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Opponents of the exemption have appealed to empirical studies that compare cases of normal bereavement to cases of major depression.
They offer evidence that normal bereavement and major depression can present substantially the same symptoms, and conclude that there is no basis for treating them differently.
Normal bereavement is a long process even in unremarkable circumstances, but a normal stress response to having witnessed the attacks or having watched them on television is likely to subside.
Clinical assessment revealed that some were suffering from complicated grief, while the others were going through the normal bereavement process.
DSM-IV-TR excludes cases where the symptoms are a result of bereavement, although it is possible for normal bereavement to evolve into a depressive episode if the mood persists and the characteristic features of a major depressive episode develop.
Major alterations in the HPA-axis are not linked to normal bereavement reactions, but are consistently found in major depression, which can be triggered by bereavement in vulnerable individuals [ 9].
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DSM-V, due out in 2013, will have a new condition called "complicated grief disorder", which allows doctors to treat excessive mourning (designated by a symptom list) as depression within a few weeks of a bereavement, and puts a limit on normal mourning at six months.
For many years, the DSM specified that, since grieving is a normal response to bereavement, such symptoms are not an adequate basis for diagnosing major depression.
Recovery is a normal part of bereavement.
This is a condition distinct from normal grief and bereavement-related depression, characterized by symptoms like disbelief about the death and searching for the deceased.
Many doctors have long prescribed antidepressants soon after the death of a family member, even though the D.S.M. urges clinicians to differentiate between normal grief and pathological bereavement.
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CEO of Professional Science Editing for Scientists @ prosciediting.com