Imagine your life, exactly as it is, but harder.

I don’t mean anything in particular: I mean everything. Every decision, every action, every moment. All harder.

Picking what to wear? Tortuous. Greeting a colleague or loved one? Embarrassing. Writing a note or typing an email? Challenging. Physical activity of any kind? Soul-crushingly complicated. Simply putting on a normal appearance for the world? Futile.

But here’s the thing: you’re not old or infirm. You haven’t contracted any exotic or deadly diseases. You have your full faculties and you’re free from pain.

You’re you.

But you’re not you.

You have an obstacle in your life. It’s a condition, neither rare nor common. Some people find relief in the few treatments that are available, but there is no cure. It’s called “the silent handicap”, and true to its name few people talk about it.

It’s hyperhidrosis—a multicausal condition whose sufferers sweat excessively, far above and beyond what’s necessary to regulate core body temperature.

I can hear the browser windows closing right now. “Back” buttons are being clicked throughout the internet. Who is this guy? Since when is sweating a debilitating condition?

Now you know why it’s “the silent handicap”. For those who haven’t lived it, the hardship of hyperhidrosis is not obvious and seems almost childishly exaggerated, like we’re all making a mountain out of a molehill. Those of us with this condition don’t ordinarily talk about it for a lot of reasons, and few people “get” it even when we do. That I’m typing this at all seems like an exercise in futility.

Go ahead. Click the “back” button. There are far more accessible issues to empathize with elsewhere. Did you hear about the earthquake in Italy? Hundreds died. Those poor people. I should make a donation to the Red Cross…

What? You’re still here?

How can I ever explain to you what it’s like to sweat? I mean really sweat. You think you understand because you sweat too. It’s just that but more of it, right?

Wrong.

The daily struggle

For those who haven’t lived it, the hardship of hyperhidrosis is not obvious and seems almost childishly exaggerated.

The next time you put pen to paper, imagine your sweaty hand soaking the paper through. Imagine having to turn in that paper to a supervisor or teacher. That’s what it’s like to have palmar hyperhidrosis.

The next time you’re walking around sockless in flip-flops or sandals, imagine having slippery wet feet. You can hardly walk; your shoes are ready to slip right off. Even if you’re just sitting, your feet actually become swollen because there are no socks to wick away the sweat. That’s what it’s like to have plantar hyperhidrosis.

The next time you come home sweaty from the gym, imagine you’re even sweatier than that. Now imagine it’s 10:00am. You never went to the gym at all: this is just another day in the office. A shower and a change of clothes are eight hours away… and you’re still sweating.

Writing on paper; walking around without socks; sitting in a chair in your air conditioned office. Easy, thoughtless activities for the average person, but full of complication for the hyperhidrosis sufferer.

Do you begin to understand?

Look, this is only the surface level of the condition; I’m about to plunge into new depths. It’s remarkable you’ve read this far, but I’m going to let you off the hook: did you catch the 2015 viral videos of pet owners scaring their cats with cucumbers? Before you laugh too much, here’s an article about why you shouldn’t. Big laughs and big concerns. You should spend some time with this topic.

You’re still here, huh?

Alright, here’s the thing: I don’t doubt your ability to understand the practical implications of this condition. Excessive sweating comes with many obvious complications. Perhaps you hadn’t realized quite the extent of it, but hopefully now you do.

However, where the discussion inevitably careens into the almost unknowable is in the psychological effects this condition causes. The true devastation of hyperhidrosis is what you can’t see.

Are you ready to go deeper?

Back to school

This is the most important thing you need to understand: for many, hyperhidrosis starts at puberty if not earlier.

How well do you remember being that age? Kids are earnestly asking themselves important questions for the first time—questions like “who am I?” and “where do I fit in?” Everyone is splintering off into cliques and trying on different personas. There’s an endless grappling with strange new feelings, awkwardness so pervasive it’s impossible to quantify, and all the conflicts of little egos in flux.

When you’re that age, you want more than anything to fit in. You want to be like everyone else. At the very least you want to conform with your clique. If you didn’t have a place somewhere, you were a loner. You all remember the loners from grade school. That was a fate worse than death.

Now take this scenario and add endlessly sweating hands.

Just sit with that for a minute. Open up your imagination.

When my hyperhidrosis kicked into overdrive, I was terrified. My immediate reaction was, “I have to hide this. No one can know.” If you’re thinking “that’s silly” you’ve already forgotten the stage I’ve set. You truly don’t remember how imperative it was at that age to fit in. Ask anyone who grew up with this condition and they’ll probably tell you the same story. It’s the natural reaction of a scared child in these circumstances.

Now imagine, if you can, the psychological ramifications of trying to hide something like this.

At a time when some of my friends were getting into short-lived relationships, I never even fathomed it. Holding a girl’s hand? Impossible. She’d know my secret and she’d tell everyone. All the girls would laugh at me. My friends would be too embarrassed to be seen with me. I’d end up sitting next to that other loner kid at lunch, not even looking at each other let alone speaking. Forever an outcast.

I didn’t touch anyone if I could avoid it. I wore oversized clothes with long sleeves that I could hide my hands in. I lived in abject terror of gym class; physical activity made my condition far worse.

These are the most formative years of a person’s life and I lived them in fear. I lived them denying myself the one thing I wanted more than anything: intimacy.

Touch. It’s such a small thing, but is there anything more powerful? The language of touch speaks louder than words ever could. It fulfills an emotional need that’s impossible to overstate.

When my hyperhidrosis kicked into overdrive, I was terrified. My immediate reaction was, “I have to hide this. No one can know.”

Hyperhidrosis would not be easy for anyone, but adults can call upon their communication skills and some form of genuine self-confidence when they’re faced with difficulties. Adults know how to ask for help; adults can overcome their fears. Children are still learning these things, and hyperhidrosis hijacks that development at such a critical junction.

That’s the tragedy of this condition: the developmental handicap hyperhidrosis causes in adolescence simply continues into adulthood. It’s a deep, dark hole that’s very hard to climb out of.

Do you understand how much worse all of this is than the actual sweating? Who would ever know, simply looking at a hyperhidrosis sufferer, what was truly happening on the inside?

I still vividly remember an appointment I had with a dermatologist at a very young age. He was as bald as a cue ball and tried comparing my excessive sweating to his baldness. “It’s just one of those things you learn to live with, young man!”

This doctor was part of the medical establishment that was supposed to help me, and he was clueless. He didn’t have hyperhidrosis and he didn’t understand. He tried—with the mind of an adult—to empathize with me, but what can an adult possibly know about dealing with hyperhidrosis as a kid?

Few people “get” it because few people examine the circumstances in which this condition ordinarily begins: adolescence. Hyperhidrosis is a condition that, among other things, causes psychological and developmental impairments in kids—impairments that roll right into adulthood.

Imagine your life, exactly as it is, but harder.

And no one knows.

They see the sweating, yes. But they don’t really know.

That is “the silent handicap” of hyperhidrosis.