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Medicalising Grief

01 April 2013

This weekend, BBC Radio 4 broadcast a 30-minute programme about grieving. Or, more accurately, about using medication to 'treat' grief. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM), written by the American Psychiatric Organisation now includes grieving as an abnormal mental state. This opens the door to pharmaceutical companies saying people need to be given medication to help them with their grieving.

In this world where we no longer accept anything other than perfect happiness, everything that stands in its way must be treated as soon as possible. Take a pill and it will all be better. And if an important medical text says that you have a DISORDER, then the threshold for prescribing that pill is severely lowered. The pharmaceutical industry stands to gain millions if all those grieving people were put on anti-depressants.

Grief makes you sad. Death makes you sad. That is not an illness. You have lost a person you loved. The sadness you feel about that is not depression. It is grief. Numbing that pain with medication that is designed for treating an illness, in my opinion, is wrong. You do not have an illness. Depression is often caused by chemical imbalances in the brain. It is an illness. It often has no particular event that causes it. People with a seemingly perfect life can be very depressed. Grief is caused by an event. It is caused by a loss. YOU WILL BE FEELING SAD! Duh. Apparently, according to this broadcast, people who experience a loss could fit the criteria for depression if they display symptoms of depression (sleeplessness, lack of appetite, poor concentration prolonged sadness) more than 2 months after the loss....2 MONTHS? Try a year.

My point is that profound sadness is not depression. If you treat your sadness with medication, you will not be able to fully 'go through the grief'. It will merely numb it for a while and hit you when you come off the pills. Because it is not an illness. It can not be cured. It is a reality you need to accept. You can not medicate it away. You can help yourself with grief therapy. And for some people, the grief is so all-consuming that they stop functioning as humans. In that case, medication might help. But that is not medication to 'cure' the grief. That is medication to help people function. Function so that they can address their loss and deal with the grief. If medication becomes the standard treatment for grief, people will never actually come to terms with their loss.

And in a completely unscientific opinion, I believe that if you do not come to terms with the loss, you will not be able to rebuild your life. It will hit you later on. And by then, you might think you are perfectly happy again and then it might actually lead to full-blown depression.

I grieved REALLY HARD for months. I cried whenever and wherever I wanted. In public, alone, in front of strangers, in front of friends. I did not hold back. I did not feel ashamed. I felt an all consuming sadness. Like a depressed person, I wasted hours, days, week in bed, staring at the wall, going through DVD box set after DVD box set. The difference? I knew WHY this was happening. There was a very clear reason. I had lost my wife. My life. My focus. Everything I thought my future was going to be was in tatters in front of me. I had 2 sessions of counselling and we decided that really, I just needed to do the grieving and that things would get better in time. And she was right. I strongly believe that diving head-first in to my grief, but with my eyes firmly on wanting to build a new life after I as done grieving, has made the pain much easier to live with.

I am not saying people should never use medication. Or that those who do are weak. My issue is with the premise that, as a starting point, grief should be treated as a mental disorder. This opens the door to pharmaceutical companies pressuring doctors to prescribe pills to people who really just need a shoulder to cry on. And it gives people false hope. That life will be better with pills, even though everything they loved has gone. That is simply not true.

Thankfully I am not the only one who thinks this is a dangerous direction. The Lancet, the world's foremost medical periodical, agrees with me and says it much more succinct that I ever can:

Medicalising grief, so that treatment is legitimized routinely with antidepressants, for example, is not only dangerously simplistic, but also flawed. The evidence base for treating recently bereaved people with standard antidepressant regimens is absent. In many people, grief may be a necessary response to bereavement that should not be suppressed or eliminated.

Building a life without the loved person who died cannot be expected to be quick, easy, or straightforward. Life cannot, nor should not, continue as normal. In a sense, a new life has to be created, and lived with.

For those who are grieving, doctors would do better to offer time, compassion, remembrance, and empathy, than pills.

The editorial is very much worth a read.

You can listen to the show here on BBC iPlayer until April 6th 2013: Medicalising Grief

1 comments:

Anonymous said...

The fusion of your lives and experiences Marieke.

Thank you for caring about us all.

didds
xxxxx

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