A grief-stricken debate


The death of Catherine Lape’s grandmother was difficult for her to overcome.

Her grandmother died in March in the final stages of dementia after a staph infection spread throughout her body.

Lape said she was not depressed, but she was grieving.

Determining whether grief is a form of depression is a hot-button topic. Organizations such as the American Psychiatric Association are in talks to decide whether grief, among others, is a form of depression in their new edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM.

The manual helps professionals recognize, diagnose and treat patients to make sure they are making the right insurance decisions. 

According to the APA, the revisions will change people’s lives.

The definition of depression is only one of many that are being examined.

David Mrazek, M.D., chair of the psychiatry and psychology departments for the Mayo Clinic, said depression is more than just feeling sad. It can take over lives by distracting people from things they once enjoyed.

The current definition in the manual does not include bereavement, the grief felt after losing a loved one. 

According to the New York Times, researchers from Columbia and New York Universities said bereavement should continue to be excluded. They argue that, if added, “there is the potential for considerable false-positive diagnosis and unnecessary treatment of grief-stricken persons.”

The New York Times also said that the psychiatrists who support the change said depression can happen after a loss of a loved one, and could sometimes become severe. The supporters argue, that as psychiatrists, they need a way to help people cope with the loss, and adding it into the definition will be a start.

Dr. Allen Frances, chair of the task force on the fourth edition of the D.S.M., disagrees with the proposed changes.

Frances said he is concerned many people might receive treatment they do not need.

“What I worry about most is that the revisions will medicalize normality and that millions of people will get psychiatric labels unnecessarily,” Frances said.

Medication is not given for grief. Instead, psychiatrists follow five stages that a person must go through in order to overcome grief.

Nearly a year after her grandmother’s death, Lape agrees.

“Grieving is a natural part of life,” Lape said. “I think you should let it run its course. If someone thinks that their grief is leading into depression then they should get help. It would be an insult to your loved one if you got medicated just because you’re sad.”

According to the National Center for Biotechnology Information, severe depression is a combination of a stressful event and a chemical change in the brain. Since depression is more than just being sad, it can be categorically treated with therapy and medication.

Peter J. Weiden, professor of psychosis treatment at the University of Illinois, said that adding grief would only cause more problems because society already has problems with drug overuse. Making the definitions of the different disorders more vague will increase the vulnerability and misuse of drugs.

Lape didn’t use drugs to overcome her grief. As for therapy, her family consoled her.

“Spending time with my family helped me through the grieving process,” Lape said. “Talking about the things we used to do with her keeps her memory alive. She was my best friend and she will always be with me.”

While Lape supports a natural remedy, officials suggest otherwise.

The task force members of the APA, who are working to rewrite the manual, say that if people are seeking help then they should get treatment that is covered by their insurance.