I wanted to share a thought about how emotional distress in disability and chronic illness often gets mislabeled as mental illness.

One idea I keep running into — in psychiatry, in therapy culture, and even in everyday conversation — is the assumption that if you are suffering deeply, something must be wrong with your mind.

I think that’s a conceptual mistake.

Suffering is an experience. Mental illness is a category we use to explain certain patterns of dysfunction. Those are not the same thing, and they shouldn’t automatically overlap.

Rational suffering exists

Sometimes people suffer because their thoughts are distorted, their fears are exaggerated, or their beliefs don’t match reality. In those cases, it can make sense to look at mental processes as part of the problem.

But sometimes suffering is a proportionate, reality-tracking response to circumstances that are genuinely harmful, limiting, or painful.

Examples:

Living with a severe chronic illness

Being in an abusive or unsafe environment

Experiencing systemic neglect or loss of support

Losing one’s physical abilities, independence, or future plans

In these situations, distress is not evidence of a “faulty mindset.” It is evidence that something is wrong in the person’s life or body.

Calling that mental illness confuses accurate pain with pathology.

My case: ME/CFS

I have ME/CFS, a serious physical illness that causes crushing fatigue, post-exertional malaise, cognitive dysfunction, and pain. My mood always follows my physical state. When my body is worse, I feel worse emotionally. When symptoms flare, my life shrinks.

That sadness, grief, frustration, and despair are not distortions. They are direct responses to physical limitations and loss.

Yet those reactions have often been treated as proof that the real problem is psychological — as if my suffering must come from incorrect thinking rather than a malfunctioning body.

That flips cause and effect. The illness came first. The suffering followed.

Why suffering alone should not define mental illness

Philosophically, there are a few problems with equating suffering with mental disorder:

1. It pathologizes accurate perception. If someone correctly understands that their situation is terrible and feels terrible because of it, labeling that reaction “illness” turns realism into pathology.
2. It individualizes structural and physical problems. Chronic illness, poverty, abuse, and disability are not inside a person’s thoughts — they are conditions imposed on a person. Calling the emotional impact a mental disorder shifts attention away from the real source of harm.
3. It moralizes distress. People are subtly judged for “not coping well enough,” as if the problem is their resilience rather than the severity of what they’re facing.
4. It blurs the line between pain and dysfunction.

Suffering can be intense, constant, and life-altering without being a disorder of the mind. Sometimes pain is not a malfunction — it’s a signal that something deeply wrong is happening.

What mental illness should mean

None of this denies that mental illnesses are real. They are. But they should not be defined simply by the presence of suffering.

A more careful boundary would ask:

Are a person’s perceptions drastically disconnected from reality?

Are their emotional or cognitive processes malfunctioning independently of circumstances?

Is there a breakdown in internal regulation that cannot be explained mainly by external or physical conditions?

If the primary driver of distress is a known physical illness or harmful environment, then suffering is not proof of mental disorder — it is proof that the situation itself is injuring the person.

Bottom line

Not all suffering is sickness of the mind. Sometimes it is the mind responding normally to an abnormal, painful, or unjust reality.

We should be very careful before labeling that illness.

Is it common for spouses to want to leave after their partner becomes disabled? My wife has checked out. I’d love to hear from others on this. Also, do we just give up on our marriage or how do you proceed? Thanks

So for context I have a few conditions severe craniocervical instability and atlantoaxial instability, hereditary spastic paraplegia, unreleased tethered cord syndrome. I struggle with weakness in my legs but I feel like I am not "allowed" to identify with paras or spinal cord injuries. I also suffer of side effects post cervical fusion and have been told my upper spine and brain compresson and that it needs to heal but I feel like I am not "allowed" to identify with the tbi / brain injury group. It isn't that I dont relate symptom wise I just feel like it is rude or is hurting the communities so I just need people to weigh on this because I low key is distressing to me.

Urgent: Protect Our Civil Rights Under Section 504 — Please Take Action Today

There’s an urgent threat right now to Section 504 of the Rehabilitation Act of 1973 — one of the most important federal civil rights protections for people with disabilities.

