Grief on a Timetable


Since the U.S. is sure to pass one million Covid deaths (970,000 and counting), it might be opportune timing that a new mental disorder diagnosis has just been added to the Diagnostic and Statistical Manual of Mental Disorders (DSM): Prolonged Grief Disorder.

The DSM is a comprehensive classification of officially recognized psychiatric disorders. Published by the American Psychiatric Association for use by mental health professionals to ensure uniformity of diagnosis, the DSM is now on version five—DSM-5.

Last fully updated in 2013, the DSM-5 contains 157 psychiatric diagnoses—158 with the inclusion of Prolonged Grief Disorder.

Clinicians now have guidelines to diagnose Prolonged Grief Disorder and insurance companies will likely start paying claims for treatment. There is also likely to be funding for research into new treatment options now, such as drugs or other therapeutic protocols.

Some of the symptoms of Prolonged Grief Disorder include intense emotional pain (or emotional numbness), debilitating sadness, difficulty moving on with your life, intense loneliness, and feeling that life is meaningless. For anyone suffering from prolonged grief in this way, a diagnosis of Prolonged Grief Disorder might serve as a ray of light. Help can be on the way.

But not everyone is on board. Whether Prolonged Grief Disorder is an actual distinct disorder—separated enough from the related Major Depressive Disorder and Post-traumatic Stress Disorder—has been debated for more than a decade.

An article in The New York Times stated that “critics of the idea have argued vigorously against categorizing grief as a mental disorder, saying that the designation risks pathologizing a fundamental aspect of the human experience.”

In other words, when your soul mate dies, when your child dies, when someone you love dearly dies, it’s natural to grieve. It would be more pathological not to grieve in these cases. Additionally, some researchers, clinicians, and others have raised concerns about the stigma associated with being labeled as “disordered,” especially during a time of intense grief. Not only are you bereaved, you’re wrong for feeling that way.

One parent said, “Anything we inject into this journey that says, ‘that’s not normal,’ could cause more harm than good. You are already dealing with someone very vulnerable, and they need validation.” But the message being sent: You’re not doing grief right.

The keyword in the new disorder is “prolonged.” Does prolonged mean one month, six months, one year, two years? In this case it means one year. If you’re still incapacitated by grief one year following a death, you might be suffering from Prolonged Grief Disorder.

I’m entirely on board with people getting any kind of help they need to alleviate their suffering. I’m in favor of including Prolonged Grief Disorder in the DSM-5. And while I realize there have to be diagnostic criteria including a time frame for how long a person has been suffering from debilitating grief, the one-year mark gives me pause. Grief is such an individual, personal journey and yours may not fit neatly into cultural or societal expectations. Then there is the uneasy sense the health care industry will generate revenue and profit by attempting to treat the untreatable—the human condition, in all its existential messiness.

Still, if it were me whose life became essentially over because grief overwhelmed and incapacitated me, I might be looking for help to get me through the rest of the way. Either that or I would say the hell with the rest of the way. It was John Irving who wrote in The World According to Garp, “We’re all terminal cases.”

By David Klein

David Klein

Published novelist, creative writer, journalist, avid reader, discriminating screen watcher.


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