Grief and depression have similar symptoms. With new changes in psychiatric diagnosis definitions, the two will increasingly overlap.
Declared complete, the fifth edition of the Diagnostic and Statistical Manual (DSM) is slated for release in May, but debate continues to surround some of its more controversial changes — specifically, the elimination of the old DSM’s “bereavement exclusion” in diagnoses of major depression disorder (MDD). People in mourning often have similar “symptoms” to people with depression; the exclusion was originally intended prevent psychiatrists from diagnosing someone with MDD before they could be sure that the symptoms they were seeing were more than the usual manifestations of grief. Now, psychiatrists will no longer be advised to wait two months after a patient loses a loved one, for the period of “normal” grief to pass, to diagnose mental illness — and prescribe antidepressants.
Writing for the New York Times’ philosophy column, Gary Gutting frames this as a moral issue. For “normal” grievers and those for whom a loss has triggered an episode of depression, he argues, “The suffering may be the same, but suffering from the death of a loved one may still have a value that suffering from other causes does not.” He insists, “No amount of empirical information about the nature and degree of suffering can, by itself, tell us whether someone ought to endure it.” He argues that psychiatrists, as medical doctors, aren’t qualified to make this decision.
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