When Grief Collides with a Neurodivergent Brain

When I was in medical school, I hit a wall. The topic was nephrology, the study of kidneys. And I’ll be totally honest with you: I don’t care about kidneys. I just don’t like them. They’re unnecessarily complicated. There’s too much physiology. There’s too much chemistry. I don’t want to follow a sodium ion through a nephron. I don’t care. And I have ADHD. It’s just not for me.

My mom is a physician, and her brilliant advice to me at the time was, “Just memorize it.” That doesn’t help me.

My dad, who was an engineer, actually did help me. He came into my room one night, and I was crying with all these books around me. He disappeared for a little while, then came back with these whiteboard sheets under his arm. Minority Report-style, he plastered them all over my room, and we started sketching out the kidney.

My dad wasn’t in medicine. He didn’t know all the medical terms, but he understood flow. He understood that if you could visualize the logic, you could master the chaos. He sat there drawing arrows and showing me where the sodium went. Eventually, I got it.

That’s what my dad did. He took complicated things and made them organized. He took things that were overwhelming and molded them into something I could hold on to. It wasn’t just with kidneys. He did that with everything in my life. He was this quiet structure that held up everything else for me.

He was the biggest part of my life. He’s the reason I became a doctor, and he’s the reason I’m on this stage.

He passed away last April.

When I say that my brain broke, I can’t explain it any other way. It shattered into pieces. I wasn’t sleeping. I wasn’t eating. I have two young children who were watching me lose connection to myself. It was an incredibly destabilizing time for me.

I remember being in the thick of it and, out of sheer desperation, reaching out to Shoshana, who created this incredible space and conversation around grief and end-of-life care. By the way, I didn’t know her. I was hunting her down on social media because I wanted to ask her, “Is this normal?”

I understand the irony of that because I’m a psychiatrist. You’d think I would know. I did not know.

When you’re in the thick of it, your brain feels hijacked. You can’t analyze yourself. You lose all objectivity. I was foggy and disoriented. I was barely functional.

I don’t remember a whole lot from that time. I don’t remember the specifics of the conversation, but I remember how she made me feel. I was comforted. When I asked her, “Is this normal?” she said, “Yes, this is normal.”

When I asked her, “Is this worse for people who are neurodivergent?” she said, “I don’t actually know that.”

I think I do know. I feel like it can be worse, and I’ll tell you why.

Before we do that, let me ask you something. When I say the term “neurodivergent,” do you know what I’m talking about?

That was conflicted, so I’m going to tell you.

I’m talking about people whose brains are uniquely wired and conditions that cause learning and thinking differences, changing how people with those conditions interact with the world. I’m thinking about ADHD, autism, dyslexia, and others.

We talk about these differences a lot. ADHD in particular has become part of the cultural zeitgeist. You see it in TikToks. You see it in memes. Your friend forgets her keys and says, “It’s my ADHD.”

But ADHD isn’t just being a little forgetful or a little distracted. It’s actually about executive function. By executive function, I mean the set of skills and the system in your brain that organizes, initiates, and sustains effort. It gets you from point A to point B. It helps you create routines, hold them together, and build your life on top of them.

When something as enormous as grief collides with that system, the impact is different.

Grief is universal. Every person will experience it, if you’re lucky, right? If you’ve loved something incredibly deeply, you will feel this way. But grief is also unique. No two people are going to experience it in the same way. Your underlying neurobiology, the way you are wired, shapes how you grieve.

If you have a relatively steady brain, one that builds habits easily, first of all, what’s that like? Second, grief may feel like a storm passing through. It’s messy. It’s painful. It’s inconvenient. But it eventually clears.

For a neurodivergent brain, the storm is landing on a house that already has holes in the roof. You’ve patched things together. You’ve built these scaffolds that mostly keep life running, and grief tears them apart. Everything leaks. Everything collapses. You’re reinventing the wheel every single day.

ADHD is about that fragmentation of focus. When grief enters, those cracks widen.

Daily life becomes overwhelming. Things you used to manage, like paying bills, eating, and taking your medication, suddenly seem impossible. You know what needs to get done, but your brain refuses to hold on to it. Every morning feels like you’re starting from scratch.

For me, this became painfully real.

When my dad got sick, we thought we had time. It was stage one cancer. He had come in for a check because he got a cough from my child. They found something and tested it. They told us, “It’s stage one cancer. It’s far away from anything important. We’ve got this.”

