If someone asked you to picture a disabled person, you’d probably envision someone using crutches or a wheelchair. You likely don’t imagine the grocery store checkout clerk or your child’s elementary school teacher. 

However, those with lifelong yet invisible diseases often struggle more than their peers with visible issues. The problem multiplies if they otherwise look healthy — people expect their bodies to perform in line with how they appear, not how they feel. Here are eight types of chronic illness that you might not see but which nevertheless cause substantial disability. 

1. Arthritis

If you research arthritis, you’ll find out there are over 100 forms of the condition, all with varying degrees of pain and disability. Some folks only have knees that creak a little upon rising, while others require a wheelchair. 

Please know that arthritis can strike at any age — including children. While osteoarthritis typically occurs in those middle-aged and older, the inflammatory form of the disease, called rheumatoid arthritis or juvenile idiopathic arthritis in those under 18, can occur at any life stage. The 20-year-old intern who requests an upgraded keyboard for arthritic hands might not be a drama king or queen seeking special favors — please don’t treat them as such. 

2. Migraines

Many people respond to the words “I have a migraine” with, “Oh, yeah. Sometimes, I get headaches, too,” and then wonder why the original speaker rolls their eyes. While it doesn’t receive much sympathy, migraine is the seventh most disabling condition worldwide and the third most common disease. 

Often, individuals can work through the pain — although migraines can literally become blinding. Visual disturbances and other auras, including partial paralysis, can prove equally disruptive. Nausea and vomiting often associated with attacks, likewise disrupt daily life.

3. Fibromyalgia 

Scientists remain unclear what causes the widespread pain condition known as fibromyalgia. Some researchers theorize that patients have more cells that carry pain and fewer signalling them to slow down. Those with other pain disorders tend to get this disease, which also runs in families. 

Those with fibromyalgia often have trigger points, such as their midback or near their knees, which become painful. They may be more sensitive to foods and have to eat an anti-inflammatory diet to help control flares. Another frequent symptom is brain fog, where sufferers feel like they can’t concentrate or focus. 

4. Chronic Fatigue Syndrome

Chronic fatigue syndrome’s most pressing symptom is what it sounds like — excessive tiredness. Patients often feel exhausted even if they slept a full night, and many become confined to bed rest for periods. 

Unfortunately, many individuals identified as COVID-19 long-haulers experience nearly identical symptoms to chronic fatigue patients. Researchers now hope that these clues may help them find a cure for both conditions. 

5. Lupus 

Lupus, like fibromyalgia, can cause widespread pain. It’s an autoimmune disease, meaning that it occurs when your body’s immune system attacks healthy tissue instead of invading pathogens. It doesn’t stop at your skin and joints — it can also affect internal organs like your heart. 

Early symptoms of lupus may mimic arthritis and fibromyalgia by causing joint pain. However, sufferers often experience a butterfly-like rash across their nose and cheeks as a telltale giveaway. While no single test can diagnose you with the disease, doctors frequently use an antinuclear antibody test coupled with your medical history. 

6. Lyme Disease 

Lyme disease arises from an infected tick bite. The symptoms include headache and fatigue, making it similar to others on this list. However, you can tell the condition apart from the signature bullseye rash that typically occurs where bitten. 

While doctors can treat Lyme disease with antibiotics, leaving it untreated can result in permanent neurological defects. During the late stages of the disease, patients may experience memory loss, confusion and the inability to finish sentences. If the individual lacks access to medical care, bystanders may confuse these symptoms with the onset of dementia. 

7. Inflammatory Bowel Disease 

Ulcerative colitis (UC) and Crohn’s disease are both autoimmune diseases that can cause significant misery. Diarrhea associated with either condition can leave patients trapped in their home, terrified of heading out without knowing where the nearest bathroom is. 

Some cases of inflammatory bowel disease respond well to newer medications like biologics, while others improve through dietary changes or a combined approach. As someone who doesn’t suffer, your job is to avoid pushing food on people. Someone with Crohn’s or UC might not feel like giving you their medical history when they refuse your brownie offer, but if gluten gripes their gut, you aren’t doing them any favors by insisting they try, “just a nibble.” 

8. Mental Disorders

Mental disorders can disable you as utterly as a broken leg during a marathon. Unfortunately, many people still go untreated due to the stigma. 

While everyone asks, “what’s the point,” from time to time, if you find you lack a sense of purpose or reason for being, talk to a mental health provider. Likewise, if you exist in a constant state of overwhelm or feel divorced from reality, seek care. Newer medications can sometimes get you feeling back to your old self — but only if you avail yourself of treatment. 

Just Because These 8 Different Types of Chronic Illness Are Invisible Doesn’t Mean They’re Less Disabling

Please don’t assume that the healthy-looking 30-year-old at your office asks for “special favors” if they request disability accommodations. The eight different types of chronic illness above may not make you look sick, but they do a number on how you feel.