts to help people and make their judgement call.
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I think that if you aren’t a danger to yourself or other people, it’s better to work things out without taking drugs.
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I hurt my knee when I was training for a half marathon. The pain in my knee didn’t really pose a danger to myself or other people. However, it really hurt to walk so I took an ibuprofen to help with the pain. It helped me walk and do everyday things during the time I needed it. During that time, I also did some exercises to strengthen the muscles around it so I wouldn’t injure it again.
Why is mental pain any different?
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But do they work for normal sadness?
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Hi Amandarose – it depends on what you define as “normal sadness”. Clinical depression does have its formal criteria and it’s best assessed by a doctor. Depression does mean someone is struggling with functioning every day for a prolonged period of time.
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My point of view is from watching someone close to me struggle with finding the right type and dose of medication. Her self esteem and relationships have suffered further from the side effects. I don’t believe mental pain is different but I do question a solution where there is a possibility of further suffering or prolonging it especially if a person is not at risk of harming themselves and others.
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Anti-depressant medication can assist people to get better while being treated via CBT / mindfullness based counseling. Taking drugs to assist in the midst of an experience of depression can really help while people build their skills/ confidence levels back up again. But it can take a lot longer without anti-depressants, which causes more of an impact on work and family relationships… That’s just my experience though
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“i do question a solution where there is a possibility of further suffering or prolonging it especially if a person is not at risk of harming themselves and others.”
People do have different reactions to the various medications and dosages. There will be monitoring and tweaking from clinicians to find the best AD and dosage for the individual. The fact remains that ADs do help many people cope better and save lives.
I’m sorry it didn’t work for the person you know and their physician should have been on top of it with also including other therapies as part of the overall mental health plan.
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I have no qualifications in mental health, but a healthy dose of experience with grief. I finally lost my mother to brain cancer in my twenties, 17 years after she was given a year to live, shortly after my 12th birthday. My brother and father died almost similtaneously eighteen months ago, my brother from an aneurism from the shock of my father dieing from a heart attack in his arms. My remaining brother is living with a serious condition that could take him from us at any time. My husband has been struggling with depression since our first child was born six years ago and I’ve had to be the one who keeps going.
I’m normally a happy and confident person but at times (like today) I have found it incredibly difficult to get over the death of my brother in particular as we were very close. I’m not the sort of person to dwell on things and feel sorry for myself, but I have found myself being dragged into a black hole every time I’m feeling like I can’t cope with life in general, the main thoughts in my mind are of my feelings of loss for my mother and brother. Grief may be a part of life, but for those that haven’t experienced the ongoing, crushing loneliness and sadness that accompany it, they should perhaps reserve their judgement until they have.
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Sandy I am so sorry for all of the heartbreak you have experienced in your life. The bravery and courage you must have to face everyday is astounding. Im sure you inspire those around you. Sending you happy thoughts and best wishes that there is nothing but love and light in your future.
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Thank you anonymous, you’ve made me cry again
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Sandy you are amazing. Much love
xx
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“The truth about grief is that it is a madness, in which the person or people you’ve lost are still there in your life. They’re palpable both by their absence, the empty spaces they leave, and by all the traces they’ve left behind. Grieving people are literally insane, in that they cannot reconcile themselves to the real world the rest of us live in.”
Sounds about right to me.
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I’ve worked extensively in mental health and I’ve never met a single psychiatrist keen to pathologise normal human emotions. What I have met, though, is people who are unable to move through their grief or people who have major depressive episodes kickstarted by grief. Including grief in the DSM means those people will be able to access subsidised medications and therapies. It means, for places like America where accessing health care is heavily dependent of private insurance, the difference between receiving some treatment and receiving none.
I don’t agree that giving someone a diagnosis is like being stuck with a ball and chain. For many people it’s actually a relief to know that what they’re experiencing is real, has a name and is experienced by others.
