Is prolonged grief really a mental illness? | READER COMMENTARY

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Holly Prigerson, a professor of sociology in medicine, at her office in Manhattan on Wednesday, March 16, 2022. Prigerson has worked to include prolonged grief as a classified, diagnosable psychiatric disorder. (Hiroko Masuike/The New York Times)

The American Psychiatric Association recently added another official psychiatric disorder, Prolonged Grief Disorder (PGD), to its existing hundreds of clinical diagnoses. It’s described as “distinct from depression” and “marked by a pervasive yearning for the deceased.”

In essence, the APA has discerned how long and how much you may be upset if you lose a loved one — say, a child — before you’re considered mentally disordered.


The APA, after about a decade of internal debate, ostensibly decided to codify this new disorder so people suffering extended grief can seek treatment, however unproved the value of such treatment and the downside of such labels to the “patients.”

To us, however, it appears the APA manufactures psychiatric disorders willy-nilly to nurture its self-appointed job to be nanny to the world.


In the early 2000s, amid a movement to raise the estimates of those thought to be suffering from mental illness, responsible psychiatrists like Paul R. McHugh, former psychiatrist-in-chief at Johns Hopkins University, greeted the changes with derision: “Fifty percent of Americans mentally impaired — are you kidding me?” He reportedly said. “The problem is that the diagnostic manual we are using in psychiatry is like a field guide, and it just keeps expanding and expanding … pretty soon we’ll have a syndrome for short, fat Irish guys with a Boston accent, and I’ll be mentally ill.”

His skepticism stemmed from not just the softness of psychiatric diagnosis, but the questionable non-medical motives of those pushing new diagnoses.

In writing about the new Prolonged Grief Disorder, Ellen Barry of The New York Times summed it up thusly: “Its inclusion in the Diagnostic and Statistical Manual of Mental Disorders means that clinicians can now bill insurance companies for treating people for the condition … [in addition] it will most likely open a stream of funding for research into treatments — naltrexone, a drug used to help treat addiction, is currently in clinical trials as a form of grief therapy — and set off a competition for approval of medicines by the Food and Drug Administration.”

Besides its lack of validity, the new disorder has the potential of adding to the psychological miseries of the “patient.” To be in the midst of grieving for a loved one, now he or she must worry about whether he or she is mentally ill, i.e., grieving too long or too intensely for a decedent.

In these fractious times dependency is the major psychological problem we have to fear, and that is fostered by our viewing ourselves as always in danger of being psychiatrically disordered.

At the very least we should stop fretting that we are grieving too long for someone who has passed to satisfy pseudo-psychiatric norms as to how long we should be upset by the death of a loved one.

Jeffrey Alfred Schaler is retired professor of justice, law and society at American University, and former member of the psychology faculty at Johns Hopkins University.

Richard E. Vatz is psychology editor of USA Today Magazine and political rhetoric professor at Towson University.


They are co-editors of Thomas S. Szasz: the Man and His Ideas (Transaction and Routledge, London, 2017).