Symptoms
This category can be used when the focus of clinical attention
is a reaction to the death of a loved one. As part of their reaction
to the loss, some grieving individuals present with Symptoms characteristic
of a Major Depressive Episode (e.g., feelings of sadness and associated
Symptoms such as insomnia, poor appetite, and weight loss). The
bereaved individual typically regards the depressed mood as "normal,"
although the person may seek professional help for relief of associated
Symptoms such as insomnia or anorexia. The duration and expression
of "normal" bereavement vary considerably among different
cultural groups. The diagnosis of Major Depressive Disorder is
generally not given unless the Symptoms are still present 2 months
after the loss. However, the presence of certain Symptoms that
are not characteristic of a "normal" grief reaction
may be helpful in differentiating bereavement from a Major Depressive
Episode. These include 1) guilt about things other than actions
taken or not taken by the survivor at the time of the death; 2)
thoughts of death other than the survivor feeling that he or she
would be better off dead or should have died with the deceased
person; 3) morbid preoccupation with worthlessness; 4) marked
psychomotor retardation; 5) prolonged and marked functional impairment;
and 6) hallucinatory experiences other than thinking that he or
she hears the voice of, or transiently sees the image of, the
deceased person.
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