Some people with disability aren’t exactly visible. They don’t require a wheelchair, a hearing aid or any other piece of equipment that helps us know to give up our seats on the subway or not shake our heads when we see a seemingly able-bodied person park their car in a handicap parking spot

1. Their experience is largely unrepresented.

Ableism is hardly a mainstream hot topic of conversation, but even when disabilities are generally discussed, invisible disabilities are often ignored.Alex Sanders, a 26-year-old with scoliosis, told Mic that while celebrities like Demi Lovato are raising awareness around mental health, “things like scoliosis or chronic pain, I don’t think those are talked about at all in a really meaningful way.”

2. Their experience is frequently questioned by those who don’t get it.

Without being made aware of invisible disabilities, many people then tend to write non-visible disabilities off. Yet these issues can be debilitating for those who experience them. For example, even after surgery, scoliosis led to immense pain for Sanders.“I was in severe pain for about four years,” she said. “It totally impacted my life.

3. It can be socially and professionally challenging.

Sanders’ biggest source of anxiety while living with scoliosis — even in the midst of chronic pain and re-learning to walk — was that some friends and coworkers interpreted her disability as laziness and failed to understand the extent to which her disability debilitated her.“We live in a world of hyperbole where people say, ‘I’m literally dying’ all the time,” she said.

4. Some downplay their experiences to avoid awkward social situations.

Both Sanders and Adams described downplaying their experiences to manage others’ judgment of them.“I would never break down and cry in the middle of work, because that’s just not what you do,” Sanders said. “And the people with chronic pain I know, that’s not what they do.

5. Dealing with these disabilities can be enormously expensive.

In addition to social struggles, invisible disabilities are costly to deal with. While the Affordable Care Act requires health insurers to provide coverage to those with pre-existing health conditions, people with disabilities still have to shoulder costs associated with their conditions.

6. For some, the experience can be empowering.

Because many individuals with disabilities can “pass” as able-bodied, some with invisible disabilities have said their experiences are not “bad enough” to qualify them as disabled and feel isolated from potential support systems and communities.

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