This month we address psychiatry’s role in end-of-life issues. Guest-edited by our newest board member, Lorenzo Norris, MD, Medical Director of Psychiatric Behavioral Services for The George Washington University Hospital, the topic is approached from a number of angles, including psychotherapeutic and psychopharmacological modalities.
And yet, any approach we take will ultimately lead us back to ourselves: Death is something we all must face, both for our loved ones and ultimately for ourselves.
Is there any contradiction in our featuring this topic at a time when winter is giving way to spring and its beautiful resurgence of life? In winter, many living things “die” or hibernate; in spring, life blooms. Yes, winter changing hands with spring is the perfect metaphor for dealing with the life and death cycle.
By learning to live in the present, as fully as our reality allows, we can consciously create a meaningful response to the inevitability of death.
James L. Griffith, MD, and colleagues very helpfully discuss the differentiation of demoralization from clinical depression (see page 127). As the authors point out, depression amplifies pain and detracts from the joy of living.
It is critical that we can detect the signs of grief, and differentiate grief and demoralization from clinical depression. Griffith et al have done the field an enormous service with this piece.
This is the second standout issue that Dr. Norris has guest edited for us (see Psychiatric Annals September 2011).
His perceptive approach to existential concerns and sensitivity to not pathologizing the human experience is impressive, which is one reason we’ve added Dr. Norris to our editorial board. I believe his expertise in psychiatric and palliative care is a valuable addition.
As clinicians, it is our job to help reduce pain, but just as important, to promote meaning in the lives of our patients, and all those whose lives we touch.
As the articles in this issue demonstrate, restoring a sense of meaning can re-create the value of life. To do this, we have to face our own existential questions and be conscious of the meaning in our own lives. Here’s to spring and all that it gives us.