I remember several years ago, when Brian was healthy and we looked forward to growing old together, hearing that grief and bereavement would become a recognized mental health diagnosis code. I was opposed to this. This was during a time when pre-existing conditions were still a debilitating ball and chain that could cost people their health coverage. Why would grief, a normal reaction to a substantial loss be considered a mental health diagnosis? Brian took the opposite view. He felt that a diagnosis would allow the bereaved access to councelling and support that they might otherwise not be able to afford.
Baby, you weren't wrong often, but I fear you might have been wrong about this.
V62.82 is the ICD-9 diagnosis code for bereavement.
"Most people can navigate the bereavement process with the help of family, friends and their faith based community if you have a particular faith. We expect you to think about the departed person, be sad and have some physical symptoms. Crying, loss of appetite poor sleep and even some weight loss are common in the early stages of bereavement. You may experience more or less of these symptoms. Some people can express this outwardly and some keep the pain inside.
You will probably never completely get over the loss and you are sure to always remember the loved one but at some point you will begin to be able to return to your life as it was before they passed. You should still be able to work, be close to others among your family and friends and find some things pleasurable to do.
If the symptoms go on too long they begin to look more like depression than normal grief. How long the bereavement process may take you depend on you and your culture. In American and most of “western” culture we expect this process to take 60 days or less. If it goes beyond that we need to look at how this loss is affecting you."
Wow. I think that these codes were defined by someone who never lost more than the carnival goldfish won in the 2nd grade. 60 days or less? This framework would imply that all loss is the same. I think perhaps the loss of a young child might take longer to process than the loss of a 98 year old grandparent. I think perhaps the loss of a loved one with whom you live may take longer than the loss of a loved one that you see once or twice a year.
I'm not done grieving the cruel and unexpected death of my 48 year old husband. I go to work, have relationships with others, and even find pleasure in some activities, but how can I ever "return to my life as it was before he passed?" Before he passed, I lived with Brian. We shared everything. We supported each other. We were best friends, lovers, two halves of a whole. I can never return to that, and it is taking me much longer than two months to deal with this horrific loss and everything it means about my life and my future.
I am working with a councillor to help me process my grief, and while I am in a much better place now than I was nine months ago, I am still experiencing debilitating pain.
When I first returned home after spending four months with Brian in the hospital and hospice, I was inconsolable, sleep deprived, and experiencing unbeleavable pain. Any time I layed down to try and rest, I experienced anxiety attacks. My doctor had me on an antidepressant, an anti-anxiety drug, and a drug to help me sleep. In addition, I was on narcotic pain medication for a medical condition. I was concerned about taking all these drugs and how they might interact. After discussing this with my councillor we agreed that I should consult a psychiatrist to manage my medications.
Let's skip over the hoops I had to jump through to get access to a psychiatrist. When I met with the doctor - let's call him Dr. Pompous to protect his identity, I told him that I was concerned with being on so many meds. I explained that I had a relationship with a councillor, and was just seeing him for drug management. He changed the anti-depressant that I was on (which seems to have been a good decision), and immediately pushed me to stop seeing my councillor because she did not provide the cognitive therapy that was so "crucial" to my mental health. When I told him that I had no intention of changing therapists he kindly let me know that I was making a poor choice.
Because it had already been more than two months since Brian's death, he didn't give me a V62.82 diagnosis, but diagnosed me as having an acute major-depressive episode.
Yes, I probably should have stopped seeing him immediately, but I didn't. Dr. Pompous, in his all-knowing wisdom then raised my dosage of the anti-deppresant to the highest available dose. We'll skip over the fact that my previous $9.00 copay jumped to over $200, it was the required therapeutic dose.
As time went on my grief did not dissipate, but some of the sharp edges smoothed. I told Dr. Pompous that I wanted to start to lower the dosage. I wasn't surprised when he objected to the idea. He insisted that the doseage worked and asked why would I stop taking it. I suggested that since I was grieving the death of my husband one would expect that I would start to feel better with time. I also said that my work with my councillor is helping me a lot, an idea he completely dismissed. He asked if I had ever been depressed before, and I admitted that I had when my first husband, an addict who abused prescription drugs, was out of control and making my life a living nightmare. This solidified his stance. I've had multiple episodes of acute depression and therefore must remain on the highest dose of medication for the rest of my life.
What?! Grief is not a mental illness! It is an unbearably painful reaction to a horrible loss. There is no timeline for dealing with grief - it is as individual as our fingerprints. Instead of viewing me as a human being in pain, Dr. Pompous viewed me as an organism with a label.
A bereavement diagnosis, and all of the ridiculous assumptions that go with it, is not helpful or realistic. My grief does not make me mentally ill; it makes me human.
I will be ending my doctor/patient relationship with Dr. Pompous. I will be working with another doctor to safely reduce my doseage. I will refuse to be labeled by a diagnosis code.
I know I will never return to the life that I had before Brian died. I don't know if I will ever stop grieving. I do know that with time and patience I will find a new normal that is OK, that brings me joy, that allows me to feel alive.
Normal people don't view others through the context of diagnosis codes, but they often have established ideas of how others "should" react, cope, and heal. Please don't paint everyone with the same brush. If you have friends and loved ones who are grieving, be supportive and allow them to work through it in their own time and way. They may need help in navigating through their grief, but ultimately nobody can say what the "correct" path through grief is. Be supportive without expectations or defined frameworks; like diagnosis codes, those frameworks simply add insult to injury.
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