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When grief looks like depression, context is everything. Psychiatrist Devina Wadhwa, MD, argues that clinicians risk pathologizing normal human distress when they rely too heavily on screening tools and brief assessments. She calls for deeper clinical judgment — asking not just what symptoms are present, but why they're there.
When a spouse dies, a job is lost, or a relationship ends, the emotional fallout — sleeplessness, sadness, poor appetite, difficulty concentrating — can look a lot like a psychiatric disorder on a screening questionnaire. But psychiatrist Devina Wadhwa, MD, warns that equating distress with illness can do real harm. In a new opinion piece, she argues that psychiatry's growing reliance on tools like the PHQ-9 and GAD-7, along with brief telehealth assessments, risks stripping away the context that makes diagnosis meaningful.
Wadhwa is careful not to dismiss psychiatric illness — she treats it daily and has seen medication and therapy save lives. Her concern is the opposite extreme: that clinicians may be too quick to move from "this hurts" to "this needs to be fixed," without pausing to understand what actually happened to the patient.
Key Takeaways:
Why it matters: Diagnosis shapes how patients understand themselves. Telling someone they have a psychiatric disorder versus acknowledging they're grieving a devastating loss are not interchangeable — and getting that distinction wrong has real consequences for patient identity, treatment, and care.
