Imagine for a moment that you’ve made dinner plans with a friend.

You’re excited to check out the new swanky place downtown that recently opened. You go to the website and check out the menu, and you’ve really got your heart set on their crème brûlée when your friend sends you a text message.

“I’m really sorry, but I won’t be able to go to dinner tonight. I called the restaurant to see if they are handicapped accessible, and they said there is limited handicapped parking available, their doors are narrow, and they do not have a bathroom large enough to accommodate my wheelchair.”

You’re bummed for sure, but you can’t be mad at your friend. If anything, you’re outraged that the new restaurant didn’t consider the needs of people like her when they opened their business. So, you pick a different place to hang out, and hopefully, you find some crème brûlée there, too.

Now, change that scenario just a little bit.

You make plans to visit this new, swanky place with your friend, and you receive this message:

“I’m really sorry, but I won’t be able to go to dinner tonight. I’m not feeling well. I think I’m going to stay home and rest.”

This is what your friend wants you to hear. What she means to say is that her anxiety is really high today. The idea of going to an unfamiliar, crowded, noisy place, in a neighborhood she doesn’t know, makes her want to crawl out of her skin. She’s taken her medicine to try to combat the shaking hands and nausea in the pit of her stomach. It helps a bit, but she’s afraid that going to that place will send her into a full-blown panic attack—the last thing she wants to go through in a crowded restaurant.

Or, maybe, your friend is struggling with depression. She can’t get out of bed today to even take a shower. She knows that even if she goes, she’s not going to be able to enjoy it. She doesn’t want to burden you with her problems. She’d rather just be alone, anyway, and not have to force conversations and interactions. Just the thought of it exhausts her. She knows she’s isolating herself. She should probably call her doctor, but she really wants to try to pull herself out of this without medicine this time. Taking antidepressants makes her feel weak. She wants to be strong and power through it, but going out tonight is just too much for her.

When you receive that vague message, “I’m just not up to it today,” you might take it personally. You might think, “She cancels on me every time we make plans. I guess she doesn’t have time for me.” You might be angry—you set aside your Saturday evening and your friend just bailed on you at the last minute. You might stop reaching out or making plans.

Here’s the thing: your friend in the wheelchair has no problem saying, “I can’t go here because my body won’t allow it.” And you can look at your friend and see that what she says is true. You can measure the wheelchair she is in, then measure the door frames in the restaurant, and determine very quickly whether it’s possible or not.

Your friend struggling with anxiety and depression probably looks fine. She’s probably become a master of putting her game face on when she goes out into the world. Maybe she’s never even mentioned that she struggles with anxiety or depression. She fears judgement and exclusion. She’s learned this by witnessing the stigma in our culture surrounding mental illness.

If your friend is diabetic, and his pancreas has stopped making insulin, you would never judge him for taking insulin shots to replace the chemical his body needs. You wouldn’t tell him he is weak for using the lifesaving medication his doctor prescribed for his condition. The same is true for people using medications for chemical imbalances in the brain. If your brain stops making serotonin, or the receptors stop responding to it, that’s not something you can wish away with positive affirmations. It’s not something you can just overcome anymore than you could pull yourself up by the bootstraps and kiss your insulin goodbye.

If you went out somewhere with your diabetic friend, and he had a blood sugar crash, you would get him some orange juice and sit with him until he felt better. You would never call him dramatic, or accuse him of doing it for attention. But, that’s what we do to our friends who are struggling with things we can’t see and don’t understand.

To be fair, our culture has taught us to view mental health this way. In America, it is cloaked in fear and misinformation.

We view mental illness as a personal weakness. We accuse people of being dramatic, seeking attention, or being lazy. We use psychological diagnoses to describe people who behave differently. “She’s crazy, anorexic, schizophrenic, ADD. He’s a psycho, alcoholic, bipolar, narcissist…” This language reinforces the negative stigma associated with mental health.

Ultimately, that negative stigma keeps people suffering in silence. That stigma makes people feel like seeking therapy or taking psychiatric medication is a personal failure. That stigma literally kills people who never seek treatment, because they’re too ashamed to admit they’re not okay.

It’s important to note that one in five Americans has a mental health diagnosis. Anxiety is the most commonly diagnosed condition; depression, addiction, bipolar, and eating disorders are also high on the list, along with attention deficit and schizophrenia. It’s likely that you, or someone you love, has struggled with at least one of these conditions.

Next time you get that vague cancellation text from your friend, remember that it’s not personal. She probably wishes more than anything that she could just live her life unencumbered by her illness. She would love to go out and spend time with you, and share that crème brûlée in the swanky new downtown hot spot.

Please don’t give up on her, she’s doing the best she can. This is the time she needs you most.

Instead of pulling away from her, can you lean in? Respond with a question: “Is there anything I can do for you?” “Would you rather hang out at the house?” “Do you want to talk about it?”

Let her know that you care about her, and want her to be okay. Don’t judge or hover. Encourage her to make that next step toward feeling like herself again. And, if you’ve ever struggled with a similar, unseen condition, share that experience. There is great power in learning that we are not alone. When you share your struggle, you open the door for your friend to talk about her challenges without fear.

If you’re struggling today, please hear me. You’re not alone. There are so many of us, and so many ways for us to cope. You are here with a purpose, your life is important, and people care about you—even some you’ve never met.

So, please, call your therapist. Take your medicine. Do everything you can to bring peace and happiness back into your world. You deserve to live a life of joy and fulfillment.

We can’t see your illness, but we see you—strong, beautiful, brave, worthy you. You deserve to be well and enjoy your days, and we are all here cheering you on through every moment.

Better days are right around the corner, precious soul. Just hold on.

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