This one hits where it feels. I haven’t gone after disability support myself (Bipolar 2 / Bipolar NOS), but I am very good at invalidating my own problems to myself — and once I’ve done that, to question why I take up time and resources from mental health professionals.
Because, really, I do have a PhD. A viable academic career. A loving wife. And I don’t break much in public. My wife gets all of it, and the last hour before sleeping is when most of my mood crashes come — but I have an education and a career, so clearly I don’t have that much of a problem.
Only, just as you point out, and autistic autism advocates do over and over again, these things are spectra, not discrete states. You don’t have cleanly separated “high-functioning” and “low-functioning”. You don’t magically get quality of life without support just because you are able to keep it together enough to keep a job.
I think, I hope, I’ve gotten past this particular mind-trap enough that I won’t drop out of treatment again — I don’t think my wife will let me, for that matter — but it’s one that kept me suffering for a decade because clearly I only had it kinda bad, not bad enough to ask for help.