When Your Doctor Says, “It’s Just Anxiety”: Understanding Medical Overshadowing

Have you ever gone to a doctor with physical symptoms such as pain, fatigue, dizziness, and gastrointestinal distress and left feeling dismissed or as if your symptoms weren’t taken seriously?

Perhaps you were told that the physical symptoms were “just anxiety,” “just stress,” or “probably related to your ADHD or autism,” without the doctor investigating your symptoms any further.

Experiences like these can feel confusing and destabilizing, especially when your body is clearly signalling that something isn’t right.

If this resonates with your experiences in the medical system, you may be encountering medical overshadowing, a common issue for many neurodivergent and chronically ill individuals. These biases and assumptions can delay diagnosis, worsen health outcomes, and erode trust in medical care.

For some people, working with an international neurodivergent coach or a neurodiversity-affirming therapist in Ontario, Canada, can offer meaningful support. These professionals provide validation, advocacy tools, and specialized understanding for experiences that are often misunderstood or dismissed within traditional healthcare systems.

In this blog, we’ll delve into what medical overshadowing is, why it happens, who it affects most, and what you can do to advocate for yourself when your concerns are minimized.

Related: The Ultimate Guide to Preparing for Your First Therapy or Coaching Session

What Is Medical Overshadowing?

Medical overshadowing is a phenomenon that occurs when a healthcare provider attributes your physical health symptoms to a known invisible illness or form of neurodivergence, such as anxiety, depression, ADHD, or autism, without even investigating other potential medical causes. 

Once a clinician sees a mental health diagnosis or a disability listed in a chart, there is a bias to focus and narrow in prematurely on mental health or neurodivergent explanations alone, instead of diving deeper and asking, “What else could be happening?” 

The term often appears in academic and clinical discussions as diagnostic overshadowing, which has been defined as the assumption that new health complaints are caused by an existing condition instead of being evaluated on their own merits.

This misattribution leads to missed or delayed diagnoses, inadequate treatment, and prolonged suffering. 

What Does Medical Overshadowing Look Like?

The experience of medical overshadowing can look different for everyone, but some common experiences include:

• Physical symptoms are repeatedly explained away as “just stress” or “just anxiety.”

• New or worsening symptoms are being minimized or ignored.

• Appointments focus only on mental health management instead of investigating the physical symptom itself.

• You feel unheard, dismissed, or even belittled when raising concerns.

  
  

Over time, these experiences can erode trust in both healthcare providers and your own body.

When Anxiety Becomes a Catch-All Explanation

Oftentimes, when someone experiences a physical symptom, anxiety is used as the explanation.

Anxiety can absolutely cause physical symptoms, such as rapid heart rate, shortness of breath, gastrointestinal upset, muscle tension, headaches, and fatigue. But it should not become the default explanation for all physical symptoms or replace a proper assessment.

When clinicians assume symptoms are psychological without ruling out other causes, patients may be left feeling unheard, confused, and increasingly uncertain about their bodies.

Imagine experiencing recurrent numbness in your hands, severe stomach pain after eating, or persistent fatigue that worsens over time. When these symptoms are repeatedly dismissed as anxiety without appropriate testing, patients may begin to doubt their own bodily experience. 

Instead of being offered blood tests, imaging, referrals to specialists, or longitudinal tracking of symptoms, they may be told to manage stress or reduce “catastrophic thinking.” Over time, this pattern can erode trust in both their own perceptions and their healthcare providers.

This often leads to misdiagnoses and prolonged suffering. Many people later discover that symptoms initially labeled as anxiety were actually caused by underlying medical conditions, including:

• Autoimmune conditions

• Hormonal imbalances

• Gastrointestinal disorders

• Neurological conditions

• Nutrient deficiencies

• Chronic pain conditions

• Sleep disorders

  
  

Why Medical Overshadowing Happens

Medical overshadowing is rarely intentional. It is often reinforced by systemic issues within healthcare systems rather than isolated instances of poor bedside manner. 

There are several overlapping drivers of this phenomenon, including:

• Time pressures: Healthcare providers, especially in public or overburdened systems, often have limited time with each patient. This constraint can push clinicians toward quick assumptions rather than thorough assessment. When time is scarce, the diagnostic shortcut of attributing symptoms to an existing diagnosis can feel easier than engaging in a lengthy investigation.

• Bias and stereotypes: Like everyone, healthcare professionals carry unconscious biases related to race, gender, neurodivergence, mental health history, and chronic illness. These biases can influence how clinicians interpret patient reports and which symptoms they consider worthy of investigation. Systemic bias compounds this issue, particularly for those whose identities or diagnoses are stigmatized or poorly understood.

