Today I read an editorial from the Lancet, one of the oldest and well respected medical journals in the world, that made me take pause. The article centers on a change to the definition of depression’s, in the newest version of the DSM (Diagnostic and Statistical Manual of Mental Disorders). Part of the change to the definition of depression's diagnosis is the drastically shortening the exclusion for those who recently had a loved one die (the exclusion shinks from 12 months in the DSM-3, to 2 weeks in the DSM-5). The editorial rails against the notion that a diagnosis of depression should be given without consideration of bereavement, concluding it could become a standard to medicate those who are grieving the loss of a loved one.
The author suggests that this change is improper, that attempting to medicate away grief may have unintended consequences. "Medicalising grief, so that treatment is legitimised routinely with antidepressants, for example, is not only dangerously simplistic, but also flawed." The author believes that grief is part of what makes us human, and fears people taking a pill rather than deal with the complex emotions of loss.
To me this speaks of a transition in our society, the 'medicalising' of conditions. Whether it is grief, obesity, or injury recovery, there may be a danger in looking first to medication for a solution. The author of the editorial says "Life cannot, nor should not, continue as normal. In a sense, a new life has to be created, and lived with." At times medication can be a vital component of the transformation of one's life, but should not be the sole component. For those who have lost a loved one they need time to make a new life in the absence of the one they lost. For those who choose to confront their obesity, they must change diet, exercise and often change their social support structure. For those with injury, they must change their activities and focus on healing and adapting to their injury.
As a chiropractor, I know that my care is most effective when the patient has committed to their new life. Transition from the previous life to the new one is often difficult, but is ultimately worth the challenge. Bill Clinton said “Character is a journey, not a destination.” Working through the transition makes the new life both an achievement and healing. My goal is to help support each patients change, nurture the new life and provide what guidance I can.
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