TL;DR
Get health and wellness essentials 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 opinion article, psychiatrist Devina Wadhwa argues that clinicians should not treat symptoms or screening scores alone as proof of mental illness. She says careful assessment must account for life events, duration, changes in functioning and risk, while recognizing that distress after a loss or crisis can coexist with a psychiatric disorder.
Psychiatrist Devina Wadhwa is urging clinicians to consider a patient’s circumstances before interpreting sadness, anxiety or sleep problems as signs of a psychiatric disorder. In a November 1 opinion article for MedPage Today, she said screening questionnaires can inform an assessment but should not replace clinical judgment about what happened, how long symptoms have lasted, how much functioning has changed and whether the person is at risk.
Wadhwa describes patients who struggle after a relationship ends, a death or the loss of a job. Their experiences may include poor sleep, low appetite, difficulty concentrating and anxiety—symptoms that can also appear in psychiatric conditions. The overlap makes it necessary, she argues, to look beyond a checklist or brief telehealth encounter and understand the person’s situation.
She does not argue that distress after a difficult event rules out illness. Grief and major depression can coexist, and a recognizable cause for suffering does not make severe symptoms harmless. Wadhwa says clinicians should examine whether symptoms are changing, how they affect daily life and whether there is a safety concern before deciding what diagnosis, if any, fits.
The article also acknowledges the value of diagnosis and treatment. Wadhwa says psychiatric conditions can cause serious suffering and that medication, psychotherapy, hospitalization and other interventions have helped patients. Her concern is about moving too quickly from pain to pathology, not about withholding care from people who need it.
How Diagnosis Shapes Patient Care
A psychiatric label can guide treatment and help a patient make sense of difficult experiences, but it can also shape how the person understands what is happening. Wadhwa distinguishes the account “I am devastated because someone I love died” from the account “I have a psychiatric disorder,” while noting that both may be true for the same person. The distinction matters because the cause and course of distress can affect what support is appropriate.
For readers seeking care, the article underscores that a screening result is not the whole assessment. Symptoms deserve attention, but interpreting them requires discussion of their onset, severity, impact and surrounding circumstances. This is not a reason to dismiss distress as normal or to avoid treatment; it is a case for assessment that can recognize both ordinary suffering and serious illness.
Products Worth Considering
Oral-B iO Series 3 Rechargeable Electric Toothbrush for Adults, Black
Therabody Theragun Elite 5th Gen Deep Tissue Massage Gun
Bowflex SelectTech 840 Adjustable Kettlebell
As an affiliate, we earn on qualifying purchases.
Symptoms After Loss or Crisis
Wadhwa’s article focuses on a challenge specific to psychiatry: many symptoms clinicians assess are also part of ordinary human responses. Sadness can follow loss, worry can follow instability, and insomnia can follow heartbreak. Their presence alone does not settle whether a person has a disorder.
She points to screening questionnaires such as the PHQ-9 and GAD-7 as tools that may identify symptoms, while warning that a score cannot supply the context a clinician needs. The article’s example is a bereaved person who is crying frequently, eating and sleeping poorly, struggling to concentrate and experiencing diminished pleasure. Those symptoms overlap with depression, but the article says distinguishing grief from a depressive disorder requires clinical judgment rather than an automatic conclusion.
Where Distress Becomes Illness
The article does not offer a formula or symptom threshold for separating expected distress from a psychiatric disorder. Wadhwa says there is no simple answer in cases such as bereavement, and emphasizes that duration, changes in functioning, risk and a person’s prior experience all need consideration. The opinion piece does not present new research, clinical guidelines or data measuring how often clinicians overdiagnose distress.
It also does not claim that screening questionnaires are inherently unreliable or that brief assessments always miss important context. Its warning is narrower: tools should not stand in for a full clinical assessment. How to make that assessment practical in settings with limited time is not resolved in the article.
Questions for a Clinical Assessment
Wadhwa’s proposed next step is a more deliberate conversation between clinician and patient. Her suggested questions include what happened, how long symptoms have lasted, how functioning has changed, whether the response is evolving and whether the patient is at risk. Clinicians should also ask what the person was like before the event and whether the symptoms represent a qualitative change.
The article sets out no policy proposal, research program or scheduled follow-up. Its closing message is that psychiatrists should make room to understand a person’s circumstances before deciding what to call the distress, while remaining alert to conditions that warrant treatment. Diagnosis and context are not substitutes for each other; the challenge is to use both in patient care.
Key Questions
What is Wadhwa arguing in the article?
She argues that clinicians should consider a patient’s circumstances and clinical history rather than treating symptoms or a questionnaire score alone as proof of psychiatric illness. She also says that serious mental illness can occur after a recognizable loss or crisis.
Does grief rule out major depression?
No. Wadhwa says grief and major depression can coexist. A bereavement may explain distress, but it does not by itself determine whether a depressive disorder is also present.
Are screening questionnaires enough to diagnose a disorder?
Wadhwa says screening tools can identify symptoms but should not be the entire assessment. She calls for clinicians to consider factors such as duration, changes in functioning, life circumstances and risk.
Is the article based on new research?
No new study or dataset is described in the supplied article. It is an opinion piece by psychiatrist Devina Wadhwa, published by MedPage Today on November 1, 2026.
Source: medpagetoday.com
![[World Report] “We don’t want it to happen to others”: suicide in young Māori](https://healthdailyguide.com/wp-content/uploads/2026/05/world-report-we-don-t-want-it-to-happen-to-others-suicide-in-young-m-ori-featured-560x300.jpg)
