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> We medicalize grief because we fear it. I think this is just incorrect. You are not obligated to seek treatment for most medical problems[1]. The point of me

> We medicalize grief because we fear it. I think this is just incorrect. You are not obligated to seek treatment for most medical problems[1]. The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in and when people enter a situation where they may need external help. One of the diagnostic criteria, which this article mentions, is that your grief is disrupting your life - but despite what this article claims they have misunderstood that criteria. Of course grief changes your routines and life. That change only becomes "disruptive" if you feel the change has somehow gone too far or you are struggling to undo it. This writer is doing neither and therefor does not meet the diagnostic criteria for disordered grief. They are grieving normally and the medical literate supports that understanding. There are of course medical professionals who use diagnostic criteria as cudgels. Trying to force people to become patients in order to enforce their idea of what someone "should" want. This is a problem but it is a problem that the official diagnostic guidelines try to avoid. For those who are interested in this kind of problem with our medical system might look into the professional philosophy of doctors (generally arrayed around identifying and curing disease) and nursing (generally arrayed around making the patient comfortable as possible). I tend to think the nursing model is the more useful and sensible of the two - even though, of course, if one wants to cure a disease a doctor is helpful. [1] There are very few diseases, such as tuberculosis, where you can be forced to treat the disease.

Aurornis 1y ago
> The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in The problem is that medical diagnoses and therapy speak have spilled over into common language where they’re so diluted that they’re not accurate any more. For many there is no line drawn anywhere because they are self-diagnosing based on flawed understandings as soon as any feeling or symptom arrives. This is scarily obvious when I’ve worked with college students and early 20s juniors lately: A subset of them speak of everything human nature in medical and therapy speak. Common human experiences like being sad about something or having a tough day are immediately amplified into full-blown medical terms like “I’m having a depressive episode today” (which is gone by tomorrow). Being a little nervous about something is “I’m having a panic attack”. Remembering an unpleasant disagreement at work “gives me PTSD”. When they’re procrastinating a task that is fun “my ADHD is flaring up today”. This is only a subset of people, but it’s a rapidly growing percentage of younger people I work with. When someone falls into this mindset it only grows: The same people using these terms usually accumulate a lot of different self-diagnoses to cover every element of common human experience: They will claim ADHD, social anxiety, often some variation of Autism despite showing none of the signs, PTSD due to a previous relationship/boss/professor they didn’t get along with, and insomnia or delayed sleep phase syndrome. Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves. I’ve been offered helpful links to TikTok ADHD influencers to help me understand them, because that’s where they think the best information comes from. 20-something engineers confidently tell me they know more than their doctors about ADHD and how to treat it (usually after their doctor refuses to increase their dose of Adderall again or denies them some other controlled substance they think they need like ketamine or perpetual daily Xanax). There’s also a growing culture of casual drug abuse and misuse that gets justified as self-medication, but that’s a topic for another post.
- ryandrake 1y ago
  I've seen this too among some younger folks and I wonder how much of this is simply standard, run-of-the-mill teenage attention-seeking and exaggeration that's not fully outgrown yet. I guess we'll know when they turn 40 and are still saying things like "I had a panic attack" and "I'm literally shaking rn".
  - gfehhffvvv 1y ago
    There’s also that linguistic phenomenon where you have to use stronger and stronger language to signify the same thing. Maybe we just think it’s ridiculous because we’re the older generation. Or at least that could be part of it.
  - portaouflop 1y ago
    Unc “I'm literally shaking rn” is only ever used ironically. In a culture of ever increasing extremes language follows, that’s all that is to this
  - giantg2 1y ago
    I think it will continue as it's been turned into socially acceptable and even expected behavior now.
- swores 1y ago
  I'm sure the numbers of people wrongly using those terms has risen at least a bit, but I think the anecdotal evidence you have is likely to be a mixture of that and also not that. Similar to how some people look at raw stats of autism diagnoses and think hugely more people are becoming autistic when in reality it's that we've got better at diagnosing autism; I think we (society, in at least some countries) have got better at being honest about mental health conditions. Meaning that more people, especially younger people who've grown up around less mental health stigma, will talk about having an actual genuine problem even without more diagnoses or more exaggeration. I think studies would be needed (that I'm not aware of) to figure out how many more people are using labels that don't really fit, vs how many more people are being honest about actual serious conditions. When I was in my 20s, if I needed a day off work because of depression I would always use a bullshit excuse to avoid mentioning the actual reason. I don't any more, most of my colleagues know what issues I do or don't have. And the younger generations are starting from that place, rather than having to grow into it.
x3n0n 1y ago
Yes! While I really like the article as an expression and exploration of the authors grief, a professional would not pathologize based on DSM criteria alone. If a person does not feel sick or want‘s not to be diagnosed for psychological illness, then they won‘t be (some limitations may apply). That said, the writing really resonated with me and i wish Bess well.
comechao 1y ago
I have a friend who was hospitalized recently. He tried to take his own life multiple times. Before reaching this point, he was struggling for months, but he thought it was ok bc he was working. So it's hard to draw the line for some people. Obviously, everything in life is a tradeoff and can be risky. But seeking medical advice is probably the best thing you can do bc you can reach a point of no return, and you will not accept treatment. How to draw the line? Like you said, disruptive changes and also disruptive behaviors. It's a complex problem.
