Invisible struggles: a mother’s story of raising a child with DHPR deficiency and the importance of mental health support

Abstract Children living with rare diseases often experience profound medical and emotional challenges that affect not only their well-being but also that of their families. This case report presents the illness narrative of a five-year-old boy with Dihydropteridine Reductase (DHPR) deficiency, a rare genetic disorder that disrupts neurotransmitter production and leads to significant neurological and developmental difficulties. Told from the perspective of the child's mother, the report captures the emotional, psychological, and systemic struggles encountered across diagnostic, treatment, and caregiving stages. Special attention is given to the mental health toll on caregivers, highlighting themes of isolation, anxiety, and advocacy fatigue, and discusses evidence-based strategies for support, including cognitive-behavioral interventions and caregiver resilience models. The report aims to raise awareness of both clinical and psychosocial needs in rare disease management, offering insights for healthcare providers and policy advocates alike.