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ANTI-DEPRESSANTS DO NOT NUMB ALL EMOTIONS!!! TAKING THEM WILL NOT AVOID GRIEF! PLEASE PEOPLE STOP CLAIMING THIS IN YOUR OPINIONS. IF YOU HAVE NEVER TAKEN THEM OR HAVE NOT RESEARCHED WHAT THEY ACTUALLY DO, THEN KEEP YOUR OPINION TO YOURSELF! THEY DO NOT MAGICALLY MAKE YOU HAPPY, YOU STILL FEEL. HOW MANY TIMES DOES THIS HAVE TO BE POINTED OUT IN THIS THREAD BEFORE THOSE WHO DO NOT KNOW BETTER STOP CLAIMING IT TO BE SO?
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I feel the use of CAPS is completely justified in this comment.
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Totally agree- anti-depressants do not eradicate depression
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Grief is natural and essential. Why do we feel the need to ‘cure’ everything with a pill??? You need to grieve when you lose someone or something dear or have an experience that’s frightening or whatever. It helps our bodies deal with the stress and allows us to mentally cope and move on. Supressing grief with medication would (I believe) lead to it manifesting itself in other forms of behaviour and not pleasant behaviour either I think. People need to grieve.
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I hope not…
We accept the joy that comes with birth as a part of life why can’t we accept the grief that comes with death? It is a part of life. People who are bereaved don’t need a pill (unless of course they feel it would help), they need time, they need space to grieve and not be judged for it.
I lost both my parents when I was 10 years old. I basically grew up in the turbulence of grief. My biggest challenge was not the grief itself, it was those around me, those who couldn’t accept that grief is a part of life. It was an interesting experience growing up in Australia as an orphan to say the least, and what I learned is that people fear grief but I also learned that it doesn’t have to be that way.
I once read – grief is an extension of love.
I am open to grief, I always have been. It is the loss of love – the loss of my parents and grief is a normal response. It is also a part of life, it is an extension of love for my parents, which is why I have accepted that grief is a part of my life and always will be.
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Of course not!!! Grief is a normal, natural part of the life cycle (though of course it will be expressed slightly differently in every person). When we come into the world we can expect many experiences – grief, pain and discomfort included. Why pathologise such a thing? Grieving people do not need judgement – just understanding and as much time as they need to work through the experience and try to live with the pain of loss.
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This makes me think of Eternal Sunshine of the Spotless Mind!
Why are we so desperate to numb every single emotion these days? Why don’t we want to feel anything, good bad or otherwise? Grief is an overwhelming emotion. It is all consuming. But it can also be cleansing, giving us a new sense of direction and forcing us to re-evaluate our lives. Is it pleasant? Certainly not. But in the days after I lost my son, I had to feel those emotions in order to move forward. If you can’t feel the emotions, how do you ever deal with them?
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I am including two links to interviews on RN Breakfast recently on this subject which may be of interest to you Marcus and to others visiting nd reading your article. I have worked extensively in mental health and come from a background in occupational therapy, I assess a persons need for therapy and medication not by the event or the label placed on the expereince but on the individuals abilty to function and manage the responsibilities that they have in daily life, when the wheels start to fall off then it is time to consider other supports (medication, therapy, counselling etc).
Interview 1: with Gordon Parker. Professor Gordon Parker is one of Australia’s foremost clinical psychiatrists and has become widely known for his strong and provocative views on the way psychiatry is practised and taught. Now, after stepping down from the Black Dog Institute after ten years at the helm, he has written an autobiography which targets the flaws he perceives in present day psychiatry.
http://www.abc.net.au/radionational/programs/breakfast/2012-02-06/3813018
Interview 2: was introduced with …It is clear that a period of prolonged grief could turn into depression. But should the two conditions be diagnosed and treated in the same way? Next year the American Psychiatric Association will publish a new diagnostic and statistical manual, and a debate has broken out over whether grief should be included in the definition of depression….Fran interviewed Dr Allen Frances, Professor Emeritus and former Chair of the Department of Psychiatry at Duke University, and Chair of the task force overseeing the compilation of the new diagnostic manual.
http://www.abc.net.au/radionational/programs/breakfast/2012-01-30/3799410
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I am including two links to interviews on RN Breakfast recently on this subject which may be of interest to you Marcus and to others visiting nd reading your article. I have worked extensively in mental health and come from a background in occupational therapy, I assess a persons need for therapy and medication not by the event or the label placed on the expereince but on the individuals abilty to function and manage the responsibilities that they have in daily life, when the wheels start to fall off then it is time to consider other supports (medication, therapy, counselling etc).
