TL;DR
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In a November 1, 2026 opinion article, psychiatrist Devina Wadhwa says clinicians should distinguish ordinary responses to loss or upheaval from psychiatric disorders without dismissing serious illness. She argues that screening tools can inform assessment but cannot replace context, clinical judgment and attention to safety.
Psychiatrist Devina Wadhwa, MD, is urging clinicians to assess life circumstances alongside symptoms before diagnosing mental illness, arguing in a November 1 opinion article that grief, heartbreak and acute stress can resemble psychiatric disorders. Her argument matters because screening questionnaires and brief assessments may not capture the context needed to distinguish distress from illness, while serious conditions can also arise after a major loss.
Writing for MedPage Today, Wadhwa describes patients who struggle to sleep, eat or concentrate after a relationship ends, a death or job loss. These experiences may produce symptoms that overlap with depression or anxiety. She says tools such as the PHQ-9 and GAD-7 can identify symptoms, but a questionnaire should not stand in for a fuller clinical assessment. The source article refers to the PHQ-9; the prompt’s source text also contains a PHQ-0 reference.
Wadhwa does not argue that clinicians should avoid psychiatric diagnoses or treatment. She says psychiatric conditions can cause severe suffering and that diagnosis may help patients understand their experiences and guide care. She also describes medication, psychotherapy, hospitalization and other interventions as treatments she has seen change or save lives. Her concern is that clinicians may move too quickly from recognizing pain to labeling it a disorder.
Grief is a central example. A bereaved person may show symptoms associated with major depression, but bereavement does not rule out depression, and depression is not automatically established by symptoms following a death. Wadhwa says the distinction requires clinical judgment, including questions about duration, changes in functioning, how symptoms evolve, a person’s prior state and potential risk. The article offers a clinician’s perspective; it does not present new research or clinical guidelines.
Why Context Changes Diagnosis
The distinction can shape both care decisions and how patients interpret what is happening to them. A psychiatric diagnosis may help someone access focused treatment, while describing a response as grief or distress may better reflect a painful event without implying that every painful emotion is a disorder. Wadhwa says the narratives can overlap, but they are not interchangeable.
The stakes run in both directions. Labeling expected distress as illness may medicalize ordinary human responses; dismissing symptoms as an understandable reaction may miss a serious condition or risk. Wadhwa specifically cautions that a recognizable trigger, such as bereavement or relationship loss, does not make severe symptoms harmless. Her argument is for careful assessment rather than a presumption either way.
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Screening Tools and Clinical Judgment
Wadhwa frames the concern around healthcare’s increasing reliance on questionnaires and brief telehealth assessments, which she says can make it harder to capture a patient’s circumstances. Screening measures can flag symptoms for further attention, but her article argues that results need to be interpreted alongside a person’s history and current situation.
The piece is an opinion essay, not a report of a new study, policy change or professional consensus. Its examples—including a spouse’s death followed by sleep, appetite and concentration problems—illustrate the diagnostic challenge rather than establish how often distress is misdiagnosed. The article does not quantify overdiagnosis or compare rates across settings.
How Often Distress Is Misdiagnosed
The article does not establish how often clinicians overdiagnose ordinary distress, whether diagnosis rates are changing or which assessment settings are most affected. It cites no new data measuring the accuracy of questionnaires or brief telehealth evaluations. Wadhwa’s claims are a psychiatrist’s clinical perspective, not findings from a population study.
It also gives no simple test for separating grief from depression. The article stresses that both can occur together and that a major life event does not settle the diagnosis. Determining when symptoms amount to a disorder, how urgently treatment is needed and whether a patient is at risk remains dependent on an individual assessment.
Assessment Beyond the Questionnaire
Wadhwa’s recommendation is for clinicians to ask about the event, the length and course of symptoms, changes in daily functioning, the patient’s baseline and any safety concerns before deciding what a diagnosis means. The article does not announce a new guideline or scheduled policy change, so no formal next step is specified.
For patients, the piece underscores that a screening score alone is not a diagnosis and that severe or persistent symptoms deserve professional attention. Decisions about diagnosis and treatment should be made with a qualified clinician who can assess individual circumstances and safety.
Key Questions
What is Devina Wadhwa arguing?
Wadhwa argues that clinicians should consider life context alongside symptoms before diagnosing a psychiatric disorder. She says distress after loss or upheaval can resemble illness, but that context does not rule illness out.
Does the article say grief cannot be depression?
No. Wadhwa says grief and major depression can coexist. Symptoms after a death do not automatically establish a depressive disorder, but bereavement does not prevent someone from developing one.
Are screening questionnaires enough to diagnose a disorder?
Wadhwa says screening tools can help identify symptoms but should not be the whole assessment. Her article calls for clinical judgment that considers duration, functioning, symptom changes, personal history and risk.
Does this opinion article provide evidence that overdiagnosis is increasing?
No. The article presents a clinician’s perspective and does not include data on overdiagnosis rates or changes over time.
Source: medpagetoday.com
