Anchorage, AK
Most people think of someone in a wheelchair when asked to imagine someone with a disability. A Google search for “disabled person” or “disability” yields various images of people in wheelchairs or people using mobility devices. However, disability covers a vast range of impairments and conditions. The Social Security Administration lists fourteen categories of disabilities, including but not limited to musculoskeletal disorders, mental disorders, and immunological disorders. One category of disability is known as an invisible disability. An invisible disability is a physical, mental, or neurological condition that is not immediately apparent but can limit a person’s movement, senses, or activity. Although these disabilities can create challenges for those with them, they are often difficult for others to recognize, acknowledge, or understand. A widespread lack of understanding, support, and education creates systemic issues for those with invisible disabilities to navigate along with the symptoms and physical challenges that already come with their disability.
Chronic pain is the most common cause of disability in the United States. Chronic pain is persistent pain that lasts months to years, commonly resulting from illness or injury. A few of the most common causes of chronic pain include diabetes, arthritis, fibromyalgia, and cancer. Some people also have chronic pain not tied to an injury or physical illness, a response known as psychosomatic pain. Although the type, intensity, and duration of chronic pain vary, and living with chronic pain is a highly individualized experience, people with chronic pain often experience similar physical, mental, and social challenges due to the nature of their condition.
Chronic pain often harms a person’s ability to work, sleep, socialize, exercise, and live a normal life. It can be challenging for those with chronic pain to perform daily chores, and even getting out of bed may be difficult some days. People with chronic pain, particularly from conditions like fibromyalgia, back problems, migraines, and arthritis, are at greater risk for mental health problems, including depression and substance abuse disorders. Chronic pain can be isolating, and a strong support network is crucial for those with chronic pain. However, chronic pain can limit social activities and strain relationships. Because chronic pain is often invisible, friends, family, employers, and healthcare providers may not be able to understand the struggles of, invalidate, or judge those with it.
The stigma surrounding chronic pain can be especially problematic in the workplace, where people with chronic pain may be perceived as lazy for having to manage work with their conditions. Missing work or being physically present at work but unable to perform at maximum capacity is common for people with chronic pain. They may need accommodations like a flexible schedule or a reduced physical workload, but obtaining them can be difficult due to a lack of legal protections. Attitudes in the workplace that promote perfection often lead to feelings of stress and guilt for people with chronic pain. A supportive workplace that promotes regular breaks, offers flexible work hours, and recommends rest can help mediate the struggles of those with chronic pain. But despite the prevalence and increasing awareness surrounding chronic pain, even in the healthcare system, people with chronic pain may struggle to find understanding. Chronic pain is frequently challenging to diagnose and treat. Some people benefit from the prescription of opioids, while others are harmed by it. Obtaining these medications can be difficult due to strict regulations. Many people with chronic pain often feel stigmatized by healthcare providers for opioid use and the desire for pain management. Evidence also exists for unconscious biases and negative stereotyping, specifically against racial minorities requesting pain treatment.
Immunocompromised people have been brought into the spotlight due to the COVID-19 pandemic. Immunocompromised people have a weakened immune system causing a reduced ability to fight diseases. Being immunocompromised may be caused by certain diseases or conditions, such as AIDS, cancer, or other genetic disorders. Certain medicines or treatments, such as anticancer drugs or radiation therapy, may also cause it. People with autoimmune diseases or those who have received an organ transplant may also use medication to suppress their immune system. Living with a weakened immune system means a higher chance of illness and infection and more frequent severe infections.
Vaccines often don’t work as well for immunocompromised people. Vaccines cause the immune system to create a strong response against a harmless version of a pathogen so that when the actual virus comes, the body can make a defense. However, if a person’s immune system is compromised, that response might be weakened or nonexistent. It is even more critical for immunocompromised people to stay updated with their vaccines. Immunocompromised people may also have to be more strict with hygiene practices. Sometimes, they may need masks or limit social interactions to protect themselves. Living with a compromised immune system and managing health concerns can also cause anxiety and be hurtful to mental well-being. These struggles were especially relevant to the recent coronavirus pandemic.
Immunocompromised people have suffered a higher burden of symptomatic SARS-CoV-2 infection and severe COVID-19 disease. As with other vaccinations, immunocompromising conditions can decrease the immune response to the COVID-19 vaccines. Diminished vaccine effectiveness has translated to higher rates of clinically significant COVID-19 after vaccination in many immunocompromised populations. This includes increased risk for hospitalization and severe disease. The strain on healthcare systems during COVID-19 significantly affected immunocompromised people as it became more difficult to access regular medical care. Although people adopted measures like wearing masks and social distancing, resistance and refusal to adopt these practices put immunocompromised individuals at a greater risk.
The number of people living with anxiety and depressive disorders rose significantly because of the COVID-19 pandemic; discussions about mental health and mental health issues have been highlighted. Mental illness is relatively common, with about 20% of the population having one yearly. Unknown to many is that mental illness is a leading cause of disability. Many people have mental health concerns, but a mental health concern becomes a mental illness when ongoing symptoms affect the ability to function in daily life. A mental illness can cause problems in everyday life, such as at school, work, or relationships. Mental health conditions refer to a large spectrum of disorders and psychosocial disabilities. Examples include depression, anxiety, PTSD, schizophrenia, eating disorders, and addictive behaviors.
Untreated mental illness can cause severe emotional, behavioral, and physical health problems. It can reduce a person’s ability to complete daily tasks, concentrate, or make decisions that could hurt their professional, academic, or social life. Mental health disorders like depression directly manifest in emotional symptoms such as reduced mood and mood swings, but they can also manifest in physical problems like back pain and headaches. The stress of mental health conditions can worsen health by weakening the immune system and altering sleep patterns. Mental illness is correlated with a greater risk of heart disease. Like other invisible disabilities, mental illness can cause strain on social relationships. Mental health issues can lead to social isolation; others might struggle to understand or relate to the struggles of someone with a mental illness.
Mental illness is still heavily stigmatized, and those with mental illness often don’t receive adequate support or access to mental healthcare services. Mental healthcare services often receive less funding and resources than other healthcare forms. The high cost of treatment and limited availability of mental health professionals also contribute to inadequate access to mental health care. People with mental health issues are often criminalized rather than provided with proper care; they are disproportionately represented in the criminal justice system. As previously mentioned, mental health issues often strain relationships which can cause social isolation and reduced support systems for people with mental health issues. These factors contribute to how people with mental illness are at a much greater risk of poverty and homelessness. People with schizophrenia have a life expectancy of 10-20 years below that of the general population.
It’s essential to recognize that disability takes on many forms, even those that may not be immediately recognizable. Unfortunately, a stigma is still attached to disability, and the isolation of not being understood can be especially true for those whose disability isn’t apparent to the naked eye. Education is critical to improving the lives of people with invisible disabilities. Hopefully, with more education, the struggles of disabled people can be mitigated, and the disparities between the abled and the disabled can be eliminated to create a more fair, inclusive world for people of all abilities.