Interview 1: with Gordon Parker. Professor Gordon Parker is one of Australia’s foremost clinical psychiatrists and has become widely known for his strong and provocative views on the way psychiatry is practised and taught. Now, after stepping down from the Black Dog Institute after ten years at the helm, he has written an autobiography which targets the flaws he perceives in present day psychiatry.
http://www.abc.net.au/radionational/programs/breakfast/2012-02-06/3813018
Interview 2: was introduced with …It is clear that a period of prolonged grief could turn into depression. But should the two conditions be diagnosed and treated in the same way? Next year the American Psychiatric Association will publish a new diagnostic and statistical manual, and a debate has broken out over whether grief should be included in the definition of depression….Fran interviewed Dr Allen Frances, Professor Emeritus and former Chair of the Department of Psychiatry at Duke University, and Chair of the task force overseeing the compilation of the new diagnostic manual.
http://www.abc.net.au/radionational/programs/breakfast/2012-01-30/3799410
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I am including two links to interviews on RN Breakfast recently on this subject which may be of interest to you Marcus and to others visiting nd reading your article. I have worked extensively in mental health and come from a background in occupational therapy, I assess a persons need for therapy and medication not by the event or the label placed on the expereince but on the individuals abilty to function and manage the responsibilities that they have in daily life, when the wheels start to fall off then it is time to consider other supports (medication, therapy, counselling etc).
Interview 1: with Gordon Parker. Professor Gordon Parker is one of Australia’s foremost clinical psychiatrists and has become widely known for his strong and provocative views on the way psychiatry is practised and taught. Now, after stepping down from the Black Dog Institute after ten years at the helm, he has written an autobiography which targets the flaws he perceives in present day psychiatry.
http://www.abc.net.au/radionational/programs/breakfast/2012-02-06/3813018
Interview 2: was introduced with …It is clear that a period of prolonged grief could turn into depression. But should the two conditions be diagnosed and treated in the same way? Next year the American Psychiatric Association will publish a new diagnostic and statistical manual, and a debate has broken out over whether grief should be included in the definition of depression….Fran interviewed Dr Allen Frances, Professor Emeritus and former Chair of the Department of Psychiatry at Duke University, and Chair of the task force overseeing the compilation of the new diagnostic manual.
http://www.abc.net.au/radionational/programs/breakfast/2012-01-30/3799410
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Grief is not a mental illness. Grief is a normal, healthy reaction and part of life. It’s normal to feel sad, depressed, devastated, when bad things happen.
Perhaps it should be considered a mental illness NOT to feel grief when grief is normal and justified.
I think it’s wrong to pathologise it
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So agree!!!!!!
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This is a tricky one, and I don’t think there could be a one-size-fits-all answer.
I’ve been on and off anti-depressents (which also help anxiety) for 5 or so years, and I recently went back on them as I simply wasn’t coping with some stuff happening in my life (we had a miscarriage, and my mother’s cancer was taking a turn for the worse just to name the big ones). I had a good chat with my GP about everything and she and I agreed it was only for the best if I had as much on my side as possible to help me get through the loss of the baby as well as my mum’s stuff. The antidepressents that I’m on aren’t a ‘happy pill’ designed to cheer me up, but they help me to not crash down as far as I could/would. I’m not as emotional when I’m on them (I was at the point of I’d drop something on the ground and burst into tears) and they basically just help me cope.
I’m not on a very high dose, but at this point in time I have no plans to come off them, and there’s no real reason for me to at this point.
I should mention I’ve also been to some fantastic psychologists over the last few years who have also helped me a lot; I wouldn’t recommend medication with no form of counselling as well, at least at first.
With greif I tend to think “Whatever helps you get through it” (though I wouldn’t advocate alcohol or illegal drugs)… be kind to yourself and don’t expect too much.
