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In a November 1, 2026, MedPage Today opinion piece, psychiatrist Devina Wadhwa argues that clinicians should not mistake painful reactions to life events for psychiatric disorders based on symptoms or screening tools alone. She also cautions that grief or other clear stressors do not rule out mental illness, and says assessment must include context, duration, functioning and safety.
Psychiatrist Devina Wadhwa is urging clinicians to weigh a patient’s circumstances alongside symptoms before diagnosing a mental disorder, arguing in a November 1, 2026, MedPage Today opinion piece that ordinary distress and psychiatric illness can overlap. Her argument matters because brief assessments and symptom questionnaires may not capture what happened to a patient, how long symptoms have lasted or whether the person is at risk.
Wadhwa describes people who have trouble sleeping after a relationship ends, lose their appetite during bereavement or struggle to concentrate after losing a job. These experiences can resemble symptoms of depression or anxiety, she writes, but symptom overlap alone does not settle what is happening. She says screening questionnaires can be useful, but should not substitute for a fuller clinical assessment.
The piece does not argue against diagnosing or treating psychiatric illness. Wadhwa says major depression, anxiety disorders, post-traumatic stress disorder, bipolar disorder and other conditions can cause serious suffering, and that diagnosis can help patients understand their experiences and guide treatment. She says she diagnoses and treats psychiatric illness in her own work, and has seen medication, psychotherapy, hospitalization and other interventions change or save lives.
Her concern is that clinicians may move too quickly from identifying distress to labeling it as disorder, particularly when care relies on brief telehealth assessments or screening tools that make it harder to establish context. Wadhwa says assessment should include what happened, how long symptoms have persisted, whether functioning has changed, whether the response is evolving, the patient’s history and any safety risks.
Why Context Changes Diagnosis
A psychiatric diagnosis can shape more than a treatment plan: Wadhwa writes that it can change how a patient understands a painful experience. Describing a reaction as grief after a death, for example, is not interchangeable with describing it as a psychiatric disorder, even though both may apply to one person. The distinction can affect the language used with patients and the decisions clinicians make about care.
The stakes run in both directions. Treating all painful reactions as illness could medicalize experiences that may be understandable responses to events; treating them as ordinary distress without assessing severity could miss a serious disorder or a risk to the patient. Wadhwa’s argument is that clinicians must avoid both premature labeling and dismissal, rather than treating either symptoms or a recognizable cause as conclusive.
That is a clinical perspective, not evidence in this source of a measured increase in overdiagnosis or a finding that screening tools are inaccurate. The opinion raises concerns about how assessments are conducted; it does not quantify how often clinicians misclassify distress or establish the effects of any particular diagnostic approach.
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Symptoms Can Follow Life Events
Wadhwa notes that sadness, worry, insomnia, poor concentration and appetite changes can occur in ordinary human experience as well as in psychiatric conditions. A major loss can produce symptoms that overlap with depression, but she stresses that grief does not protect a person from developing depression. Likewise, a clear precipitating event does not establish that someone’s response is harmless or that it should go untreated.
Her example of a bereaved person includes crying, disrupted sleep, reduced appetite, difficulty concentrating and loss of pleasure—symptoms that can also be associated with major depression. Wadhwa says there is no simple rule for labeling that experience. Grief and depression can coexist, while depressive symptoms after a loss do not by themselves prove that grief has become a depressive disorder.
The article is an opinion essay by a psychiatrist, not a new clinical study or a formal change to diagnostic guidance. Its central recommendation is to keep the person’s history and circumstances in view while assessing symptoms, rather than relying on a questionnaire result alone.
Where Distress Becomes Disorder
The opinion offers no numerical estimate of how often normal distress is diagnosed as illness, and it does not report new research comparing diagnostic approaches. It also does not set a specific threshold for when grief, anxiety or another response to a life event should be diagnosed as a disorder. Wadhwa says there is no simple answer in cases where grief symptoms overlap with depression.
That uncertainty does not mean the distinction is unimportant or that a recognizable cause rules out illness. The piece says clinicians should examine duration, changes in functioning, symptom progression and risk, along with personal history. How those factors should be weighed in an individual case depends on clinical judgment and information not supplied by a screening score alone.
Questions for Clinical Assessment
Wadhwa’s piece does not announce a policy change, new study or scheduled follow-up. Its practical recommendation is for psychiatrists to keep asking what happened, how symptoms have changed over time, how daily functioning is affected and whether the patient may be at risk. Screening tools can contribute information, but should sit within a broader assessment.
For readers, the article’s conclusion is a call for careful evaluation rather than a rule for self-diagnosis. It does not advise people to disregard symptoms or avoid care. Whether distress reflects a psychiatric disorder, a response to events or both remains a question for an assessment that considers the individual’s circumstances and needs.
Key Questions
What is Devina Wadhwa arguing?
Wadhwa argues that clinicians should consider life events and personal context alongside symptoms before diagnosing a psychiatric disorder. She says screening results should inform, not replace, clinical judgment.
Does the article say grief is not a mental illness?
No. Wadhwa says grief can involve symptoms that overlap with depression, and that grief and major depression can coexist. She also says symptoms after a loss do not automatically establish a depressive disorder.
Does a stressful event rule out psychiatric illness?
No. Wadhwa explicitly cautions that a relationship ending, bereavement or another difficult event does not prevent someone from developing a serious condition. She says clinicians should assess symptom severity, changes in functioning and risk.
Is this a new study about overdiagnosis?
No. It is a psychiatrist’s opinion essay published by MedPage Today on November 1, 2026. The source provides no new study data or estimate of how often distress is misdiagnosed.
Source: medpagetoday.com
