Idk about health appts, but I've noticed that IRL when I'm isolating, when forced to engage in conversation, I use a lot less minimal encouragers (like 'yeah', 'mmm', 'uh huh' which encourage people to keep talking to you) and just talk less with one word responses etc, which gives people the (often correct) impression that I don't want to talk (though sometimes I'm happy to listen). It's even worse on the phone cos they can't see me listening so they assume that I've not heard them because I haven't said anything for so long. That's annoying though cos sometimes when I was away at Uni, I felt lonely and wanted to hear my Mum talk, but didn't really have the energy to say much, and she found it disconcerting and so didn't want to keep talking to no response so would end the call, leaving me still feeling lonely.

*Willow*