Tuesday, April 19, 2011

DSM-5 coming out in 2013

Leave it to journalists to jump on this one. This is the bible of psychiatric disorders, primarily in the US.

Prolonged grief proposed as mental disorder

CMAJ - 29 Mar 2011

In a recent paper, Shear and several colleagues considered whether complicated grief met the criteria for a treatable mental disorder (Depress Anxiety 2011;28:103-17). They suggest that about 10% of bereaved people develop complicated grief, and that inordinately prolonged symptoms — persistent feelings of disbelief and anger, a sense of emptiness, suicidal thoughts, estrangement from other people — warrant a targeted treatment.

Grief is normal, there are abnormal reactions to grief. That is when a doctor gets involved. Whether it is two weeks or two years, it is important that your physician understands your situation.

To be suffering from grief two years after the fact, and to have it crippling you IS abnormal. There are many who should seek psychiatric help, or a bereavement group. (Available through local hospice groups.)

Journalists are worrying for nothing!

I was in a very deep depression after moving, the death of my mother, a new job, etc. Drugs may be indicated, but counselling is effective. It depends upon the person. Unfortunately, it is the drug companies and other US lobbyists who direct much healthcare in the USA. 

The DSM is used in the USA in order for people to access medical insurance. In order to qualify, a doctor has to refer to one of the DSM-IV-TR (current version) qualifiers. I've read it. It is only a diagnostic tool. 
I have never, ever been referred by a doctor in Canada using this. Psychiatrists use it when diagnosing and giving a report in Canada. These worries are crazy.

A doctor never needlessly prescribes a drug just because the characteristics are in the DMS-IV. Surely, they are better trained than that! We simply do not use the DSM-IV in Canada in the ways in which it has been suggested.

It seems, in the Psychology Today article, that they jump to conclusions. 

Normal Grief vs Depression In DSM5 | Psychology Today

16 Mar 2010 ... How to avoid medicalizing grief. By Allen J. Frances, M.D..

"Undoubtedly, this would be helpful for some people who would receive much needed treatment earlier than would otherwise be the case. But for many others, an inaccurate and unnecessary psychiatric diagnosis could have many harmful effects"

It depends upon one's reaction! Yes, grief is normal, but it is too easy to slip into an extreme reaction. Deep depression can be prevented. Surely, before going to a psychiatrist, one would visit a GP who knows us. 
Another doctor responded:

Jonathan Rottenberg, PhD
by Jonathan Rottenberg, Ph.D.

I agree!  

DSM-V: Medicalization of Grief - Mental Health Association of Nebraska

22 Mar 2010 ... According to Dr. Allen Frances, MD, small changes in the in the Draft DSM-Vcould have profound impact on how people dealing with grief are 

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