The Distortion of Grief

CHICAGO – How long does it take to mourn the death of a loved one? The question is peculiar, even mildly offensive. Recovery from bereavement is a personal process that varies significantly among individuals. While it could take months to surface, grief – in its many forms and at various levels of intensity – remains a natural response to loss.

But the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), produced by the American Psychiatric Association (APA), deems invalid the long-accepted understanding of bereavement as a highly individual and unpredictable experience. The updated manual advises psychiatrists and general practitioners that two weeks is an appropriate interval for grief. After that, depression supposedly can be diagnosed.

In other words, doctors can – and should – be able to distinguish grief, a normal response to loss, from depression, a mental disorder, after just 14 days, when most people would still be coping with the initial practicalities of a loved one’s death. The implication that mourning should be fast and efficient is both disturbing and unnecessary.

Moreover, with significant potential for misdiagnosis, defining “acceptable” grief could have serious unintended consequences. Allen Frances, who led the previous DSM Task Force and has 40 years of experience in the field, said that he could not distinguish normal grief from mild depression at two weeks – and “challenge[d] anyone else to do so.”