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

[Abstract]

You are totally right Shellbell. Oops it is.:oops: Complicated Grief of which I am only now learning more about. It seems from what I have read it is grief with symptoms of depression and PTSD thrown in. Been reading up some research this afternoon.

 

[Shellbell]

Anthony will come tell us off soon as it's his thread :p

I know nothing about complicated grief, but I'm sure there are various similar symptoms.

I think the process of grieving the loss of a loved one, is similar to some people with certain trauma's. Like having a bad childhood and bad abusive parents - the process of grieving for what should have been but wasn't and a childhood lost to abuse, is a grieving process.

My T said I need to grieve my childhood. Ugh!

 

[KatB]

One of the problems I had is that I certainly would never have thought of them being trauma related illnesses and did not even think to bring up so much that was relevant. Mostly I was just concentrating on looking as normal as possible without even realising that

To be normal, to ever feel normal, was never reallity for me(I secretly wanted to be). I have always looked the world as people who looked fake and never real. As good as the world was created, people have ruined what is supposed to be good. I think a lot of people of my family have the same reality when it comes to trauma and trauma-related illnesses. I agree.

 

[AS1975]

I've attached an interesting article on what Complicated Grief is and is not, there are major similarities with the accepted PTSD criterion, but there are differences. Interestingly the article cites at least one study in which bereavement is a major cause of PTSD.

Simon, NM, 2012 'Is Complicated Grief a Post-Loss Stress Disorder' Depression & Anxiety, vol.29(7), pp.541-544.

 

[Shellbell]

I read it, thank you for sharing it. It definitely highlights the similarities and the differences.

 

[Abstract]

Hi AS2975,
Thanks for that! Have started reading it. I found this one which I was working through earlier but it is heavier reading. [DLMURL="ftp://baccommunicationjeunesse.uqat.ca/CharestJ/Articles.pdf/Bonanno%20GA%202007.pdf"]ftp://baccommunicationjeunesse.uqat.ca/CharestJ/Articles.pdf/Bonanno GA 2007.pdf[/DLMURL]

One of the interesting things was the depression of heart rate etc as opposed to PTSD which sees an acceleration when trauma is mentioned. They seem to link that to separation reactions. It also interested me that it seems that there were a percentage of those tested that met both PTSD and CG. And as you mention CG comes with yearning and wanting to be closer to the person whereas PTSD comes with avoidance. From what I understand.

 

[AS1975]

There would appear to be some fairly non-trivial issues to be dealt with in order to bring in the proposed changes in DSM-V. There are a range of stress-reactions that are proposed for inclusion (including C-PTSD and DESNOS). There is some major overlap issues arising, given the nature of PTSD and the highly visible fight to get it recognised (and compensated for), it has become a rather nice diagnosis to aim for when people want to go off on stress leave for extended periods, thus the difficulties being addressed by the tightening of the diagnostic guidelines

 

[anthony]

There are a range of stress-reactions that are proposed for inclusion (including C-PTSD and DESNOS).

These have already been clarified with the DSM 5, as CPTSD has been kicked into touch and instead there is now a sub-type of PTSD that caters for the dissociation and depersonalisation aspects for those who have endured complex trauma. DESNOS is dead as dead now in this regard due to these changes approved and written for DSM 5.

That was a very nice PDF AS... I think it pretty much highlights what is already contained in the DSM 5 draft surrounding both of the disorders. Under the current system, PTSD would be diagnosed for instances that Britt has cited previously. Come DSM 5 release, all such prior diagnoses would no longer meet the criterion and instead fall under complicated grief, as the most accurate diagnosis must be used based on presenting symptoms.

I think there will be people who no longer meet PTSD with the release of the improved system, who may be currently diagnosed with it.

I agree... that due to the overlap issues this is where people become confused, even counsellors and psychologists, who are diagnosing their clients. They either don't think, or don't have a comprehensive knowledge of diagnoses to correctly formulate for their clients. Instead, they give a select range of diagnoses based on their own familiarity.

IMHO... I still think all mental health diagnosing should be left for psychiatrists, and maybe the high-end of psychologists (doctorate levels).

 

[Britt.f7]

Britt, I hope you continue to do so as your T has suggested.

Thank you. Had a real difficult time falling asleep after it, my brain kept going over things. Definitely need to work through it. Felt very unsettled.

 

[Deleted member 1860]

I disagree with the statement in that article that bereavement is a major cause of PTSD, given that losing people is a normal and expected part of life unless you die at a young age or live life as a complete and total hermit. If bereavement is a cause of PTSD then the door is WIDE open for PTSD to be diagnosed for other normal life occurances. Dont get me wrong, I'm talking about straightforward bereavement, not grieving at the loss of your husband who was shot dead in front of you in a random act of violence. How in the heck can bereavement be a criterion A qualifier?!? Yes, give them their own diagnosis. Otherwise the "cure" rate for PTSD will skyrocket.

 

[Britt.f7]

Scared and Lonely, I think it clarifies that it can be due to the death of someone you are close to that is an accident or tragic event, and not straight bereavement. Though I could be mistaken.

I don't think that the trauma of my friends deaths caused my PTSD, though I do think it marred me for life and was definitely beyond complicated grief. Don't know why I added this part. Just seemed like something I needed to say. Hmmm. Crazy.

 

[AS1975]

I disagree with the statement in that article that bereavement is a major cause of PTSD, given that losing people is a normal and expected part of life unless you die at a young age or live life as a complete and total hermit. If bereavement is a cause of PTSD then the door is WIDE open for PTSD to be diagnosed for other normal life occurances. Dont get me wrong, I'm talking about straightforward bereavement, not grieving at the loss of your husband who was shot dead in front of you in a random act of violence. How in the heck can bereavement be a criterion A qualifier?!? Yes, give them their own diagnosis. Otherwise the "cure" rate for PTSD will skyrocket.

I think what the author's of that article were doing was stating that if one followed the wider use of DSM-IV and applied it, as has happened, then the field studies (a formal field study of the application of DSM-IV was cited) show badly skewed results. As such there was a real need to improve the diagnostic criteria, as CG was falling within the guidelines causing people with time-limited, stress reactions to be diagnosed with PTSD, a more difficult stress reaction. Thus the inclusion (or proposed inclusion) of CG in DSM-V, many similarities to PTSD, but a vastly different cure rate and treatment regime (it also provides a mechanism for diagnosing what would be Major Depressive Episodes, that are excluded under the bereavement exclusion - a whole 'nother story).