TL;DR
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In a November 1, 2026, opinion article, psychiatrist Devina Wadhwa argues that clinicians should assess life circumstances alongside symptoms before diagnosing mental illness. She says ordinary distress can resemble psychiatric disorders, while grief or stress can also coexist with serious illness; careful evaluation, not a screening score alone, is needed.
Psychiatrist Devina Wadhwa argues that clinicians should not treat symptoms or screening scores as enough to diagnose mental illness, particularly when a patient is responding to grief, a breakup or another major life stress. In an opinion article published by MedPage Today on November 1, she says careful assessment must account for context while recognizing that distress after a loss can also occur alongside a psychiatric disorder.
Wadhwa describes patients who struggle to sleep, eat, concentrate or manage anxiety after events such as a death, job loss or relationship ending. Those experiences can overlap with symptoms used to identify conditions including depression and anxiety disorders. She notes that questionnaires such as the PHQ-9 and GAD-7 can indicate symptoms, but argues that a screening result should not stand in for a fuller clinical assessment.
Her article does not argue against psychiatric diagnosis or treatment. Wadhwa says psychiatric illnesses can cause substantial suffering, and that diagnosis can help people understand their experiences and guide care. She writes that she has seen medication, psychotherapy, hospitalization and other interventions change or save lives. Her concern is that clinicians may move too quickly from identifying pain to labeling it as illness without first understanding what has happened to the patient.
Wadhwa uses bereavement to illustrate the difficulty: poor sleep, frequent crying, reduced appetite, impaired concentration and loss of interest may follow a spouse’s death, but those symptoms can also appear in major depression. She says grief does not rule out depression, and depressive symptoms after a loss do not by themselves establish that someone has a depressive disorder. Distinguishing the two requires clinical judgment and attention to the person’s circumstances.
Why Context Changes a Diagnosis
The distinction matters because a diagnosis can shape a patient’s understanding of what is happening, as well as influence treatment decisions and clinical records. Wadhwa argues that describing a reaction as understandable grief and describing it as a psychiatric disorder are different accounts, even though both may apply to the same person. A label made without adequate context could frame painful but expected reactions as pathology; overlooking illness because a stressor is apparent could leave a person without needed care.
For readers, the article’s practical point is not to dismiss symptoms or avoid professional help. It is that symptom checklists are indicators, not a complete assessment. Wadhwa says clinicians should ask what changed, how long symptoms have lasted, how much daily functioning is affected, whether the response is changing and whether the patient may be at risk. Those questions can help distinguish between distress that follows a life event and a condition requiring psychiatric care, while allowing for overlap.
The article also addresses how health services use brief assessments, including telehealth encounters. Wadhwa worries that these formats can make it harder to capture a patient’s history and surroundings. She does not provide data measuring how often overdiagnosis occurs, but calls for clinicians to keep the individual’s story central when using screening tools.
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Symptoms Can Follow Major Loss
Psychiatry often assesses experiences such as sadness, worry, insomnia and difficulty concentrating. Those symptoms can be associated with mental disorders, but they can also arise during ordinary responses to upheaval, Wadhwa writes. Her examples include a person struggling after a relationship ends, a bereaved parent whose appetite disappears, and someone feeling anxious after losing a job.
That overlap makes assessment more complex than matching symptoms to a checklist. Wadhwa says context is important, but not decisive: the presence of a recognizable cause does not prove that symptoms are benign. A person grieving a death may develop depression; someone facing a difficult life change may also experience a severe mood disorder. The article therefore rejects both automatic diagnosis based on symptoms alone and automatic reassurance based on circumstance.
The piece is an opinion article by a psychiatrist, not a research study or a report of new clinical guidelines. It presents Wadhwa’s professional perspective on diagnostic practice and does not offer estimates of how frequently normal distress is misdiagnosed or how screening tools perform across different settings.
Where Distress Becomes Disorder
Wadhwa says there is no simple answer to when grief or other distress becomes a psychiatric disorder. Her article offers questions clinicians can ask, but does not set out diagnostic thresholds, new criteria or a method for determining the distinction in every case. It also provides no research data on how often clinicians overdiagnose normal distress, or on whether screening tools have led to more incorrect diagnoses.
The author’s examples are illustrative, not assessments of actual patients. The article does not claim that a particular questionnaire is inherently unreliable or that a certain diagnosis is being routinely misapplied. Individual symptoms, their duration and severity, effects on daily life, changes over time and potential safety risks all require assessment by a qualified clinician. Grief and psychiatric illness can coexist, so the presence of a loss or stressor cannot settle the question on its own.
Questions for Clinical Practice
Wadhwa’s proposed next step is for clinicians to keep asking about circumstances, history and changes in functioning rather than relying on a screening score as the full account. She urges psychiatrists to stay curious about what happened and to assess whether the person’s response is evolving, whether it marks a substantial change from their usual functioning and whether there is a risk of harm.
The article does not announce a policy change, a new clinical protocol or a scheduled follow-up. It is a call for more context-sensitive judgment in everyday practice. People experiencing persistent, severe or unsafe symptoms should seek assessment from a qualified health professional; the article does not offer an individual diagnosis or treatment plan.
Key Questions
What is Wadhwa arguing in the article?
She argues that clinicians should consider a patient’s life circumstances and history before interpreting symptoms as a psychiatric disorder. Screening tools can help identify symptoms, but should not replace a full assessment.
Does grief rule out depression?
No. Wadhwa says grief and depression can coexist. A loss may explain distress, but it does not by itself determine whether someone also has a psychiatric illness.
Does a positive screening result mean someone has a disorder?
Not on its own. The article says questionnaires can show symptoms, but diagnosis calls for clinical judgment and consideration of context, duration, functioning and risk.
Is this article based on new research or guidelines?
No. It is an opinion article by psychiatrist Devina Wadhwa, published by MedPage Today on November 1, 2026. It does not present new research findings, frequency estimates or updated diagnostic guidelines.
Source: medpagetoday.com
