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Complicated Grief Needs Specific Treatment - Losing a Loved One is Not PTSD

Discussion in 'News, Politics & Debates' started by anthony, Sep 29, 2006.

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  1. anthony

    anthony Renovation Aficionado Founder

    Sometimes, after the loss of a loved one, symptoms of grief linger and become increasingly debilitating. This condition, called complicated grief, has features of both depression and post-traumatic stress disorder (PTSD). And there is some evidence that a distinct type of treatment may bring relief, reports the October issue of the Harvard Mental Health Letter.

    The most characteristic symptoms of complicated grief are intrusive thoughts of the deceased person and a painful yearning for his or her presence. When grief is most severe, a person may deny the death or consider suicide.

    The risk of developing complicated grief depends on both the immediate circumstances of the death and the background against which it occurs. Complicated grief is more likely to occur if the death was sudden, violent, or unexpected. But just as experiences not typically regarded as traumatic can still lead to PTSD symptoms, so can even normal bereavement produce complicated grief.

    “Whether complicated grief occurs depends on how the person copes, not just with trauma, but with loss,” says Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter. “If a person could not respond to earlier losses without losing emotional equilibrium, complicated grief becomes a greater danger for him or her.”

    Treatment of complicated grief often relies on the idea that grieving is an experience to be worked through. A promising treatment called traumatic grief therapy uses cognitive behavioral methods for symptoms and stress relief, along with interpersonal techniques to encourage re-engagement with the world.

    Source: Newswise
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  3. Cin

    Cin Active Member


    It would make sense for someone with C-PTSD to suffer complicated grief after losing someone significant in their life.. yes?

    I only ask because my BF, who has had C-PTSD for as long as he can remember, lost his wife 3 years ago to cancer and I have wondered for a while now if his PTSD seems magnified since she passed (I knew him prior to her death).

    He thinks he is getting worse with age, I've always had the feeling that grief hit him harder than the average person.
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  4. Xibalba

    Xibalba Active Member

    This headline seems misleading. Where does it say anywhere that "losing a loved one is not PTSD"? The article does not appear to rule out that "complicated grief" (not a formal diagnosis per the DSM-IV, but rumored as being considered for DSM-V) can simultaneously be PTSD. In fact the article asserts that such grief could "lead to PTSD symptoms" and that is "has features of both depression and PTSD." The article talks about a "distinct form of treatment" but never makes the case for it being a different diagnosis. Various subtypes of PTSD require different therapeutic approaches, but that doesn't invalidate the diagnosis.

    The headline is hurtful to anyone going through PTSD due to the loss of a loved one. My PTSD is primarily due to grief associated with sudden loss of my loved one, and not even through death, but instead because of traumatic cult activity. But it's been diagnosed as PTSD nevertheless, and multiple treatment paths have been attempted, some not normally associated with PTSD.

    Also, using cognitive behavioral therapy techniques to help a person through their intense grief is nothing new; I am not sure what is "new" in this article, except someone repackaged it all and decided to run a press release in a mental health journal.

    But as I've said before, ten psychiatrists = eleven different diagnoses.
  5. anthony

    anthony Renovation Aficionado Founder

    The DSM V is actually closing the criterion A criteria down to what PTSD diagnosis has always been about, being occurrences outside of the normal scope of traumatic life experience.

    They are also still reviewing the above, being the current DSM V new criterion A, which supersedes the existing two part a+b method.

    Because physicians have taken word meaning and broadened them outside the scope of the DSM IV-TR states, they have instead closed the criterion A completely to isolate it to what its actual purpose always has been since DSM III.

    What people completely miss about diagnostic criterion and disorders, is that having the symptoms does not mean you have the disorder. Being exposed to a traumatic event and having a normal posttraumatic stress reaction, even for months afterwards, does not mean its a disorder. There is a difference between the two, and this is where people have tripped up and become confused with diagnosis.

    PTSD is the most researched, most focused diagnosis at present, with only DID being right behind it due to its complications. It used to be "uncool" to be given something like PTSD, but now people think they have it because they have endured a traumatic event. Outside of the diagnosis, the DSM IV clearly provides further details about the diagnosis, of which entails "outside the normal scope of life expected traumatic events", which means the death of a loved one, etc. Grief is very normal, it can even go for months or years... but it does not negate having a disorder. Very very different actually.

    All those who have been diagnosed outside the scope and meaning upon release of the DSM V will no longer have a valid diagnosis, because the current manual will dictate they do not meet the criterion for it.

    This should never be confused though with the person who has suffered... as each person who endures trauma still needs help, but the labeling itself is what will change drastically, and it rightfully should, considering PTSD is the one disorder that can have financial benefit through disability or compensation. It will all stop though soon, and people who do not fit the criterion, will still seek treatment, but they won't have the label beyond the DSM V's release the way it is going.
  6. Abstract

    Abstract I'm a VIP Premium Member

    Hi Anthony,

    I wondered if you have an idea of what they would be referring to here.
  7. anthony

    anthony Renovation Aficionado Founder

    What people miss, is that many diagnoses have overlapping symptoms... and even if symptoms are present, it does not mean you have a diagnosed disorder, nor should one be diagnosed, because there is a fundamental difference between "normal" classified grief symptoms vs. "abnormal" classified symptoms. Grief is normal, it comes with anxiety / depression / mood / sleep / agoraphobia / etc etc etc... starting to see that these are the same as PTSD symptoms? Because they are... but they also go away by themselves through nothing other than time, ie. a few months, the person begins getting better.

