Bad news: Your friend just told you they have a chronic illness. It’s going to be a long road ahead for them and they are in pain.
You’re sad, and you don’t know what to say. Maybe something optimistic, like “Just stay positive!” Or maybe you should offer a solution, like “Have you tried going gluten-free?”
While there’s no right thing to say in a situation like this, fight the instinct to jump to either of those responses. Try starting with “Wow, that sucks” and let your friend lead the conversation from there.
The most important thing isn’t what you say in the moments after you find out. It’s how you act in the weeks, months and years ahead. If you’re not mindful, chronic illness can wedge itself into your relationships and cause friends to drift apart.
While I’ve had supportive family and friends through my own ordeal with chronic illness, there was a period when I was living by myself, in a lot of pain, mentally out of it and going four or five days at a stretch without getting out of bed.
When I didn’t see any people, the isolation really got to me.
As Knox College psychology professor Frank McAndrew wrote for Psychology Today, “when we go through a trying ordeal alone, a lack of emotional support and friendship can increase our anxiety and hinder our coping ability.”
Erica Lupinacci, who has lupus and co-founded invisible illness advocacy nonprofit Suffering the Silence, found that the start of her illness was an incredibly confusing time, for her and the people who loved her.
“When I first got sick, I felt isolated because I had to miss so much school, I didn’t know what was going on with me and had no answers at all,” she said.
“Some of my friends were confused because one day I could be fine and the next I could not leave my bed. I was still learning what it meant to be chronically ill so I had trouble articulating my experience and helping them understand.”
If illness is something that makes you uncomfortable, I hope it encourages you to know that your continued friendship is so important. It might seem overwhelming now, but it isn’t actually that hard to stay close.
In the last seven years of dealing with my own illnesses, including chronic Lyme disease and dysautonomia, I’ve found that I appreciate even the smallest efforts. Here are some best practices for staying close with your chronically ill friends.
Stay in virtual contact with your friend. It is as easy as a text, DM or email every once in awhile.
Maybe send them a picture of your cute pet. Interact with them on social media, which they probably find themselves on way more than they would like. Share with them some recommendations for television shows, movies, books, articles or podcasts (they might have a lot more free time or need some distractions).
It doesn’t have to be deep. Just like you can use little pick-me-ups, they can too, even more so.
[Related: Can You Have Love and a Chronic Illness?]
Stay in actual contact with them, too. Try to schedule some one-on-one time. You’ll probably have to work with them on a time when they have the energy to see you, but they will surely appreciate the human interaction.
If they can’t get out of bed, go see them or suggest a Skype session.
Ask them how they’re doing and listen to what they say.
“I really appreciate when my friends ask questions about lupus, how it affects me, what it feels like, et cetera,” Lupinacci said. “It makes me feel like they truly want to understand as much as they can and are taking the time to listen and learn.”
So let your friend vent, and reciprocate when they ask how you are. Don’t forget that friendship is a two-way street.
If conversation isn’t in the mix due to it being a really bad day for them, be a willing couch potato alongside them.
Just because they’re not always feeling great doesn’t mean they don’t want to be included in big plans.
Are you having a party? Invite them. Going to a concert they would also like? Invite them. A movie that you want to see? Invite them. There are going to be instances of them having to decline the offer or cancel last minute, but I promise you it’s not personal. As frustrating as it is for you, it is definitely worse for them.
What is worse than not being to do things is not being invited; you can’t go to things you don’t know about. And you should trust them to know themselves. They probably have good days better at predicting. Or they may be willing to push through the pain so they can do the fun thing, even though they know they’ll be paying for it for days.
Make a point to check in with your chronically ill friends over the holidays. When people are the busiest it is those living on the periphery that are forgotten. Your friend could be feeling this.
Those little “Happy Thanksgiving!” texts or a short phone call during the winter holiday season could mean everything to them.
In the years I’ve been sick, I have had a handful of friends drop out of my life, and ones who pop up maybe once a year, so I’m aware it isn’t always easy to stay close.
As with any relationship, it takes some work. Just know it’s hard for your ill friend, too. They’ve lost some control over their life and don’t feel like other people their age, which only exacerbates their isolation.
Having your friendship can drastically improve their quality of life.
“Every person has something that they are going through, and just because illness can be easily pinpointed, that doesn’t mean your friend deserves anything less than anyone else,” Lupinacci said. “Though you may have to change plans last minute or hang at home more, your friend is still your friend.”
Bradley Jamison is a freelance writer from Northern Virginia. She lives with multiple autoimmune illnesses as well as Lyme disease, which often inspires her writing. For now, she considers herself a cat wrangler, chronic illness advocate, makeup addict and a total geek. She has had writing featured in Vice, Glamour and Guideposts. You can follow her on Twitter @bgjamison or Instagram @beautybradley.