• Lack of training: Many clinicians receive limited education on neurodivergence, complex chronic conditions, and overlapping symptom profiles between physical and mental health. Without this knowledge, they may default to familiar explanations that feel simpler to apply.

• Diagnostic anchoring: Once a diagnosis appears in a chart, subsequent providers may anchor on that label. This anchoring bias means that the presence of a previous diagnosis like ADHD, autism, an anxiety disorder, or depression can overshadow new clinical information that may point to an unrelated or co-occurring physical condition.

These systemic issues can unintentionally reinforce patterns of dismissal.

Who Is Most Affected by Medical Overshadowing?

Although anyone can experience medical overshadowing, research and patient narratives consistently show that it disproportionately impacts certain groups. This includes:

• Neurodivergent individuals (ADHD, autism, learning differences): Communication differences, sensory processing challenges, and neurologically influenced symptom descriptions can make it harder for providers who lack neurodiversity-affirming training to interpret concerns with nuance.

• People with chronic illnesses or invisible disabilities: Because their conditions may not have obvious outward signs, providers may default to psychological explanations when symptoms do not match textbook presentations. 

• Women and those assigned female at birth: Research shows that they tend to face dismissal more frequently in clinical settings, reflecting patterns of gender bias in medical diagnosis.

• BIPOC patients: compounded bias due to systemic racism and disparities in healthcare access and treatment. The intersection of racial bias, mental health stigma, and file-based assumptions can lead to a higher likelihood of symptoms being misinterpreted or dismissed.

  
  

These identities often intersect, increasing the likelihood that symptoms will be minimized or misattributed. For example, a neurodivergent woman of color with anxiety may face layered assumptions that significantly reduce the quality of care she receives.

The Impact of Medical Overshadowing

The impacts of medical overshadowing extend far beyond the consultation room. When symptoms are continually misattributed or disregarded, patients may go months or years without proper diagnosis or treatment. 

Delayed diagnosis can lead to:

• Progression of untreated medical conditions 

• Increased physical pain or disability 

• Heightened anxiety and hypervigilance 

• Loss of trust in healthcare providers 

• Self-doubt and disconnection from bodily signals 

• Avoidance of future medical care

  
  

Over time, individuals may internalize the belief that they are exaggerating or imagining their symptoms. This can make it harder to advocate for care even when symptoms worsen.

Repeated dismissal can also leave patients feeling angry, invalidated, and unsafe in healthcare settings. Some may begin to mistrust their own intuition about their bodies, while others may avoid seeking care altogether out of fear of being dismissed again.

These experiences can leave lasting emotional scars and even contribute to trauma responses during future medical interactions.

On a broader scale, medical overshadowing contributes to health disparities. When conditions go undiagnosed or untreated due to dismissive explanations, populations already marginalized in healthcare systems face worsened outcomes and increased morbidity.

Medical Overshadowing and Neurodivergence

Neurodivergent individuals may face additional barriers due to differences in communication, sensory processing, and interoception (the ability to sense internal body signals).

Without neurodiversity-affirming training, providers may misinterpret these differences as unreliability. This can result in:

• Symptoms being described differently than expected by providers

• Difficulty advocating under stress

• Being perceived as unreliable or inconsistent

  
  

A neurodiversity-affirming approach recognizes these differences as valid and adjusts care accordingly, rather than dismissing concerns.

Neurodivergent individuals may experience additional barriers in medical settings due to differences in communication, sensory processing, and interoception. Interoception refers to the ability to notice and interpret internal bodily signals.

How to Advocate for Yourself in Medical Settings

When you have to repeatedly explain yourself, justify your experiences, and push for tests, referrals, or follow-ups, this can feel draining. 

Advocating for yourself is not always easy, especially when you’re unwell. Still, some strategies may help reduce the impact of medical overshadowing.

Practical advocacy strategies:

• Keep detailed records of your symptoms: Tracking onset, frequency, duration, and any associated triggers provides concrete details that can guide clinical decision-making and reduce misunderstandings. If possible, bring these notes to appointments and refer to them when describing your concerns.

• Ask direct questions that encourage providers to think beyond default explanations: Asking, “What other causes have we ruled out?” or “What tests would normally be done for these symptoms?” invites your clinician into a more thorough exploration of your experience. These questions can shift the conversation from assumption to inquiry.

• Bring a support person to your appointment: A friend, family member, or advocate can provide emotional support, help remember details from the conversation, and ensure your concerns are heard even if you become overwhelmed or anxious.

