When psychiatrists revise their diagnostic manual, today’s normal is tomorrow’s medicated
The new normal
“It rocked my boat pretty hard.”
That’s how my friend Chris described the way his life was knocked off balance when he was just 21 years old and his father died suddenly. He would never get over the loss, of course, but in a few months his life returned to some kind of normal — a new normal.
I lost my father under very different circumstances. I was in my 40s and he’d been sick for decades. Still, Chris had it right — it rocks your boat pretty hard. Then, in time, you get back on an even keel.
That’s grief — heartbreaking, but also a normal part of life. And now, with the stroke of a pen (or rather, a printing press), grief is about to officially become a medical condition.
And you know what happens next: Send in the drugs!
No more talking
Psychiatrists are currently busy revising their “bible.”
It’s called the “Diagnostic and Statistical Manual of Mental Disorders” (DSM), and a revised fifth edition should be ready sometime in 2013.
This is a big deal for American Psychiatric Association members because it’s been almost two decades since the last DSM revision, so even small changes will alter standards of psychiatric treatment for many years to come.
Meanwhile, the proposed revisions have already been causing controversy for several years. In 2010 I told you about a union of UK mental health experts who complained: “With the classification of so many new disorders, we will all have disorders.”
One of those new disorders will very likely include grieving as part of the definition of depression. According to the New York Times, this has set off a “bitter skirmish” between those who believe that grieving is normal and runs its course in time, and those who believe grief is a form of depression that requires treatment.
Of course, there was a time when psychiatric “treatment” would have meant “talk therapy.” But no more.
Last year I told you about big changes in the psychiatry field. Throughout the 1980s and 90s, health insurance companies sharply reduced coverage for traditional talk therapy, which completely transformed (and gutted) talk therapy practice.
Today, instead of spending 45 minutes with a patient, most psychiatrists spend just 15 minutes. The patient quickly details or updates his primary concerns and the doctor writes or adjusts prescriptions.
So in 2013, under the new DSM edition, if your boat is badly rocked by the loss of someone dear, you won’t just be grieving, you’ll be depressed. And unless you can pay a few hundred dollars per session out of pocket, talk therapy with a psychiatrist won’t be available.
But your health insurance probably WILL cover a psychiatric mini-session that will set you up with Prozac or some other selective serotonin reuptake inhibitor — as if grief suddenly pushed your brain into reuptaking serotonin in abundance.
It’s absurd.
If your doctor suggests an SSRI or another antidepressant to treat grief, tell him you’d rather try the age-old method: Grief + time = an even keel.
Sources:
“Grief Could Join List of Disorders” Benedict Carey, New York Times, 1/24/12, nytimes.com