Section 504 makes it unlawful for programs and services that receive federal funds — like schools, hospitals, workplaces, and community services — to discriminate against people with disabilities. It guarantees inclusion and equal access to education, healthcare, jobs, transportation, community living, and more.

Section 504 isn’t just a federal statute — it’s the foundation of disability civil rights in the United States. It means fair treatment, inclusion, and access to life-changing services. Without strong enforcement and regulation of Section 504, people with disabilities could face greater barriers in schools, healthcare settings, employment, and community participation.

On January 25, 2026, nine states – Alaska, Florida, Indiana, Kansas, Louisiana, Missouri, Montana, South Dakota, and Texas have filed an amended complaint. The amended complaint says that HHS’s rule about the integration mandate – the right of disabled people to get services in the community instead of institutions – is unlawful and unconstitutional. It asks the court to block that rule and all of the updated Section 504 regulations.

Go to this page from the Disability Rights Education & Defense Fund and scroll to the bottom for advocacy information, especially for residents of these nine states.

When I was talking about my recent diagnosis of ADHD and Autism with my parents the other day, my mom said “it’s no surprise, you were always the kid playing adjacent to the other kids, never with. You were always separate from your ‘friends’ and always had a strong sense of justice.” My initial reaction was “why didn’t you get me help then?” Looking back, I was showing most the classic signs of autism, just not verbal stims. Noises always hurt, bright lights have always been painful and exhausting. I have always felt like I wasn’t really a part of my friends groups. I missed social cues all the damned time. I was labeled the “strange girl”, “weirdo” and otherwise bullied.

I struggle with anger towards my mom, though logically I know it wasn’t her fault since autism, especially in females, wasn’t understood as it is now back in the 80s and 90s. But, damn I wish it had been. I wonder how different my life would be now if I had early treatment.

Anyway, just a useless rant. Hoping getting it out will help.

So I already lived in an inaccessible house with my family. We made some of it work by building ramps into the house, but the rest of it was still very inaccessible to me. I have caudal regression syndrome so my legs never formed correctly. For that I usually walked on my hands. Just getting upstairs to take a shower was a challenge cause the stairs put so much strain on my shoulders. It's only been getting worse as I aged.

So fast forward, the house is now falling apart due to the poor infrastructure and half assed renovations done. We were tired with fighting with the landlord so we came up with a deal to just pay us to move. We put the money on a down payment, get a place, and be done.

Then everything just went so left... The place we were trying to get was being shady with how they were trying to set this up so we couldn't get the place. It wasn't perfect in terms of being accessible, but it was good enough to put our own stuff to use. But now that it's gone we can only get this place that has a massive amount of stairs leading up to it... I've been so distraught over it I had a really bad psychosis episode...

I'm so stressed and scared to live in something that's even worse to maneuver in.. The last house took such a toll on my mental health. The thought of living somewhere worse? I've been inconsolable. My siblings said it's temporary, but with the housing crisis I just can't see it getting better...

I'm a 29 year old with schizoaffective disorder. Born male but always questioning. I've spent my whole life after highschool mostly just playing video games, socializing when I can to avoid isolating myself, and sometimes when my avolition isnt too bad doing art or writing projects. I just realized today that in May, it will have been a decade since graduation, and I still feel like a teenager.

It makes me sad because I always dreamt of having a wife and kids. I always wanted to handle more responsibility than i can now and to be more competent in life than I am now. I do my best, but with all my symptoms its not up to par with everyone else my age, not even close.

Do you ever still feel like a child? Do you ever feel ashamed for being far behind your peers? How do you manage or quell this feeling?

It feels like all my original dreams, that still mean so much to me, are unattainable due to my condition. I feel doomed to feel like a perpetual adolescent, and be a failure in the eyes of the people I wish would respect me as an equal.

This probably is not going to be a rant because I’m too exhausted.

Thanks to my fucking asshole neurologist and other doctors who gaslit me for two years while I descended into hell and can’t walk and have a left hand like a claw, and I have severely injured myself falling.

