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Losing some friends due to chronic illness is practically inevitable and nearly impossible to prevent entirely.  However, there are definitely things that you can do to help yourself maintain many of your friendships, and become closer to the friends you are able to keep.  The first step is to face reality and recognize why you are going to lose at least some of your friendships.  The second is to save the friendships you can through honesty and vulnerability.

The ripple effect – you can’t opt out, but your friends can

Your condition creates ripples in your life and affects those who care about you…and who care about them. For some, that extra energy is too much.

What I want you to understand that whenever you do have a major change in your life, that change has a ripple effect.  That change affects your family, your friends, and your own identity. In turn, your loved ones’ responses and adjustments to your life changes create ripples in their loved one’s lives and so on.  The changes and adjustments do get smaller depending in part on the significance of your relationship, but the more impact your injury or illness has on your life, the larger the ripples.

The less significant or more replaceable you are to that person, the less likely they are to accept and work around the changes that have happened in your life.  The less experience or knowledge they have about the condition you have, the more uncomfortable they might feel about your situation – which they will only be reminded of by thinking about or interacting with you. 

By not interacting with you, they don’t necessarily need to come to terms with their own mortality or handle extra stress, or whatever your situation triggers for them.  Whatever that effect is, it’s not your fault, as your condition wasn’t something you chose.

So if you happen to be the first person in your group of friends to have a life-altering negative experience, or yours is significantly more severe than previous ones, the likelihood of one or more of your friends ‘checking out’ on the whole thing is high. 

I am not condoning this behavior or thinking, simply giving you an additional explanation for this behavior and one that shows that none of it is necessarily your fault, or theirs(you didn’t fail to be a good friend, and possibly they didn’t mean to fail you). 

Your illness simply pushed some emotional buttons for them that might have been too much, or they might need some extra time to process through your condition and how it has affected them.  Give them time and see if it helps.

person sitting on ground, looking at vista
You may need to focus on the larger world, and not just your position in the moment

It’s hard to step back like that and take the broader view when you are hurting.  It’s easy to feel mistreated or abandoned by your friends.  However, that feeling doesn’t help you in the long run and is most likely to strain the friendships that survive the initial shock. 

Remember, their lives haven’t changed like yours has – in fact, they might not have changed their behavior patterns during or after your illness at all.  Also remember, this may not be about you – think about your priorities and behaviors before your injury – your friends are still in that world, it’s your reality that has changed.  

You also need to remember that a lot of people don’t understand the true differences between chronic illnesses and being sick.  They may be assuming that things will ‘go back to normal’ when you get better, not understanding that this is your new normal.

My suggestion is that if you are not getting the empathy and support you need, you might want to reach out to your friends, individually, and plan some time for a conversation.

Planning your conversation about your condition

Start with the friend or friends that you think might be most likely to understand and help you.  The idea here is to get an ally who can help steer your group of friends towards activities you can participate in, or who can help defend you or your needs if needed.  

Meet up with them in a space that feels safe for both of you, and where you can have some privacy. Before you meet up, have a rough plan for yourself about what you want to ask and what you feel like they need to know.  

In my case, I initially shared that I was having urgency problems and that with my history with depression, I was trying to make sure that I didn’t let that combination keep me from being with them.

This let my friends know that I 1) knew what was going on with me 2) had a specific set of concerns, and 3) that specifically they could help me by encouraging me to hang out, joining me in my space( since that was more comfortable for me), and by being patient with how often I had to run to the bathroom.  

Being able to lay it all out like that helped maintain the friendships. I had shared some intimate information, showing them how much I trusted them, and I did so in a way that made clear what my limitations and concerns were, and what expectations and hopes I had from them.

My friends could then know that I was aware of the problem and that I was doing what I could to manage it. This removed a lot of the mystery, and my ask wasn’t very big, either. It worked. I suspect it could work for you too.

Plan on a one-on-one conversation about your condition so your friend can better understand your situation and needs.

If this feels strange to you, or like a lot of work, think about how strange your changes in behavior or attitude(most likely both) must feel to them!  

The better you can explain what’s happening to them, the better chance there is of them understanding what is going on. They can understand whatever changes have been going on in your life, and be able to help you and be your ally instead of potentially becoming another source of stress.  To do this well, be prepared!

If your illness is associated with a physical trauma, they likely know some details, but a lot of people just don’t think about some of the additional complications that become part of your day to day life after an injury.  In Al’s case, for example, his friends knew that he had fallen and broken his hip, but the severity of the break and the unknowns behind the cause were a big part of our stress.

Many physical traumas can cause additional mental/emotional pain, or sometimes life events trigger a mental or emotional health problem. Very often similar trauma can cause very different reactions in people – so even if your friend has had a similar experience, your reaction might be very different from what theirs was.  

If your friend doesn’t understand what you are experiencing they can’t help!  If they haven’t experienced a life-altering change like yours they might not be able to imagine how far-reaching some of those effects can be. This is why you need to have a conversation like this as soon as you can handle it, mentally and physically.  

