How to care for your neurodivergent needs in a doctor’s appointment
If your brain doesn’t work the way that’s generally expected, chances are doctors appointments are particularly stressful.
That’s because doctors appointments ask you to navigate a physical space and an interpersonal conversation with significant time and cognitive pressure.
Clinics and appointments are designed with neurotypicals in mind, so when you enter that space with different neurological needs, you might struggle.
In an ideal world, all of your healthcare providers would automatically recognize and accommodate your needs. Until that day, here’s how to set yourself up for success.
There are infinite ways that brains can operate outside “the norm”, and I’m including all of those variations in the term “neurodivergent”. You might be familiar with ADHD and autism as the main labels under this umbrella, but it can also include FASD, OCD, migraine, CFS/ME-related brain fog (full blog on that coming soon!), post-concussion syndrome, personality disorders, c-PTSD, experiences that may not be associated with specific diagnoses (like being a highly sensitive person), and many many more.
This blog post applies broadly to many of these experiences - take what’s helpful for you and leave what’s not.
Prepare and rehearse
Preparing for the appointment
You’ve made a doctor’s appointment for a reason - so spend some time preparing what you’re going to ask your doctor, and gathering the information you’ll need to share with them. You can find an in-depth guide for what to prepare in this post.
If you tend to fall back on scripts, struggle to communicate verbally when under stress, or often over-explain or go on tangents, I strongly recommend actually rehearsing the words you’ll say. You can even try role playing - ask someone you trust to ask the usual questions a doctor will ask:
What brings you in today?
When did this start?
How often do you experience [symptom]?
How intense is the pain?
Remember you won’t be able to anticipate and prepare everything your doctor will ask or say, because those details will be determined by your specific case.
Planning your visit
If you’re going to a new clinic, or it’s been some time since you’ve been in, you may want to look up what to expect. Search it on Google Maps, and consider looking at their website too.
This can help you anticipate:
How long it will take to get there - in turn, this will help you plan your trip
Decide how you’ll get there
Make a plan to arrive at least 5 min before your appointment time (longer if recommended by the clinic), so you have time to check in, and don’t have to stress about missing your appointment
Remember that it’s normal to be expected to wait for your doctor to be ready for you - family doctors in Ontario are extremely over-extended right now, and they might not be able to see you at your exact appointment time. Bring something to do while you wait. Some people like music or a podcast, while others want their ears free so they don’t miss their name being called. Some people like to read, while others can’t focus in a public space. If you knit or crochet, this can be just the right amount of engagement. If you don’t, consider bringing a fidget toy or soothing object.
What the space looks like: look up images of the space - it can be reassuring to know what the outside and inside of the clinic will look like when you get there.
Consider bringing a support person with you, whether that’s a partner or parent who knows your health details really well, or a friend who isn’t afraid to advocate for you or give you a big squeeze when you need it.
Navigating sensory challenges in doctor’s appointments.
Waiting rooms can be loud, exam rooms can be bright, chairs can be unpleasant on legs, clinics can be intensely air-conditioned, equipment may be cleaned with strong-smelling chemicals, your mask may irritate your face, and there are any number of other sensory stressors that can come up during a clinic visit.
So how do you cope?
Figure out what you can control.
You have some degree of control over sound, light, and your own clothing. You may be able to ask for some accommodations for things like light and physical touch during the appointment, but some of this may be unavoidable for a proper assessment. You can’t control the temperature, smell, or furnishing of the clinic.
Sound: Clinics can be busy places with a lot of hard, echoey surfaces. If you’re sensitive to sound, consider bringing at least one noise-minimizing tool, if not two. Noise-cancelling headphones or ear protection can be used while waiting, e.g. in the waiting room or before the doctor joins you in an exam room, especially if your waiting room has a visual cue to call you in for your appointment. Noise-reducing earplugs like Loops, Flare Calmers, Happy Ears, and others, can be worn the entire time to help reduce background noise while leaving you aware enough to hear your name called, and conduct a conversation.
Light: You can wear sunglasses inside - this is me giving you permission. You may want to consider taking them off during your actual interaction with your doctor, but you don’t have to unless they need to examine your eye area. You can also ask for the lights to be turned off in the exam room - again, this may or may not be possible.
Clothing: Wear comfortable, layered clothing that you can take on and off to adjust for the temperature of the space and allow for physical exams.
Create recovery time.
If you’re very sensitive to sensory experiences, you will probably not be able to avoid all sensory stressors. Some of that may be secondary to the experience, like loud construction happening outside the clinic, while some of it may be directly related to healthcare. For example, some physical exams require your doctor to touch you, or to shine a bright light, sometimes into your eyes.
