[8 min read]
In this article:
- Three in four American adults have at least one chronic condition that affects their daily life, including their emotional health and well-being.
- Living with a chronic condition can be a full-time job; people with chronic conditions can spend a lot of time managing symptoms, medications, appointments, medical equipment and more.
- Showing up for a friend with a chronic illness can feel challenging. What should you say? What is ok to ask about? How can you offer to make plans?
- A Providence Swedish is here for you with guidance to help you build a supportive relationship with your loved one that's about you and them, not just their illness.
Chronic illness affects far more people than many realize. According to the U.S. Centers for Disease Control and Prevention (CDC), about 6 in 10 adults in the United States live with at least one chronic condition, and many manage two or more at the same time. Chronic illnesses are conditions that last a year or longer and often require ongoing care or affect daily life. Common examples include diabetes, arthritis, inflammatory bowel disease, multiple sclerosis, lupus and chronic migraines. Because symptoms can vary widely—even day to day—no two experiences are exactly the same.
Supporting a friend or family member with a chronic illness can feel overwhelming — especially if you’re not sure what to say or do. Chronic illness is often long‑term, unpredictable, and invisible, which means even wellintended support can miss the mark. We spoke with Janarthan Sivaratnam, Ph.D., a psychologist with Providence Swedish South Lake Union Primary Care, for some guidance to help you understand what your loved one may be facing, avoid thinking of them as “sick” and show up with confidence and compassion.
Acknowledge your own thoughts and feelings
“No two reactions are the same when it comes to a loved one’s response to supporting someone who is living with chronic illness,” says Dr. Sivaratnam. “However, there are some reactions to be mindful of that could indicate that you are particularly being impacted by your loved one’s diagnosis.”
Common reactions to a loved one’s illness can include:
Grief (even without loss). People often experience a form of grief not necessarily because of death, but because things have changed. This can include:
- Loss of the person’s previous lifestyle or personality (if the illness affects mood/energy)
- Loss of shared plans or expectations for the future. This is sometimes called “ambiguous loss,” and it can be especially hard to process.
- Helplessness and frustration. It’s common to feel frustrated when you can’t “fix” the situation.
Friends and family may struggle with:
- Not knowing what to say or do
- Feeling useless when the person is suffering
- Wanting to take the pain away but being unable to
Guilt. Guilt can show up in different ways:
- Feeling guilty for being healthy
- Resenting the situation or the added responsibilities
- Wishing for a break, then feeling bad for wanting one
Strengthened bonds (in some cases).
- Not all impacts are negative. Some families and friendships become closer, with:
- Deeper empathy and understanding
- Stronger communication
- A clearer sense of what really matters
“Many chronic illnesses are invisible—like autoimmune diseases, chronic pain conditions, or fatigue disorders. Someone can look completely “normal” while dealing with significant symptoms. Judging based on appearance often leads to people not being believed or taken seriously,” adds Dr. Sivaratnam. “You might find yourself thinking things like ‘They don’t look sick, so they must be fine’ or ‘They just need to eat better, exercise more, or think positively’. These are common myths associated with chronic illnesses.”
“Lifestyle changes can help some conditions, but they’re not cure-alls. This advice, when oversimplified, can feel dismissive — especially when the person has already tried those things. Oftentimes with my patients who are going through a potentially life-changing chronic disease, I acknowledge at the outset that 'changing your thinking’ or ‘finding the counter-evidence' is not going to be helpful. Instead, considering acceptance of the circumstance as is, AND choosing to notice the glimmers rather than feeling you have to pick one or the other, is a place where I like to start.”
It’s also possible to veer too far in the other direction, and assume that your friend is miserable all the time.
“Chronic illness is difficult, but it doesn’t erase joy, meaning, or connection. Many people build fulfilling lives, just with different limits or adaptations. In fact, a common point of feedback I get with patients is that they wished people in their life would talk about “trivial” things or even their own problems. Patients often want to be treated as normal just like anyone,” Dr. Sivaratnam emphasizes. “A useful way to think about it: chronic illness often forces people to become experts in their own bodies. Listening to them—and taking what they say at face value—is usually more helpful than trying to reinterpret or “fix” their experience.”
People aren’t their illness
It’s also important to avoid thinking of your friend or loved one as a “sick” person whose illness is their identity. People with chronic illnesses are exactly that: People with chronic illnesses.
“Make sure you keep seeing them as a whole person, that means people with typical responsibilities, life issues, concerns and relationships,” says Dr. Sivaratnam. “Make sure you’re inviting them into everyday conversations, not just health updates. If every interaction is about their illness, they may feel like that’s all you can see.”
Ways to reinforce feelings of healthy connection include:
- Talk about normal things: shows, work, random life updates.
- Invite them into everyday conversation.