KurSix 1y ago
I think when the author says "we medicalize grief because we fear it," she's not arguing that clinicians are eager to diagnose grief, but that society at large wants a clean, manageable container for something inherently messy and terrifying
munificent 1y ago
I think you are misinterpreting what the author means with "medicalize". They aren't saying "require to be treated by a medical professional". What they're saying is that as a culture, we reason about grief using the tools and concepts of the medical industry. Because it's part of our culture, this is so automatic that it's almost hard to conceive of any other way. But it is indeed a choice to describe grief as a sort of labeled pain which can be explored using falsifiable scientific experiments, is amenable to treatment by medical professionals, is a problem representing a delta between a "normal healthy human" and their current state, etc. We could just as well have a culture that treats grief as a normal part of the human experience. We could consider a person currently grieving as exactly as healthy and normal as someone playing the saxophone. We could (and some do) consider that the most appropriate people to offer help for grief be spiritual counsellors. I'm not saying we should handle grief differently. I'm just trying to point out that what the author's saying is that it's a cultural choice the way we present and work through it socially. (But, for what it's worth, I do think we should handle it in a less medical way.)
- aeturnum 1y ago
  I think what you are talking about is a problem. Having a medical diagnosis gives personal experience an extra weight in the social realm that's quite problematic. We should all get to say how impactful something for us and the medical folks can have their own standards for when they feel comfortable intervening. That said, if that's what the author was trying to talk about, I think they are doing so in a way that unfairly indicts the medical system for assertions it doesn't make. They say "Apparently, that’s a disease", but as I said I do not think it is. I think they've misunderstood what makes a disease under the diagnostic criteria they list. > We could just as well have a culture that treats grief as a normal part of the human experience. That culture does exist. Even in this article there is an experience of grief that's considered normative in the medical community. Including, I would argue, the authors' grief. I would argue that the medical approach to grief is actually better than other western treatments of grief. I agree that western cultures (and US culture in particular) is horrible about grief. We want people to be robotic and predictable and not make us think about loss and be sad in private and a whole mess of awful, inhuman things. But I don't think that pressure either comes from the medical community or is furthered by how the medical community talks about grief.
ericyd 1y ago
I would posit that you are reading this too literally. I didn't get the impression that the author was trying to rail against the medical establishment but rather to process her own experience in relation to professional guidance on the topic. I took it much more as a personal reflective essay than a professional medical critique.
- aeturnum 1y ago
  Sure - it's an expansive essay on the authors' experience around their grief. I never said that this was their thesis, but I do think the way they talk about medicalization is worth critiquing. They put their experience in tension with medicalization in a way that I don't quite see. Edit: I specifically think it's wrong to say we medicalize grief because we fear it. We medicalize it because some people would like a medical intervention with their grief. It's great and right that the author does not want that - but also they shouldn't write in a way that suggest that medical interventions in grief are wrongheaded.
  - ericyd 1y ago
    Ok fair enough. I read her sentence as more of a figurative reflection on social attitudes towards grief, but if it's taken at face value then I see your point.
aogaili 1y ago
Grief is feared and timed because it impacts the velocity in scrum. Closing your Jira tickets on time is the order. Therefore grief by preventing the closure creates disorder. Stop reading HN and work on your next Jira.
zenoprax 1y ago
Agreed. I think the word "disorder" in DSM terminology is commonly misunderstood/trvialized by lay people. Being forgetful, sad, or tired is just part of life. If it becomes your whole life then you likely need help but an orderly life will contain pain, joy, pride, shame, boredom... We are always at risk of medicalizing discomfort. Allowing oneself to be miserable for a while can be therapeutic alongside patience, forgiveness, and compassion. Edit: after a re-read I noticed that she says she feels most of the symptoms daily a year later. That does feel pretty disruptive on its own but the definition is a bit tautological in that case. Regardless, what she's going through sounds really hard.
dredmorbius 1y ago
Further: by defining the criteria under which a condition becomes medically treatable, other parts of the healthcare system, such as insurance (private or government-funded), treatment protocols, and the like, come into play. Individuals should they choose to seek treatment are then able to do so within a much larger system. By making the criteria reasonably loose and readily met, such a definition also minimises the number of individuals who would benefit from treatment who are excluded from being able to do so. This would include those who are very much unable to function or face larger grief-related risks. We medicalise grief not because we fear it, but because there are genuinely useful therapies which may be of use to some, and denying them that merely compounds suffering. And yes, absolutely, grief ultimately is a lifelong experience. You never stop missing that which you've lost, so long as you have the capacities of memory, reason, and feeling. That is not what the clinical definition is about.
bonoboTP 1y ago
A piece of paper from a medical professional stating that you have some medical need is extremely powerful against the cold machine of corporate and state bureaucracy. You may want to handle grief through general compassion or something but lawyers and managers don't run on that fuel, but medical documents work on them like garlic on Dracula. That's just how it is.

