There was a time in my life when I wouldn't ask for help. In fact, I wouldn't dare let you know I needed help. If you'd asked how I was doing, I'd dodge the subject and instead divert the attention back to you... all the while frustrated that no one seemed to care about me!
To someone who doesn't experience anxiety or live in chronic worry and internal pressure this may sound silly; even crazy. But for those of us who do, this is our existence.