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Yes, grief is completely normal. But a person experiencing the grief can gain assistance from medication if necessary, and providing medical practitioners with information about the diagnosis and treatment of grief is not a bad thing.
While grief is obviously not pathological, I don’t see it’s inclusion in the DSM as a negative. As the author mentioned, the DSM has undergone a number of revisions, and it will continue to be an evolving document as long as we continue to study the human body. Just because the majority of the current DSM focuses on disease is no reason to keep other related mental health issues out of the manual.
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Research shows that grief, especially complicated grief, can lead to a major depression episode.
But more importantly, the DSM is an American diagnostic manual (although, far reaching). Inclusion inthe DSM means those not coping with grief can claim therapy via medical insurance. They can also be covered by insurance if they need time off work for example.
Inclusion in the DSM also means more research into undertanding and treatment of grief which can only be a good thing.
I’m all for the inclusion of grief in the DSM.
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I think the baby blues (which are normal) can turn into depression for some women and grief can turn into clinical depression for some people also. How do we define what is healthy, normal grief and what is pathological grief? I assume by severity of symptoms and length of time. People are probably already asking for and using meds to deal with grief right now, you don’t need any formal diagnosis to be prescribed anti-depressants.
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I totally believe that grief is an important emotion that we need to have. Yes it hurts and yes it is awful for anyone to go through but it is important to FEEL the whole tumble of emotions that come with grief to be able to move on. However. If the grief is to a point where it is leading to depression and is taking over your life, I think anti-depressants AND councelling can help to get you back on track. But for most people I don’t think grief should be classed as a mental illness.
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Grief and depression are different things. HOWEVER, one can often lead to another – depression can often go unrecognised and undiagnosed when a person has just lost someone close to them, because everyone (often including the person in question) assumes that what they are experiencing is “natural”. Which depression is not.
I have experienced (and come through the other side of) extreme depression. A few years later, I lost my mother. Having experienced both circumstances, I can tell you that grief is different to depression – but if you had not experienced both, you probably wouldnt be able to identify the difference.
As a side note, I object to the idea that anti-depressants “block out all emotion” and that if you are on them, you wouldn’t experience tha natural process of grief. You do. Believe me – you well and truly still feel the full spectrum of emotion (assuming you are taking a form of antidepressant that works for you, and isn’t too high a dose). What they do – as the name suggests – is stop you spiralling into a depressive state – which is NOT part of grief and shouldn’t be. The choice to take anti-depressants is entirely personal, but from my perspective, I do not believe it to be ridiculous that a doctor should prescribe them to a patient dealing with a massive personal loss.
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If the grief extends out for months and interferes with a person’s ability to function in daily life then the question is – why wouldn’t they you the tools to feel better?
Therapy, exercise, medication, support groups; these are all tools best combined together in order to recover.
Grief is obviously natural, however, if that grief becomes immovable it could then trigger more serious depression – and that obviously requires assistance to recover from. You wouldn’t walk around with a broken leg for 6 months, so why wouldn’t seek help with emotional challenges?
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I think it depends on the individual.
My aunty lost her husband a year ago after a long illness. She was his main caregiver and although we knew it was going to happen sooner or later, it was still a shock.
My aunty is not coping well. She has become paranoid and is convinced that the family is plotting against her to write her out of our lives. She seems to have forgotten that others have lost a brother, a dad, an uncle, and a friend. She says some very personal hurtful and thoughtless things that everyone excuses because she is grieving (understandably) and also has unpredictable rage blackouts that are really scary, especially to those who are not close to the family.
So in this case, I think anti-depressants would be appropriate. Although her sons have tried to help, she refuses to see a professional. I know it’s not ok, but I feel so awkward when I see her, like I can’t talk about my uncle passed away because I don’t know how she will react. I feel like if I do talk about him, she’ll be upset, and if I don’t, she will also be upset. Bit of a lose/lose situation but if anti-depressants will help her get back on her feet, I am all for it.