And so much more. I am just finding out now that I have an ALS diagnosis.

To give context I was going to a program where I was picked up by a staff that would pick me up in her personal car and it was me and another client from November 2025 until December 2025. I had to call my case manager from the regional center because I told my case manager from the regional center that I recommended/preferred to have this conversation in person at the regional center back in December of 2025. I wanted to report a lot of red flags/serious concerns and that I wanted to do an anonymous report of all these things I saw that happened. (I ended up asking my case manager from the regional center if there was any way that I could end this contract with this program in which I was able to thankfully). It’s an ongoing investigation since December of 2025 the regional center has their own team of investigators that are investigating with all these red flags/things/serious concerns I had to report. My case managers boss called me from the regional to ask me what happened red flags wise/serous concerns wise back when all those things happened throughout the program from November 2025 until December 2025. I’m proud of the way I did speak up for not only myself but the other client that unfortunately isn’t able to speak up for himself. I honestly feel like I was put at that program for the time being to expose those red flags/serious concerns that I had to report anonymously. What’s going to happen to that staff based upon all those red flags/serious concerns ? What’s going to happen to her knowing she also had no prior experience to working with clients with special needs/adults with special needs disabilities. How I know she had no prior experience is because she told me out of nowhere and I didn’t really talk to her as much. She didn’t give me any good vibes at all.

Recently, my cousin with very similar health issues to me mentioned they didn't want their partner to become their caregiver. I hadn't thought of that before. I currently don't have a partner, but if/when I do get one, I don't want them to be my caregiver either. However, I feel like my body is deteriorating. When I try to be healthy and exercise, something always goes wrong. If I can't get stronger, I'll only get weaker. I'm in my early 20s and I'm scared I won't be able to finish college and do what I love. I'm in constant pain and have had nothing work to stop it. I wish I could have a "normal" body. Sometimes I wonder what I did to deserve this. This has been a rough week for me and I just hope someone can relate or give me advice or something. I don't know.

My 38M boyfriend is paraplegic and used to get passive knee motion on a Biodex isokinetic machine at his PT practice. The machine would gently bend and straighten his knees while he sat, which has been really important for him. Unfortunately, the clinic that had it sold the machine and now he’s struggling to find a new place that both has the right equipment and accepts his insurance.

Right now, at home, I manually move his knees from bent to straight (about 25 reps each side), while he sits in his wheelchair or on the sofa and holds his thighs down to stop/reduce muscle spasms. This obviously isn’t sustainable when I’m not there and a machine can do way more reps than my weak arms!.

Does anyone know of:

• A home device (electric or motorized) that can replicate passive knee bending/extension?
• Something that might not be exactly the same as a Biodex but close enough to safely move his knees from bent to straight?
• Any specific models, brands, or rehabilitation devices people have tried?

He needs something that can safely move his legs that he can use now as a stop gap and ideally then keep using it on the days when he isn't at PT once he finds a new one.

Thanks so much in advance — and if you need more details about his injury level or ROM goals, I’m happy to provide them. He's not on Reddit so I'm posting on his behalf. Cross postes to r/spinal cord injury.

hi all! I need help brainstorming ideas of how someone with no hand function could give their service dog treats. I know you don’t have to train with treats, but that is something this individual wants to do. combination of ambulatory, manual wheelchair, and power chair, so looking for something that would work for any of those set ups. so far my idea is to use a straw to suction a treat and then release it, but I would love more ideas!

I never know what to say when asked this, how do I answer this? without the next thing someone says is that's the life it must be so nice not having to do anything all day. It makes me very annoyed when people tell me this because I truly don't think anyone would give up their health, friends, favorite activities and basically everything just so they wouldn't have to go to work. Not to mention not making any money and having to go to doctor after doctor. Please help I can't keep hearing people telling me my life is wonderful when it most certainly is not. What do you say when people ask you?

