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January 2011



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Allan Schwartz, LCSW, Ph.D. Updated: Aug 16th 2010

This past Sunday, August 15, 2010, Dr. Allen Frances, MD, wrote an article in the opinion section of the Sunday New York Times entitled, “Good Grief.” Dr. Frances has very impressive credentials. He is an emeritus professor and former chairman of psychiatry at Duke University and was on the task force that created the DSM IV.

In the article, Dr. Frances expresses concern about the idea that is being considered for the DSM V, that runs the risk of treating many grief reactions as abnormal and in need of medication and treatment. This is a concern that I share with him.

In my experience as a Licensed Clinical Social Worker and psychotherapist for over thirty years and in my personal life, I have learned that people have a wide variety of reactions to the death of a loved one. In addition to tearfulness and weeping, among the emotional and physical reactions to loss that I have witnessed in private practice and private life are:

Emotional Reactions:

1. Denial,
2. Sadness,
3. Anger,
4. Confusion,
5. Despair 
6. Guilt.

There is no order or combination to the ways in which these occur.

Physical Reactions:

1. Sleeping problems,
2. Changes in appetite, 
3. Drop in energy level,
4. Body aches and pains,
5. Development or worsening of an illness such as a virus.

Often, there are unrealistic ways of thinking about the death of a loved one, such as, “I could have prevented this death if…,” “I could have called him back from the edge of death while he lay in a coma,” “If I had been a better person this would not have happened,” and many others.

There is no doubt that grief is a wrenching experience that brings people to the edge of despair, hopelessness and depression. However, does this mean that the person in grief is depressed?

What I believe Dr. Frances is saying and what I assert, is that the answer is no, grief does not mean depression except in a small number of cases in which the individual crosses the boundary from grief into major depression.

Read in Full:  http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=39245&cn=58

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