- The summary of a report, "Removing the Exclusionary Criterion about Depression in Cases of Bereavement," submitted to the ADEC Board of Directors in November 2010 by its Scientific Advisory Committee
- The full content of the webinar "The DSM-V Exclusion Criteria Explained, Processed, and Problem Solved," which will be available online for the next month (through March 21).
ADEC, the Association for Death Education and Counseling, has made two valuable resources publicly available on the Internet, which cover important background information on the proposed removal of the bereavement exclusion for depression in the DSM-V (see "DSM Debate Grows over Grief and Depression"). The newly revised and updated Diagnostic and Statistical Manual of Mental Disorders (DSM-V) -- which is the result of several years of intensive and comprehensive review, analysis, and discussion by the foremost experts in the world -- is expected to be completed by the end of the year. The ADEC resources are free to access:
A recent New York Times article highlights a growing controversy over the next version of the Diagnostic and Statistical Manual (commonly called "the DSM"), which is the bible of classifications of mental disorders in the United States.
Even as it is due at the printers in December, new material planned for DSM-V is being intensely debated, including the proposed elimination of the current exclusion from a diagnosis of depression for a person experiencing grief:
Under the current criteria, a depression diagnosis requires that a person have five of nine symptoms -- which include sleeping problems, a feeling of worthlessness and a loss of concentration -- for two weeks or more. The criteria make an explicit exception for normal grieving, which can look like depression (Benedict Carey - "Grief Could Join List of Disorders" - New York Times - 01/24/2012).
On one side of the argument are those who believe the current exclusion does a disservice to grieving people who would benefit from a diagnosis of (and treatment for) depression:
“If someone is suffering from severe depression symptoms one or two months after a loss or a death, and I can’t make a diagnosis of depression, [says Dr. David Kupfer, professor of psychiatry at the University of Pittsburgh School of Medicine,] well, that is not being clinically proactive. That person may then not get the treatment they need” (Carey).
On the other side are those who fear that grief will come to be considered as an illness:
“An estimated 8 to 10 million people lose a loved one every year, and something like a third to a half of them suffer depressive symptoms for up to month afterward,” [says Dr. Jerome Wakefield of New York University]. This [eliminating the exclusion] would pathologize them for behavior previously thought to be normal” (Carey).
Here is a quote from "What to Do about Valentine's Day," by Cheryl Eckl, whose husband died of cancer in 2008:
The problem is that it's Valentine's Day weekend—which always brings up the whole idea of love. And, for widowed persons, the question of loving again after loss. Clearly, this is a matter I have avoided because, in surveying my present circumstance, I realize that I have, indeed, replaced my husband—but ... not with a sentient being. These days I spend the majority of my time with my desktop Mac, laptop, iPhone, and soon-to-be-purchased iPad.
I have been working with people bereaved by suicide since 1999, and I started Unified Community Solutions in 2001 as an independent consultancy specializing in peer grief support and suicide prevention project management and advocacy. "Personal Grief Coach" is an extension of the dozen of years of experience I've had with those endeavors. I am now beginning to create publicly accessible online connections with interested people and organizations through
Grief after Suicide posts are by Franklin Cook (unless noted). Learn more about Franklin's work in suicide grief support.
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