TL;DR
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In a Nov. 1 opinion article, psychiatrist Devina Wadhwa argues that grief and other painful life events can produce symptoms that overlap with psychiatric disorders, so screening tools should not replace clinical judgment. She also cautions that a clear life stressor does not rule out serious illness, and calls for assessment of context, duration, functioning and safety.
Psychiatrist Devina Wadhwa argues that clinicians should be cautious about diagnosing mental illness when people show symptoms after grief, relationship breakdown or job loss, while still screening for serious disorders and risk. In an opinion article published by MedPage Today on Nov. 1, she says questionnaires and brief assessments can miss the life circumstances needed to interpret symptoms.
Wadhwa describes people who have trouble sleeping after a breakup, lose their appetite while grieving or struggle to concentrate during a period of upheaval. These symptoms can overlap with depression or anxiety, she writes, but their presence alone does not establish a disorder. She says clinicians need to ask what happened, how long symptoms have lasted, how functioning has changed and whether the response is evolving.
The article does not argue that distress following a loss is always normal or that treatment is unnecessary. Wadhwa stresses that grief can coexist with major depression and that a recognizable trigger does not make severe symptoms harmless. A bereaved person may become suicidal, she notes, and someone facing a relationship crisis may develop depression. Assessing safety and the possibility of illness remains part of care.
Wadhwa says diagnosis can help patients make sense of their experiences and guide treatment, which may include medication, psychotherapy or other interventions. But a diagnosis can also shape how a person understands what is happening. The article’s central point is that symptom checklists should inform, not determine, an assessment; clinical judgment should take the person’s circumstances and history into account.
How Context Changes Psychiatric Assessment
The distinction matters because many symptoms used to assess psychiatric conditions—such as sadness, worry, poor sleep and reduced concentration—can also arise during painful life events. If clinicians treat a screening result as a complete answer, Wadhwa warns, they may frame suffering as illness without first understanding its cause. That can affect a patient’s diagnosis, treatment pathway and personal account of their distress.
The reverse risk is also important: describing a reaction as understandable grief or stress cannot, on its own, rule out a disorder or immediate danger. Wadhwa’s argument calls for attention to both possibilities rather than a choice between medicalizing every painful experience and dismissing symptoms. For readers, the practical issue is how mental health assessments balance standardized questions with time for individual history and follow-up.
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Symptoms Can Overlap With Grief
Wadhwa’s piece is a first-person professional opinion, not a research study or a report of new clinical guidelines. She writes from her experience as a psychiatrist and says she diagnoses and treats psychiatric conditions, including with medication, psychotherapy and hospitalization. The article offers her perspective on how clinicians should approach ambiguous cases; it does not present new outcome data or quantify how often normal distress is misdiagnosed.
Her examples center on overlap between grief or acute stress and symptoms associated with depression, including crying, appetite and sleep changes, reduced enjoyment and difficulty concentrating. She notes that these similarities do not settle the diagnosis. The assessment, in her view, requires considering the precipitating event, symptom course, baseline functioning and safety, not simply counting symptoms at one point in time.
Where Distress Becomes Disorder
The article does not establish how often clinicians overdiagnose normal distress, whether that rate has changed, or whether questionnaires lead to incorrect diagnoses. It supplies no prevalence estimates, comparative data or study findings; its claims are the author’s clinical perspective and recommendations.
It also offers no single threshold for when grief or stress becomes a disorder. Wadhwa says there is no simple answer, and that grief and depression may occur together. How clinicians distinguish them in an individual case depends on assessment, including symptom duration, functional change, course and risk. The article does not propose a new diagnostic rule or a specific change to screening practice.
Clinical Judgment After Screening
Wadhwa’s recommendation is for psychiatrists to use screening tools as one part of a broader assessment, then ask about the person’s circumstances, prior functioning, symptom progression and safety. The article does not announce a formal policy, professional-body response or follow-up study. Its immediate implication is a practice principle: understand what happened before deciding what to call the symptoms, while acting promptly when symptoms or risk warrant care.
For patients, the article does not provide personal diagnostic guidance. It underscores that a questionnaire result is not, by itself, a full clinical assessment, and that distress after a loss should neither automatically be labeled a disorder nor assumed to be harmless. The next step in any individual case remains a conversation with a qualified clinician who can assess symptoms and risk in context.
Key Questions
What is Wadhwa’s main argument?
Wadhwa says clinicians should interpret symptoms such as sadness, insomnia and poor concentration in the context of a person’s life, rather than treating a screening result as a diagnosis. She also cautions that serious psychiatric illness can develop after a major loss or other stressor.
Does the article say grief is not a mental illness?
No. Wadhwa says grief can resemble depression and can also coexist with major depression. Her point is that symptoms after bereavement do not automatically establish a depressive disorder, and the distinction calls for clinical judgment.
Are mental health questionnaires useful?
Wadhwa does not say clinicians should stop using questionnaires. She argues that tools such as symptom screens should not become the entire assessment because they may not capture a patient’s circumstances, history or changing level of risk.
What does the article say clinicians should assess?
It recommends asking what happened, how long symptoms have lasted, how much functioning has changed, whether symptoms are evolving, whether the person is at risk and what their baseline was before the current difficulties.
Does the article provide evidence that overdiagnosis is increasing?
No. It is an opinion article based on Wadhwa’s clinical perspective and does not provide data on misdiagnosis rates or trends over time.
Source: medpagetoday.com
