psychiatry

If you're sad, you're clinically sick, says DSM-V psychiatry manual (and you need chemical treatment)

Monday, December 24, 2012 by: J. D. Heyes
Tags: DSM-V, psychiatry manual, chemical treatment

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(NaturalNews) Do you get emotional and sad, grieving the loss of a friend or loved one? Well, if you are one of the 99.99 percent of human beings who do, you may want to think about hiding your emotions because new psychiatry guidelines could classify you with a mental illness - one that would necessarily require drug therapy, of course.

The changes to official psychiatric guidelines for depression are already controversial, as you might imagine, raising concerns that grief over the sickness or death of those close to you will be classified as clinical depression, turning a basic human emotion into a sickness that will no doubt become recognized as such.

The changes, which are contained in brand-new revisions to the DSM-5 - a set of guidelines and standards used to categorize mental illnesses - eliminates the so-called bereavement exclusion. The standard removes the diagnosis of depression for a two-month period of grieving unless they demonstrate symptoms that are self-destructive and extreme. Under the new norms, depression can be more easily diagnosed a scant two weeks following a death.

'This goes over a line'

"Virtually everyone who is grieving has milder symptoms of depression. What the bereavement exclusion did is separate the normal responses from the severe ones," such as suicidal tendencies or feelings of worthlessness, psychiatrist Jerome Wakefield of New York University, who studies bereavement and depression, told Wired.com.

"This goes over a line. If you can pathologize this kind of feeling, any kind of suffering can be a disorder. It's a disagreement over the boundaries of normality," he said. "What kind of world do you want to have? One where intense, negative feelings we don't like are labeled as disorders, or a world where people grieve?"

Those defending the change - which was announced officially on Dec. 1 by the American Psychiatric Association - say concerns about anthologizing grief are overstated. They argue that even though not all grieving is depressive in nature, grief-related depression is not much different from what is considered normal depression.

As such, they say, the exclusion makes it too difficult for clinicians to recognize and treat depressive, grief-stricken people who really do need help.

The change has been in the works for some time. In 2007, a study published in the journal World Psychiatry:

Since the publication of DSM-III in 1980, the official position of American psychiatry has been that the presence of bereavement is an exclusion criterion for the diagnosis of a major depressive episode (MDE). However, the empirical validity of this exclusion has not been well established. As DSM-V is now being planned, it is timely to reexamine the bereavement exclusion, particularly in the light of new evidence since the last reviews of this subject.

It looks as if the "reexamination" has finally come to fruition, much to the chagrin of many psychiatrists who obviously don't find it appropriate.

Not all of them feel that way, though. Some see the change as no big deal.

"I think a good clinician can separate the two," Jan Fawcett, a University of New Mexico psychiatrist and head of the DSM-5 working group that authored the change, told Wired. "We feel that clinicians have been making this judgment all along."

'It's not too late to save normality'

The DSM - the acronym used for Diagnostic and Statistical Manual of Mental Disorders - is American psychiatry's official guide for deciding what is a mental disorder and normalcy. With the first edition published in 1952, it is now considered to be psychiatry's "Bible," used by doctors, insurance companies, the legal system and just about any social institution that formally deals with mental health.

The most recent changes are being called the most controversial ever in some corners of the psychiatry field, in part because of the new conditions cited. Besides the change eliminating the bereavement period conditions like hoarding, severe pre-menstrual syndrome, temper tantrums, binge eating and everyday memory lapses in the elderly have now been classified as mental conditions.

Critics are having none of it. They say labeling common conditions as mental problems requiring treatment is akin to medicalizing the normal range of human emotion and experience.

"This is a societal issue that transcends psychiatry," Allen Frances, professor emeritus and former chairman of the department of psychiatry at Duke University and chairman of the task force that created the current DSM, wrote in the Los Angeles Times. "It is not too late to save normality from DSM-V if the greater public interest is factored into the necessary risk/benefit analyses."

Sources:

http://www.wired.com/wiredscience/2012/12/dsm-5-bereavement/

http://alert.psychiatricnews.org

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219913/

http://articles.latimes.com

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