Should prolonged depression be considered a disease of mental health?

Katie C. Reilly (Undark Magazine)

The weekend I graduated from law school my mother told me she had amyotrophic lateral sclerosis also known as ALS or Lou Gehrig’s disease. this one neurological disease (disease) for which there is currently no cure. I remember for the next whole year his muscles got weak and he died. After a year and a half, my father was diagnosed with cancer. They chemotherapy completed one round of cancer Due to which he died in a few months. My father passed away on the day of my mother’s birthday, August 12.

After the death of my parents, I wanted to focus on work, friends and dating like everyone else in my 20s and 30s, but I couldn’t. I am intensely emotional sadness and worry was struggling with. I longed to see my parents again, even if I could only hug them once – I struggled to accept that they were no longer in this world.

prolonged suffering mental disorder

The emotions I felt until this March can now be classified under a new mental health disorder. That month, the American Psychiatric Association officially added chronic pain disorder, or PGD, to its list of mental disorders called the Diagnostic and Statistical Manual (DSM). This is a widely used guide to psychiatric diagnosis.

Since the 1990s some mental health experts have argued that acute or long-lasting sadness should be classified as a separate mental health disorder and treated separately from other disorders such as depression. . In 2018 the World Health Organization accepted PGD as an official diagnosis in its International Classification of Diseases, which applies when a person has been in a state of bereavement for six months or more or “persistent and widespread”. Remain in a state of sadness (persistent and pervasive grief response).”

What is PGD

According to the American Psychiatric Association, Prolonged Grief Disorder (PGD) is a condition when a bereaved person experiences constant yearning for the deceased person, intense emotional pain, as well as being lost in the memories of the deceased. According to the Diagnostic and Statistical Manual of Mental Disorders, PGD “causes medical difficulties in performing the functions of social, occupational, and other vital areas.” To diagnose it, a person must experience at least three of the eight symptoms which include “disbelief, intense emotional pain, feeling of identity confusion, Avoidance of reminders of the loss, feelings of numbness, intense loneliness, meaninglessness or difficulty in living life.

“For an adult to meet the criteria for a PGD diagnosis, a loved one must have died at least a year ago and symptoms must be present on most days and almost every day for at least the previous month. In children, after showing this symptom for six months, it can be diagnosed as PGD.

This new definition and terminology runs the risk of distorting normal grief responses, and will likely create a false social expectation of what suffering should be like.

I have experienced several symptoms associated with Prolonged Grief Disorder (PGD). I was definitely finding it difficult to move on with life, which was described in an APA press release as a symptom. And my experience is not an anomaly. “I meet people every day who can meet the criteria for long-term suffering,” said Joan Cassiatore, a professor in the School of Social Work at Arizona State University and founder of the MISS Foundation. This foundation helps families struggling with painful grief.

PGD ​​is a disorder

Jerome Wakefield, a professor of social work and bioethics at New York University, says of the intense emotions that follow the death of a loved one, “If you look at the criteria, all the symptoms are common symptoms of intense grief.” The gist of the PGD diagnosis, says Wakefield, is that if the sadness lasts for a very long time, it is not normal suffering that will go away on its own, it points to a disorder.

A one-year deadline on suffering sets up dangerous societal expectations. Ever since my parents died I’ve felt as though I’m waging a battle against the belief that suffering is a short, limited process after which one magically returns to their former state. A few months after my parents left, the family members stopped coming. While my sadness persisted, employers could not understand that my sadness was not limited to a few days or weeks. Even my friends could not understand my position that my grief was still affecting me and it still happens years after the death of my parents.

Social support plays an important role

There was very little about my experience that was unusual. Only 36 percent of people in a recent study, which was done by Cassiatore and colleagues, said they found good support when they were sad. The respondent said that feeling abandoned, and feeling neglected by family and friends were some of the reasons why emotional support was not felt. Cassiatore told me in an email that social support in particular – or lack thereof – plays a key role in shaping our ability to cope with grief. A 2015 study found social constraints to be associated with depressive symptoms.

As my own social support system dwindled after my parents’ death, I began to feel ashamed of my constant suffering and inability to “move on.” I started feeling that something was wrong with me because I was still going through those experiences and missing my parents.

Now what I worry about is the misperception of how one should grieve – the new definition of PGD may have even less social support for the bereaved when they really need it.

Advocates for recognizing PGD, which by some estimates affect about 10 percent of bereaved people, say its diagnosis will help mental health professionals identify those who need support. This could potentially make it easier for people to get insurance reimbursements for mental health issues related to bereavement. But these positive aspects will not overcome its negative social effects.

In a 2002 essay, Cheryl Strayed wrote: “As a culture if we do not witness grief, the burden of loss is placed entirely on the bereaved while the rest of us close our eyes and Grieving people wait for their suffering to end and if they can’t – because they loved what was gone, if they wake up every morning thinking I won’t be able to live – then we distort their pain Huh; We call their suffering a disease.”

To help the bereaved, we must understand their grief

It has been almost 12 years for my mother and eight years for my father. There have been moments in my life when I missed him a lot, when I got married, when I got pregnant for the first time, when I bought my house and on many normal days I felt the same sadness remembering him.

Although the duration of suffering has now reduced or say the intensity of suffering has decreased but it still happens. Time, therapy and supportive people around me have helped me a lot. But the biggest help for me was to understand that there is no one way to grieve.

(Katie C. Reilly is a freelance writer and lawyer based in Oakland, California. Her writing focuses primarily on women’s health, mental health, and parenting, and her articles have been published in The Washington Post, The New York Times Magazine, Elle Magazine, among other publications. and has appeared in Newsweek. This article was originally published on Undark.)

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