A great deal of mental health advice out there encourages people who are suffering to ask for help. This fails to recognise all of the things depression and anxiety do that make it difficult to ask for help. Here are some lists, I doubt I've covered everything.
Anxiety makes you feel like you're making a fuss and there's no reason for anyone to take you seriously. You are afraid that people may be annoyed with you, or react in other ways that make things worse. You think it may be obvious to them that this is all your fault and you are desperately afraid that everything happening is both entirely your fault and wholly your responsibility. You are afraid people will hate you and push you away. You are afraid you will hurt and harm people who already have more than enough problems of their own, you are afraid you are being unreasonable.
Depression tells you that you don't deserve help. You don't deserve love, or care, or support or kindness. Everything going wrong for you is going wrong because it is exactly what you deserve, so why should anyone want to help you fix that? They almost certainly have much more important things that they need to be doing instead. Other people are in far more trouble than you and are far more deserving of help. Other problems are far more serious than your problems. Depression will have you believing the people who tell you that you should just snap out of it, try harder, stop the self pity. Depression will persuade you that it really is all your fault for not trying harder and that it would be totally reasonable if everyone hated you for your failures.
Asking for help is easier if you don't have a history of being bullied or abused. Ask for help in those circumstances and you're putting weapons into the hands of the people who mean you harm. It's also easier to ask for help if you don't have a history of being ignored, shamed, or humiliated, if you haven't had your issues minimised, and if you've not been told off and emotionally punished for making a fuss.
Thankfully we're starting to establish that mental illness isn't primarily a chemical imbalance issue. Mental illness is a consequence of trauma, stress, and abuse. It's the fallout from gaslighting, poverty, insecurity and living in fear. The help that most people need is the help that deals with these issues and the legacies they leave. It's also hard to ask for help when you know from experience that all you will be offered to deal with your gaping wound is a packet of sticking plasters.
If you can manage it, don't wait for people to ask you for help. Offer it. Making helping people part of how you go through a day. A little kindness, patience and generosity can make a lot of odds, especially when no one has asked you to do that for them.
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