Can or should grief be medicated?

It is with dismay, bewilderment and some disbelief I read that grief has now been medicalised and been classified as a “pathological” condition. Grief is the most natural emotion or feeling experienced when someone they love dies. I mean even swans grieve (or at least show signs of loss) when their mate dies and will remain near the body of their mate.

Humans have suffered grief and have mourned since they first walked the earth – some 1.5 million years ago so why is it only now in the last few years that it is considered in the same category as a “mental illness”?

Now (as “defined” by the American Psychiatric Association – APA, in their Diagnostic and Statistical Manual version 5, DSM 5) there are Major Depressive Disorders (MDD); bereavement-related major depressions (BRMD); Later Bereavement Disorders (LBD); also - possibly - an Adjustment Disorders (AD) – adjusting to the now changed circumstances. Then there is also apparently research into the validation of intense lengthy grief to determine if this is a “pathology”, (in other words a biological “illness”) - a pathology called “prolonged” or “complicated” grief (PG or CG). Validation, I understand, rests on the risk of “future harm” – thus confusing the (possible) risk of a “illness” with an actual “illness” – if you get what I mean! Or even (gasp!) that grief has been “derailed” and become “frozen” or an “interminable” grief!   

Furthermore, apparently, those who determine these things have decided that grief should only last for two weeks. Any longer and it then becomes depression. Once it becomes depression antidepressants may then prescribed.

One is left to wonder if these “experts” have ever grieved or mourned.

It has been written that: “Grief is an automatic reaction, presumably guided by brain circuitry activated in response to a world suddenly, profoundly, and irrevocably altered by a loved one's death.”

There is one HUGE assumption in that statement; the presumption that grief is the result of brain function. But is this really the case?

In my case it was my “heart” that felt the pain of loss – a gut loss - like a wrenching, a tearing of something. My reasoning – my head – tells me that my wife is dead but it is my heart that feels it, that feels the emotion of the loss. Her love; her companionship; her emotional support; her intelligence; her sense of humour are all now absent.

And I still feel the loss – eighteen months after the “event”. But do I need to be medicated; am I depressed; am I suffering from a “frozen” or “interminable” grief?

Apparently, and totally unconsciously, I have adopted an ancient method of coping – writing and reading about grief and grieving. I certainly find this helps me.

But I know that I will always miss her.

Germanwings flight 4U9525 disaster.

Shocking and senseless! A few general facts are necessary, however, to stop the various notions about why the unfortunate, and relatively inexperienced pilot, Andreas Lubitz committed  such a horrendous and apparently entirely selfish, mass murder/suicide – as is so far alleged to be the theory - before the actual facts (and suppostions) are presented in a sober and reasoned manner.

First up, no test (or tests) is (are) available which will confirm any “mental illness” (Alzheimer’s and Huntington’s diseases excepted). Mental issues are not (repeat not) similar to any physical illness such as the much quoted phrase “diabetes or heart disease”. Any person presenting with a mental issue is “diagnosed” by observed behaviour and by the presenting person’s self-reported mental state – and then subjectively judged, by a Mental Health professional, using an “approved” check list of “depression indicators”.

The operative word is “presenting”. Anyone with any intelligence and who has been psychologically tested many times before will “know the ropes” and be able to circumvent questions which may be “compromising” or which may impact unfavourably on that person’s future.

It was therefore not possible for any mental health professional to have determined, with any degree of absolute certainty, that Lubitz was “mentally ill”- whether he was depressed or a closet sociopath or had psychopathic tendencies. Possibly he was just someone who was trying to fulfil a dream and was found wanting – something he may have had difficulty in accepting.

We will never know.

My second point is that, as I understand it, anyone working for an airline must attend that particular airline’s approved doctor or doctors. It is that doctor who has the responsibility to inform the airline of any misgivings he (or she) may have about a particular employee’s health – mental or physical. I am sure that an airline with Lufthansa’s standing would have had such a medical regime in place.

It would appear, therefore, that either the doctor involved did not pass on the medical details (regarding prescriptions or any other concerns) to Lufthansa. Or, and I would find this very difficult to comprehend or believe, Lufthansa ignored the doctor’s concerns and/or advice regarding Lubitz.

Either way – if there is blame to be apportioned (and believe me there will be) it should lie somewhere in the orbit of the medical doctor and/or the pilot administration of Lufthansa.

Lubitz’s life, family, friends and career will be eviscerated by the investigators and the media trying to find any possible reason or reasons for such a horrendous and callous act. This is to be expected because the airline industry survives on trust and its fiercely protected safety record. Anything which impacts on this will be examined as never before.

And so it should be.

However research into suicide is notoriously difficult. It is always referring to an historic act – something that has already happened. Police, coronial, autopsy, psychiatric and psychological and counselling reports are analysed and carefully combed to try and establish some reason or motive for the suicide. This is fraught as it is impossible to know what was actually going through the person’s mind at the precise moment in time when they took their own life and (particularly, as in this case) when this includes the lives of so many other innocent people. At some moment – sometime earlier that fateful day - Lubitz made a choice.

Why? We will never know.

More on ethics and psychology

Just to let you all know that I know there are some very caring and very good psychologists. I do NOT dislike Psychologists or Psychiatrists. Just sometimes I think that they get too hung up on the science side of things. We are each of us quite different in our approach to life, our view of the world, the way we react to the inevitable problems that arise, and most importantly the way we view ourselves.

If someone needs help to straighten out their life – they may be depressed, or aggressive, or confused, or they may want to be a better athlete, or they may be lonely and just need someone to talk to, then do whatever you can to help! They might have been asked to do something at work which makes them uncomfortable, because of the ethics involved – the list is endless. It matters not whether you use Cognitive Behaviour Therapy, Neuro-Linguistic Programming or whatever. If it works use it. If it doesn’t, then stir the pot and use what does! Mix and match!! This is never a one size fits all approach.

And some medication, in the short term, repeat short term, may calm down a client to the point when therapy may be utilised. To rely on drugs however, for insomnia as an example, indicates a lack of understanding of the human psyche, and is very unhealthy in the long term (despite what the drug companies say). Sleep is the most natural thing in the world. If you can’t sleep then get some help, talk to someone, solve the problem, but don’t take the easy way out by taking drugs.