• Request referrals or second opinions: Asking for further evaluation or seeing another specialist does not make it difficult to treat. It simply ensures that your symptoms receive the attention they deserve.

• Stay persistent: Needing follow-up does not mean you are difficult. It means your symptoms matter.

  
  

Building a Collaborative Healthcare Relationship

The most effective care relationships are those built on mutual respect, clear communication, and shared decision-making. 

A collaborative healthcare relationship is one where the healthcare provider:

• Invites your lived experience into the diagnostic process rather than relegating it to the background

• Listens to your concerns

• Explains their reasoning

• Explores alternatives if symptoms do not resolve with initial explanations.

• Encourages you to ask questions 

• Acknowledges uncertainty when present

  
  

Seeking clinicians who practice trauma-informed and neurodiversity-affirming care can significantly reduce experiences of dismissal because these professionals are trained to recognize and challenge biases that contribute to overshadowing. 

If possible, seek providers who explicitly practice trauma-informed, neurodiversity-affirming, or patient-centered care.

Reclaiming Trust and Practicing Self-Compassion

Medical overshadowing is not your fault.

Being dismissed by a provider can feel deeply personal.

It can erode your sense of self-trust and make you doubt whether your symptoms are real or worthy of attention. 

But it is important to remember that medical overshadowing is not your fault. 

Being dismissed also does not mean:

• Your symptoms aren’t real.

• You’re overreacting.

• You’re imagining things.

• You failed to explain yourself correctly.

  
  

It is a systemic issue rooted in bias and cognitive shortcuts that even well-meaning clinicians can fall into.

Practicing self-compassion involves acknowledging your struggle, validating your experiences, and recognizing that advocating for yourself is not rude but necessary.

Gentle Self-Compassion reminders

• You know your body better than anyone else.

• You deserve thorough, respectful care.

• Self-advocacy is not rude. It’s necessary.

• It’s okay to rest, pause, and ask for help.

  
  

Practicing self-compassion can help rebuild trust in yourself after invalidating experiences.

When to Seek Additional Support

Medical encounters that leave you feeling dismissed or unheard can feel traumatic. 

Working with a neurodiversity-affirming therapist or coach, especially one who understands neurodivergence and chronic illness, can help you:

• Understand patterns in how your care has unfolded.

• Process medical trauma.

• Rebuild confidence in your bodily signals.

• Develop strategies for navigating future medical systems with confidence.

  
  

Likewise, working with an international neurodivergent coach can offer support in self-advocacy, communication skills, and systems navigation so you feel empowered in your health journey.

Book a Free Consultation With Blue Sky Learning

If experiences of medical overshadowing have impacted your mental health, self-trust, or ability to advocate for yourself, support is available.

At Blue Sky Learning, our neurodiversity-affirming therapists and coaches support individuals navigating healthcare systems, chronic stress, and medical invalidation.

Book a free 20-minute consultation today and begin a collaborative and affirming journey toward better care and self-understanding.

Book a Free Consultation

Frequently Asked Questions About Medical Overshadowing

What is the difference between medical overshadowing and misdiagnosis?

Medical overshadowing refers to a pattern where physical symptoms are attributed to an existing mental health or neurodevelopmental diagnosis without adequate investigation. Misdiagnosis can occur for many reasons, including incomplete information or atypical presentation. Medical overshadowing is a specific pathway to misdiagnosis that is rooted in bias, assumptions, and diagnostic shortcuts.

Can anxiety and physical illness exist at the same time?

Yes. Anxiety and physical illness frequently coexist. Having anxiety does not protect someone from developing physical health conditions. In fact, unmanaged physical symptoms can worsen anxiety, and anxiety can intensify physical discomfort. Comprehensive care considers both without assuming one explains the other.

Why do neurodivergent people experience more medical dismissal?

Neurodivergent individuals may communicate symptoms differently, experience sensory differences, or struggle with interoception. Without neurodiversity affirming training, providers may misinterpret these differences as unreliability or exaggeration. This increases the risk of symptoms being dismissed rather than explored.

What should I do if my doctor will not take my concerns seriously?

If your concerns continue to be dismissed, it is reasonable to request further testing, referrals, or a second opinion. You may also benefit from bringing a support person to appointments or preparing written documentation. Working with a therapist or coach can help you build confidence and strategies for these conversations.

Is it okay to change healthcare providers?

Yes. If you consistently feel unheard or unsafe, changing providers can be an important step in protecting your health. A collaborative and respectful relationship is essential for effective care.