There has been a lot of talk about mental health over the past week, most prominently around Simone Biles choosing to prioritize her mental health over competing in most of her scheduled events at the Olympic games.

There are many people on the internet/in the media championing her and many people disparaging her. The positive side is that many people are calling her brave, strong, and an icon. Much of the negative commentary tends to focus on her “just not wanting to lose,” “not being mentally tough enough,” and “using mental health as a crutch.”

Sadly, this is a theme we see often; the theme of assuming the motives of women and implying some selfish gain. It is not that dissimilar from people saying things like, “isn’t it a convenient time to come out about sexual assault allegations after all this time,” “why didn’t she say something before,” and “she is using this as an excuse to get money and ruin someone’s life.” One thing is clear, it’s hard for many people to believe women at their word.

It’s hard to imagine how extremely difficult this decision must have been to make, especially knowing that people are going to doubt you and trash you when you’re already likely at your lowest. This is the same reason it is so difficult for abuse survivors to say anything. Not only are you struggling in an immense way, but now you have to brace for the unsolicited criticism of the masses. Insult on top of injury.

I have seen this challenge time and time again in my work with patients who have needed to set boundaries at work for their mental health or have been brave enough to take FMLA for mental health reasons. I have always been moved by the people who are willing to admit they need to “take a break.” I am ashamed to admit that even as a mental health professional, I would be terrified to ask for time off for my mental health. The stigma that exists around this is deeply entrenched. Trying to put myself in the shoes of some of my patients who have set boundaries or taken leave, I hear loud and clear the voice in my head that would say, “you clearly can’t handle life like normal people,” “people will think you just want to get paid to not work,” “you’ll never be treated normal again,” “you’re a weak person and a failure,” etc. It’s no wonder many people don’t set boundaries or take leave.

What is particularly interesting is the outrage and confusion at Simone Biles’ timing. People are upset she wouldn’t just “push herself a few more nights”, “pull it together for her team and the entire USA for a couple more days”, or “just dig deep and find that mental toughness.” But this is how mental health burnout works. It is not uncommon for people to realize just how bad things are right at the exact time that the stage and the scale seem more important than they have ever been.

Sometimes it’s those moments that illuminate how much a person has been giving to stay afloat, and how little they have left, both physically and emotionally. It’s also the hardest time to walk away, to take that space, knowing that people will be confused and possibly judgmental. Often people keep trying to push through and find themselves struggling even more, and then experiencing long-term suffering and seeing a negative ripple effect throughout other aspects of their lives.

Simone’s decision to set a boundary, take time away, and put herself first was an example we can all live by. “I have to put my pride aside,” she said in media reports.” I have to do what’s right for me and focus on my mental health and not jeopardize my health and well-being. That’s why I decided to take a step back”. Can you say or do the same?

Thea Gallagher is a clinical psychologist in Philadelphia and is the co-host of a podcast about Mental Health, Mind In View.