This issue: Bereavement, Depression, and the DSM-5

No time to grieve: Inuit loss experiences and grief practices in Nunavik, Quebec

“…Grief theorists emphasize the multifaceted, unpredictable, and complex aspects of the grief, one that is highly individualized and influenced by factors such as sex (Doka & Martin, 2011), age (Walter & McCoyd, 2015), culture (Stroebe & Schut, 1998), and the circumstances of death (Nader, 1997;Parkes & Prigerson, 2013). Zisook and Shear (2013) have described grief as a process within which persons vacillate between accepting and resisting the reality of death and within which persons may experience widely varying emotional, cognitive, social, and behavioral reactions to the death. Though feelings of grief may come and go, grief can eventually become integrated into the life and identity of the bereaved person such that they can continue to function and develop ongoing relationships.…”

“… Zisook and Shear (2013) have described grief as a process within which persons vacillate between accepting and resisting the reality of death and within which persons may experience widely varying emotional, cognitive, social, and behavioral reactions to the death. Though feelings of grief may come and go, grief can eventually become integrated into the life and identity of the bereaved person such that they can continue to function and develop ongoing relationships.…”

The “ins” and “outs” of the depressive disorders section of DSM‐5.

“…Proponents of the decision to remove the bereavement exclusion point out that even mild depressive episodes can have significant clinical implications and sequelae (Zisook, Paulus, Shuchter, & Ludd, 1997). In particular, authors have noted that MDD is a serious, potentially fatal disorder that can have harmful physical consequences, regardless of the precipitant (Cassem, 1995;Zisook & Shear, 2013; although see Wakefield & Schmitz, 2014, for recent evidence of lower suicide rates in bereavement-related depression compared to MDD). As evidence for both the treatability of bereavement-related depression and its similarity to standard MDD, those in favor of removing the bereavement exclusion point to data showing that individuals with bereavement-excluded depression benefit from the same antidepressant medications as people diagnosed with standard MDD (Zisook et al, 2001), a point also made by Jan Fawcett (2010Fawcett ( , 2012, chair of the DSM-5 mood disorders workgroup.…”

“…On the other side of the debate about removing the bereavement exclusion from DSM-5 is the concern that individuals in need of mental health services are being overlooked and undertreated (Shear et al., 2011). Because these persons do not have a formal diagnosis, bereavement-related depression is often dismissed as a “normal” response to grief (Zisook & Shear, 2013). Proponents of the decision to remove the bereavement exclusion point out that even mild depressive episodes can have significant clinical implications and sequelae (Zisook, Paulus, Shuchter, & Ludd, 1997).…”