Some people no longer ask for help; they prefer to die in silence rather than seek help. Some of these people might have been humiliated, abused, or suffered rejection while seeking help. Those who are privileged to be blessed sometimes believe they shouldn't give out alms without gaining something in return—it can be as menial as reverence, or more. Once someone who is privileged feels as if their conditions are not met, they make the one asking feel worse than they were before meeting them. Such people rarely seek help again from anyone, no matter how much they're suffering.
A woman was once humiliated by her friend who helped her while she was in need. No one knew the woman's story until they quarreled that day. The friend started to mention all she had done for the woman, how she was the reason behind the woman's survival, and how she had picked her up from the gutter to clean her up—else she never would have been in her current position. The quarrel started when the friend was confronted with what she believed was disrespect, and the only way to defend her ego was to pour out what she believed was the other woman's ugly past.
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I believe the other woman was hurt and embarrassed, and perhaps regretted having received help from the person she called a friend. The friend might have said that out of anger, but the damage was already done, and she may never accept or ask for help from that friend again. Like this woman, so many people have suffered humiliation because they asked; this memory never goes away. It remains for years and haunts them each time they feel like asking. While trying to protect one's peace and self from unknown disgrace, many people refrain from asking.
Finally, some people grew up being a provider. They've never experienced dependency, and this becomes programmed in them. They don't ask; they may prefer to die in silence because they've programmed themselves to be the provider and giver rather than the receiver. I have seen a few people like that who never ask because of this programmed mindset. Unlike the people mentioned above, this kind may later start to ask on a few occasions if they meet people who genuinely show them that they need others as much as others need them.