Being diagnosed with a chronic illness—a long-term condition that in most cases has no cure—can upend a person’s entire world. Someone who just found out they have a chronic illness is often simultaneously grappling with symptoms, starting treatment, implementing lifestyle changes, and coping with the enormous emotional impact of their new reality.
If you have a friend who was recently diagnosed with a chronic condition (or would like to better support a friend already managing one), you may not know what to say or do. You might even be wondering if there’s anything you can say or do that will really help. The good news is that there absolutely is: Being a supportive presence in your friend’s life can actually influence how well they can manage their illness both mentally and physically.
“Social support plays a critical role in coping with the condition,” Amy Walters, Ph.D., a psychologist and director of behavioral health services at St. Luke’s Humphreys Diabetes Center, tells SELF. It may even help them have a more positive health outcome. “People who have strong social support networks tend to do better long-term,” says Walters, who also consults and trains health providers about the psychosocial factors of chronic disease management.
Research bears this out, licensed independent social worker Deborah Miller, Ph.D., who works at Cleveland Clinic’s Mellen Center for Multiple Sclerosis to help families adjust to an MS diagnosis, tells SELF. “There’s an increasing body of evidence that social support and other aspects of social wellbeing are almost as important in how a person manages their disease as other aspects of their medical care,” Miller says. For instance, a 2011 review of 61 papers in Chronic Illness found that social networks including friends and family affect how someone handles having a chronic illness over the long-term. It makes sense, when you think about the fact that friends can help a person with a chronic illness shape how they view their condition and how they change their lives to manage it.
It’s clear, then, that your support as a friend can be valuable here. So, how do you show up for a person you love during this tough time? If you want to be a good friend but aren’t really sure how, here are nine expert recommendations.
1. If you hear about your friend’s diagnosis through the grapevine, let them take the lead on telling you.
Let’s say an acquaintance mentions that a friend of yours just received a type 2 diabetes diagnosis. Resist the urge to immediately shower your friend with attention. Right now, they may be overwhelmed by a flood of lifestyle changes and medical treatments, or still emotionally processing their diagnosis and not ready to share it more broadly than they have already.
“It’s really important that the person with the disease sort of owns that information,” Miller says. “Who they choose to disclose it to is sometimes the only sense of control that they have during that time.”
2. When you do first talk to your friend about their condition, keep your message general and simple.
You may feel like based on their condition, the situation, and your friendship, it makes more sense for you to take that initial step and bring up their condition. You know best, but Miller recommends not naming the condition or otherwise being super specific, since your friend isn’t the one sharing the news. “Give them the opportunity to decide how much they want to reveal,” she says, adding that you can say something like, “I ran into [this person] and they said you’re having some health problems. If you want to talk about it or there’s anything I can do, please let me know.” This way, you’re letting them know you are concerned without being presumptive or intrusive.
If your friend tells you about their diagnosis directly (or, say, shares the news on Facebook), it’s clearly something they’re comfortable with you knowing, so you can feel free to mention it. If you’re not sure what to say, keep it simple and open-ended. Walters suggests something like, “Being diagnosed with [their condition] must be overwhelming. Do you want to talk about it?” or “You’ve been through a lot lately, how are you doing?” Do your best not to assume how they’re feeling about the actual condition, though. Saying something like, “I’ve read about lupus; it sounds so awful” might just make them feel more upset.
3. Study up on the condition so you can make your friend’s life easier through your actions.
You don’t need to become an expert, but knowing the basics of your friend’s condition can help you better understand what life is like for them, Miller says. With that in mind, Walters suggests asking yourself, “What are the small adjustments I might be able to make to really help my friend cope more effectively with this condition?”
For example, if your friend’s condition comes with dietary restrictions, read up on which foods and ingredients they need to stay away from. That way you can suggest restaurants with options for them next time you grab dinner together and stock up on safe snacks for when they’re around. “Those little conscientious gestures can make a huge difference,” Walters says. (Of course, it never hurts to double-check with your friend if you’re unsure about their restrictions or the decisions you’re making, but try to do most of the research on your own so they’re not having to educate you.)
Megan N., 27, who was diagnosed with celiac disease at 17, was stressed about staying gluten-free in college. But her friends made an effort to learn about the condition so that they could look out for her. Megan remembers a house party where the only thing on tap was beer (which is typically brewed using gluten-containing barley or wheat). “Before I could do anything, I [turned] around and my friend [was] chatting with the host of the party to get me access to the secret stash of liquor,” she says. And these days, she always appreciates when friends ask about gluten-free items at restaurants so she doesn’t feel like she’s being a hassle.
