Would you feel happy if your partner died last month?

What are you talking about Dr Alex? I would feel lost and lonely. I wake up and remember my partner has gone. Friends comfort me and cheer me up, but there’s not a day when I don’t miss my partner.

You seemed depressed to me.

Sure, I feel so down.

Let me prescribe for you the latest SSRI, “Happizac”. It will make you feel happy again.

Great. Thanks, Doc.

 

This is not such a far-fetched conversation. In fact, doctors are basically encouraged to think this way.

The DSM or “Diagnostic and Statistical Manual” published by the American Psychiatric Association defines what mental illnesses are. Originally published so that psychiatrists knew how to bill the patient’s health funds, over time it has become the de facto authority for doctors to diagnose mental illness.

When I was a hospital resident, bereavement over a loved one was considered a normal and dramatic shift in one’s life. The then current manual the DSM-III that was published in 1980 stated that a doctor should not diagnose depression within two years of losing someone close. I remember the elderly Greek women in my extended family would in fact wear black for the rest of their lives after losing their husbands.

In 1994 the DSM-IV was published. They reduced the bereavement “exclusion” period to two months.
The latest, DSM-5 (no one can read Roman numerals anymore!) published in 2013, has reduced that period to two weeks. In one generation, the bereavement period has shortened from two years to two weeks. We truly live in a nanosecond world.

US figures demonstrate that in 1990, around 3% of over 65-year olds were on antidepressants. The latest figures show 19% of over 65-year olds are taking antidepressants. That my friends, is disease mongering. As they say, “Follow the money”.

 

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