Should Grief Be Characterized as a Disorder?

[Audley Strange]

I'm not particularly an emotional person (though I'm angry at this shite) but this idea that you can label an emotive state a "disorder" without understanding whether it is a perfectly natural reaction, almost like an auto-immune response or if it is a neuropathy or a psychological problem.

But the psychologists and psychiatrists arguing for this change do understand that some negative things in life are a natural reaction, and some of these natural reactions should not be interfered with (as attempting to diagnose and treat them can make the situation worse for the individual). This is why with "grief", they are looking at the evidence. The previous exclusion of grief in the DSM4 was based purely on fears of over-diagnosis - that is, they didn't want to try to treat people who would actually be better off without help. However, now psychologists are pointing out evidence that excluding it completely is resulting in an under-diagnosis of people that need help. In other words, there is "normal" grief, and then there is a more intense form of grief which, in some people, can exacerbate and worsen physical and mental conditions. This is because grief is obviously a significant stressor in someone's life, and ignoring it because it's "normal" or "natural" has resulted in a lot of people unnecessarily developing serious, and sometimes irreversible, problems in their lives.

The important thing to keep in mind is that they are not diagnosing or medicalising 'grief'. People get sad sometimes, and sometimes it's good to get sad. Nobody is trying to change that.

To start calling things "disorders" like that is to claim an objective baseline for a mental state. What the fuck did they use for the baseline an ecstasy fuelled gay pride march?

There's no need for a "baseline" or a comparison of what is "normal" to determine whether something is a disorder. The entire mental health field actively ignores what is "normal" because something being "normal" doesn't prevent it from being a problem for someone where they need help (and of course the reverse is true, where something being abnormal doesn't mean it's a problem for someone). A "disorder" is something which simply significantly affects the functioning of an aspect of someone's life. It doesn't mean that the person is "inferior", or "abnormal", or anything like that. It just means that they are asking for help and there have been groups of people with common symptoms which resulted in their collection of problems being given a name for easy communication.

Grief is a symptom. Yes it can affect the functioning of someone's life, often it can be crippling. I'd suggest that if this proceeds for an excessive length of time (though how do you measure that exactly? Will we have a chart for proper terms of grief of household cats and murdered children?) then it could be symptomatic of a disorder, but I think it is not the disorder itself. To label it such for convenience is not, in my opinion a good idea.

Despite what people might think labels are important, especially when dealing with mental illnesses. The public perception is less than sympathetic currently, however I do not find it hard to imagine situations where sat someone is off work suffering a post trauma disorder after being in an minor accident and being diagnosed and medicated for "grief" when one of their workmates was back after a few weeks after the loss of a child. One one hand this sort of thing would reduce the public sympathy further and thus in turn increase the claims of quackery and result in less funding. On the other hand given I could see politicians and businesses getting the wrong end of the stick and expecting grief to be like a cold. "Your sister was burnt to death in a fire? Yeah take tomorrow off and 4 of these, I'll expect you back bright eyed and bushy tailed by Wednesday."

When I worked as a staff liaison, I came up against common negative attitudes against mental illness all the time people often can't differentiate between feeling glum and clinical depression, they don't understand the difference. As such using grief in a highly specific way is bound to be conflated with common terminology, that is not good for anyone except those who wish to make profits off of those suffering from grief, whether they have a illness or are enduring a tragedy.

[Jesus_of_Nazareth]

Takes at least seven weeks to overcome proper grief with residual effects lasting from one to two years afterwards. These shrinks are low life coffin chasers trying to make money out of others loss.

Grief is a perfectly normal emotion - and is a good thing. If it don't hurt, then they didn't matter.

When my father falls off his perch I will be sad, but comforted by the fact that "he had a good run". and I will inherit a couple of million When me mother dies I won't even bother with the funeral, and will genuinely not care.

When me older brother died (in his early 40's) I was sad (and still am), but not to any great degree - for my Father it was of course devastating. it still is. and he won't ever "get over it".

For me, the Missus falling off her perch (at 37) ripped my entire world apart and stole not only my future, but my also my dreams (a world without dreams is a shitty place ).....and I lost most of my motivation for getting out of bed in the morning - often litterally. In many respects my world did stop 4 years back, and her dying is something I will never"get over", albeit I have never actually cried over it and I expect that in due course I will re-marry etc.

The one thing that links me Father (and my Brother) and me (and the Missus) is that we each felt a responsibility for the person who died, both real and imagined - not neccessarily about guilt but simply the fact that they were let down. I didn't get that with my brother, as he was older and not my responsibility.

Somethings you are never meant to "get over" - you just learn to live with 'em better and accept that won't be perfect, it's just how life is......kinda like losing a leg, can work around that 99% of the time - but part of you always knows it's gone. and sometimes your toe will itch ......and sometimes you will fall over ......but that's just how it is. Suck it up.


The funny thing is that I have a long (and glorious!) history of self medicating ......and I never turned back to that on the industrial scale it once was. Surprised both others and me!

IMO the secret is to puzzle your own way through - something others (or meds) can't do for you - the book of dead people is a long one, we each get to add a chapter (or 2). Same old same old - but each unique.

