American Psychiatric Association

Is Grief a Medical Disorder or a Part of Life?

January 7, 2013 — Pat Bertram

Every once in a while I write a post that really strikes a chord with people, and such a post was The Half-Life of Grief. It’s garnered over 126 shares on Facebook alone, so apparently it’s an important message: grief is not simply emotional, but it’s physical, too. And if it’s physical, then no amount of sublimating our emotions will get rid of the grief. It’s in our very cells.

This is a message that the American Psychiatric Association doesn’t get. According to the updated Diagnostic and Statistical Manual of Mental Disorders to be released by the American Psychiatric Association, grief is considered a medical disorder, and should be treated as major depression. There used to be a bereavement exclusion in the description of major depression, but they have taken that away, and now more than a few days of pain after the loss of a loved one is considered a crisis. There can be “a few days of acute upset and then a much longer period of the longing, the tearfulness. But typically sleep, appetite, energy, concentration come back to normal more quickly than that.”

As I said in 2010 when I first posted the information about the APA getting rid of the bereavement exclusion: In whose world is grieving a medical condition that needs to be treated? Not my world. In my world, grief is one of the bookends of a relationship. Love. Grief. If grief is a medical condition, then watch out. One day love is going to be considered a treatable disease.

During the past couple of years, there has been a concerted effort by grief counselors, therapists, and other health professionals to rectify this gross misrepresentation of grief, but the American Psychiatric Association is sticking to their decision that grief is a medical disorder.

A medical disorder? For cripes sake, it doesn’t take a fistful of degrees to understand that for the majority of people who have lost someone important in their lives, grief is a completely sane and healthy reaction. So what if grief is hard? Someone we loved dearly is gone from our lives and will never return. What do they expect us to do, just blithely continue with our lives as if nothing important happened? As if the dead had never even existed? As if we’re happy about the situation? And even if we wanted to be joyful despite it all, there is the simple matter that our bodies also grieve, and we’d have physical reactions even if we were drugged into placidity.

I realize that in certain cases people do entertain thoughts of suicide, but those thoughts are part of the grief process. It’s only when people start stockpiling pills or buying guns or starving themselves on purpose that grief might become a medical concern.

Admittedly, some people do manage to continue after a major loss as if nothing happened, and to be honest, I thought I would be one of those people, but death and loss have a way of making themselves felt even in the strong and stoic.

It might seem from these grief posts that I dwell on grief, but I don’t. I dwell on life. And grief is part of life. I understand that. And so should the American Psychiatric Association.

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Pat Bertram is the author of the suspense novels Light Bringer, More Deaths Than One, A Spark of Heavenly Fire, and Daughter Am I. Bertram is also the author of Grief: The Great Yearning, “an exquisite book, wrenching to read, and at the same time full of profound truths.” Connect with Pat on Google+

Posted in culture, grief, life. Tags: American Psychiatric Association, bereavement, death, Diagnostic and Statistical Manual of Mental Disorders, grief as a medical disorder. 6 Comments »

One Woman’s Grief

August 8, 2010 — Pat Bertram

The American Psychiatric Association has labeled grief that lasts more than a few weeks a mental disorder. I wrote about this in my last blog post, “Grief Is Not a Medical Disorder,” but I can’t stop thinking about it. The problem with grief is not the pain, though sometimes the agony is so unbearable it takes one’s breath away, but the reason for the pain: a very dear person, a part of your life, is gone and will never return. When one is depressed for no reason, then perhaps the misery can be classified as a mental disorder. But if there is a reason for the pain, if there is a direct cause for the depression, then it is not a disorder. It is life.

Grief varies, of course. Everyone grieves in a different way, and everyone feels each subsequent death in a different way. The loss of an aged aunt you barely knew is different from the loss of a beloved mate. In the first case, prolonged grief could be a sign of depression, but in the second case, prolonged grief is a way of coping.

When I lost my mate, I was in such pain I thought my heart would burst. I couldn’t breath, couldn’t focus, couldn’t see how I could ever get through the day let alone the rest of my life. I was also still in shock from witnessing his horrific death.

I did get through those first days, though how I don’t know — the pain escalated by the minute. Then I found out about a local bereavement support group. I am a private person, one who keeps her emotions to herself, but I went to the group meeting anyway hoping someone could tell me how to deal with the pain. No one could, of course, but I did meet people who had survived a similar loss, and that taught me survival was possible. One of the problems with grief is how it isolates you, and the group made me feel less isolated. And that was a comfort.

I had no intention of writing much about grief on this blog. I posted a few articles mentioning my pain, and found that not only did the articles help me, they gave comfort and support to others who were going through the same thing. So I continue to write about grief. Perhaps someday the private me will look around and be aghast at all I have made public, but for now it’s my way of coping.

The point of this bloggery is that the pain of grief made me reach out and let others into my world. If I had been treated for depression during this time, I wouldn’t have connected with others. I would have remained isolated, and the effects of intense grief would have last much longer than they did. Everyone has the right to grieve the way they want, of course, but feeling the pain was the only way I could do it, both for me and for my mate. He deserved to have someone grieve that he died, to have someone feel the imbalance of the world without him in it. And that is not a mental disorder.

Posted in blogging, culture, grief, life. Tags: American Psychiatric Association, death, death of a mate, depression, grief, life, life experience, loss. 15 Comments »

Grief is Not a Medical Disorder

August 4, 2010 — Pat Bertram

According to the new Diagnostic and Statistical Manual of Mental Disorders released by the American Psychiatric Association, grief is considered a medical disorder, and should be treated as major depression. There used to be a bereavement exclusion in the description of major depression, but they have taken that away, and now more than a few days of pain is considered a crisis. There can be “a few days of acute upset and then a much longer period of the longing, the tearfulness. But typically sleep, appetite, energy, concentration come back to normal more quickly than that.”

In whose world is grieving a medical condition that needs to be treated? Not my world. In my world, grief is one of the bookends of a relationship. Love. Grief. If grief is a medical condition, then watch out. One day love is going to be considered a treatable disease.

Perhaps emotional pain is not necessary. Perhaps people can survive quite nicely without going through the pain of grief — perhaps avoiding grief won’t cause the future problems people say it will — but the truth is, grief is a life experience, an incredibly deep and painful and raw experience that changes the way you think about yourself and the world. Grief helps you process the amputation of having a child or a mate torn from your life, let’s you experience the loss in a visceral way, makes it real. In past eras, grief was acceptable, in fact, was even encouraged. In today’s world, grief needs to be hidden so that it doesn’t offend people’s sensibilities, so that it doesn’t bring the spector of bad luck into people’s lives. Drugs can hide your grief, of course, but that’s all it can do.

I didn’t grieve excessively when my mother or my brother died, but when my mate died? I was devastated. (Still am, but at the moment I am going through a hiatus, a time of peace.) It wasn’t only the death of him. It was the death of our future, our dreams, our hopes, our lifestyle, our shared life, our private jokes. It was the death of my companion, my love, my friend, my confidante, my fellow traveler on life’s journey. No drug is going to make any of those deaths acceptable.

“He” died. “We” died. But “I” didn’t. Grief made me realize that. Surviving grief has taught me that I can survive anything. No drug could ever give me that.

I know a woman who mourned the loss of her mother for two years. Actually, she wasn’t mourning the loss of the mother so much as the loss of the emotional support and attachment the mother never gave her and now never would. She emerged from this period a strong, vital, wise woman. No drug could ever give her that.

In a strange way, grief is a gift. Easy? No. Painful? Yes. But . . . If you let yourself feel it, let it become a part of you, it will take you where you need to go. And no drug can ever give you that.