The change is contained in new revisions to the DSM-5, a set of standards used to categorize mental illness, and it eliminates the bereavement exclusion, which exempts grieving people from diagnoses of depression for two months unless the symptoms are self-destructive. Now under the changes, depression could be diagnosed more easily just two weeks after a death.
The bereavement exclusion separated the normal responses from the more severe ones, like worthlessness and suicidal impulses. The bereavement exclusion’s removal was announced on December 1, by the American Psychiatric Association, citing that worries of pathologized grief are overblown. They argue that though not all grieving is depressive, grief-related depression isn’t that different from normal depression. As a result, they say the exclusion made it difficult for clinicians to deal with bereaved patients, who legitimately needed help.
The Diagnostic and Statistical Manual of Mental Disorders represents American psychiatrists’ tool for deciding between normalcy and metal disorders. It was first drafted in 1952. The latest changes developed over the last seven years and were recently approved. New conditions include hoarding, severe pre-menstrual syndrome, being eating, temper tantrums, and everyday forgetting for elderly patients. Critics state that this represents a tendency in modern psychiatry to medicalize the normal range of human emotions.
Editorials opposing the decision have appeared in medical journals like The Lancet and the New England Journal of Medicine.
Although any death of a loved one can be emotionally devastating, unexpected deaths provoke especially strong responses, as there is less time to prepare for and adapt to the death (10–12). Throughout the lifespan, unexpected death of a loved one is associated with the development of depression and anxiety symptoms, substance use, as well as other psychiatric disorders (3, 13, 14) and heightened risk for prolonged grief reactions (15), Despite this evidence that death of a loved one is associated with common psychiatric disorders and substance use, however, the impact of unexpected death in the general population remains understudied. Central unresolved issues regarding the association between unexpected death and psychiatric morbidity include whether certain disorders are more likely than others to occur in the wake of a loved one’s death, whether death has different associations with mental disorders at different points across the life course, and whether a greater number of unexpected death experiences are associated with greater psychiatric disorder episodes. Studies to date have predominately examined death occurring in discrete developmental periods, such as early (e.g., (16)) or late childhood (e.g., (6)) or older adulthood (e.g., (3, 7)), yet traumatic experiences can have differential effects across developmental periods (17). Existing studies have considered a limited set of psychiatric outcomes, and outcomes such as mania have been rarely considered in population-based studies despite numerous case reports of onset during acute bereavement (18–26). Finally, it remains unclear whether a greater number of unexpected death experiences are associated with a greater number of psychiatric disorder episodes, or whether individuals become inoculated to the adverse effects of a loved one’s death after many experiences of loss. Given the high prevalence of unexpected death experiences in the population, greater knowledge of the nature, magnitude, and breadth of psychiatric outcomes is necessary.
The present study uses U.S. population-based data to examine the association of unexpected death of a loved one with onset of mood, anxiety, and alcohol use disorders. Unexpected death is ascertained in this study by self-report regarding whether someone very close to the respondent died unexpectedly, such as an accident or terrorist attack, murder, suicide, or through an acute medical condition such as a heart attack. We examine how the association between unexpected death and onset of common psychiatric disorders varies across different stages of the life course. Finally, we examine how the experience of multiple loved ones dying unexpectedly is associated with the number of psychiatric disorder episodes experienced across the life course.
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