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At a Grand Rapids concert on Monday, singer Kehlani reportedly broke down on stage in tears and had to stop her performance. “I truly feel like I might have to go to the hospital at this point because I feel crazy,” she told the crowd, later offering refunds for the show. “I’m so sorry, but I came up here and I promised my team that I would try.”

Kehlani’s hospitalization last year after a suicide attempt was highly publicized, and the press cycle for her bubbly debut album SweetSexySavage often focused on her mental health struggles. After the show Kehlani responded in a now-deleted Instagram post clarifying that the incident was due to exhaustion from touring rather than a “mental breakdown.”

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“Physically I need a lot of rest and I’m resting up all day today to finish my tour,” she said in a now deleted Instagram video, clarifying that she is “mentally fantastic.” In the video she also called out media outlets who incorrectly reported she had suffered “a mental breakdown” and wrote that people should “speak only what they know” in the caption. A representative from Atlantic Records confirmed to Jezebel that Kehlani is “doing well.”

The toll that touring can take on the mental and physical health of musicians has recently become a lot more transparent as high-profile pop stars open up about the tiring cycle of being a performer. Kanye West and Selena Gomez were both hospitalized last year and Justin Bieber frankly told fans that photo-ops with fans were exhausting him, saying it made him feel like “a zoo animal.” A study commissioned last year by the organization Help Musicians UK titled “Can Music Make You Sick?” found that out of 2,211 self-identified musicians, 68.5% of them experience depression, 71.and 54.8% of that same sample say it is hard for them to get help.

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This February marked a decade since Britney Spears shaved her head, a moment that was initially interpreted as an extension of her party-girl antics and “acting out,” as one psychoanalyst interviewed back in 2007 put it. Now we know that Britney’s episode wasn’t some wacky stunt but something far more complicated, including anxiety and a tumultuous relationship with her ex-manager. And in the 10 years since, artists and those studying the mental health of performers have made it clear that being a pop star, despite the money and fame, isn’t nearly as glamorous as people think it is. For artists like Kehlani, checking out in the middle of a show due to exhaustion is more than warranted and accepted.