Some people are good at making others believe they are fine even when they are not. They go to work, look after their families, meet their responsibilities and rarely complain. Yet behind that routine, they may be struggling in ways nobody knows.
We usually notice distress only when something changes drastically, like a person withdrawing from things they once enjoyed. But what about those who keep doing everything expected of them, even as it grows harder?
We need to pay more attention to them. We judge people by what they accomplish and rarely ask how they feel while doing it. This World Mental Health Day, we should look beyond appearances.
Pressures we rarely talk about
Emotional difficulties often arise within ordinary life. Young people face pressure to succeed and become independent. Older adults juggle demanding jobs, finances, children and ageing parents, and many hesitate to admit exhaustion because everyone depends on them.
Senior citizens may feel less needed after retirement or lonely after bereavement, yet their sadness is often dismissed as a natural part of ageing.
People respond to such situations differently. Neither coping well nor needing more support makes someone stronger or weaker, and we should not decide how much another person ought to handle simply because their problems seem ordinary to us.
Why listening matters
When someone says they are worried or unhappy, we rush to reassure them: “Don’t think too much”, “Everything will be fine”, “You have so much to be thankful for”.... We mean well, but such words can make people feel dismissed.
A person with anxiety may not know why they feel terrible. Someone with depression may struggle to explain why simple tasks have become exhausting.
Often, advice is not what they need first. They need someone to listen. Asking “What has been troubling you?” tells a person their feelings matter, even if we do not fully understand them.
However, privacy matters. Nobody should feel pressured to share more than they wish.
Looking beyond diagnosis
A diagnosis cannot tell us everything about a patient’s experience. Two people may seek help for anxiety, one worried about a health condition, the other under pressure at work. Their symptoms may be similar, but their circumstances and needs differ.
Good care requires proper assessment and treatment, but it also depends on trust. Many people hesitate to seek help because they fear judgement, or worry about confidentiality and stigma. Accessible care means ensuring people feel safe and respected when they ask for it.
Awareness begins internally
We hear more discussions about mental health today. But awareness means little if it does not change how we treat one another.
We may tell a family member to stop worrying, or question why someone needs treatment when their life appears comfortable. At work, we assume a ‘high performer’ cannot be struggling.
At home, we overlook the person who has always been strong for everyone else. Calling someone weak, overly sensitive or attention-seeking can discourage them from asking for help.
Listening and family support matter, but they cannot replace professional treatment.
Persistent sadness, overwhelming anxiety, significant changes in sleep or behaviour, or difficulties that interfere with daily life deserve professional attention. This deserves the same understanding we offer someone undergoing treatment for a physical illness.
Behind the smiles
We often know who is doing well at work, who manages the household and who is always available. We may not know who lies awake worrying, who feels lonely in a crowded home or who struggles under the weight of expectations.
Not every quiet person is depressed, and not everyone who smiles is hiding sadness. We should not make assumptions, but we can be more thoughtful in how we respond.
For doctors, this means remembering that every patient has a life beyond their symptoms. For loved ones, it means listening without rushing to judgement or advice.
Understanding another person’s struggles does not require having experienced them. It requires patience, respect and a willingness to listen.
Perhaps real change begins not in how often we talk about mental health, but in how we respond when someone finally tells us they are not okay.
The writer is the founder and chief consultant at Dr Beema Healthcare and Child Development Centre, Kochi.