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In a November 1, 2026 opinion article, psychiatrist Devina Wadhwa argues that clinicians should consider a patient’s circumstances before interpreting symptoms of sadness or anxiety as a disorder. She stresses that grief and psychiatric illness can overlap, and that screening questionnaires should inform—not replace—a fuller assessment.
Psychiatrist Devina Wadhwa is urging clinicians to look beyond symptom checklists when evaluating people distressed by bereavement, relationship breakdown or other major life events. In a November 1 opinion article for MedPage Today, she argues that screening results alone cannot distinguish ordinary suffering from a psychiatric disorder, a judgment that can shape both treatment and how patients understand their experiences.
Wadhwa describes patients who may struggle to sleep after a breakup, lose their appetite after a death or become anxious and unable to concentrate after losing a job. Those symptoms can overlap with depression and anxiety disorders, she writes, but their presence does not by itself settle whether a person has a mental illness. The circumstances, duration, changes in functioning and the patient’s risk all matter.
She warns that questionnaires and brief telehealth visits can make it harder to capture those circumstances. Tools such as the PHQ-9 and GAD-7 can identify symptoms, but Wadhwa says they should not become the whole assessment. She does not argue that symptoms following a loss should be dismissed: grief and depression can occur together, and a recognizable trigger does not rule out serious illness.
Wadhwa writes that diagnosis can help patients make sense of difficult experiences and guide treatment. She says she has seen medication, psychotherapy, hospitalization and other interventions change or save lives. Her concern is that moving too quickly from distress to diagnosis may frame painful, understandable responses as evidence of illness before a clinician has established what is happening.
Why Context Can Change Care
The distinction matters because diagnosis can affect treatment as well as a patient’s understanding of an experience. Naming a disorder may help someone access focused care, while treating every painful response as pathology could give an incomplete account of grief or upheaval. Wadhwa’s argument is not to withhold diagnosis, but to make sure that a label follows a careful assessment rather than a checklist alone.
There is a corresponding risk on the other side: calling symptoms an understandable reaction must not obscure severe depression, suicidality or another condition needing treatment. Wadhwa emphasizes that clinicians should hold both possibilities in view. For patients, the practical takeaway is that symptom scores are one part of an evaluation, not a complete answer about what a person is experiencing.
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Symptoms and Life Events
Psychiatric assessments often rely on symptoms that also occur in everyday life. Sadness, worry, poor sleep, appetite changes and difficulty concentrating can arise during grief or acute stress; they can also appear in mental health disorders. Wadhwa says that overlap makes psychiatry different from fields where a symptom may point more directly to a physical condition.
She uses bereavement to show why a simple rule would be inadequate. A person grieving a spouse may have symptoms associated with major depression, but grief does not prevent depression from developing, and the two can coexist. Conversely, depressive symptoms after a devastating loss do not automatically establish a depressive disorder. The article is an opinion piece, not a new clinical study or a change to diagnostic guidance.
Where Distress Becomes Disorder
Wadhwa’s article does not propose a single test or threshold for separating grief and other distress from a psychiatric disorder. She says there is no simple answer in cases such as bereavement and that the distinction requires clinical judgment. The piece also does not present new data measuring how often clinicians overdiagnose or quantify the effects of screening tools on diagnosis.
Whether a specific patient’s symptoms amount to a disorder depends on an individual assessment. Relevant details include how long symptoms have lasted, how much functioning has changed, whether the response is evolving and whether the person is at risk. Those details cannot be determined from the article’s examples alone.
Questions for a Fuller Assessment
Wadhwa calls on psychiatrists to ask about what happened, what the patient was like before, how symptoms have developed and whether functioning or safety has changed. The article sets out a clinical approach, not a new policy or announced change to diagnostic criteria. It does not specify a timeline for any further action.
For patients being assessed, the issues she highlights are reasons to discuss the timing and context of symptoms, their effect on daily life and any safety concerns with a qualified clinician. A screening score can be a starting point, but Wadhwa argues that decisions about diagnosis and treatment should follow a broader conversation.
Key Questions
What is Wadhwa arguing?
She argues that clinicians should assess life context and clinical history alongside symptoms, rather than relying on screening tools alone to determine whether distress reflects a disorder.
Does grief rule out depression?
No. Wadhwa says grief and depression can coexist, and a major loss does not protect someone from developing a psychiatric illness.
Does a screening questionnaire diagnose a disorder by itself?
Wadhwa says tools such as the PHQ-9 and GAD-7 can show symptoms but should not replace a fuller clinical assessment.
Is the article a new clinical study or guideline?
No. It is Wadhwa’s opinion article in MedPage Today, published November 1, 2026. It does not announce new research findings or diagnostic rules.
Source: medpagetoday.com