[maiforpeace]

Takes at least seven weeks to overcome proper grief with residual effects lasting from one to two years afterwards. These shrinks are low life coffin chasers trying to make money out of others loss.

Grief is a perfectly normal emotion - and is a good thing. If it don't hurt, then they didn't matter.

When my father falls off his perch I will be sad, but comforted by the fact that "he had a good run". and I will inherit a couple of million When me mother dies I won't even bother with the funeral, and will genuinely not care.

When me older brother died (in his early 40's) I was sad (and still am), but not to any great degree - for my Father it was of course devastating. it still is. and he won't ever "get over it".

For me, the Missus falling off her perch (at 37) ripped my entire world apart and stole not only my future, but my also my dreams (a world without dreams is a shitty place ).....and I lost most of my motivation for getting out of bed in the morning - often litterally. In many respects my world did stop 4 years back, and her dying is something I will never"get over", albeit I have never actually cried over it and I expect that in due course I will re-marry etc.

The one thing that links me Father (and my Brother) and me (and the Missus) is that we each felt a responsibility for the person who died, both real and imagined - not neccessarily about guilt but simply the fact that they were let down. I didn't get that with my brother, as he was older and not my responsibility.

Somethings you are never meant to "get over" - you just learn to live with 'em better and accept that won't be perfect, it's just how life is......kinda like losing a leg, can work around that 99% of the time - but part of you always knows it's gone. and sometimes your toe will itch ......and sometimes you will fall over ......but that's just how it is. Suck it up.


The funny thing is that I have a long (and glorious!) history of self medicating ......and I never turned back to that on the industrial scale it once was. Surprised both others and me!

IMO the secret is to puzzle your own way through - something others (or meds) can't do for you - the book of dead people is a long one, we each get to add a chapter (or 2). Same old same old - but each unique.

Nice post - wow, you've been to the darkside and back. Thanks for sharing.

[Mr.Samsa]

Grief is a symptom. Yes it can affect the functioning of someone's life, often it can be crippling. I'd suggest that if this proceeds for an excessive length of time (though how do you measure that exactly? Will we have a chart for proper terms of grief of household cats and murdered children?) then it could be symptomatic of a disorder, but I think it is not the disorder itself. To label it such for convenience is not, in my opinion a good idea.

...You do realise that this opinion above is essentially a perfect description of the DSM's proposals for including "grief" into their manual, right? That is, they aren't including "grief", they're including "complicated grief" - grief that extends for an excessive time, or negatively impacts someone's life significantly enough to require earlier intervention. In other words, if this disorder is included in the DSM, someone who mourns the loss of their wife or husband for 3 months, loses their appetite, cries themselves to sleep most nights, would not be diagnosed as having a mental disorder.

Despite what people might think labels are important, especially when dealing with mental illnesses. The public perception is less than sympathetic currently, however I do not find it hard to imagine situations where sat someone is off work suffering a post trauma disorder after being in an minor accident and being diagnosed and medicated for "grief" when one of their workmates was back after a few weeks after the loss of a child. One one hand this sort of thing would reduce the public sympathy further and thus in turn increase the claims of quackery and result in less funding. On the other hand given I could see politicians and businesses getting the wrong end of the stick and expecting grief to be like a cold. "Your sister was burnt to death in a fire? Yeah take tomorrow off and 4 of these, I'll expect you back bright eyed and bushy tailed by Wednesday."

I can't really imagine that happening, unless the mental health field radically redefines the definition of "disorder" to include everyday problems that don't impose significant problems. I currently see no reason or evidence to suggest that such a change would occur in our lifetimes at least.

When I worked as a staff liaison, I came up against common negative attitudes against mental illness all the time people often can't differentiate between feeling glum and clinical depression, they don't understand the difference. As such using grief in a highly specific way is bound to be conflated with common terminology, that is not good for anyone except those who wish to make profits off of those suffering from grief, whether they have a illness or are enduring a tragedy.

Sure, I can understand wanting to avoid ambiguous terminology to make it less likely that people will confuse serious disorders with everyday issues, but unfortunate the reverse is true as well: when psychologists come up with new names for disorders, they get accused of creating confusing terminology in order to medicalise normal disorders. Look at all the ridiculous articles on "sibling rivalry disorder" and "restless leg syndrome", with people confusing these serious disorders with everyday mundane issues. I remember reading one article once where the author said something along the lines of, "I used to fight with my brother as a kid and sometimes I tap my foot, am I crazy now?!". The guy was a fucking moron, it wouldn't have taken him more than a few minutes to read through the wiki page on mental disorders and then to browse the criteria for each disorder, and then realised that he of course did not have those disorders.

[Atheist-Lite]

I'm not sure general doctors can be trusted with making distinctions between normal grief and something deeper in the first few weeks after a loss when people are especially vulnerable. Not when money means 'ering on the side of caution and the culture of mission creep means more and more anti-depressents in circulation. Doctors also have a bloated sense of self-worth which blinds them to the common human insights and empathy, like a slaughterhouseman or a butcher they are numb to suffering and need to be because of their profession. They will always harp on about the many years training they have etc...oblivious to their lack of specialisation and many are little more than than chemists, with a book or web access, pushing drugs on behalf of their suppliers.