“But You Look Fine”: The Invisible Struggles of Mental Health and 5 Ways to Respond

One of the most frustrating things about living with depression, anxiety, or any mental health disorder is when someone tells you, “But you look fine!” as if a lack of visible symptoms means the struggle isn’t real. This misunderstanding, often well-intended, can feel invalidating. For those of us battling internally, this comment serves as a painful reminder of how mental health struggles can be invisible—masked by a smile, or an outward appearance that doesn’t show the chaos inside.

I once saw a quote that deeply resonated with me:

“I am not faking I am sick. I am faking I am okay.”

This sums up the experience for so many who deal with mental health challenges. We’ve mastered the art of appearing “fine” because society doesn’t always leave room for vulnerability, especially when others can’t see what’s wrong.

However, looking “good” or “okay” doesn’t magically make the depression or anxiety disappear. It doesn’t erase the emotional battles or the mental fatigue. And the fact that people—often our own loved ones—can misunderstand this truth shows just how much more awareness and education are needed.

Responding to Misunderstanding Comments

When someone says “look fine,” or offers similarly dismissive remarks, it can feel difficult to respond. You might feel angry, frustrated, or too exhausted to explain, but responding can be an opportunity to educate. Here are a few ways you might handle these interactions:

1. Acknowledge the Comment, Then Educate
   • Response Example: “I know I might look fine on the outside, but mental health challenges don’t always show physically.
   • Why It Works: This response acknowledges the person’s perception but gently corrects it by reminding them that mental health issues aren’t always visible. It invites further understanding rather than shutting down the conversation.
2. Set a Boundary and Shift the Focus
   • Response Example: “I appreciate your concern, but comments about how I look don’t really reflect what’s happening inside. I’d prefer to talk about how I’m actually feeling rather than how I seem.”
   • Why It Works: This helps establish a boundary that your appearance should not dictate conversations about your mental health. It shifts the focus to where the attention should be—your actual well-being.
3. Use a Metaphor or Analogy
   • Response Example: “Think of it like an iceberg. You’re only seeing what’s on the surface. Most of the struggles are beneath, where you can’t see them.”
   • Why It Works: Metaphors can help people visualize mental health in a way that’s easier to understand. It simplifies complex emotions and can prompt more empathy.
4. Share a Resource
   • Response Example: “It’s hard to explain in a few words, but if you’re interested, I could share an article or video that explains how mental health works. I think it could help you understand what I’m going through better.”
   • Why It Works: Offering an external resource takes some of the pressure off you to explain and provides your loved one with a chance to learn on their own. It also opens the door to future conversations.
5. Emphasize the Impact
   • Response Example: “I know you mean well, but comments like that actually make it harder for me to talk about what’s really going on. I need support and understanding, even if you can’t see what’s wrong.”
   • Why It Works: This response is direct and honest. It helps the person understand that their comments, while not malicious, can have a negative impact on your mental well-being.

Mental health is a journey, often a silent one. The next time someone says you “look fine,” remember that your feelings are valid, regardless of your outward appearance. Use these moments to open a dialogue, educate, and remind others that mental health isn’t always something you can see—but it’s something you can always be compassionate about.

If you or someone you know is in crisis, please reach out to a mental health professional or crisis helpline immediately. There is help available, and you don’t have to navigate this journey alone.

Emergency: Call 911

National Suicide Prevention Lifeline: 800-273-8255

Online Chat: suicidepreventionlifeline.org