(Time Healthland) Good Grief! Psychiatry’s Struggle to Define Mental Illness Goes Awry
A proposed new definition of depression would include normal bereavement. Why that’s a bad idea.
The editors of the forthcoming fifth edition of the Diagnostic and Statistical Manual — psychiatry’s diagnostic handbook — are having a hard time. They’ve been attacked by autism advocacy groups for proposing to eliminate the Asperger’s diagnosis. They’ve been slammed for adding a diagnosis, or “prediagnosis,” for people determined to be “at high risk” of developing schizophrenia. And, now, they’re being pummeled for introducing a provision to diagnose grief as depression.
It has not gone unnoticed that the illnesses for which proposed definitions have been expanded are mainly those that are treatable by drugs — antipsychotics or antidepressants, for which manufacturers seek increased marketing opportunities — while the contractions tend to be in conditions for which no specific medication is available.
Indeed, the suggestion to label normal grief as depression would allow, for example, a bereaved widow to “treat” the sadness over the loss of her husband with Prozac — a condition that previously would have been remedied with time and family support. Meanwhile, other diagnoses that the DSM-5‘s editors have rejected — including developmental trauma disorder for children whose mental problems can be best explained by early negative experiences, such as being shuttled between multiple foster homes — often share the quality of not being easily amenable to pharmacological solutions.
Also see Is It Possible to Literally Have A Broken Heart?, Don’t You Want Your Partner to be… Interesting?, The A.D.H.D. Relationship, Are You a Narcissist? and Is It Possible to Literally Have A Broken Heart?