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Should Grief Be Considered A Disorder?


If you're grieving over the loss of a loved one, is that normal? Or should it be diagnosed as depression?

That's the controversy over a proposed change to the medical diagnosis of depression that would characterize grieving as a disorder and greatly increase the number of people treated for it, reports the New York Times.

The American Psychiatric Association is finishing work on the new edition of its Diagnostic and Statistical Manual of Mental Disorders, considered the psychiatrists' bible and used to make medical and insurance coverage decisions that affect the lives of millions of people.

The proposed changes to the manual, available  online, are being closely watched and debated because it could make the difference between whether a person's treatment is covered or not. The manual hasn't been updated since 1994.

Last week, experts and consumer groups heatedly criticized the proposed tightening of the definition of autism, which could make it more difficult for people who no longer meet the criteria to get health, educational and social services.

This week, the argument is over whether bereavement -- grief over the loss of a loved one -- should be added to the current definition of depression, possibly resulting in more people being treated for the disorder.

Some experts say grief can be severe and debilitating and it deserves to be mentioned so that people can be given adequate care. But other psychiatrists argue that the current definition, which excludes normal grief, is more accurate.

Under the current criteria, a person can be diagnosed as depressed if they have five of nine symptoms - which include sleeping problems, a feeling of worthlessness and a loss of concentration - for two weeks or more. The criteria specifically excludes  bereavement, which can resemble depression.

If bereavement is included, as proposed, some experts worry that too many people will be diagnosed as depressed and unncessarily treated with anti-depressants, which can have side effects, including low sex drive and sleeping problems.

"What I worry about most is that the revisions will medicalize normality and that millions of people will get psychiatric labels unnecessarily," psychiatrist Allen Frances, M.D., of Duke University, who was chairman of the task force that revised the last edition, told the Times.

On the other hand, psychiatrist David Kupfer, M.D., of the University of Pittsburgh, said that without the proposed change, a person who is suffering from severe depression symptoms one or two months after a loss can't be diagnosed as depressed and "may then not get the treatment they need."

In other words, one expert says grief is normal to feel and doesn't need a medical diagnosis and treatment. The other says, if you're grieving and need help, it won't be covered because there's currently no diagnosis criteria for it in the manual.

One wonders why this can't simply be solved with a definition that includes a provision for severe grief-related depression that lasts for an extended period of time. Let the doctor decide if it's "normal" grief or not.

In other health news:

We're doing better, but still falling short of government cancer-screening goals. According to new stats from the Centers for Disease Control and Prevention, not enough people are following federal recommendations for getting regular breast, cervical and colorectal cancer screening tests. Although the colon screening rates had "increased markedly," it was still only 58.6 percent, far short of the federal 70.5 percent goal.

More men than women are infected with the oral cancer virus. About 15 million Americans are orally infected with a virus that is sexually transmitted, a new study shows. The human papillomavirus, or HPV, affects 10 percent of men ages 14 to 69 compared with just 3.6 percent of women, Ohio State University researchers found. It is most common among those ages 60 to 64. Although HPV infections increase the risk of oral cancer, this type of cancer is still relatively rare.

Pork. The other... nosebleed cure?  It sounds crazy, but using strips of cured bacon as a "nasal tampon" has been effectively used to stop an uncontrollable nosebleed. Doctors at Detroit Medical Centre, writing in Annals of Otolaryngology, said they used this old-fashioned method to treat a girl with a rare hereditary disorder that causes prolonged nasal bleeding. Evidently this was done in the 1940s, but fell out of favor with the advent of better surgical techniques and the risk of "bacterial and parasitic complications" from using bacon. By the way, we do not recommend trying this at home.


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