- Avoid making every interaction about their illness, because it can feel like that’s all you see
- Offer help in a low-pressure, specific way. Vague offers can feel like emotional work. Instead of "Let me know if you need anything" try something such as "I’m going to the store, can I pick anything up for you?" or “Want me to handle dinner one night this week?” This makes support feel natural, not like charity.
- Keep invitations openeven if they often say no. People with chronic illness are often excluded because others assume they can’t come. And continue inviting them. Add flexibility: “No pressure at all if you’re not up for it”
- Treat accommodations as normal, not special favors. If something needs to change (plans, timing, environment), act like it’s just part of making things work—not a big deal. For example, small phrases such as the following can help: "Cool, we’ll adjust" or "Let’s find something that works for both of us".
Say this, not that
At the same time, talking with someone about their chronic illness can be challenging. It’s important to stay connected with them while also respecting their privacy and autonomy. A well-intentioned question can feel intrusive, as chronic illness is extremely personal, and it’s important to keep that in mind when talking with your loved one. Treat the discussion the same way you would any personal issue, not like the 'elephant in the room'.
Lead with consent, not curiosity. Before asking anything, give them control over how much they want to share. This frames the conversation as support—not interrogation.
- “I care about you and want to understand how you’re doing, but only if you feel comfortable talking about it.”
- “Can I ask how things have been with your health lately? It’s totally okay if you’d rather not talk about it.”
Center the focus on their experience, not your assumptions. Avoid wording that suggests you already know what they’re going through. Invites them to share what they think matters.
- “How has it been for you lately?”
- “Is there anything that would make things easier for you right now?”
Offer support without making them talk. Sometimes the best way to start the conversation is to make sharing optional. It gives them room to choose.
- “I’m here if you ever want to talk or if you ever need help.”
- “You don’t have to explain anything, but I’m thinking of you.”
Focus on their humanity, not just the illness. Remember, you’re there to connect with them. This can reduce the illness from becoming their whole identity. It can also allow the person to notice other aspects of their life that are still occurring as they navigate their illness.
- “How are you feeling emotionally with everything going on?”
- “How’s your week been? Anything you’re looking forward to?”
“Their experience is often invalidated — usually unintentionally — in conversation with others,” says Dr. Sivaratnam. “If you haven’t managed one of these conditions, it’s easy to forget how much people might struggle to be understood.”
So, what is some we can keep in mind when talking with someone about their illness?
Acknowledge their reality. These statements show you believe them without questioning or minimizing.
- “I believe you.”
- “That sounds really difficult.”
- “I’m sorry you’re going through this.”
- “Your pain/experience makes sense.”
- “I can see how much this affects you.”
Validate their emotions, not just symptoms. People often feel pressured to stay positive, this can allow them to release the “pressure valve” they might be feeling.
- “It’s okay to feel how you feel.”
- “Your frustration/sadness/anger is completely understandable.”
- “You don’t have to pretend you’re fine with me.”
- “It’s completely valid to be overwhelmed.”
Normalize their limits without judgment. This can help counter the fear of being a burden.
- “You don’t need to apologize for needing rest.”
- “It’s okay to cancel or change plans, really.”
- “Your health matters more than the schedule.”
- “Take the time you need.”
Recognize their strength without romanticizing suffering. Avoid “you’re so strong” in a way that pressures them to stay silent.
- “You’re handling something incredibly hard.”
- “I admire how you keep going, but I know you shouldn’t have to be this strong.”
- “You deserve support too.”
You can be there, even if you can't be there
“Geography doesn’t have to be a barrier to closeness; you can show up consistently and be present in their life in small but meaningful ways. Regular low-pressure check-ins, voice notes, or texts that don’t require an immediate response help them feel cared for without adding to their mental load. Sharing bits of your own life, asking about things they mentioned, or remembering important dates or appointments can create a steady sense of connection. Thoughtful gestures like sending a card, a comfort item, a meal delivery, or even a funny meme, also remind them they’re on your mind and valued beyond their illness,” Dr. Sivaratnam emphasizes.
"It also helps to create moments of togetherness, even at a distance. Watching a show at the same time, hopping on a short video call, or playing an online game can keep your relationship feeling alive and mutual. Just as important is giving them room when they’re low on energy and making it clear there’s no pressure to respond quickly. The most supportive long-distance presence often comes from a balance of gentle consistency and respect for their capacity, which can often add up to your loved one being reminded that they are not alone."
Learn more and find a physician or advanced practice clinician (APC)
If you are looking for help managing holiday stress or learning to deal with holiday stress, support is available at Providence Providence Swedish Behavioral Health. Whether you require an in-person visit or want to consult a doctor virtually, you have options. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can use our provider directory to find a specialist or primary care physician near you.
Information for patients and visitors
Additional resources
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Let glimmers of meaning bring shine to your life
Choosing a therapist: identifying your mental health goals and what to keep in mind
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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