Not every pain is an existential threat. Sometimes it's an existential threat, contrastingly, to let your pain distract or stop you. As the Serenity Prayer suggests, it takes "the wisdom to know the difference." And wisdom is not automatically available to everyone at birth in equal amounts. We're born slightly different and develop even more differently. We can and should expect to see some who are wiser than others, or wise in one way, foolish in another. Noticing this in the wilderness of daily living should not surprise us much.
By the time you feel it's important to admit and talk about some pain, whether it's medical or social or anything else, it's usually bothering you or someone you care about enough to make you a little frantic, and not necessarily as rational as you would be otherwise.
The stigma against speaking up and speaking out about what bothers you (especially you yourself: and this is why allies are so important) is therefore not only that 1) humans tend to automatically prefer victim blaming ("you must have done something wrong to bring this on yourself"; this belief allows me to feel more secure, because by the unconscious and rather lazy logic, I'm safe as long as I'm not an idiot making obvious mistakes like this "victim") and 2) the status quo magnetizes brains, distorting or damping out some of their perceptions, making it difficult to see/recognize the causes of others' pain even when we're told point blank and 3) people interpret others' victimhood in the frame of resource fairness, as an imposition on them and an unfair claim for special treatment or even an excuse, but also, crucially, that 4) when you're in pain, you're likely to speak in a way that's charged.
Exaggeration, simplification, cherry picking, magical thinking, emotional reasoning, defense mechanisms, and the whole range of human biases - these are no less likely in someone in pain. (Putting aside limited benefits like "depressive realism," which is the tendency to be in some ways more objective when unhappy - feeling threatened usually triggers our defense mechanisms, which, while they evolved to save us just like pain, are primitive biases and a factory of delusions.) You can expect a person upset to be about as irrational as others, and probably more so. They may be angry, and the anger probably isn't perfectly accurately, precisely, provably, reliably, undeniably, or even fairly directed. There will be some scatter; it may look/feel more like a sawed-off shotgun blast than a sniper bullet. They can also seem selfish or self-absorbed, for the natural reason previously mentioned - pain evolved to tend to collapse us in on ourselves, to focus us on our own problems so we can fix the situation.
Choosing to focus on others instead of your own pain can be a super useful way to deal with it; but the same tactic can also kill you. Expect people not to always know which is right.
The solutions we need most aren't always straightforward or visible at all. Not finding a way to repair in spite of all the pain and focus can exhaust us on every level. Sometimes we need to talk about problems not only for connection or protection, but to find out from others any factors and details and solutions we're missing. There's a conventional wisdom against giving unsolicited advice, but sometimes people fall into exhaustion and hopeless mindsets. Sometimes it might be your responsibility to risk being douchey and give advice where it isn't asked, because the alternative is watching a friend remain hopeless and gradually succumb or self-destruct.
People need to make effort for themselves, but a person who has lost hope may need your help. The risk of not helping them see from another perspective, and notice possible solutions or measures, is greater than the risk of seeming annoying or full of yourself for giving advice. Getting offended by advice is also rather childish; if it's bad advice or the person really isn't listening and is advising simply as a casual brush-off or put down, that's obnoxious. But I find it's important to recognize the good aspects of thoughts and efforts. Any kind of advice may qualify as some kind of attempt to help, and that's a thought that should count for something.
There is a presumptuousness in any person believing they know - or might know - what another person doesn't - ESPECIALLY if that person really needs to know it. A person not knowing something they desperately need to know - something others casually happen to notice - is a vulnerable and possibly pathetic picture. This in no way lowers the value of imparting that information, or trying.
Sometimes the best way to do so is with nuance and balance. Other times we've got to be really punchy. Yet other times we should wait for a good moment. Which is better when is not something anyone is born knowing the first thing about.
Good criticism essentially means "the wisdom to know the difference."