Steps to take

  1. Know what/how much you are comfortable telling them about your current issue.  Your job is to bridge the gap in their knowledge or experience, so you can truly communicate again.  You can explain things like their risk of catching your condition(usually non-existant), what you are feeling, physically or emotionally, and what effects your condition has on your day-to-day existence.
  2. Have one or two very specific requests, things they can do to help you through your situation.  The nature of that request depends on what’s happening, but things like reaching out more often, being understanding if you don’t respond quickly, or advocating with your friends and/or family for quieter or closer activities would all be good examples.  The point is that it should be a very identifiable thing that you know will help you, and something concrete that they will likely able and willing to do once asked. You shouldn’t ask them to move mountains, but instead to help clear your path.
  3. Make your plans for a day, time, and location that is comfortable for both of you, and that will give you the privacy (and/or anonymity) to have this conversation without interruption.  This might be your house, or theirs, or a nearby coffee shop or park. Wherever you meet, make sure you will not be rushed or interrupted and that both of you feel comfortable there.  Both of you are likely under enough stress as it, and meeting in a safe space will help you both focus on the conversation.

    meet your friend in a comfortable space to talk
  4. Plan when you are going to start the conversation.  If you are anxious, this is especially important. A conversation like this is displaying vulnerability and a lot of us have a hard time with that.  So have a plan for starting the conversation. It can be ‘I’ll start right after we order our coffee’ or ‘She needs to vent about her family for a bit, so I’ll ask her how she’s doing, and then share when she asks how I am’.  Whatever you need, do it, but be sure to give yourself a firm plan about when and how you are going to start the conversation.  
  5. Carry through.  Make your plans with your friend, and if it feels appropriate, let them know you have something you want to talk about when you make plans.  Some people appreciate a heads up that you might have an intense conversation or that you have a specific thing you want to discuss. Other friends might interpret a statement of ‘we have to talk’ as something threatening or anxiety producing.  Think about your friend’s needs and likely interpretation of your request and then act appropriately.  You want them to be in the best possible state of mind to have an open and intimate conversation.
  6. Make space for your friend to share concerns, respond, or otherwise give you feedback.  This needs to be a conversation, not a set of statements. While telling your friend what is happening to you and what support you need, make sure that your friend knows that you are sharing this because you trust them and because you value their friendship and insight.  This confirms to them that they are valuable and important to you and that you are concerned about preserving your friendship with them.  
  7. If all goes well, recruit them to help you strategize who else to talk to and when.  Your friend is likely to be a great source of insight and feedback about how, as a friend, your changes are being interpreted.  They are the best person to help you make sure the message gets expressed clearly to mutual friends or challenging family members.  This friend can help make the explanation process go easier and potentially help make other members of your circle of friends understand better.  

Keep your friends close

Maintaining friendships with your group of friends requires having at least one friend who understands your situation

Explaining your physical or mental health problems to friends can be challenging and frightening.  

The alternative, not explaining them, is likely to result in broken or damaged friendships.

If you are dealing with a long-term condition, the likelihood of losing some friends is high, but the better able you are to help bridge the divide, the more likely you are to maintain valuable friendships and to better understand who your true friends are(as opposed to acquaintances you like).  

When you are sick or injured, you need to focus extra hard on taking care of yourself and your needs. Having friends and a social outlet is one of those needs, and maintaining a friendship through a difficult time is one of the best ways to grow your emotional bonds with people who care about you. 

This is a time where reciprocity is needed – the friends you helped through tough times in the past are hopefully helping you through yours now.  

Finding out that some people are not as good friends as you had thought can be a painful process, but it’s something that is bound to happen sooner or later. While your health issue might be forcing it to happen a little sooner than it might otherwise, you still are having that learning experience.  You are also learning the values of the people you have considered friends.  

Conclusion: losing friends due to chronic illness

Losing some friends is practically inevitable.  It’s part of life.  After you are disabled, though, your opportunities to make new friends are often decreased, sometimes dramatically, and the emotional energy you have for your friends also often goes down.

Your condition has dramatically changed your life and changed the lives of people closest to you.  The further a person is from you, physically or emotionally, the less effect your condition has to have on them, and the easier it is for them to choose to opt-out of your life, at least while things are at their worst.

You can choose to lash out and risk losing more friends, or you can choose to be vulnerable and share your fears and concerns with your friends, and give them the option to help.  It’s up to you, but I suspect that vulnerability and sharing confidences will help you maintain and nurture more and stronger friendships.

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  1. A rich discussion of keeping (and losing) friends once diagnosed with a chronic illness. Such a healthy approach to communication. In particular, I liked the idea of 2 specific action items for your friends. This way a friend can show me that they care and are listening. And I figure out and define 2 specifics that help me to carry on.

    1. Thank you Verla! I think it’s hard to know what to do when a loved one is dealing with a disabling condition or chronic illness, so a conversation like this is vital – and living with a condition, the better you can articulate what will help you, the easier it is to ask for it!

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