TL;DR
Get workout gear delivered free with Prime
- Fast, free delivery on millions of items
- Prime Video, Amazon Music and more included
- Member-only deals all year
In a November 1, 2026, opinion article, psychiatrist Devina Wadhwa urges clinicians to distinguish ordinary distress from psychiatric illness through careful assessment of a patient’s circumstances, symptoms and risk. She stresses that grief and other painful events can coexist with mental illness, and that screening tools should inform—not replace—clinical judgment.
Psychiatrist Devina Wadhwa, MD, is urging clinicians not to mistake every painful response to a life event for a psychiatric disorder, while cautioning that grief and stress do not rule out illness. In an opinion article published by MedPage Today on November 1, 2026, she argues that screening questionnaires and brief assessments should not replace a fuller evaluation of a patient’s circumstances, functioning and safety.
Wadhwa describes patients who struggle to sleep after a breakup, lose their appetite after a death, or feel anxious and unable to concentrate after losing a job. Those symptoms can appear in psychiatric conditions, she writes, but can also occur as responses to difficult events. Symptoms alone do not settle the diagnosis; clinicians need to ask what happened and how the person’s condition is changing.
She says tools such as the PHQ-0 and GAD-7 can help assess symptoms associated with depression and anxiety, but warns against treating a questionnaire score as a complete assessment. Her article uses bereavement as an example: grief may involve crying, poor sleep, reduced appetite and loss of interest, symptoms that can overlap with major depression. Grief does not prevent depression from developing, she says, and the two can occur together.
Wadhwa also emphasizes that diagnosis can shape how patients understand their experience and guide treatment. She says psychiatric conditions can cause severe suffering and that medication, psychotherapy, hospitalization and other interventions can change or save lives. Her argument is not to withhold care, but to use clinical judgment before deciding whether symptoms reflect illness, a response to circumstances, or both.
Why Context Changes Psychiatric Assessment
The distinction matters because a diagnosis can influence a patient’s self-understanding as well as clinical decisions about care. Wadhwa writes that telling oneself, “I am devastated because someone I love died” differs from describing the experience as a psychiatric disorder, although both may be true at once. Labels and treatment decisions should follow an assessment that considers the person’s history and circumstances, rather than symptoms in isolation.
Her warning also points in two directions: clinicians may risk medicalizing ordinary suffering, but they may also miss serious illness if they dismiss symptoms as an understandable reaction to loss or stress. Wadhwa says clinicians should consider duration, changes in functioning, symptom progression and safety risks. That balance is relevant to patients seeking help and to providers conducting brief telehealth assessments or using screening tools.
Products Worth Considering
Fitbit Charge 6 Fitness Tracker – Porcelain/Silver
Fitbit Sense Health & Fitness Smartwatch (White/Gold, International Version)
Oral-B iO Series 3 Rechargeable Electric Toothbrush for Adults, Black
As an affiliate, we earn on qualifying purchases.
Screening Tools and the Role of Judgment
Wadhwa’s article is an opinion piece, not a study reporting new data or a change to diagnostic guidance. It presents her perspective as a practicing psychiatrist on how clinicians should interpret symptoms that overlap between everyday distress and psychiatric disorders. She says she diagnoses and treats psychiatric illness regularly and has seen treatment make a major difference in patients’ lives.
The central example is the overlap between bereavement and depression. Wadhwa does not offer a simple rule for distinguishing them; instead, she argues that the distinction depends on careful clinical judgment. A clear precipitating event, such as a death or relationship ending, cannot by itself establish that symptoms are not psychiatric illness. Context informs diagnosis but does not determine it.
Where Distress Becomes Disorder
Wadhwa does not set out a diagnostic test or threshold for deciding when distress becomes a psychiatric disorder. Her article instead says there is no simple answer in cases such as grief, where symptoms may overlap with depression and the conditions may coexist. It also does not present new research measuring how often clinicians overdiagnose distress or how frequently screening tools lead to misclassification.
The piece offers clinical perspective rather than evidence of a specific change in practice. The degree to which short appointments or questionnaire-based assessments affect diagnosis is not quantified in the article. Individual assessments still depend on the patient’s symptoms, history, functioning and risk.
Questions Clinicians Should Ask
Wadhwa calls on clinicians to ask what happened, how long symptoms have lasted, how much functioning has changed, whether the response is evolving and whether the patient is at risk. She also recommends considering what the person was like before the event and whether something has shifted beyond an expected response. These questions, she writes, take more time than a screening form but keep the patient’s circumstances in view.
The article does not announce a policy change or prescribe a formal next step for the profession. Its practical message is that clinicians should continue to assess symptoms carefully, use screening results as one part of that process, and remain alert both to serious illness and to the possibility that pain is not itself a disorder. Diagnosis and treatment decisions remain matters of individualized clinical assessment.
Key Questions
What is Devina Wadhwa arguing?
Wadhwa argues that clinicians should not diagnose a psychiatric disorder from symptoms or questionnaire results alone. They should consider a patient’s circumstances, history, functioning, symptom course and safety.
Does grief rule out major depression?
No. Wadhwa says grief does not protect someone from developing major depression, and bereavement and depression can occur together. A life event alone cannot determine the diagnosis.
Does the article say screening tools are unhelpful?
No. Wadhwa’s point is that tools such as the PHQ-9 and GAD-7 should not be the entire assessment. She says clinicians need to interpret results alongside the patient’s circumstances and clinical presentation.
Is this a new study or a change to diagnostic rules?
No. It is an opinion article published by MedPage Today on November 1, 2026. It presents Wadhwa’s clinical perspective and does not report new research or announce a change to diagnostic guidance.
Source: medpagetoday.com
