As I got off the subway, I looked up at the taunting cement steps as people whisked by me without a moment’s hesitation. I waited until the majority of the people left to make my slow ascent up the endless stairway. Tears formed as I continued to make my way up, step-by-step. People would pass me and some would make judging glances; they probably assume I’m lazy or unfit.

It’s moments like these when I become incredibly frustrated with my life. I’m 20 years old and have as much difficulty as an 80-year-old lady with arthritis. It’s been two years since my chronic hip pain began and it hasn’t gotten easier, especially with stairs. As difficult as it is, I’m thankful to have understanding friends who help me when needed, yet many chronic pain sufferers hide in the shadows, going unnoticed by others, even by people who know them.

Chronic pain is something that’s invisible unless the person uses a wheelchair or wears a brace. It’s less visible for young people because you wouldn’t expect them to be handicapped. In fact, there aren’t many statistics on how many 18-25 year olds suffer from chronic pain because a lot of the time they go ignored, mistreated or undiagnosed. Having consistent pain every day can drastically alter someone’s life, yet these young people are still expected to go to college, keep up with work, and basically live a “normal” college life. But it is far from normal.

Pain is something everyone is familiar with. We feel pain if we accidentally touch a hot stove, cut our finger while cooking, bang a knee against the table and so on. The thing about acute pain, which is a sensation set off in the nervous system to tell you to stop doing whatever it is you are doing, is it doesn’t last very long. Eventually, the pain goes away, and you can continue on with your life. Even if you sprain a joint, break a bone or have a major surgery, most of the time the pain you experience will end with time.

With chronic pain, it’s a whole other situation. The pain never goes away. The very word itself, chronic, refers to something that is recurring, and sometimes for sufferers, it can mean for the rest of their lives. This is because, generally, when you suffer from something that is chronic—or, in other words, something you go through on a daily basis—you are able to manage it well enough to hide your pain from others. No one likes to see other people suffering, hence why sufferers feel the need to hide what they are going through.

There are many different causes of chronic pain, but it varies between patients and the root of the cause isn’t always clear. The deputy director of the National Center for Complementary and Alternative Medicine, Dr. John Killen, stated, “It’s a complex problem that involves more than just the physical aspects of where the hurt seems to be.” If you don’t know the cause, you can’t solve the problem. Most sufferers don’t just wake up one day with pain; it happens gradually over time until it becomes clear that it is here to stay. Most chronic pain sufferers deal with more than one area of pain where their nervous system constantly keeps firing pain signals.

According to the National Institute of Health, chronic pain is the leading cause of disability, affecting more people than heart disease, diabetes and cancer combined, and yet it’s a condition that not many people are aware of. In fact, more than 115 million people in the United States suffer from chronic pain—and that doesn’t even account for all the undocumented cases, many of which are probably young adults.

Having chronic pain in college can be a great struggle and prevent you from having a normal college experience. Dana Marvin, a 21-year-old State University of New York student, who suffers from a variety of diseases/illnesses, described her struggle. “I think the biggest thing for me is pushing myself harder than I’d like to because of my pain in order to do everything that I want to do. Yet I still miss out on so much.” Imagine writing all those papers, participating in classes, pulling all-nighters to study, balancing your internship or job with your schedule, all while experiencing pain 24/7. Life with chronic pain can be very unpredictable, as the pain varies from day to day. Just because someone was able to do something yesterday doesn’t mean they’ll be able to do it today.

College is stressful enough without having to deal with doctor appointments, physical therapy, prescriptions, surgeries, procedures and more. Chronic pain can also come with side effects such as depression, stress, anxiety, weight loss or gain, fatigue, lack of focus and other mental problems, making it hard to keep up with the fast pace of college life. Devin Edwards, a 19-year-old student at Stark State University, who was diagnosed with Fibromyalgia, a disorder characterized by widespread pain accompanied by fatigue, sleep, memory and mood issues, this year, wishes people would realize that “I’m always in pain in some way, shape or form. No matter how much I sleep or live healthy, I hurt.” Young people with chronic pain often feel alone, misunderstood, and don’t know how to express themselves. Dana Marvin like many others, tends to keep her conditions to herself. “I’ve learned that people really could care less about my illness, and it actually scares a lot of people away.” Most of these people look relatively normal on the outside, but when others ignore you because “you don’t look sick,” it can be a toll on your mental health as well.

That is why chronic pain often goes hand in hand with depression. Michael Clark, a psychiatrist at Johns Hopkins Hospital, states “Approximately one-third to three-quarters of people with chronic pain experience moderate to severe depression, [possibly because] depression and chronic pain share some of the same neurotransmitters and nerve pathways.” You mourn the way you used to be, and feel so helpless over the lack of control you have over your body. Since you can’t see pain, it can be hard convincing others that it’s there. Unless there’s a particular cause, doctors have to rely solely on the patient’s testimony, and then there’s only so much they can do. That’s why a lot of times doctors just hope it resolves on its own.

It’s a common assumption that young people are active, strong and basically invincible, but that’s a view that needs to change. Marvin phrased it well when she said “Chronic pain and chronic illnesses don’t discriminate based on age, race, gender or anything like that, really.” It’s time for us to stop ignoring young people’s cries of pain. Sufferers don’t want you to feel bad for them, they don’t want your sympathy, they just want you to believe them and understand what they are going through. Devin Edwards speaks for chronic pain sufferers everywhere when she says “People claim that this illness is fake and that people use it as an excuse to live for free in life, and to those naysayers I say try to live one day in the hell that is my body.”