We, as humans, have a sensitive side and a tougher wall surrounding it. When our wall has already been damaged, it no longer protects our sensitive side and words hurt more than they should. There are cases where the outer wall is already practically non-existent and the sensitive side is completely exposed. This is when you need to be careful. The smallest things can set them off and make them think about some ways that aren't true. Here are some examples...
Person 1: *playing their ukulele*
Person 2: Stop that. It's really annoying.
Person 2: *puts ukulele away and doesn't play for weeks because they're afraid of being annoying*
Mom: *texting daughter* Please don't get your hopes up. You'll just be another burden she has to deal with.
Daughter: *spends every waking moment believing that they are a burden to other people*
I can list so many other hurtful things that people have said without thinking about how it might affect the other person
"You're such a lazy ass."
"Where's your thigh gap?"
The bottom line is watch what you say because other people hear.