Expect that the appointment could be stressful even if you’re perfectly prepared, and plan for some low-sensory, low-demand recovery time immediately after your appointment.
Set expectations and ask for what you need
You should feel safe to ask questions, take time to process information, care for your sensory needs, and stim during appointments. Your doctor should not have a problem with this, and you can help them be ready for it by letting them know your needs up front. If you don’t have a formal diagnosis for your neurotype, or you’d rather not disclose it, you can simply say something like “I get nervous in appointments, so I have this with me to help calm me.”
Self-diagnosis can be valuable and empowering. It can give you language, tools, and community that help you navigate the world. But in a medical setting, it’s different. Medical systems are structured around formal diagnoses, and because a formal diagnosis can have profound legal and medical consequences, doctors are trained to be skeptical of diagnoses they’re not able to formally verify. This is an important policy in medicine to reduce the risk of misdiagnosis.
Because of this, saying “I’ve self-diagnosed with ADHD” or “I’m autistic” without paperwork from a professional can sometimes create tension or even shut down the conversation with a doctor.
That said, you can still share your experiences and needs with your doctor without associating those details with a diagnosis. For example, you can say, “I’m really sensitive to light - could we turn the overhead lights off?” Or you could say “I sometimes get overwhelmed in appointments, so I’m going to refer to my notes a lot. If you ask me a question I wasn’t expecting, I might need a minute to think about the answer.”
If you think it’s relevant or helpful, you can even share your understanding of your neurotype with your doctor in less definitive or medical language, like “I suspect I’m autistic because…”, or “I’ve been wondering if I might have ADHD because…”.
Think of it this way: self-diagnosis is powerful for you—it helps you understand yourself and connect with others. But in a medical setting, if you’re not specifically seeking support with mental health during that appointment, you’re more likely to get your needs met by specifically asking for what you need, rather than throwing a conversation about self-diagnosis into the mix.
Don’t be afraid to stim, fidget, sit weird, and otherwise make yourself comfortable. Doctors are trained to take a wide variety of behaviour in stride. If your doctor asks about it, don’t assume they’re judging you or asking you to stop - they’re probably just trying to understand how your behaviour fits into their assessment.
For example, when my patients move around a lot in an appointment, sometimes I ask if they’re restless, if they’re moving to ease pain, or another reason; their answer contributes to my assessment and eventual diagnosis.
Unfortunately, there are situations where a doctor may become frustrated, hostile, or prejudiced if they observe stimming and self-soothing behaviours. These biased reactions are more likely to happen with practitioners you don’t have an established relationship with (e.g. emergency room doctors), and if you are a person of colour - especially Black or Indigenous, if you are visibly gender non-conforming, or if you struggle with self-care and grooming.
This is not your fault or your responsibility. I am so sorry if this has happened to you.
Your provider will ask some questions you won’t be able to anticipate, as every health concern brings up different considerations. Take your time to answer honestly and accurately. You may find it helpful to say something like “Good question, let me think about that,” so you can pause and think about your answer. It’s also fine to say you’re not sure.
In short
Navigating healthcare as a neurodivergent person can be hard. It’s not your fault if the system feels overwhelming or mismatched with your needs. The more you prepare, advocate for yourself, and build in recovery time, the more likely you are to leave an appointment feeling heard and supported. And it’s not your fault if things don’t go how you had hoped.
You deserve care that works with you, not against you. Every step you take to set yourself up for success is an act of self-advocacy worth celebrating.
What are the best sensory tools for medical appointments?
Many neurodivergent people benefit from noise-cancelling headphones, earplugs, sunglasses, fidget toys, or soothing objects. Comfortable layered clothing can also help you regulate temperature and make physical exams easier.
Should I tell my doctor if I self-diagnosed with ADHD or autism?
Self-diagnosis can be empowering and help you connect with community, but doctors usually require a formal assessment before recognizing a condition. In medical settings, it’s best to describe your symptoms and challenges rather than state a self-diagnosis. If you have a good relationship with your doctor, you can have a more nuanced conversation about the benefits and risks of a formal assessment.
How do I advocate for my neurodivergent needs with my doctor?
You can let your doctor know what helps you, such as needing extra time to process questions, turning off bright lights, or using notes during the conversation. Clear communication about your needs helps your doctor support you better.
Looking for a healthcare provider who works with your brain, not against it? Book a free 15 minute discovery call with me to see how a naturopathic doctor can help with your health concerns.
This post is part of a series about navigating healthcare.