Aurornis 1y ago

> The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in The problem is that medical diagnoses and therapy speak have spilled over into common language where they’re so diluted that they’re not accurate any more. For many there is no line drawn anywhere because they are self-diagnosing based on flawed understandings as soon as any feeling or symptom arrives. This is scarily obvious when I’ve worked with college students and early 20s juniors lately: A subset of them speak of everything human nature in medical and therapy speak. Common human experiences like being sad about something or having a tough day are immediately amplified into full-blown medical terms like “I’m having a depressive episode today” (which is gone by tomorrow). Being a little nervous about something is “I’m having a panic attack”. Remembering an unpleasant disagreement at work “gives me PTSD”. When they’re procrastinating a task that is fun “my ADHD is flaring up today”. This is only a subset of people, but it’s a rapidly growing percentage of younger people I work with. When someone falls into this mindset it only grows: The same people using these terms usually accumulate a lot of different self-diagnoses to cover every element of common human experience: They will claim ADHD, social anxiety, often some variation of Autism despite showing none of the signs, PTSD due to a previous relationship/boss/professor they didn’t get along with, and insomnia or delayed sleep phase syndrome. Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves. I’ve been offered helpful links to TikTok ADHD influencers to help me understand them, because that’s where they think the best information comes from. 20-something engineers confidently tell me they know more than their doctors about ADHD and how to treat it (usually after their doctor refuses to increase their dose of Adderall again or denies them some other controlled substance they think they need like ketamine or perpetual daily Xanax). There’s also a growing culture of casual drug abuse and misuse that gets justified as self-medication, but that’s a topic for another post.

ryandrake 1y ago
I've seen this too among some younger folks and I wonder how much of this is simply standard, run-of-the-mill teenage attention-seeking and exaggeration that's not fully outgrown yet. I guess we'll know when they turn 40 and are still saying things like "I had a panic attack" and "I'm literally shaking rn".
- gfehhffvvv 1y ago
  There’s also that linguistic phenomenon where you have to use stronger and stronger language to signify the same thing. Maybe we just think it’s ridiculous because we’re the older generation. Or at least that could be part of it.
- portaouflop 1y ago
  Unc “I'm literally shaking rn” is only ever used ironically. In a culture of ever increasing extremes language follows, that’s all that is to this
- giantg2 1y ago
  I think it will continue as it's been turned into socially acceptable and even expected behavior now.
swores 1y ago
I'm sure the numbers of people wrongly using those terms has risen at least a bit, but I think the anecdotal evidence you have is likely to be a mixture of that and also not that. Similar to how some people look at raw stats of autism diagnoses and think hugely more people are becoming autistic when in reality it's that we've got better at diagnosing autism; I think we (society, in at least some countries) have got better at being honest about mental health conditions. Meaning that more people, especially younger people who've grown up around less mental health stigma, will talk about having an actual genuine problem even without more diagnoses or more exaggeration. I think studies would be needed (that I'm not aware of) to figure out how many more people are using labels that don't really fit, vs how many more people are being honest about actual serious conditions. When I was in my 20s, if I needed a day off work because of depression I would always use a bullshit excuse to avoid mentioning the actual reason. I don't any more, most of my colleagues know what issues I do or don't have. And the younger generations are starting from that place, rather than having to grow into it.

x3n0n 1y ago

Yes! While I really like the article as an expression and exploration of the authors grief, a professional would not pathologize based on DSM criteria alone. If a person does not feel sick or want‘s not to be diagnosed for psychological illness, then they won‘t be (some limitations may apply). That said, the writing really resonated with me and i wish Bess well.

comechao 1y ago

I have a friend who was hospitalized recently. He tried to take his own life multiple times. Before reaching this point, he was struggling for months, but he thought it was ok bc he was working. So it's hard to draw the line for some people. Obviously, everything in life is a tradeoff and can be risky. But seeking medical advice is probably the best thing you can do bc you can reach a point of no return, and you will not accept treatment. How to draw the line? Like you said, disruptive changes and also disruptive behaviors. It's a complex problem.