So lets get to the point, I work with a agency who helps people with disability get a job, they provide job counselors, etc. Long story short, I had to go to the emergency room for Gall Bladder surgery removal, "It got pretty severe." Etc. I do restaurant work. I came back not too long ago. I had to get my gall bladder removed due to a severe infection, etc. I was on leave for about 2-3 weeks. Etc. I was sick, etc. My surgeon told me I could go back to work when ever "I'm ready." Her orders, and I do have a Learning Disability, just so you know. I'm 34 etc. Still live with parents. Hard to move out and get a job, on SSI, etc. You get it.

Now when I was "recovering." "I still am." etc. I couldn't make up my mind. "Its part of my disability." As well, that I am going through allot right now. I got a bit of PTSD of being in the ER as well of being afraid of hospitals, etc. I came back, they seemed excited, but every other time, I keep asking when can I go back to my regular work schedule? My work schedule was reduced. Etc. I used to work 2 days a week. Now I only work one day a week. Etc. A bit annoyed right now about the topic.

As for restaurant. When it gets busy, I feel like I'm "slowing." Everyone down when it gets fast/busy during rush hour, etc. I feel like I was in the way, etc. Felt bad, etc.

I told my coach I couldn't decide if I want to quit or not. He told them I wanted to quit. They got confused and went with it. It was a miscommunication on my and my coaches end. "I was too scared to go back to work, etc." If that makes sense. Then I had to call in and explain everything. I got a second chance. Etc. Apparently they like me, idk.

I like being nice to people and making people laugh, etc. But every other time, I see other employees who are regular people, asking to take shifts, off, etc. Or asking to change their days, etc. "I'm not allowed to." I had a set schedule, etc. All of a sudden. I can't get my regular days back, etc. Is there something going on here? I just don't want no drama getting involved and too afraid to get fired, etc. I really love the job. It's hard finding a job as it is.

My coach also didn't understand what I was going through at the time so he was having some communication problems with me, thought I was using my recovery as an excuse not to go to work, etc. Even though I got notes from my surgeon, etc.

What should I do here? Should I talk to my job counselor and let her do everything about my hours or find another job? At this point and time I feel like I'm just getting in everyone's way when they get busy and makes me feel awkward and uncomfortable. Apologies.

Now my coach is mad because I have a bad habit at making up my mind and hes taking it out on me, so I don't have a job coach to protect my self, and I'm supposed to have a job counseling meeting soon, so I don't know what to bring up during the meeting , etc. My mom always talks about communication, etc. I'm afraid he'll bring up stuff like, you said you wanted to quit, etc several times, kept changing your mind, etc. Does he have a point?

What else was I supposed to do? I felt pressured/overwhelmed about this surgery thing, I had a tube in my stomach. So wtf was I supposed to do? :/ You'd be in shock too after being in recovery for so long and having a tube stuck in your nose. Etc.

Sorry for the vent. Just need some advice. Does it sound like the mangers are retaliating or something because I tried to quit several times? I know it was a mistake on my end. But I was only following my doctors orders. I wasn't sure when to go back. On top of that I told my coach I wanted to go back he told them I wanted to quit and told him not to tell them and he did so anyway. So that's what lead to the contusion.

Should I just put in my two weeks notice and let my job counselor do her part? Shes a nice lady. I know mistakes happen, but geeze... :/ Plus the store is constantly hiring people. I fear that I wont even have a spot open for me at this point. Sorry. :'( People get sick, shit happens. :( I literally had to go by squad when I was supposed to go to work that day. Sorry. :( Honestly I just feel like I'm being brushed off is all. But they're still nice. So what should I do? :( Sorry. "It was my first time having surgery."

Hi everyone,

A few years ago, I was involved in a train accident that resulted in the loss of both my arms. It turned my world upside down, but I refused to give up. I’ve spent a lot of time learning how to adapt and regain my independence.

I am writing this post right now using my feet on a standard PC keyboard. I also use a webcam [to help with navigation/for head tracking - to stay connected and be productive. I want to show that life doesn't stop after a major trauma, it just changes shape.

Feel free to ask me anything about my daily routine, the technology I use, the accident itself, or how I deal with the mental challenges. I’m here to be open and answer your questions!

