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In a MedPage Today opinion published Nov. 1, psychiatrist Devina Wadhwa argues that clinicians should not treat screening scores or symptoms alone as proof of mental illness. She says distress after grief or other major life events can overlap with psychiatric disorders, so assessment should consider context, duration, functioning and risk without dismissing the possibility of illness.
Psychiatrist Devina Wadhwa argues that clinicians should not diagnose a mental disorder based on symptoms or screening questionnaires alone, particularly when distress follows events such as bereavement, a breakup or job loss. In an opinion published by MedPage Today on Nov. 1, 2026, she says psychiatric illness is real and treatable, but assessment must account for a person’s circumstances, functioning, symptom course and safety.
Wadhwa, writing as a practicing psychiatrist, describes patients who experience insomnia, sadness, appetite changes, anxiety or difficulty concentrating after major losses or disruptions. Those symptoms can appear in conditions such as depression and anxiety disorders, she writes, but they can also be part of a response to painful events. A screening score may flag symptoms; in her view, it cannot by itself settle what they mean.
She says clinicians should ask what happened, how long symptoms have lasted, how much a person’s functioning has changed, whether the response is evolving and whether the patient is at risk. They should also consider what the person was like before the event and whether the symptoms represent a qualitative shift. That judgment, she argues, requires attention beyond a brief assessment or questionnaire.
Wadhwa also cautions against assuming that distress is harmless because it has an understandable cause. Grief can coexist with depression, and a person facing a major loss can develop a serious psychiatric condition. The article is an opinion essay, not a new study or clinical guideline, and it does not report new data about diagnosis rates.
How Context Shapes Diagnosis
The argument concerns a difficult distinction in mental health care: symptoms can signal a disorder, but they can also arise during ordinary responses to loss, fear or instability. A label may help a patient make sense of symptoms and guide care, Wadhwa writes; it may also shape how that person understands their experience. She distinguishes the account, “I am devastated because someone I love died,” from the account, “I have a psychiatric disorder,” while noting that both can be true at once.
For patients, the practical point is that assessment should not stop at whether symptoms match a checklist. Too quick a diagnosis may medicalize distress, while too quick a reassurance may miss serious illness or risk. Wadhwa’s position is that clinicians need to hold both possibilities open and use clinical judgment to decide what support or treatment is appropriate.
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Screening Scores Need Context
Wadhwa notes that tools such as the PHQ-9 and GAD-7 are used to assess depressive and anxiety symptoms. These questionnaires can help identify concerns, but the opinion argues they should not replace a fuller clinical conversation. Symptoms including poor sleep, low appetite and concentration problems are not unique to psychiatric disorders, making the surrounding circumstances relevant to interpretation.
The article does not argue that grief or other life events rule out a diagnosis. Instead, it rejects a simple either-or distinction: a recognizable trigger can accompany a psychiatric illness, and emotional pain alone does not establish one. Wadhwa says the clinician’s task is to determine how the symptoms fit the individual’s history and current situation.
Where Distress Becomes Illness
The opinion offers no single test or threshold for distinguishing an expected response to a life event from a psychiatric disorder. Wadhwa says there is no simple answer in some cases and that the distinction depends on clinical judgment, including symptom duration, changes in functioning and risk.
It is also unclear from the article how often clinicians overdiagnose distress, whether particular screening practices cause that problem, or how frequently serious conditions are missed when symptoms are attributed to grief or stress. The piece presents a clinician’s perspective, not evidence establishing the scale of either risk.
Assessment Beyond the Checklist
Wadhwa’s recommendation is for clinicians to keep asking about a patient’s circumstances and history alongside symptoms, and to assess whether the response is changing or creating safety concerns. She does not propose a new screening tool or a revised diagnostic standard. Her closing argument is that tools can inform care, but the person’s context must remain central.
For readers, the article does not settle whether a particular person’s distress is a disorder. It makes the case for a careful professional assessment that neither automatically medicalizes suffering nor assumes that a clear cause makes severe symptoms benign.
Key Questions
What is Wadhwa arguing?
She argues that clinicians should interpret symptoms in context and not rely on a screening questionnaire alone to decide whether a person has a psychiatric disorder.
Does grief rule out depression?
No. Wadhwa says grief and depression can coexist, and that bereavement does not prevent someone from developing a psychiatric illness. The distinction requires individual assessment.
Does the article say distress should go untreated?
No. Wadhwa says psychiatric illness can cause serious suffering and that treatment can help. Her concern is with assigning a diagnosis too quickly, not with dismissing distress or withholding appropriate care.
Is this a new clinical study or guideline?
No. It is a MedPage Today opinion by psychiatrist Devina Wadhwa, published Nov. 1, 2026. It reports no new data or formal change to diagnostic guidance.
Source: medpagetoday.com