4. Ask your friend what they need or the best way to help them instead of assuming.
You can go ahead and make small lifestyle adjustments that are instinctive and that you know your friend would appreciate if they knew about it, like making sure a concert venue is fully accessible before surprising a friend who uses a wheelchair with tickets to an upcoming show.
Beyond that, the surest way to be there for your friend in the most helpful way possible is to ask them how, Walters says, with questions like, What do you need? What would be helpful? Is there something that I can do? It could be a practical favor, like picking up their kid from school, bringing over dinner, or walking the dog when they’re not up to it. Perhaps they’d just appreciate your company.
Of course, your friend might not feel comfortable saying exactly what they need, or they may be unsure of whether you’re just offering help to be nice. If you think that’s the case, ask what they need while also suggesting specifics so they know you mean it, like, “How are you eating? I’m meal-prepping a huge batch of chili this weekend and would love to bring some over if you’re low on food.”
The biggest benefit to this approach is that you’ll actually be helping your friend in the way they need most. That said, always remember that assuming someone needs a certain kind of help when they might not runs the risk of offending or infantilizing them, Miller says. As an example, she cites always rushing to get the door for a friend with multiple sclerosis who’s perfectly capable of doing it themselves. This kind of well-intentioned but unsolicited act may make someone feel helpless or embarrass them by making them feel different.
5. When your friend brings up their problems, practice the art of active listening instead of immediately offering advice.
We tend to underestimate the power of being present. “Being heard is very healing,” Walters says. But in her experience, people often feel like they need to save the day when a loved one is talking about their health struggles. She recommends keeping your advice to yourself unless your friend asks for it. Unfortunately, the issue your friend is having may be one without a solution if it’s something like a life change to meet the new demands of their condition.
That’s why you should view yourself primarily as a sounding board, not a problem-solver. “Listen with empathy, reflect back what [you’re] hearing in a nonjudgmental way, show interest by asking questions, and show your support by just being really present,” Walters says.
Megan, for instance, appreciated having an outlet to vent about what a pain it was to adopt such a strict new diet to manage her celiac disease. (This was 10 years ago, she points out, before gluten-free foods were more widely available.)
6. Don’t fall into the trap of always injecting your own experience into the conversation.
Miller cautions against presuming you understand something you really don’t, even in a genuine attempt to make your friend feel less isolated. Let’s say your friend has chronic fatigue syndrome and is having a hard time with ever-present exhaustion. “It’s important not to say, ‘Oh, yeah, I know exactly what you mean,’” Miller says. “Their experience is something that’s completely not known to you. You can empathize [without] saying, ‘I know exactly how you feel.’”
7. Be as flexible as you can when it comes to making and keeping plans.
“[The condition] may wax and wane, and [your friend] may have good days and difficult days,” Walters says. The more flexible you are in rolling with the ups and downs, the better support you’ll be to your friend.
This means being forgiving and understanding when your friend cancels or shifts plans at the last minute. If it becomes a regular occurrence, know that they’re (probably) not just being flaky. “It’s not a change in personality, it’s a change in their health,” Miller says.
Being flexible can also mean suggesting alternative activities. “If a friend says, ‘I’m not up to doing what we had planned,’ it can be very helpful to find out if they just need to be home by themselves and resting or if there’s something else you can do instead,” Miller says.
8. By definition, a chronic condition isn’t going anywhere. Show your friend that you aren’t, either, by continuing to support them in the long run.
Being there for your friend over the weeks, months, and years following their diagnosis, through the highs and lows, is just as crucial as being there in the beginning. “Chronic disease is a marathon, not a sprint,” says Walters. It might be even more important in the long-term if some of your friend’s friends fade away instead of stepping up to the plate.
That doesn’t mean you have to ask about their condition every time you talk. It could just be a “Hey, how are you doing?” text every so often—even when things seem to be going relatively well. “Occasional check-ins can be a great way to show support,” Walters says. “Let your friend know you are happy to be available when they need you, then put the ball in their court.”
9. Finally, don’t forget to take care of yourself, too, so you can be the best friend possible.
The classic “put your own oxygen mask on before helping others” metaphor applies here. Walters sometimes sees people try to overcommit to doing things for their friends with chronic illnesses, offering to take on so much that they don’t have time for their own needs.
You don’t have to be a superhero and try to do everything. “It’s OK to set boundaries,” Walters says. This makes it easier for you to be there for the long haul, maintain your friendship, and help your friend live the most full life they can with their condition.
Don’t forget the reciprocal nature of being friends, either. “A friendship of any sort is a two-way street, and it’s important to keep that balance in the relationship,” Miller says. That might help you avoid the position of always giving love and care and feeling like you don’t receive it, which can lead to friendship burnout. In other words, let your friend be a good friend to you, too.
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