How would you feel two weeks after a loved one – perhaps a son or daughter or mother or father – had died? Might you still feel sad or empty most of each day? Would you have lost interest in most activities? Could the loss affect your appetite or your sleep? If so, you could be officially diagnosed as mentally ill under the criteria adopted in the newly released fifth version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – or DSM as it is commonly known. Older versions of this psychiatric bible contained a bereavement exclusion. You would not be considered to be suffering from a major depressive disorder if the depression were due to the loss of a loved one. The new version drops this exclusion. One could well argue that any parent who has recovered after the loss of a child in just two weeks is mentally ill, but DSM-5 makes you mentally ill if you have not.
Dropping the bereavement exclusion is one of the more controversial changes in the new DSM; like many of my friends and colleagues, I could make no sense of it. It seemed barbaric, idiotic and senseless. In The Book of Woe, Gary Greenberg explains the logic of the decision. You see,