Should grief be treated medically?

Our support systems  may give way to unnecessary medication when
grief strikes.

The American Psychiatric Association (APA) has decided to include grief among one of the mental disorders which afflict people. This means treating a natural emotion with anti depressant drugs and other methods. If this strange proposal gets incorporated into the latest revised edition of the ‘Diagnostic and statistical manual of mental disorders’ – the standard reference for psychiatric treatment and insurance decisions - and becomes the bible for practicing psychiatrists all over the world – hospitals will add thousands more to their list of mentally deranged patients. Pharmaceutical giants will prosper. So will insurance companies. Their nexus with doctors and hospitals will increase. The first casualty will be senior citizens who suffer bereavement.  Theirs will be a twin tragedy.

If you are wondering how this would affect us in India, the answer is simple. We have allowed the west to lead us in medical matters. We are already following the American pattern of healthcare. As a doctor of a small clinic in my neighbourhood pointed out, we have imbibed the worst of it already. Even though we know that it is highly unsuitable for a country whose main concern should be affordable primary healthcare that reaches out to all sections of society, we continue to mimic the American model of tertiary treatment linked with insurance policies in super specialty hospitals which only the very rich can afford. So, if America comes up with the ridiculous idea of labeling sorrow as a mental disorder, will India be far behind?   

Needless anti depressants

The worst hit by these new fangled ideas will be the elderly and children, being the most vulnerable sections of society. Even as things stand, have we not imported new medical theories concerning them? With the advent of geriatrics and pediatrics, doctors have already started treating elderly patients and children with needless anti depressants. In Indian society, if an older member of the family was bereaved, relatives rallied around her supportively, instead of branding her as a psychiatric case. If children were inattentive in the classroom, parents would think of changing the class teacher instead of labelling the child with an attention deficit syndrome. The very idea of seeking psychiatric help and treatment was unknown. Today, with newer drugs in the market, more and more ‘psychiatric’ cases will surface, more and more powerful drugs will be administered, some of them experimentally. Doctors will prefer quick cures rather than natural methods of recovery from crises. Our support systems like family and friends may give way to unnecessary medication and hospitalization when grief strikes.

The dangers of drug abuse cannot be emphasised enough. Anti depressants suppress the central nervous system in order to disrupt the normal brain function. They alter the brain activity and change its chemistry so as to reduce emotional responses. This can cause serious side effects like memory loss, for one thing. They may also result in physical dependence and become habit forming. Their withdrawal may cause anxiety in addition to depression. According to some doctors, the body adapts itself to these side effects and craves for more. The consequent overuse of such drugs can be dangerous. When they are suddenly withdrawn, ‘the brain rebounds and races out of control’ leading to life threatening conditions. Must we subject bereaved persons to all this torture when they are already facing a  trauma? According to one leading psychiatrist, a normal human condition will be ‘medicalised’ if the APA has its  way, and millions of normal people across the globe will get psychological labels.

As it is, anti depressants are administered to young persons in this country to treat frivolous conditions like lethargic behaviour, binge eating and pre menstrual discomfort – all common characteristics of adolescence. Thanks to a coercive media, public fear is whipped up in these matters. The winners are the pharmaceutical empires which manufacture these drugs. The losers are the gullible public, especially those who are already traumatised by the loss of someone near and dear. Since India has already been perceived as a captive market for anything and everything, the former will leave no stone unturned to push dangerous drugs into our homes and hospitals.  
 
As it is, the concept of a personal physician interacting closely with his patient is becoming a thing of the past. Gone are the days when a doctor diagnosed simple ailments by using his own diagnostic skills. Today, the machine has taken over. When hospitals spend crores of rupees on sophisticated state-of-the-art equipment, they must recover those costs only through their patients. Sometimes unnecessary tests are done to diagnose simple ailments without the doctor interacting with the patient. In psychiatry, where such rapport was all important, it will become care without humanity when natural emotional responses such as grief are regarded as mental disorders to be treated only medically.