Bupropion Sustained Release for Bereavement: Results of an Open Trial. “Major depressive symptoms occurring shortly after the loss of a loved one (i.e., bereavement) appear to respond to bupropion SR.
Treatment of these symptoms does not intensify grief; rather, improvement in depression is associated with decreases in grief intensity. The results of this
study challenge prevailing clinical wisdom that DSM-IV-defined bereavement should not be treated.” J Clin Psychiatry IMHO, this study’s conclusions exemplify the worst of the mechanistic modern psychopharmacologically astute but psychologically naive clinical psychiatric approach. The authors appear to think that their findings challenge the ‘prevailing wisdom’ because they have demonstrated the efficacy — measured in terms of symptom intensity reduction — of treatment, but refraining from treating grief with antidepressants was never based on the misapprehension that the treatment would be ineffective! It is precisely because antidepressant treatment does decrease grief intensity that the ‘prevailing wisdom’ suggesting that bereavement not be treated is wisdom! Just because we can treat something doesn’t mean we must, and bereavement is a prime example; grieving serves a purpose which should not be prevented from unfolding in most instances. From Freud’s psychoanalytic understanding of melancholy to the modern psychobiological conception of depression and the evolutionary biology perspective, the distinctions as well as the similarities between grief and melancholic depression have been clear — the latter is the former gone awry in some way. And that, in simple but profound terms, is the reason you treat one but not the other.