I had a bit of a tough time last week and into the weekend.
The combination of a major holiday, Easter, and the eighteen month anniversary of the accident left me feeling sad and pre-occupied. I wasn’t really depressed, just sad.
It set me to thinking about a controversy swirling around bereaved parent circles. It has been proposed that a grief disorder be included in the Diagnostic and Statistical Manual edition five (DSM-V) of the American Psychological Association.
Now I’ve spent a rather large junk of my career as an administrator of Behavioral Healthcare organizations, so I have a passing understanding of the DSM and what it’s used for.
The proposal as it stands now is to include as a diagnosis, a grief disorder, when someone is suffering symptoms of grief more than two months after the death of a friend or loved one.
Most bereaved parents, this one included, laugh out loud at the two month thing.
It was at least four months after Kevin’s death that I was able to actually begin the process of reconciling my grief. I had wandered around in circles in a thick mental fog before that. I had not begun my journey nor even decided if the work was worth it. I was in a state of total shock.
In the eyes of the new DSM-V I was suffering from a grief disorder.
No one likes to be told they are crazy, or pathological to use the clinical term.
I took a little time to look up the specifics of this diagnosis. The following comes from an article on the Psychology Today website originally published on Feb. 9, 2012 written by Stephan A. Diamond, PhD.
The symptoms of grief disorder are as follows:
- Guilt (not related to actions or inaction around the actual death )…check,
- Thoughts of or a preoccupation with death…check,
- A morbid per-occupation with worthlessness…check,
- Marked psycho-motor retardation (a marked slowing of thought and/or movement)…OK check,
- Marked functional impairment…check,
- Hallucinatory experiences (note that seeing or hearing your deceased loved one is specifically omitted here…so no, I didn’t have this symptom.
Five out of six, way more than two months after my loss, I guess I really am crazy.
I would posit that any parent who loses a child of any age, and for any reason, who doesn’t show the majority of these symptoms for a period far exceeding two months after the loss is suffering from pathological denial or is completely without emotion (a diagnosis in its own right).
Grief hurts. It’s painful and depression is a part of the process, but the process is NOT pathology. In the first editions of the DSM homosexuality was a diagnosis, a pathology if you will. Individuals “suffering” from this “problem” were often depressed, suicidal and had difficulty functioning in day to day situations. Of course in time Psychology (and society for the most part) came to realize that homosexuality wasn’t a “problem” but dealing with the fallout, primarily rejection and isolation was the real issue.
Grief can become pathological. You can get stuck, and the results can be brutal. You can suffer from stress related disorders as a result of your grief, you could find yourself unable to live a happy and fulfilling life, and you might even become suicidal. The issue as I see it is that these pathologies are a result of unresolved grief, but if anyone thinks your going to be all better in two months, they are out of their minds (pun intended).
Now here’s the flip side. There’s always a flip side. Even a reasonably healthy grief process can use a little help. I’ve found talk therapy to be helpful, many find anti-anxiety and anti-depressant medications to be helpful. Now if “grief” is in the DSM-V your Doctor and or your therapist have a diagnostic code to put on your chart (and on the billing to your insurance company). Now they can write treatment notes to show your progress, another hot insurance company requirement.
I believe my grief process, as difficult as it has been, has been healthy. I haven’t contemplated suicide; for the most part I meet my day to day obligations and requirements. Sometimes I get angry. Sometimes I get depressed. Some days I wonder if there is any purpose to all this. It’s been eighteen months since my loss.
I suspect that every day, for the rest of my life, I will think about Kevin. I will regret that he is gone, and I’ll have an emotional reaction from a fixed box of choices to that thought. Some days will be harder than others. I hope I’ll be able to experience joy again someday.
I’m not crazy. I just had something really horrible happen to me and everyone I love. It sucks and it will never stop sucking.