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When my mother died my world fell apart mainly out of relief/guilt our dysfunctional relationship was finally over. This has impacted my whole existance and ability to cope let alone think myself worthy to even be here and its only with the introduction of anti-depressants do I feel like I can face each day.
I was one of the people who would scoff at those who werent ‘strong’ enough to get on with life, so its been a very humbling experience. Everyone and everyones relationship with the deceased is difference therefore grieving may take many different shapes and forms. Death changes who you are and only you know the best way to navigate through the dark times. Do what feels right or what you know deep down you need to do
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I think it’d be a really, REALLY bad move to classify grief as depression.
They’re different things, but that’s not to say you can’t be depressed and grieving at the same time.
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Don’t think this article goes any way to reducing the stigma of mental illness. In fact the repulsion at the idea of being considered mentally ill portrayed here, leaves me feeling nauseated. Grief often triggers depression, grief of course in it’s ‘normal’ course includes a degree of depression, but if it is ongoing and stopping you from functioning in day to day life, then what is wrong with taking an anti-depressant for a period. Anti-depressants are not miracle cures, they don’t make the grief go away, that still has to be worked through. One needs to recognise clinical depression for what it really is, so much more than feeling down and sad, there are many physical ailments that go along with it, failing to address those will most likely prolong ones depression. Please don’t place your insecurities on those who have the courage to say they need some help.
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I disagree with you. I think the article talks about the seriousness of mental illness – instead of playing it down as some sadness or grief that you suffer
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I don’t believe it does, references such as ‘broken’ ‘crazy’ and ‘ball and chain you’re stuck with’ are ridiculous and uneducated. The article completely disregards the incidence of depression stemming from grief and attempts to suggest that grief cannot have wider implications. To need an anti-depressant when it is completely natural, is wildly based on assumption. I would question the authors credentials regarding mentall illness and ask what qualifies him to make such comment on the subject, other than his own experience of ‘a dozen years ago’. What has been learnt about mental illness and treatment of it, has certainly changed in the past dozen years. Clearly the author has not changed his understanding of mental illness, citing stigmas which many have been fighting damn hard to remove, from what I can see, it is insecure people stuck on old ideas that stigmatise it, majority are beginning to get it. Why? Because it is so common!!
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I totally agree with you.
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Depends on the grief and the person going through it.
My youngest sister’s baby boy died suddenly at only 3 weeks of age.
It was a horrible ordeal for her to go through & would’ve been even crueler without the antidepressants she was prescribed. She has an older daughter who she needed to help navigate her way through losing her brother as well.
Whatever help can be given to those who need it shouldn’t be held back because others think that you should just “suck it up”, which is basically how I read the article.
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There also seems to be a misconception here that antidepressants delay you having to go through the emotions of grief. In my experience, they don’t stop emotions, but help you work your way through them. They’re not a magic pill that puts you in a happy kind of la-la land until you stop taking them. They’re serious drugs which can save lives if used properly.
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I agree with your comments Kristy. I think it’s extremely difficult to honestly grieve when you have others to look after. It adds another dimension to your grief.
Ultimately, grief is a very personal thing. I don’t think it’s a mental illness. Doctors prescribe anti-depressants for a number of reasons (not just mental illness).
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I agree too, Kristy. When the world becomes overwhelming because somebody so close has died, it can be a real struggle to go on living. When my dad died a few years ago, anti-depressants no doubt saved my mother from committing suicide as she simply could not cope without him. To say that anti-depressants are purely for clinical depression and that grief is merely a ‘miserable experience’ is lightweight – it goes far deeper than that. People don’t just ‘get over’ grief. They survive it.
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Completely agree. I think grief can definitely be classed as a mental illness, if only for a short while. My own grief from a series of devastating losses in quick succession led to me – normally a positive, energetic person – being unable to cope and crying in controllable every night. I thought that time would heal it, but when that wasn’t working (after a couple of years it was actually getting worse), a combination of counseling and natural medications helped to lift the overwhelming anxiety and the fog cleared and I could begin to heal properly. Am I mentally ill? No. Was I trying my best to live through grief and face up to it? Yes. Did medication help? Absolutely. It didn’t numb the pain, but certainly gave me extra strength to cope. Was it a cop out? Definitely not.
