You can't simply look at someone and know what they're going through.

I have a huge amount of anxiety, especially in social situations. I avoid leaving the house, answering the door and talking on the telephone. I like it when the checkout person at the grocery store is polite but does not try to engage me in conversation. It is nothing personal. I just find the experience excruciatingly painful. And it’s not as if I don’t like people. I do. I’m often very lonely, and I enjoy being around people if I’m used to them and trust them. But it’s difficult to get to that stage when meeting people and getting to know them is so hard.

I also experience severe depression, sharp mood swings and vivid flashbacks.

When I was in my twenties, I tried very hard to lead a “normal” life. I went to school, had jobs, tried to socialize. And I went to therapists and doctors and tried a number of treatments. Some seem to think that all you need to do is “get some help” and all psychological problems can be fixed with a few sessions, and that quality help is available on every street corner. This is not the case. Some problems are intransigent, and sometimes it’s better to cope with who you are rather than trying to change who you are. Trying to fit in, and trying to do all those “normal” things when I was in my 20s, destabilized my condition. The stress was overwhelming. I was on the edge of oblivion most of the time. The best therapist I ever had gave me permission to stop trying so hard, and she probably saved my life by doing that.

When I was 31, a brain tumor knocked me on my ass for over a year. After the surgeries, I would often experience extreme head and ear pain when I moved around. Just getting out of a chair could cause pain. It was because of the change in blood pressure in my head. Even when I recovered from that, I still had Bell’s palsy, and I was hearing and balance impaired. And my surgeon warned me that I probably would never have a huge amount of energy.

A few years later, I started having strange pain in my lower abdomen. It turned out to be two hernias. One was repaired, and that helped a lot, but it still hurts if I strain or if I’m on my feet for long periods of time. Sometimes it hurts, and I don’t know what I did to make it hurt.

In recent years, arthritis has been causing me trouble. It’s still in an early stage, and I hope that it doesn’t progress, but aside form the pain and stiffness, there’s also mild fever and flu-like symptoms. That leaves me feeling tired. Many don’t know this, but depression and anxiety drain you of energy and strength. And the head surgeries took a lot of my energy, too. Now arthritis is taking even more. I’m limp as a rag doll half the time. Sometimes I’m so weak and tired, I fear I’m dying.

But I do the best I can. I try to make the most of my life. There are still many things that I enjoy, such as my online friends, finding and sharing beautiful images, movies and books, writing stories and yearly trips to nearby Yosemite.

Just from looking at me, you might not know that I’m struggling. If I come across as aloof, you might think I’m a snob. You might not know just how painfully anxious I am. You might not know that images of a traumatic or embarrassing event from thirty years ago are flooding my consciousness. You might not know that I’m about to have a panic attack, and I feel like I’m about to lose my mind. If you see me in the grocery store—that’s about the only place you would see me—and I’m slumped over my cart, you might think I’m lazy. Maybe the slack expression on my face might make you think I’m hung over. But I’m actually exhausted, and half my face is partially paralyzed. If you notice I have premium ice cream in my cart and other treats, you might think I have money to burn. But I don’t drink much alcohol because I don’t seem to get as much enjoyment from it as most people do, so I often use food to add just enough pleasure and distraction to help me get through the day.

You can’t simply look at me and know what I’m going through. And that’s the case with most people, especially those with disabilities. Often disabilities aren’t obvious.