Chronic pain and many chronic health conditions are often invisible. People may look well, but they could be feeling awful or experiencing intense pain. When they hear the words “You don’t look sick,” it can be upsetting, especially when the phrase is used in a derogatory or judgmental way. Of course, it can also be said as a compliment—and who doesn’t enjoy receiving a compliment?
How to Support Someone Who Has an Invisible Illness
“You Don’t Look Sick” – Why I Like to Hear it (Sometimes)
Who wants to look sick? I certainly don’t. So when someone says, “You don’t look sick” or “You’re looking well,” I’m usually happy to hear it. Maybe someone has seen me looking worse, so at that moment I don’t appear as bad as I do on other days. I definitely don’t want to look the way I feel most days—though sometimes, perhaps I do.
People might use that phrase as a compliment or simply to try to make me feel better. They might think it would be cruel to tell me exactly how I really look. I might feel terrible at times, but I wouldn’t want someone to point it out.
The Phrase Can Be Judgemental
Many years ago, I needed airport assistance. A young woman was driving an electric buggy, transporting disabled passengers to their departure lounges. She looked at me with a puzzled expression and then asked, “Why do you need this? You don’t look sick.”
Why I needed it was really none of her business, but I wasn’t brave—or rude—enough to say so. Part of me wanted to give myself a mental high-five: I was going on holiday and I had rested, prepared and paced myself carefully beforehand. Yet I still felt judged, as though she assumed I shouldn’t need airport assistance.
How to Cope if You Feel Judged
What it Actually Sounds Like to People Who Live With Pain or Chronic Illness
Saying “You don’t look sick” can be hurtful and judgmental, because it sometimes implies that someone is not really ill or in pain. It can cast doubt on their experience, downplay their illness, and even feel like an invasion of privacy.
This is how “You don’t look sick” can be interpreted by people living with pain or a chronic illness:
- “You don’t look sick, so you can’t be — are you making it up?”
- “I want to know what’s wrong with you. Tell me your diagnosis so I can decide if you’re genuine.”
- “Your symptoms can’t be as bad as you say. Are you exaggerating or lying?”
- “It looks as though there’s nothing wrong with you. Why are you taking that medication? Are you addicted?”
- “Nothing seems wrong with you. Are you a benefits cheat? You’re probably fit enough to work.”
- “I think you’re just lazy, enjoying sitting at home watching daytime TV.”
- “You look healthy and don’t have a wheelchair, so why are you using a disabled parking spot?”
- “Nothing appears wrong—should you be using the disabled toilet?”
- “You’re using a wheelchair or mobility scooter. Why? You look fine — you might just be too lazy to walk.”
How to Make it Sound Better
The words themselves aren’t the problem — it’s how they’re used.
If you don’t know the person, don’t say it. Don’t judge people. You don’t know them, and you don’t need to know why they use a disabled toilet or a mobility scooter. If they take medication or claim benefits, that’s between them and their doctors.
If you do know the person, the phrase can work if you clarify that you don’t doubt them. It also shows empathy.
For example, you could say:
- “I know you’re in pain, but you’re looking good today.”
- “You’re dealing with horrible symptoms, but you’re looking well today.”
Even better, simply ask: “How are you feeling? Really, how are you feeling?”
Empathy Makes a Difference
Words can have a bigger impact than we realise. Even well-meaning phrases like “You don’t look sick” can unintentionally hurt or make someone feel judged. Taking a moment to consider your words, show empathy, and ask how someone is really feeling can make all the difference. A little awareness and care go a long way.
Thank you so much for reading.
If this post resonated with you, I’d love to hear your thoughts in the comments.
And feel free to share it with your friends or support groups.
Take care,
Liz.
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Words matter. So Does Kindness
Great post – thank you.
Excellent post! It’s something I deal with frequently. I know some mean well, but others … I am truly invisibly disabled and people can’t see why I need the scooter, etc. But if I don’t, they certainly will see the results.
100% this! When I hear those words as a person with a chronic illness, it makes me feel so much guilt about how I am feeling so often I end up masking how bad it is to comply with their version of how I should be and it’s dangerous. I get home and just flip in pain and exhaustion sometimes. My symptoms might be milder than other people, but when they flare and someone says “but you don’t look sick”, the barriers go up. Such a great post, thank you for highlighting this! Xx
This is such a great post about a comment so many of us have to deal with. I’d like to believe the best in people and I’m sure people mean well when they say it but the majority of the time it makes me feel like I’m being doubted and questioned. There’s also nothing worse than being told the opposite that I don’t look well when I’m having a better day. I love your suggestions of how to reword the phrase to make us feel less guilty. I completely agree that just asking how we’re feeling is the best and kindest way.
Although my disability is predominantly visible, it’s often the things that can’t be seen, such as fatigue and weakness, that I struggle with most. So this is relatable. Sometimes I find the only people that get it are those with illnesses of their own. I often give up trying to make others understand.
I like that you’ve covered the less stigmatising side to “you don’t look sick”. It’s true that it’s not always insulting and judgemental (it just usually is).
I’m sorry for what was said to you at the airport. I had similar going to the disabled toilet at the airport; there were huge queues at the regular toilets and I needed to change my bag before the flight because I was getting anxious about it as I knew the edges were peeling away. I waited outside the toilet while someone was in there and a member of staff came over and said I shouldn’t be there because it’s for the disabled, not everyone can do what they want and come here to save waiting so I should do the right thing and let the lady who’d just come up behind me with a walking stick go next. I was mortified. I have a thing about being told off too, it makes me start to cry, totally unstoppable because it’s like an instinctual reaction 😂 I tried to whisper that I had a stoma bag and suddenly she gets it, tells me to go ahead and looks a bit embarrassed as she walks off. Not as embarrassed as I was though.
I think we can start thinking about what others are thinking about us (if that makes sense) and twist ourselves up in knots over it. Even when there’s nothing to suggest someone is really judging us, we start to feel continually guilty or continually like we have to prove we’re not lazy. It’s an insidious feeling because of how we can be made to feel when our conditions, disabilities and pain are invisible.
I love your alternative suggestion. “Really, how are you feeling?” It’s rare that someone without a condition of their own asks that and actually wants to hear the answer. A little less judgement and more compassion would make the world a brighter place.
Another fantastic post, Liz. I’m sorry I’m late with catching up on reading it but it was worth the wait! It’s horrible knowing others can feel the same, but it’s also reassuring to know we’re not alone. xx