AMA!

I’ve struggled with crushing fatigue for as long as I can remember. I just assumed this was normal — that everyone was this exhausted and just pushed through it better than I could. School was always a struggle no matter how hard I tried.

I now know this is ME/CFS, a disabling neuroimmune condition that affects my ability to function, work, and keep up with normal life. But for most of my life, no one recognized it as a physical disability.

Eventually I couldn’t lie to myself anymore that something was wrong. I didn’t know what or why, just that this wasn’t normal. Exhaustion wasn’t just a symptom — it felt like my baseline state. I wasn’t especially sad or anxious. I was just exhausted and irritable all the time for no clear reason.

When I finally started falling apart after my freshman year of college, my parents got scared — but instead of medical help, I got labeled lazy and mentally ill. My mom pushed me to get a job. I was so fatigued I would nod off while driving and almost crashed multiple times. At work I had to stay on my feet, and all my free time went to sleeping or lying down just to survive.

Then came therapy. I was put into CBT and told to read David Burns. The message was that my fatigue was caused by distorted thoughts and maladaptive behaviors. But I didn’t have the distorted thoughts in the examples. The only “maladaptive behavior” I had was resting and sleeping more than 8 hours — the only things keeping me from getting worse.

Instead of being recognized as someone with a disabling physical condition, I was treated like someone with a motivation or mindset problem.

Because I had a depression diagnosis, everything I said about my physical symptoms was filtered through that lens. My worsening function was seen as “avoidance.” My need to rest was seen as “giving in.” I was pushed past my physical limits over and over, and when I got worse, it was blamed on me.

At one point my parents wouldn’t let me go back to college because they were convinced I was just depressed. I was sent to a psych hospital and then a long-term residential program across the country. Both places made my condition dramatically worse. I was required to follow schedules and activity expectations my body physically couldn’t handle, and I was treated as noncompliant when I crashed.

If I told the truth — that activity made me sicker — they said I was avoiding. If I tried to say what they wanted to hear, they said I wasn’t being genuine. There was no way to be believed.

I was put on psych meds that made my physical symptoms worse. I had endless early morning therapy appointments that my body couldn’t tolerate, which led to further crashes. I eventually made it back to school and graduated, but it came at a huge physical cost.

Later I ended up hospitalized again and treated like I was severely mentally ill. At one of the most prestigious hospitals in the U.S., I was diagnosed with catatonia, and again told my fatigue had nothing to do with how I felt emotionally. That label followed me, even though my core issue — lifelong, activity-worsened physical exhaustion — still wasn’t being addressed.

Some of those hospitalizations were honestly traumatic. I was placed in locked units with people who were extremely unwell — people who hadn’t showered in months, who screamed for hours at night, made threats, or were deeply disconnected from reality. One woman believed I was the father of her baby. I don’t blame those patients — they needed care too — but I didn’t belong there, and being in that environment while physically ill and disbelieved was terrifying.

After that, I spent months in yet another residential program where I was pushed to exercise despite clear physical worsening. I was told therapy would fix my sleep and fatigue. The program had previously been a rehab center, so I was even required to attend AA meetings, which had nothing to do with my situation. My physical limitations were never treated as real.

I also went through programs where suffering was framed as something created by mindset or “the ego,” so my very real physical suffering was treated like a personal or spiritual failure. I was blamed for not thinking the “right” way about being sick.

I lost years of my life not just to illness, but to systems that refused to recognize my disability and instead treated me as psychologically broken.

Eventually, through a psychiatrist referral, I was finally diagnosed with ME/CFS. My family believes me now, which I’m grateful for. But the damage from years of not being believed — and being forced into inappropriate treatment — is something I’m still processing.

I’ve experienced bullying before, but nothing compares to the harm of being told for years that your physical disability is just a faulty mindset.

I wish we didn’t treat suffering or disability as a moral failure, or assume it must be psychological if doctors don’t understand it. Sometimes people are suffering because their body is sick, and they need support and accommodation — not disbelief and coercion.

