Chronic Pain & Mental Illness: Recognizing Invisible Disabilities this Disability Pride Month

July is Disability Pride Month! This week, we’re digging into some common but often invisible disabilities that often go overlooked: mental illness and chronic pain.

The history of honoring Disability Pride goes back to July 26, 1990, when the Americans with Disabilities Act (ADA) was passed. The ADA prohibited discrimination against people on the basis of disability at work or in government programs. It also protected access to many other public spaces like businesses and transportation. The ADA was a landmark achievement that took decades of work by activists in the disability rights movement. Subsequently, Boston held the first Disability Pride Day event in July 1990. Since then, major cities across the U.S. have celebrated Disability Pride.

What accounts for this elevated rate of mental distress? Certainly, mental illness itself can be disabling. In fact, depression is the most common cause of disability worldwide for people under the age of 60. Other common mental health conditions like anxiety and post-traumatic stress can be causes of “invisible disability”. That is, disabilities that are not visible from the outside, but still create an ongoing physical or mental challenge.

Chronic conditions of all kinds have an impact on our mental health. They can impede our ability to access things like basic medical and mental health care, or create isolation from the things and people we love. This is often not an individual problem, but a systemic one. Health stigma, lack of necessary accommodations at work and in public spaces, and poor understanding among family and friends can play a primary role. This can be incredibly isolating and can lead people to feel shame about their conditions.

Chronic Pain and Invisible Disability

According to The Invisible Disabilities Association, more than 125 million Americans have at least one chronic condition. That’s over a third of the population! Among them, chronic pain is the most common cause of long-term disability, affecting more people than heart disease, diabetes and cancer combined. This can show up in a variety of forms, including chronic headaches and migraine attacks, or debilitating joint and muscle pain as seen in rheumatoid arthritis. Other examples include chronic fatigue, and autoimmune-related illnesses such as lupus, fibromyalgia, and POTS. 

For many people, chronic pain is an invisible disability, not seen by most outside observers. This can be a privilege in some respects. People with invisible disabilities avoid much of the overt stigma and marginalization that people with a visible disability experience. They may also have more freedom to choose whether and how to disclose their disability status.

On the other hand, people with invisible disabilities face unique challenges. My clients often share experiences where their disability is minimized or dismissed by others. Without visible “evidence”, it can be difficult for family or friends to understand how their disability might be impacting them. At work, this can translate into employers being less willing to provide reasonable accommodations, or viewing the employee as less competent or dedicated. At its worst, this lack of understanding means people with invisible disabilities are accused of faking their disability, or taking up resources meant for people with “real” disabilities.

It can be more difficult to obtain medical care too. Although symptoms are often widespread, it can be difficult to obtain medical test results to “prove” the illness’ existence in many cases. Women and people of color, already less likely to receive high-quality medical care, can especially struggle with being believed and taken seriously by their doctors.

The disability pride movement reminds us that stigma, shame, and oppression are a collective problem, and a collective responsibility. It also contextualizes ableism within the bigger systems of white supremacy and patriarchy. If you’re new to learning about disability justice, I highly recommend checking out this excellent pride month article on disability justice through an intersectional lens.

Cultivating Community Healing

For my clients living with chronic pain and other disabilities, it’s so important to connect with the people who *do* get it. No one shares the same exact experiences as you. You alone are the expert of what your mind and body experience. However, there is something to be said about sitting with the shared experiences of human suffering. It’s actually part of mindfulness practices and self-compassion practices to recognize that as humans, we all experience pain and suffering. It’s radical acceptance of this general human condition. While acknowledging that we also have unique challenges, we also know that we don’t have to go through it all alone.

Research shows that finding sources of social support improves the quality of life, reduces the physiological experience of pain severity, and decreases disabling impact of chronic conditions on daily life. Whether online, among friends, or in support groups like the ones I facilitate here at Stella Nova, it can be both validating and healing to connect with other people who have lived experience of disability.