Honestly, that is a good list of the internal struggles, though everything she had said to which you were replying were external pressures. I agree wholeheartedly with your list, but I feel we need to also represent the externalities we face as well.

I can only speak for myself and from a neurodivergent US perspective. I see a society which still applies enormous pressure on men to be the "provider" in a system which as made being a sole provider nearly impossible. A society which ties our worth and value as a human being to what we can provide, primarily, for employers, then secondarily to loved ones. We are expected to sacrifice our health, both mental and physical, to work in often abusive or untenable positions from which we see no escape becacusr to escape is to fail our family. We are told continuously that our only purpose in existence is to sacrifice, and if we try to take some space for ourselves when WE need it, we are selfish, inconvenient, or heartless and abusive.

To expand on HowManyNimons point about making friends and finding a partner, we are still expected, on the whole, to be the instigators of romantic relationships. To place ourselves in the position of being vulnerable, then rejected, sometimes with damaging savagery, repeatedly for a good chunk of our adolescent and post-adolescent years. As to the friendship relationships, as we get older and our focus is mandated by society to be focused on ever increasing sacrifice, we see the potential pools of friendships shrink. We are so stressed from work, money, and family that the idea of having to put in extra effort for finding and developing new friendships just feels Sisyphean. We end up in a negative feedback loop of social isolation which leads to even further mental dysfunction.

Again, this is my self assessment and social observation. I suffer all of this, and more, daily. My family is very worried about me because it has gotten so bad for me that it is like I have forgotten what happiness and contentment feel like.