The American Psychiatric Association is in the midst of a controversy around the updating of its Diagnostic and Statistical Manual of Mental Disorders or D.S.M., psychiatry’s official tool for deciding between mental disorders and “normality.”
Apparently, the DSM-5 is preparing to classify grief from the death of a loved one as clinical depression, as early as two weeks after the loss. The change eliminates the so-called “bereavement exclusion,” which exempts grieving people from diagnoses of depression for two months unless their symptoms are self-destructively extreme.
The change was first proposed over a year ago, and there has been a hue and cry in psychiatric circles about this change in classification. The controversy has yet to die down, and the D.S.M. 5 will not be published until May.
Opponents of the classification change worry that it is an easy way to simply medicate people to ease their pain, when in fact, the need for processing, perhaps coupled with talk therapy and simply time is usually the best way to move through profound loss.
I haven’t been in therapy in many years, but my understanding is that there is a movement towards medicating for even what could be classified as mild depression, rather than spending months on the couch working out your problems through talk and analysis. My hunch is that this has to do with the movement in our quite-broken health care and insurance system, the same one that moves women who have had babies onto the conveyor belt out of the hospital the same day they give birth, or, when generous, the next.
In other words, a quick fix for something that probably could benefit from a little more time.