MARIANNE LEONE’S continued grief over the tragic death of her son is certainly understandable, and no psychiatrist wants to label ordinary grief a “disorder’’ or put a two-week time limit on it (“A mother’s grief — without time limits,’’ Op-ed, Sept. 8). The changes proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders simply state that if a bereaved individual meets all the standard criteria for major depressive disorder within two weeks after the death of a loved one, the diagnosis may apply.
Most bereaved individuals do not meet full criteria for major depression, although they often experience profound sadness, bouts of tearfulness, and disturbed sleep. Painful recollections of the deceased are often interspersed with fond memories, and the grieving person is usually able to carry out the activities of daily living. This picture is quite different from that of major depression, in which the person is often suicidal, guilt-ridden, inconsolable, constantly depressed, and unable to function.
Grief is a normal, adaptive response to loss that usually resolves with love and support; major depression is a serious illness that requires professional care. Mental health professionals do appreciate the difference.
Dr. Ronald Pies
Lexington
The writer is a psychiatrist affiliated with Tufts University School of Medicine. 