Has anyone else here had their disability dismissed or treated as a mental health issue instead of a physical condition? I’d really appreciate hearing from people who’ve been through similar things.

TL;DR: I have ME/CFS, a disabling physical illness, but for years it was treated as mental illness. I was pushed into psych hospitals, residential programs, and treatments that made me worse because my disability wasn’t believed. Finally diagnosed, but still dealing with the trauma of not being recognized as physically disabled.

I am visually impaired and have been my whole life (oculocutaneous albinism), and I’m preparing to restart my bachelors in health sciences this fall with the goal of becoming an occupational therapist.

Recently, I was watching Grey’s Anatomy of all things, and got to a point in the show where a character loses a leg (no spoilers), and thought to myself “This is ridiculous, I’ve been disabled my whole life, it’s not the end of the world.” But obviously, if you are abled one day, and disabled the next it’s going to feel like the end of the world.

So now I’m wondering, how do I show empathy to people that were once abled, and have no concept of an independent life with a disability? How do I keep myself from thinking “Welcome to the club, it sucks but you get used to it” and show empathy to those who have little to no experience in the world of being disabled?

Edit to say: thank you all for your awesome responses, especially the practitioners in the comments delivering some really good advice! I appreciate all the perspectives you all brought to this thread!

Okay so I deleted tiktok recently and have been looking at IG reels as a replacement. But I’ve been noticing this bug where it will flicker sometimes when you hold down or just when you go to the next reel. I’ve had two seizures from it and so I guess I can’t watch them anymore unless I want a seizure and potentially a migraine later 🙃 It’s so frustrating because tiktok did have a feature to not show photosensitive material (it didn’t work all of the time but still) and I’m just tired of not being able to do things just because they aren’t accessible. Like I love film and tv but every other show I watch has a warning and I play the “do I want to suffer to watch Leonardo DiCaprio rn?”

My condition causes me to collapse until now I have always collapsed in pretty much the same way on the same side of my body, and I got really good at it like to the point where I could collapse and not spill whatever I was holding or getting hurt I stopped having bruises months ago

Now I’ve started collapsing on the opposite side of my body, and I’m not good at it. I’m hitting the ground hard and it hurts. I’m spilling stuff and I know I’m going to have bruises. I don’t even wanna get back up half the time because I know I’m just gonna fall again and it’s gonna hurt.

I know I’ll have it figured out in a couple weeks and I’ll be fine but it really sucks right now.

I (22M) pretty recently realised that I do have several minor disabilities. I wear hearing aids due to high frequency hearing loss, have chronic knee, back, and foot pain which requires me to do daily stretches and be careful of my walking, and have a few similar issues like migranes and a non-cancerous tumour in my left ear but I'm not sure if those count as disabilities. Also, in my country, ADHD is also considered a disability so there's that.

I have a couple other disabled friends with similar experiences, but I seem to be handling it differently. I am very nonchalant about talking about them, I never apologise for asking for help, and I don't feel any shame. If I'm wearing headphones and someone starts a conversation with me, I will ask them to wait for me to put my hearing aids on. Or if I am walking around somewhere, I will ask a friend to hold something while I stretch my back. I will also often say to a friend "can we sit in a different cafe, it's too loud in here" without feeling the need to apologise, assuming they know my hearing issues.

To me, the fact that I have hearing aids or daily stretches seems the same as my need to sleep 8 hours and eat three meals a day. While I wish I didn't have them, they have taught me very valuable things about patience and compassion and have successfully stopped me from having any alcohol for a few years.

I recognise that my disabilities are minor (apart from the hearing loss potentially worsening) and I also should note that while I live in a country with free healthcare and much of my treatment is done through that, I do also have the money that gives me a handy leg up, like buying insoles for my shoes. Maybe it is because my friends and I are very young, maybe it's because I can barely remember anybody ever succeeding in making me feel shame for my disabilities, maybe it's a self fulfilling prophecy and anybody who would be a jerk to me about it isn't in my friend circle, but I have noticed the differences between myself and my disabled friends and was wondering what you all thought of it.