Showing posts with label grief. Show all posts
Showing posts with label grief. Show all posts

Monday, July 16, 2007

Grief vs. Depression: Over-medication Redux

Eric has once again sparked a new post with his comments on my rant this Sunday in favor of antidepressants. He agrees that depression still retains a stigma today, and causes a level of suffering, that merits more attention from health care professionals, rather than less, as popular opinion seems to hold.

(Speaking of popular opinion, I Googled the CNN story that sparked my first post, and found quite a lot of tripe, most of it quoting one silly anecdotal story in the article, about a woman whose life was supposedly damaged by a careless prescription.)

But Eric includes an interesting proviso:
I don't know if meds should be prescribed for people suffering emotional tragedies, such as the death of a loved one[...]


Grief is a good example of a disorder which might inspire over-medication. This is also, sadly, a question I have already faced more than once in my young career. Let's look at it.

By the standards of the field, prescribing for bereaved patients is questionable, at best. The Diagnostic and Statistical Manual of Mental Disorders, the clinical touchstone for the field, says that grief and depression look very much the same, but aren't.

However, the DSM specifies that, if the symptoms of grief continue for more than two months, or are extreme (suicidal thoughts is one example), then the subject might be suffering from depression. At this point, we can presume that professionals are justified in investigate this possibility, and possibly prescribing accordingly.

The book describes examples of extreme symptoms fairly carefully. And it is that kind of care, built into the handbook for the field, that strengthens my conviction. If health practitioners simply apply the basic standards of the trade, combined with their own common sense, there will be very little over-medicating. Then the bandwagoneers could turn their considerable energies to figuring out how to resolve the war in Iraq. Everybody wins.

Some might say that I am assuming too much common sense on the part of all health care professionals. But it's only what should be assumed.