Bob’s dog recently died leaving him heartbroken. Weeks went by as he continued to grieve. He didn’t want to get another dog right away because it would only remind him of Sadie and make him unhappy. His sadness was intense. He had trouble eating and sleeping and had difficulty concentrating. He would call friends on the phone which made him feel more composed, that is, until the phone call ended.
Bob’s brother worried about him and urged him to get help. Maybe, since Bob was depressed, an antidepressant medication may be useful. But is Bob depressed or just going through the normal grieving process? He certainly has all the signs of clinical depression. However, whereas depression is usually constant, grief is more likely to ebb and flow like waves crashing on the shore. Grief does not usually invoke feelings of worthlessness and low self-esteem that are typical of true depression. Those who grieve long to be reunited with someone they loved. The clinically depressed believe they are unlovable.
Antidepressants are not recommended to overcome bereavement. These drugs can mask grieving which will only return after the person stops taking them. They can take weeks to kick in and have a long list of side effects.
A 2014 study examined the prescribing of antidepressants to bereaved parents who lost their newly born children. Of those prescribed medication, antidepressants were most common (80%) followed by benzodiazepines/sleep aids (20%). The bulk (75%) of these prescriptions were written within a month after the death. Obstetrician/gynecologists wrote nearly all prescriptions given shortly after loss, not giving the parent time to work through the process.
The majority of parents who were prescribed antidepressants took them long-term. These data raise disturbing questions about prescribing practices for anyone who grieves over a loved one. The grieving process gets close at what it means to be human. Handling that process over to professionals armed with pills approximates the most dangerous misuse of pharmaceuticals imaginable.
Nevertheless, powerful Big Pharma would rather have you take a pill to better fuel the $10 billion antidepressant market. Lost your sock in the laundry? There’s a pill for that. Someone cut you off on the highway? Pills for that too. Just had a bad day? Another pricey medication is a-waitin. Anyway, isn’t that what martinis are for?
But more seriously, when should the bereaved be medicated? For years, the official handbook of psychiatry, issued by the American Psychiatric Association, advised against diagnosing major depression when the distress is “better accounted for by bereavement.” Such grief, experts said, was better left to nature.
In what some prominent critics have called a cash cow for the drug companies, the American Psychiatric Association voted in 2013 to drop the old warning against diagnosing depression in those who are mourning, paving the way for more of them to be diagnosed with major depression , and, thusly treated with antidepressants. It’s a game of "I will scratch your back if you scratch mine."
Of the 11 members of the American Psychiatric Association committee that spearheaded the change, 8 of them reported financial connections to pharmaceutical companies — either receiving speaking fees, consultant pay, research grants or holding stock, according to the disclosures filed with the association. Six of the 11 panelists reported financial ties during the time that the committee met, and 2 others reported financial ties in the 5 years leading up to the committee assignment, according to APA records.
Several small studies have indicated that antidepressants do decrease grief intensity. And it is true, those who are so bereaved that they cannot function or those who were clinically depressed before the loss and the loss has magnified their depressive symptoms may benefit from an antidepressant. But for everyone who has lost a loved one? No. It’s just putting money into an industry that is already swimming in gold.
Instead of a pill, discuss your feelings with a priest, minister, rabbi or other spirtual advisor. Get counseling from a social worker or psychologist. Go on a trip to Europe. Get some exercise at the gym. Work through those tough times knowing that what you are feeling is natural and normal. A lot of dogs need good homes, so after a while, consider a rescue dog from a shelter.