KurSix 1y ago

I think when the author says "we medicalize grief because we fear it," she's not arguing that clinicians are eager to diagnose grief, but that society at large wants a clean, manageable container for something inherently messy and terrifying

munificent 1y ago

I think you are misinterpreting what the author means with "medicalize". They aren't saying "require to be treated by a medical professional". What they're saying is that as a culture, we reason about grief using the tools and concepts of the medical industry. Because it's part of our culture, this is so automatic that it's almost hard to conceive of any other way. But it is indeed a choice to describe grief as a sort of labeled pain which can be explored using falsifiable scientific experiments, is amenable to treatment by medical professionals, is a problem representing a delta between a "normal healthy human" and their current state, etc. We could just as well have a culture that treats grief as a normal part of the human experience. We could consider a person currently grieving as exactly as healthy and normal as someone playing the saxophone. We could (and some do) consider that the most appropriate people to offer help for grief be spiritual counsellors. I'm not saying we should handle grief differently. I'm just trying to point out that what the author's saying is that it's a cultural choice the way we present and work through it socially. (But, for what it's worth, I do think we should handle it in a less medical way.)

aeturnum 1y ago
I think what you are talking about is a problem. Having a medical diagnosis gives personal experience an extra weight in the social realm that's quite problematic. We should all get to say how impactful something for us and the medical folks can have their own standards for when they feel comfortable intervening. That said, if that's what the author was trying to talk about, I think they are doing so in a way that unfairly indicts the medical system for assertions it doesn't make. They say "Apparently, that’s a disease", but as I said I do not think it is. I think they've misunderstood what makes a disease under the diagnostic criteria they list. > We could just as well have a culture that treats grief as a normal part of the human experience. That culture does exist. Even in this article there is an experience of grief that's considered normative in the medical community. Including, I would argue, the authors' grief. I would argue that the medical approach to grief is actually better than other western treatments of grief. I agree that western cultures (and US culture in particular) is horrible about grief. We want people to be robotic and predictable and not make us think about loss and be sad in private and a whole mess of awful, inhuman things. But I don't think that pressure either comes from the medical community or is furthered by how the medical community talks about grief.

ericyd 1y ago

I would posit that you are reading this too literally. I didn't get the impression that the author was trying to rail against the medical establishment but rather to process her own experience in relation to professional guidance on the topic. I took it much more as a personal reflective essay than a professional medical critique.

aeturnum 1y ago
Sure - it's an expansive essay on the authors' experience around their grief. I never said that this was their thesis, but I do think the way they talk about medicalization is worth critiquing. They put their experience in tension with medicalization in a way that I don't quite see. Edit: I specifically think it's wrong to say we medicalize grief because we fear it. We medicalize it because some people would like a medical intervention with their grief. It's great and right that the author does not want that - but also they shouldn't write in a way that suggest that medical interventions in grief are wrongheaded.
- ericyd 1y ago
  Ok fair enough. I read her sentence as more of a figurative reflection on social attitudes towards grief, but if it's taken at face value then I see your point.

aogaili 1y ago

Grief is feared and timed because it impacts the velocity in scrum. Closing your Jira tickets on time is the order. Therefore grief by preventing the closure creates disorder. Stop reading HN and work on your next Jira.

zenoprax 1y ago

Agreed. I think the word "disorder" in DSM terminology is commonly misunderstood/trvialized by lay people. Being forgetful, sad, or tired is just part of life. If it becomes your whole life then you likely need help but an orderly life will contain pain, joy, pride, shame, boredom... We are always at risk of medicalizing discomfort. Allowing oneself to be miserable for a while can be therapeutic alongside patience, forgiveness, and compassion. Edit: after a re-read I noticed that she says she feels most of the symptoms daily a year later. That does feel pretty disruptive on its own but the definition is a bit tautological in that case. Regardless, what she's going through sounds really hard.

dredmorbius 1y ago

Further: by defining the criteria under which a condition becomes medically treatable, other parts of the healthcare system, such as insurance (private or government-funded), treatment protocols, and the like, come into play. Individuals should they choose to seek treatment are then able to do so within a much larger system. By making the criteria reasonably loose and readily met, such a definition also minimises the number of individuals who would benefit from treatment who are excluded from being able to do so. This would include those who are very much unable to function or face larger grief-related risks. We medicalise grief not because we fear it, but because there are genuinely useful therapies which may be of use to some, and denying them that merely compounds suffering. And yes, absolutely, grief ultimately is a lifelong experience. You never stop missing that which you've lost, so long as you have the capacities of memory, reason, and feeling. That is not what the clinical definition is about.

bonoboTP 1y ago

A piece of paper from a medical professional stating that you have some medical need is extremely powerful against the cold machine of corporate and state bureaucracy. You may want to handle grief through general compassion or something but lawyers and managers don't run on that fuel, but medical documents work on them like garlic on Dracula. That's just how it is.