香山リカのココロの万華鏡:別れが悲しいのは病気? /東京

July 07, 2013(Mainichi Japan)
Kaleidoscope of the Heart: Is mourning the loss of a loved one an illness?
香山リカのココロの万華鏡:別れが悲しいのは病気? /東京

In May, the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders,” used by psychiatrists around the world as a basis for making diagnoses, received a major revision that has become a large topic of discussion in psychiatric circles.

Among the revisions made, what bothers me is the deletion of “bereavement exclusion” in the section on depressive disorders. In the previous version of the manual, there was an exclusion saying that when people lost a loved one, they shouldn’t be diagnosed with depression for the next two months even if they showed symptoms of it. In the new version that exclusion is gone, and the death of loved ones is generally treated the same as other stress or shock factors, with patients to be diagnosed with depression if they show depression symptoms for two weeks.

To be frank, I am doubtful of the correctness of this change. I myself lost my father over two years ago, and I feel that since then my view of the world has greatly changed. I continue to go to work because I can’t leave my job unattended, but sometimes I am struck by indescribable feelings of emptiness.

I often see people in my consultation room who complain of sadness and regret after the loss of a spouse or child. I sympathize with them greatly, because considering how much I am affected by the loss of my aged father, the loss of one’s child seems like it must be unbearable. Except in extreme cases, I don’t feel like labeling these people as “depressed.” However, if I send them away with a diagnosis of “completely normal,” patients having trouble sleeping can’t get prescriptions for sleeping medicine, so with no other choice I diagnose them with “insomnia,” or with “psychogenic reaction,” a response to temporary but harsh psychological stimuli.

Perhaps before long, I will have to tell a person who comes complaining that, three weeks after a family death, they feel down and without energy, “That’s depression. Let’s take some antidepressants and get better.”

In our lives, we have many sad and hurtful experiences. That is something all people face, and one might even say the ability to mourn deeply and for a long time is a defining characteristic of humanity. A society that labels that without exception as “depression” is both shallow and dull.

The Japanese Society of Mood Disorders has not yet announced how it will react to the revised manual, but I hope that they will say, “Being sad because of a family member’s death is not an illness.”

(By Rika Kayama, psychiatrist)
毎日新聞 2013年07月02日 地方版


srachai について

early retired civil engineer migrated from Tokyo to Thailand
カテゴリー: 英字新聞 パーマリンク



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