Thursday, March 15, 2012

Good Grief! Am I Crazy?

The American Psychiatric Association will be issuing a new Diagnostic and Statistical Manual of Mental Disorders (DSM) next year.  There is, apparently, a movement to add complicated grief to the manual. 

I just read this fascinating piece on Slate:

The heart of the article is expressed in this excerpt: 

"Grief, even the ostensibly extreme variety that the DSM might include, is a universal and normal human reaction to the loss of a loved one. Unlike most disorders in the manual, it is a condition we will all experience. It is not a disease and it has no place in a book dedicated to listing mental disorders. In a culture that has largely turned grief into a private experience rather than a communal one, the decision to include grief in the DSM risks doing more harm than good, making it easier than ever to view those who are simply experiencing a painful rite of passage as abnormal."

I thought the Slate piece had some great points.  On the other hand, I also think there is some point where grief goes beyond "normal" and might be a psychological problem.  The proponents of including grief in the DSM-V, at least according to the article, would base this on the length of one's grief.  To some extent, this may be valid, though I (a person with no formal psychological training, educated in grief only through firsthand knowledge, self-help books, support group experience, grief counseling, and scouring online resources) think this oversimplifies things. I believe -- and I know a lot of others, including so-called grief "experts" believe -- that grief never ends.  You don't "get over it."  Sure, you might start to "feel normal," as participants in a Slate research study on grief eluded to, but you don't stop feeling it for good.  I will never get to the point where I can say, "I'm done missing Brian.  I'll never yearn for him, nor feel nostalgic for what we shared again." I don't see that happening.  I know I'll never be the same person -- does that make me clinically mentally ill?  That could be how I'd be classified if the wrong definition of grief was used in the manual.

I would classify problematic grief as that which, after some amount of time (which would vary depending on the loss), continues to be all-consuming.  Grief that lasts a long time -- even forever -- isn't a psychiatric problem.  Grief that lasts a long time and keeps you from enjoying life probably is.

What are your thoughts?


  1. Grief will always be a part of your life. Nobody can supress or banish it from the heart. The only way to continue your life is to learn how to handle it.

  2. I'm not sure something like that can be so simply defined! My first inclination would be to say it's problematic if you lose the ability to function. But for at least the first year after my mom died, I barely functioned, only on auto-pilot, and might not have even done that well if it weren't for my pets who needed to be taken care of. According to those people, during that time I was mentally ill, I guess?! Despite the fact that I took steps to try and become happy again? I do think for some people I know that grief continues to control their lives years and years after the fact, and I do think that's a problem. While my grief largely still defines who I am seven years later and still causes irrational fears that other people don't deal with, it doesn't control me anymore. But how can you place a timeframe on someone else's grief when it's so personal and different for everyone? I think people have to try and recognize within themselves if it's actually a "problem" or not or seek help to find out, but I think it's unfair to label it this way and suggest that people have an abnormal problem for feeling sadness and longing years later. If I get to be a hundred, I will still miss my mom!