    This comes back to things I have said in the CBT wiki page, in that studies use basic criteria on symptoms vs. whether the person actually has a disorder vs. normal grief that is expected after a traumatic event. Because you have a car crash, and then suffer symptoms, it does not mean you have PTSD, it means you have posttraumatic stress, which is normal. Now, the majority of the time, nothing other than time, and all symptoms are gone within a few months. Studies also demonstrated this when trying to say a specific therapy has a 100% effective rate, then the waitlist for 3 months, meaning nothing done, 60% no longer met PTSD, then at six months, a further 20%... so 80% no longer met PTSD when reviewing symptoms with nothing other than time.

    What that means, they didn't have PTSD, being a disorder, they suffered normal posttraumatic stress. Enduring a traumatic event, even in the scale of abnormal, does not automatically mean you have PTSD because you have the symptoms. This is where those less than experienced physicians go wrong, and even the top guru's in mental health are stating this... they have it so wrong, they are changing the criterion to be so straight forward within a select group of trauma, so these people who wish to diagnose for the sake of it, can no longer give out a PTSD diagnosis, because their skills are obviously lacking, and they read a diagnostic criterion without the accompanying documents / pages that go with it in the DSM.
  8. Abstract

    Abstract I'm a VIP Premium Member

    So I'm guessing you are saying that a statement such as that is not really accurate and that the new criteria should rule such things out. And also maybe that them saying things can lead to PTSD symptoms is very different to someone having PTSD.
    I havn't had any grief related stuff to deal with (grateful of course) and guess was interested in that phrase which obviously refers more to PTSD and just becasue I have an inquiring mind.

    I wondered what some people consider as causes of PTSD and that are not commonly thought of as being able to cause it.
    No need to reply if you are busy!
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  9. anthony

    anthony Renovation Aficionado Founder

    The new criteria will limit the PTSD diagnosis severely, compared to what it is being handed out for presently due to misinterpretation of wording.

    Breaking up from a relationship is one such example seen here lately, where people are being diagnosed with PTSD due to a relationship breakup. What absolute nonsense. PTSD was reserved for combat and complex types of trauma, to put it simple, then physicians branched out a little due to wording interpretation, then further, further and now... if you stub your toe, a physician is telling people they have PTSD. PTSD is that serious that you should not ever recover from it, yet today we see recovery rates, people saying they have been cured, etc. 99.999999999999% of such cases, they don't actually have PTSD to begin with, they simply have normal symptoms after suffering an event. Have PTSD symptoms and PTSD disorder, two very different things. The diagnosis is being handed out for symptoms vs. the actual disorder itself. Confusion!

    Most car accidents would not be able to meet the criteria for PTSD typically, yet physicians are diagnosing it for anyone who says they are in a car accident and suffering a few symptoms.

    I for one will be glad once it is changed, because a whole lot of people with prior diagnosis will no longer meet it, health care, disabilities, any type of remunerative payments, will cease, as all they will need to do is send them for a current assessment, and they will no longer meet the criteria based on the new criterion A being heavily tightened. No more issues with people thinking they have PTSD from a relationship breakdown, someone dieing under natural, known or expected circumstances, etc, which you can read above are now clearly ruled out, by including only violent and accidental deaths by proxy, ie. learning about it to the extent to cause psychological damage to obtain PTSD vs. posttraumatic stress, and they must be very close vs. you just knew them and hadn't seen them in years.

    There are specific indicators associated with the PTSD diagnosis, one is frequency. If the frequency is not present, then they don't have PTSD, even if they have had, or experience every symptoms once a week... that is not frequent enough for PTSD to be diagnosed under the current DSM, yet those aspects are being disregarded when diagnosed.
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  10. intothelight

    intothelight Just Being Me Moderator

    The main reason that PTSD is not curable are the significant neurobiological changes that occur within the brain itself. I am not an expert by any far stretch of the imagination, but if my understanding is correct, other stress related disorders have symptoms in common with PTSD, but not the associated brain damage.

    Someone please correct me is this is not accurate.
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  11. Abstract

    Abstract I'm a VIP Premium Member

    That is what I have gathered to, Intothelight!
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  12. anthony

    anthony Renovation Aficionado Founder

    If you want to really understand where it has gone wrong, listen to one of the leading experts in the world, direct, Terence Keane, PH.D, Director for behavioral sciences division of the NCPTSD.


    Click through until the menu comes up on the left, then click classifications, as that is the beginning of his expertise on where classification has gone wrong, and how it will be corrected, why PTSD exists, complications with criterion A currently, etc. You will need about 15 minutes for those relevant parts.
  13. Mary

    Mary Active Member

    Wow. I just read this.

    I have been poking around PTSD support sites ever since, during a 2-year horror, my counselor referred to my "PTSD-like symptoms." Because my anxiety spikes when I think about diagnosis, she steers me away from any talk about diagnosis. We just focus on treatments for symptoms. I don't medicate or pay for counseling through insurance, so there is nothing requiring a diagnosis. In fact, there is reason to avoid sharing with me any diagnosis that will set me in a spin. But I have not been able to understand how I could possibly have "PTSD symptoms" and not have PTSD--I figured she was trying to keep me from freaking out by refusing the diagnosis. What you wrote seems to explain how that might be possible.

    I feel confused. And, I guess, hopeful that I might be able to cure my symptoms after all. I don't know what to do now.
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