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In a November 1 MedPage Today opinion article, psychiatrist Devina Wadhwa argues that grief, heartbreak and other painful experiences should not automatically be treated as psychiatric disorders. She says clinicians must assess context, duration, functioning and safety while recognizing that distress after a life event can also coexist with mental illness.
Psychiatrist Devina Wadhwa argues that clinicians should not equate painful reactions to loss, relationship breakups or job insecurity with psychiatric disorders without considering a patient’s circumstances. In an opinion article published by MedPage Today on November 1, she says symptoms and screening results need to be weighed alongside duration, changes in functioning and safety—not treated as a diagnosis on their own.
Wadhwa describes people experiencing sadness, anxiety, poor sleep, appetite changes and difficulty concentrating after major life events. Those symptoms can overlap with depression or anxiety disorders, she writes, but their presence does not by itself settle whether someone has a psychiatric illness. She points to questionnaires such as the PHQ-9 and GAD-7 as tools that can identify symptoms while warning that a tool should not replace a broader assessment.
Grief is a particular example in her article. Someone who has lost a spouse may cry often, sleep poorly, eat less and lose interest in activities—experiences that can resemble major depression. Wadhwa says grief and depression can occur together, and a bereavement does not rule out illness. At the same time, depressive symptoms after a loss do not automatically establish a depressive disorder; distinguishing between them calls for clinical judgment.
The article does not argue that clinicians should avoid diagnosis or treatment. Wadhwa says she diagnoses and treats psychiatric illness and has seen interventions including medication, psychotherapy and hospitalization change or save lives. Her concern is that clinicians may move too quickly from recognizing suffering to labeling it as illness, especially when brief assessments or screening tools leave little room for a patient’s story.
Balancing Diagnosis With Human Context
The distinction matters because a diagnosis can shape more than a treatment plan or billing code: Wadhwa says it can affect how patients understand their own experience. Describing distress as a reaction to a loved one’s death is not identical to describing it as a psychiatric disorder, though both accounts can be true for the same person. Her argument is that clinicians should avoid turning emotional pain alone into proof of illness.
The opposite risk also matters. Treating a reaction as understandable does not establish that it is harmless. Wadhwa warns that a person can develop major depression after a relationship ends, become suicidal while grieving or experience a serious mood disorder during a stressful period. Her approach asks clinicians to hold both possibilities in view: not every painful experience is an illness, and context does not rule illness out. For patients, that means careful assessment should neither impose a disorder too quickly nor dismiss symptoms that need care.
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Symptoms Overlap With Life Events
Psychiatry often evaluates experiences—such as sadness, worry, insomnia and reduced concentration—that also occur in response to ordinary or difficult events. Wadhwa says that overlap makes the patient’s circumstances especially relevant. A screening score can record symptoms, but it cannot by itself explain what happened, how long symptoms have lasted, or how the person’s life and functioning have changed.
Her article is an individual psychiatrist’s opinion, not a report of new research, updated diagnostic guidance or a change in clinical standards. Wadhwa acknowledges that diagnosis can give people language for what they are experiencing and direct treatment. The article’s central proposal is to keep the assessment grounded in the person’s account, asking about a change from their usual state and whether the situation is evolving rather than relying on symptoms in isolation.
Where Distress Becomes Disorder
Wadhwa does not offer a simple rule for deciding when distress after a life event meets the threshold for a psychiatric disorder. Her article says there should not be one-size-fits-all answer: symptoms can overlap, grief and depression can coexist, and the assessment depends on clinical judgment. It does not provide new prevalence figures or evidence that clinicians as a group are diagnosing too much.
The article also does not specify how often brief telehealth assessments or questionnaires lead to missed context, or compare outcomes from different assessment approaches. It therefore makes a clinical argument about caution and context, not a quantified finding that overdiagnosis is increasing. For an individual patient, severity, duration, functioning and risk remain questions for a qualified clinician to assess.
Questions Clinicians Should Ask
Wadhwa urges clinicians to ask what happened, how long symptoms have continued, how much functioning has changed and whether the response is shifting over time. They should also assess risk and the patient’s previous baseline, she writes, rather than relying only on a symptom checklist. These questions can help determine whether the person is experiencing distress, a psychiatric illness or both.
The opinion article announces no new policy, study or scheduled change in practice. Its closing appeal is for psychiatrists to keep patients’ circumstances central even as screening and brief assessments are used. For readers experiencing significant symptoms or concerns about safety, the article is not a diagnosis; they should discuss their situation with a qualified health professional.
Key Questions
Does the article say grief should not be treated?
No. Wadhwa says grief can coexist with major depression and that symptoms after a loss require careful assessment. Her point is that bereavement alone does not establish a depressive disorder, just as it does not rule one out.
Can a screening questionnaire diagnose depression or anxiety by itself?
Wadhwa cautions that questionnaires such as the PHQ-9 and GAD-7 can record symptoms but should not make up the entire assessment. Her article says clinicians should also consider context, duration, functioning and risk.
What does Wadhwa recommend clinicians consider?
She says they should ask what happened, how long symptoms have lasted, how much the person’s functioning has changed, whether the response is evolving, whether the patient is at risk and what the person was like before.
Is the article new research or a change to diagnostic rules?
No. The source is a MedPage Today opinion article by Wadhwa, published November 1, 2026. It presents her clinical perspective and does not announce new research findings or a change to diagnostic standards.
Source: medpagetoday.com