We did the chemotherapy. We did the radiation. We were reassured. The tumor was shrinking.

After all his treatments, I got a call from him. He said, “I just don’t feel great.” Forty-five minutes later, I was on a plane.

I took one look at him and said, “Off to the hospital we go.” We went to the hospital, and I pushed and pushed for a PET scan. They finally agreed.

There was metastasis everywhere.

Thirteen days later, he was gone.

My dad’s brain worked like a grid. Even at the end, he was making these horrible spreadsheets. They were awful. They were color-coded, task-oriented, and prioritized. I got all the green ones, which were horrible. But it was his way of bringing order to the chaos.

Meanwhile, my brain was everywhere. While he was streamlining, I was spiraling.

To give myself a little structure, I threw myself into the logistics: medications, appointments, hospice care. If I stayed busy, I didn’t have to feel the anticipatory grief.

Then it ended. The funeral was over. The calls stopped. Suddenly, there was silence.

That’s when the real grief hit.

In those first few days, my brain was frantic. I cried from the moment I woke up to the moment I went to sleep. But I wasn’t really sleeping either. My body felt like it was made of lead, but I couldn’t fall asleep or stay asleep. Every day felt like it was 11 days long.

I didn’t have the energy to do much of anything, but I did have the energy to write. So I did.

I wrote on napkins. I wrote on Amazon boxes. I wrote on weird pieces of paper I found in my purse. There were fragments of thoughts, poems, words, and little bits of things I remembered my dad saying. Writing was the only thing that quieted my brain.

That writing eventually became a screenplay about a psychiatrist who is trying to help everyone else but doesn’t know how to ask for help herself.

I didn’t know it at the time, but in writing it, I was able to give the pain and grief a container. Instead of spilling into every corner of my life, it had somewhere to live.

It didn’t erase the grief, but it transformed it into something meaningful for me.

My container was writing. For someone else, it might be painting, gardening, music, or helping others who are grieving. The form doesn’t actually matter. What matters is that you give your brain a place to put the pain, a structure so it doesn’t swallow you whole.

Even with an outlet for grief, it isn’t going to be easy. It was the hardest thing I’ve ever had to do, besides the kidney stuff in medical school.

If I could go back to that time, here’s what I would tell myself.

First, know your baseline. If you already struggle with routines, know that those struggles are going to intensify under grief. Don’t be surprised.

Second, delegate, and be specific when you ask for things. The grieving brain doesn’t handle vague requests well. Ask, “Can you handle dinner on Friday?” or “Can you pick up the kids from school on Tuesday?”

Third, create safeguards. Your brain is going to be so full that things will fall through the cracks. Write things down. Leave a voice note. Make to-do lists.

Your brain is full. It isn’t broken.

Finally, give yourself permission to grieve differently. You don’t have to do it like your siblings. You don’t have to do it like your spouse. You don’t have to do it like anybody else. If your grief is messy, scattered, and nonlinear, that’s fine. It’s going to get weird. It’ll be fine, though.

My husband’s brain is whatever the opposite of ADHD is. I don’t know what that is, but it’s the opposite of my brain.

He lost his mom years before I lost my dad. His grief was a long goodbye. They went through 26 months of glioblastoma. He had time to anticipate, time to say goodbye, and time to slowly let go. I had this sudden drop over 13 days.

We’ve compared them many times. His was gradual and lingering. Mine was chaotic and abrupt. Neither was easier. Neither was better. Both were grief. Both required support.

That’s the truth. Grief never looks the same from one person to the next. If you’re neurodivergent, it may look messier, but that doesn’t mean failure.

Let’s circle back to the original question. Do neurodivergent people need different conversations about death and grief?

Yes, they do.

The grief itself is not fundamentally different, but the scaffolding around it is. We need to normalize the fact that executive function is going to collapse under grief. We need to normalize accepting that our journey will feel different. We need to normalize asking for help.

Grief doesn’t vanish. It doesn’t resolve. But it can be channeled, sometimes into meaning, sometimes into service, and sometimes into art.

For me, it was writing, a way to process the loss, make sense of the chaos, and give my grief a home.

The goal was never to eliminate grief. It was to give it structure, to organize it just enough so it didn’t overtake everything else.

Whatever your brain needs, however your brain works, you can work with it. You can make space for it. You can channel it.

Sometimes, that channel becomes the very thing that keeps you afloat.

Thank you