As a newer clinician, the process of diagnosis has been a slowly cultivated skill. Building the ability to hear someone describe their challenges and translate them into tidy criteria within a flawed medical framework has been daunting. Through a social work lens, I’m often thinking about systems and the way these systems cause the dysregulation I’m tasked with treating in an individual. Pathologizing the feeling of increasing dread over our dying planet doesn’t feel particularly helpful, but no one has yet asked me to diagnose or treat the billionaire corporations who are killing our planet. Instead, I get to sit with my clients in our shared frustration, grief, overwhelm, and persistent negative beliefs about the state of the world.  

So how do we diagnose climate grief? Sometimes I turn to PTSD-chronic, sometimes it feels more like Persistent Grief Disorder. Of course, PTSD-chronic is messy partly because C-PTSD was rejected from the most recent iteration of the DSM 5TR. PTSD’s particular diagnostic criteria include “Directly experiencing the traumatic event(s)” and “Witnessing, in person, the event(s) as it occurred to others”(1). Hurricanes, flooding, and wildfires to name just a few. We are witnessing the horrendous effect that global warming has on all of us, particularly people who are part of our most vulnerable communities.

I’ve also spoken with clinicians who see the impacts of global warming present more through an experience of Persistent Grief Disorder (PGD). Bereavement becomes PGD after 12 months and is characterized by “intense yearning/longing for the deceased person” and/or “preoccupation with thoughts or memories of the deceased person”(2). That’s where it gets sticky because limiting criteria to a “person” feels unhelpful when people grieve deeply for many endings; pet death, moving, job loss– the list goes on and on.

Pathologizing doesn’t feel helpful – yet insurance requires we jump through these hoops, so we do. I think that ultimately, what makes the burden feel just that much lighter is living into our values, and holding our grief with others.