Disabilities can be visible or invisible to outsiders. A white tipped cane, hearing aid, or wheelchair might make a disability more apparent to others, more visible. Certain chromosomal or genetic differences may be noticeable even without such aids. An amputated limb is visible with or without prosthetic. However, most disabilities are invisible and can’t be readily recognized by untrained lay people.
All mental illnesses are invisible. So are most cancers; the hair loss and other signs we associate with cancer are results of the treatment in many cases. Traumatic brain injuries, epilepsy, and learning disabilities are invisible. Food allergies, dietary restrictions, and most chronic pain conditions are invisible too.
Sometimes if you’re lucky, you can get a picture of your insides. A brain scan, x-ray, or MRI can give visual proof of the unseen experience, can make the invisible visible. This may not help much with strangers, coworkers, and neighbors, but it can greatly cut through the obstacles to getting doctors to acknowledge your condition.
You see, doctors have biases that influence what level of care they give their patients. Numerous studies have shown that doctors as a whole discount and disbelieve the reported pain of women and of people of color, and doubly so for women of color. Long discredited theories of “female hysteria” and hypochondria as a “woman’s disease” and of black and Brown skinned people as “beasts of burden” combine to ignore and deny pain that is felt by people who are non-white and/or non-men.
This bias delays accurate diagnosis and effective treatment, especially in matters of chronic pain, conditions that women suffer from at much higher rates than men. It also teaches the patients to doubt themselves. This wide scale medical gaslighting is influenced by and plays into broader cultural disdain for impairment. Without a diagnosis, which takes women years longer than men to obtain, and in the presence of constant denial of their pain, disabled people begin to doubt themselves. Maybe I could work. Maybe I’m just faking it. I by they’re right and this is all in my head.
This self doubt can persist even once a diagnosis (or several) has been acquired. I am diagnosed with juvenile rheumatoid arthritis, tendinitis of the right hip, obsessive compulsive disorder, ulcers, major depressive disorder, social anxiety disorder, post traumatic stress disorder, and irritable bowel syndrome. They’re in my head, my guts, my joints, everywhere.
Yet I still wonder sometimes if I’m not secretly the horrible faker my mother always accused me of being. I know she was wrong. I’ve seen the x-rays. I know my hip was really dislocated on and off for three years while I got no treatment and was told to stop malingering. But the way she was wrong, as my mother, my loved one, burrowed deep into the shame center of my mind, and I hear her voice from decades ago in my darkest hours. Not comforting me, but doubting me. Refusing to believe.
No one doubts a diagnosis more than the person who bears an invisible disability it took them years to have acknowledged. Not the doctors who call them drug seekers or hypochondriacs, not the employers who ask them to pick up the pace and stop taking sick days, not even the loved ones who hold their good days against them. No one has been more painfully trained to have no faith in the patient than the afflicted.
If you have doubts, seriously consider the long-term harm on might cause if you are wrong, if you encourage a disabled person to keep pushing, to ignore their symptoms, to break their mind-body connection so that they can’t hear their body tell them to stop. Then keep those doubts to yourself.