Resisting the medicalization of grief...

One thing that sets us apart from other mammals is the extent of our emotional capacity to connect to one another - and with this, comes the intense pain we feel when these emotional connections are suddenly broken. The loss of a loved one is one of the hardest things we go through as human beings. Whether through a break up, divorce or death.

Every one of us is different, every relationship is different, and the nature, extent and expression of our grief will vary widely from person to person. I am by no means an expert on grief but there are two things that I know for certain to be true – one is that it’s a damn hard thing to go through, and two, is that there is absolutely no right or wrong way to deal with it.

There are no rules that can apply to something as complex as grieving the loss of a loved one, your relationship with them, all of the associations in this world that were connected to that person and the experiences you shared, the love you used to receive from them, your need to express your love for them and your own identity without that person. I’m sure this list could go on, but hopefully it at least begins to show just how intricate the web of grief can be for those of us who suddenly find ourselves in it.

I have no words for what I felt (or not) when I lost my mum 11 years ago at the age of 19. People say it gets easier with time. If I’m honest, I spent the better part of 10 years trying to make sense of the world and myself without her. I am only now starting to find any peace around this loss. For many psychiatrists, I would qualify as having ‘complicated grief disorder’. This is one of the latest disorder constructions which was being bandied about by the American Psychiatric Association when they were producing the most recent version of the Diagnostic Statistical Manual of Mental Disorders (DSM-V) last year. Despite the fact it has not yet been approved for inclusion, it is recognized by many clinicians and organizations, including the Mayo Clinic, as a condition requiring medication.

Apparently if your grief continues past a few months, you are cause for concern. Surely the amount of time it takes a person to grieve depends not only on the individual and their personal ways of coping, but also on the depth and nature of the relationship they lost? The previous version of the manual aimed to protect people who are grieving by stating that someone who has been recently bereaved must be excluded from adjustment disorders or depression as they will naturally display these ‘symptoms’ in reaction to the death of their loved one. This statement has now been removed from the current edition, meaning that many people dealing with grief will be diagnosed with depression and encouraged to take medication to treat what are essentially normal reactions to grief. Not that the previous inclusion of that statement stopped my doctor from diagnosing me with clinical depression after my mom passed away, but at least it was there to show that he was wrong.

This manual, which is more or less accepted as the gold standard by the professionals we rely on, conveniently gets much fatter each edition as new disorders (with substantial pharmaceutical profit potential) magic themselves into existence. In truth, grief is only one example of how normal human reactions to abnormally difficult experiences are medicalized by the disciplines of psychology, psychiatry and, of course, the pharmaceutical industry…

...maybe I’ll leave the rest of those worms in the can for today.


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