TL;DR
In a November 1 opinion article, psychiatrist Devina Wadhwa argues that clinicians should not treat screening results or painful reactions to life events as a diagnosis on their own. She says distress can overlap with psychiatric illness, so assessment must account for context, duration, functioning and risk without dismissing the possibility of serious illness.
Psychiatrist Devina Wadhwa argues that clinicians should look beyond symptom checklists before diagnosing psychiatric disorders in people facing grief, relationship loss or other upheaval. In an opinion article published November 1 by MedPage Today, she says screening tools cannot replace a contextual clinical assessment—while stressing that understandable distress can coexist with serious illness and should not be dismissed.
Wadhwa describes how insomnia, appetite changes, sadness, anxiety and difficulty concentrating can follow events such as a bereavement, breakup or job loss. Those symptoms can also appear in psychiatric disorders, including major depression and anxiety disorders. She writes that a patient’s responses on tools such as the PHQ-9 or GAD-7 may indicate symptoms, but a questionnaire alone cannot establish what is causing them.
Her example is a bereaved person who is crying frequently, sleeping poorly, eating less, struggling to concentrate and experiencing a loss of pleasure. These experiences may overlap with depression, she says, but grief and psychiatric illness are not mutually exclusive. Distinguishing between them calls for clinical judgment, including questions about what happened, how long symptoms have lasted, changes in functioning, how the response is developing, the person’s history and any safety risk.
Wadhwa’s article is an argument about clinical practice, not a report of new research or a change in diagnostic guidance. She says diagnoses can give people language for their experiences and help direct treatment, and describes medication, psychotherapy and other interventions as having changed or saved lives. Her concern is that labeling distress too quickly may shape how patients understand their experience, while overlooking illness can also leave people without needed care.
Balancing Recognition and Overdiagnosis
The distinction matters because a diagnosis can influence a person’s treatment pathway and their understanding of why they are suffering. Wadhwa cautions against turning every painful response into evidence of disorder, but her argument is not that grief or stress rules out illness. A bereaved person may also develop depression, and severe symptoms after a recognizable loss still require attention.
For readers, the practical point is that screening results are a starting point for discussion, not a complete account of an individual’s health. Careful assessment can help clinicians avoid both pathologizing ordinary distress and minimizing symptoms that need treatment. The article does not provide a numerical estimate of overdiagnosis or establish how often either error occurs.
Symptoms Need Their Life Context
Psychiatric assessment often involves symptoms that also occur in everyday life: sadness after loss, worry during instability, poor sleep after heartbreak and reduced concentration under stress. Wadhwa says this overlap makes psychiatry distinct, because the presence of a symptom does not, by itself, settle whether it reflects a disorder.
She also points to the limits of brief assessments and questionnaires, including those used in telehealth, when they leave little room to understand a person’s circumstances. Her article does not argue that such tools have no value; rather, she warns against allowing them to become the entire assessment. The central question, she writes, is whether a person’s response has shifted from understandable distress into psychiatric illness—a judgment that requires more than a score.
Where Distress Becomes Disorder
The article does not set out a new diagnostic test, a threshold for when grief becomes a disorder, or data on how commonly clinicians overdiagnose normal distress. Wadhwa says there is no simple answer to the distinction in cases such as bereavement, and that grief can coexist with depression. The article also does not assess whether screening tools are being used inappropriately across healthcare settings or quantify their effect on diagnosis.
Each patient’s duration of symptoms, functional changes, history and risk may differ. Wadhwa’s position is that clinicians need to explore those factors rather than infer a diagnosis solely from a precipitating event or a questionnaire score.
Clinical Judgment Remains Central
Wadhwa calls on psychiatrists to keep asking about a patient’s circumstances and changes over time, even as screening and telehealth tools remain part of care. Her article does not announce a forthcoming policy, study or clinical guideline; it is a call for clinicians to make space for individual assessment before deciding what symptoms mean.
For patients concerned about distress or a possible psychiatric condition, the article offers no substitute for an individual evaluation. Wadhwa’s argument is that assessment should consider both the person’s lived circumstances and the possibility of illness, including whether symptoms are severe or changing and whether the person is at risk.
Key Questions
What did Devina Wadhwa argue?
She argued that clinicians should consider a patient’s circumstances, symptom duration, functioning and safety—not just questionnaire scores—before diagnosing psychiatric illness.
Does grief rule out depression?
No. Wadhwa says grief and depression can coexist. A clear cause for distress does not by itself show that symptoms are harmless or that a psychiatric disorder is absent.
Do screening questionnaires diagnose a disorder?
Wadhwa says screening tools can identify symptoms but should not serve as the entire assessment. Her article does not offer a new diagnostic rule or evaluate the accuracy of specific tools.
Is the article based on new research?
No. It is an opinion article by psychiatrist Devina Wadhwa, published by MedPage Today on November 1, 2026, and presents her perspective on clinical practice.
Source: medpagetoday.com
