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In a November 1 opinion article, psychiatrist Devina Wadhwa argues that clinicians should not treat screening results or symptoms alone as a diagnosis. She says grief and other painful responses can overlap with psychiatric disorders, so assessment must weigh context, duration, functioning and safety.
Psychiatrist Devina Wadhwa argues that clinicians should take a patient’s circumstances into account before diagnosing a mental disorder, warning that grief, anxiety and sleep problems can be responses to painful events as well as symptoms of illness. In an opinion article published November 1, she says screening questionnaires can inform an assessment but should not replace clinical judgment.
Wadhwa describes patients who struggle after a relationship ends, a death in the family or a job loss. They may report sadness, poor sleep, appetite changes, anxiety and difficulty concentrating — experiences that can also appear in psychiatric disorders. A score on a depression or anxiety questionnaire may indicate symptoms, she writes, but it does not establish by itself what is causing them.
The article does not argue that distress after a loss rules out illness. Wadhwa says grief can coexist with major depression, and that severe symptoms following a recognizable event still require assessment. Clinicians should ask how long symptoms have lasted, how much functioning has changed, whether the condition is evolving, whether the patient is at risk and what the person was like before the event.
Wadhwa writes that psychiatric diagnoses can help people make sense of their experiences and guide treatment. She also notes that treatment — including medication, psychotherapy and hospitalization — can change or save lives. Her concern is that relying too heavily on brief questionnaires or telehealth encounters may leave too little room to understand a patient’s situation.
Why Context Changes Diagnosis
The distinction matters because a diagnosis can shape a patient’s treatment pathway and understanding of their experience, not just the language used in a medical record. Wadhwa contrasts describing devastation after a death with describing a psychiatric disorder, while stressing that the two accounts can both be true.
Her argument points to a clinical balance: labeling every painful reaction as illness may medicalize ordinary suffering, but dismissing symptoms as an understandable response can miss a serious condition. A screening result can help identify concerns, but the article says it should be considered alongside the patient’s history, circumstances, functioning and safety.
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Screening Tools and Clinical Judgment
Wadhwa is a psychiatrist who says she diagnoses and treats psychiatric illness in her daily practice. Her article acknowledges the role of diagnosis in identifying conditions such as major depression, anxiety disorders, post-traumatic stress disorder, bipolar disorder and psychotic illnesses, and in directing care.
The piece focuses on the overlap between symptoms used in psychiatric assessment and ordinary human responses. It specifically raises concern about questionnaires and brief telehealth assessments when they make it harder to capture context. Wadhwa’s position is that such tools can contribute information, but a clinician still needs to understand what happened and how the person is responding over time.
This is an opinion article, not a new research study or a change to diagnostic guidance. It offers Wadhwa’s clinical perspective on how psychiatrists should approach assessment.
Where Distress Becomes Illness
Wadhwa says there is no simple answer for when grief-related symptoms amount to a depressive disorder. The article does not offer a new diagnostic test, a cutoff for symptom duration or a rule that can settle the distinction across patients. It instead describes the decision as one requiring clinical judgment.
The article also does not provide new data measuring how often distress is overdiagnosed, or evidence that screening tools alone are causing misdiagnoses. Its concerns about brief assessments are presented as Wadhwa’s clinical perspective. The appropriate diagnosis and care for any individual patient cannot be determined from the examples in the article.
Assessment Beyond a Screening Score
Wadhwa calls on psychiatrists to keep asking about what happened, how long symptoms have lasted and how daily life has changed, while assessing whether a patient may be at risk. Her article sets out no formal policy change or scheduled next step; it is a call for clinicians to make context part of their existing assessment practices.
For readers, the piece does not advise ignoring persistent or severe symptoms because they followed a difficult event. Wadhwa says context does not protect someone from psychiatric illness and that serious symptoms, including suicidal risk, need attention. Decisions about diagnosis and treatment require assessment by a qualified professional.
Key Questions
What is Wadhwa’s main argument?
She argues that clinicians should not diagnose from symptoms or screening scores alone. They should consider a patient’s circumstances, history, symptom course, functioning and safety.
Does grief rule out major depression?
No. Wadhwa says grief and major depression can coexist. A death or other loss does not by itself establish or rule out a psychiatric disorder.
Does the article say screening questionnaires are useless?
No. Wadhwa says tools such as depression and anxiety questionnaires may identify symptoms, but should not be the entire assessment.
Is this a new study or change to diagnostic rules?
No. It is an opinion article by psychiatrist Devina Wadhwa, published November 1, 2026. It presents her clinical perspective rather than new research findings or revised diagnostic guidance.
Source: medpagetoday.com