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In my experience, grief of itself is best dealt with over time and processing emotions. However, there comes a point that if you aren’t coping, your life is being impacted and your mental health is declining that grief can become depression and sometimes medication is appropriate.
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My brother committed suicide 8 weeks ago and I am experiencing this horrible, agonising thing called “grief”. I am still functioning on a day to day basis – just. I would not like to think that I should be automatically classified as mentally ill and medicated, however I do believe there would be people that in order to function at such a time may require medication. It should be an option not the norm. I am seeing a psychologist who tells me to lean into every emotion as it comes over me otherwise the pain will only resurface ten times worse somewhere in the future. My fear would be that by being medicated I am only delaying the inevitable anger, sadness and despair that I am experiencing every day. Like everything of this nature, everyone is different and to arbitrarily suggest one course of action is best for all is unrealistic.
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I am really very sorry about the loss of your brother.
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I am truly sorry to hear of your loss. I do feel you have a misconception about the effects of an anti-depressant, which if you feel you are functioning while grieving, you may well not need, Anti-depressants do not make normal emotions just disappear, in fact, they allow normal emotions to occur, which may not, if the chemicals in your own body are not doing what they are designed to do. I too believe that one course of action cannot be perscribed to everyone, no one grieves the same way. Any doctor that believed medication was required for grief regardless, is not worth the time. I do hope though, if you do find yourself having trouble coping at any time in the future, you will seek help and won’t be put off by an idea that it is weak to do so.
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I am so sorry to read about your brother. Grief is intensely painful and seemingly unbearable in those early months and years. My 3yo son died suddenly 7 years ago and those first two years were very hard. The next three were also very hard. I had lots of people wanting me to take anti depressants but I knew they wouldn’t make me miss him less and I actually wanted to FEEL the pain of his absence. Life is good (really good) now. I carry him with me in my heart and I no longer feel I spring from that place of pain (well there will always be moments and days it hurts). I hope this for you and your family too, in time. I didn’t ever take the AD’s but I did have a heap of counselling. My heart goes out to you.
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Thankyou so much Aussie Mum for your reply. It is stories like this that give me hope and I can say that the length of time between moments of complete despair and anguish grow a little every day. To lose a brother is one thing to lose a child is incomprehensible to me. I know now more than ever I hold my two children closer than ever (almost suffocatingly so !) and this helps me. Grief is such an individual thing . For me I could talk about it and him and what happened till the cows come home. For his wife this is just too hard and medication and an inward perspective is her path, but that is her way and I have mine. We will all get through in our own way. Congratulations Aussie Mum for finding happiness again and I bet you treasure even more now x
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IMO, it would really depend on the person grieving. For me, I tend to keep to myself and talk about it when I’m ready. Medication wouldn’t have helped me at all, I just think it would have put off the grief for another time, possibly a time I wouldn’t be ready for.
I do strongly believe however, that no one can be told HOW to grieve. It’s such a personal thing. I know I was judged when I was grieving after my husband died. But I did it my way, and it worked, and almost 3 years down the track I’m fine. Bugger those who took issue with it.
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Hey, I’m sorry for your loss. Truly sorry. I have a close friend who lost her husband suddenly almost three years ago. She has two small children. We do our best to help by taking the children when we can, cooking the odd meal and helping with some chores/gardening however I never felt like we are doing enough. As someone who has been there, can you suggest some things that you found helpful? I try to help but when she cries all I can do is hug and say that I’m sorry it’s do hard for her. I can’t understand what she is going through and I can’t bring him back. What can I do to help?
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You already sound like you are physically doing heaps for your friend. You are awesome. Sounds like though she needs support with her emotions, so all I can say is just be there. Don’t try to fix it. Just let her vent, let her cry. She’ll probably go through a stage of being really angry too. When that happens, take her to paint ball or something, somewhere she get let the anger out.
I promise she will appreciate just having someone there to release the emotions to.
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What ever works. I think some doctors are too quick to prescribe medication but for some people they may need something to help them through short term.
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