Should grief be considered a mental illness?

17 Apr 2012, 7:52 pm   -   Source: SBS Staff

There have been calls for prolonged grief to be medicalised, with some studies saying it's often associated with serious health conditions.

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Professor Richard Bryant told SBS' Insight program he wants a new psychiatric disorder for bereavement which would apply when acute grieving goes on for longer than 12 months.

"A serious condition threatens 10 to15 per cent of people from six to 12 months. These people will have this very persistent stress and pain and we know that’s associated with a range of significant problems like suicide, mental health issues, poor health outcomes, cardiovascular problems, poor behaviours like smoking and alcoholism.

"If we know that those problems are associated with it, it actually creates an incredible public health issue. We know in Australia alone that we’re probably getting 80,000 new cases a year".

Professor Bryant sits on committees for both the Diagnostic and Statistical Manual and the World Health Organisation’s International Classification of Diseases. 

Both the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual for Mental Health Disorders (DSM IV) and the WHO’s International Classification of Disease (ICD 10) exclude grief reactions as possible psychiatric disorders because grief is considered a normal response to someone's death.

But in the upcoming manual for mental health disorders, (DSM 5, due out in 2013), this is being debated and potentially changed.

The APA has proposed two important changes to bereavement in DSM5: removal of the bereavement exclusion in the diagnosis of major depression; and adding complicated grief as a new diagnosis under adjustment disorders.

Professor Gordon Parker from the School of Psychiatry at UNSW , and founder of the Black Dog Institute is critical of what he sees as the increasing medicalisation of normal human behaviour and is against any new diagnosis to do with grief.

"Putting a 12 months final period poses a risk. I think it's quite conceivable that you will lose someone so close to you that you will never really get over it," he told SBS.

"So I think that it's allowable that you move on in certain ways over a matter of months and maybe the first 12 months, but there is a time when grief will go on for ever and I don’t think that it’s something to pathologise, I think that's not necessarily to say that's a problem. It's part of the normal human behaviour".

Concerns have been raised about the wide-spread use of antidepressants.

"What is happening at the moment is a lot of people are getting given anti-depressants. From the few trials done we know that the treatments really won’t touch grief," Professor Bryant says.

"When I say grief, the essence is a persistent yearning for a loved one. We know that now through a lot of studies. It’s really not explained by anxiety or depression type symptoms. It’s actually different from the current things we have. So having depression or anxiety doesn’t quite cap these people and yet we do know by trials that a developed psycotherapy-cognitive behaviour therapy approach works on this".

Julia Bianco and her husband Loris lost her only child in January last year. Yasmina, 9, was hit by a train in Coledale, NSW.

Although devastated, Julia and her husband Loris say they have made an effort to move on with their life and be positive for Yasmina. Julia requested anti-depressants within a month of the death and says they gave her the strength to cope.

"Certain parts of grief have the ability to destroy you if you let them into your life," Loris Bianco told SBS.

"Eventually you find a way to live with your grief. You don’t want to get over the grief because the pain is the love. You don’t suffer grief if you don’t love so you don’t want to lose that, but at the end of the end you don’t want to let that destroy you".

Watch Insight on Tuesdays at 8.30 pm on SBS ONE, repeated Wednesday at 1pm on SBS ONE and Friday at 7:30pm on SBS TWO

Grief

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