What NOT to Say to Someone With a Chronic Illness

Who among us hasn’t put their foot in their mouth on occasion? Sickness and disability can make you feel uncomfortable and tongue tied. Here’s what you need to know about people who have a chronic illness: they’re people just like you. They don’t necessarily want to talk about their health every minute of the day and they don’t need anyone to remind them of it when they’re out trying to have a good time.

It’s highly likely that they’ve spent a great deal of time learning about their condition and how to cope with it, so unsolicited advice is probably not a good idea, especially if they’re like these gems:

At least it’s not…(whatever)

The implication here is that things could be worse…and they certainly could, but so what? Just because something could be worse doesn’t mean it’s not challenging or that a person can’t be having a hard time. Telling someone with type 1 diabetes that they’re fortunate they don’t have stage IV pancreatic cancer is not helpful.

Let’s put it this way: When you have the flu and you’re feeling like death warmed over you probably don’t need anyone to tell you how fortunate you are not to have a hot poker sticking in your eye, too — you already know that, but you’re still sick. Comparing diseases is a bad idea.

Try this instead: “I’m not familiar with (whatever disease). If you don’t mind, I’d like to hear a little bit about it.” Or this: “I don’t know what it’s like for you, but I’m here for you.”

You just need to de-stress

Yes, don’t we all. If you’re alive, you’re going to have a certain amount of stress. Some we can eliminate, some we can learn to cope with, and some we’re just stuck with. Stress can certainly affect your health. And having a chronic illness? Well, that’s stressful. What you don’t want to do is sound as though you’re blaming that person for creating their own illness. It’s cruel to imply that they are ill because they don’t know how to handle life.

If you have a friend who seems stressed, make a specific offer to help out, like making dinner, running an errand, babysitting, etc. Help ease a bit of that stress.

It’s all mental…you just need some positive thinking

Tough one. Of course a positive attitude is better than a negative one. The mind-body connection is very real and quite powerful. But it’s important to remember that people with a chronic illness have the same range of healthy emotions as everyone else. They can feel sad or angry or proclaim it a frustratingly crappy day and still be positive people. And let’s face it, disease isn’t all in your head. Positive people get sick, too. Let’s not pile on by telling them they could fix it if they would only try harder.

Instead, you could offer to engage in some positive mind-body activities together. Make a date to get massages, take a yoga class, learn to meditate, etc.

I wish I had a handicapped parking pass

Hmm…maybe you’d like a prime parking spot, but would you trade your health for it? Not likely. This one falls into the “be careful what you wish for” category. Just don’t say it.

Must be nice not having to (whatever)…or getting to (whatever)

Not “having” to work or “getting” to take an afternoon nap may sound enticing, but not working because you’re not healthy enough to work isn’t a good feeling. And though taking an afternoon nap to catch up on your zzzs can be refreshing, it’s a lot less fun it you need that nap because you cannot physically get through the day without it. It’s not a choice or a privilege, so it’s best not to go there. Instead, why not offer something that is nice, like hanging out together, sharing a meal or going to the movies?

The (whatever) diet will cure you

Dave Bexfield, who has MS and runs the site Active MSers, isn’t a fan of the diet police. “I get it, eating healthier and losing weight is good for you. So is avoiding crystal meth, poorly packed parachutes, and street gangs. But with my disease, multiple sclerosis, no diets have been shown to have any scientifically proven effect. So please, don’t tell me I should go on an anti-inflammatory, turmeric-laden vegan diet for my health, especially when we are out for a nice lunch together.”

If you want to talk about diet, perhaps you could talk about it in the context of your own life, or as a general topic of conversation rather than as a cure for someone else’s illness.

You should try taking vitamins instead of medication (or whatever treatment)

Barby Ingle, president of International Pain Foundation, says, “Don’t judge. People have to be okay with the choices they make when it comes to their care.”

Absolutely. We all need to get our vitamins, but it could be dangerous to suggest that someone ditch their medications in favor of dietary supplements.

You don’t need that cane (or whatever assistive device)

“Don’t try to take away my tools because of your embarrassment or trying to push me into being better,” said Ingle. She relayed the story of a friend who was asked to leave her cane in the car when attending a graduation because it would take attention from the big moment. Long story, short — the cane stayed in the car, followed by several days of pain and “see, you didn’t need the cane…”

I can relate, I really can. I’ve used a cane during MS relapses, and have I ever gotten a boatload of unsolicited advice. “You’re too young for a cane,” was my favorite. Utter nonsense.

You don’t use a cane because you want to be dependent on something. You use it because you want to stay independent. You want to stand on your own two feet, walk, and participate in life. If you’re living with a chronic illness, you do what you have to do to work around it and function. Whether it’s because of muscle weakness or balance issues or numbness, if a cane can help, it’s cruel to make someone feel foolish for using it. The same goes for walkers and wheelchairs and braces and handicapped parking placards and whatever assistive devices help a person get through the day.

And, of course, everybody’s favorite: But you don’t look sick (or, but you look so good!)

This is a favorite “what not to say” among people with chronic illness. The implication is that you look perfectly fine so why don’t you get off your ass and stop faking? Most chronic illnesses have “invisible” symptoms so it’s not hard to see why casual observers get confused.

Personally, I don’t think people always mean this in a bad way. It could just as easily be meant as a compliment. Hey, if you think someone looks fantastic, by all means say it. Then ask how they really feel.

Fear of saying the wrong thing might lead you to simply stay away and say nothing. That’s the worst thing you can do. Go. Talk. Hug. Be a friend. Do your best. If you make a mistake, apologize and move on. You’re only human, too.

Related Reading
Why We Can’t Say What Multiple Sclerosis Looks Like
10 Odd Things to Say to Someone with Breast Cancer
I’m a Survivor, but Breast Cancer Awareness Month Stresses Me Out

Read my Living with Triple-Negative Breast Cancer Series on Care2 Healthy Living and Care2 Causes. And check out my books about living, laughing & loving despite multiple sclerosis and triple-negative breast cancer.


Siyus Copetallus
Siyus Copetallus10 months ago

Thank you for sharing.

federico bortoletto
federico b11 months ago

Grazie per l'articolo.

Muff-Anne York-Haley

I have Elhers Danlos, I we born with it! I rarely tell anybody about it because it always needs to be explained, just like my name! This way I avoid many questions and have less explaining!

Jim Ven
Jim Ven11 months ago

thanks for the article.

Alexander Hay-Whitton

How about "Can I have that smart leather jacket when you die?"

Julie W.
Julie W11 months ago

Sometimes people don't say anything hurtful directly, but just don't listen. I had a nice man helping me in the garden, being paid to do what I can no longer do.

He sent me an email about a gardening busy bee some distance away saying he thought I might be interested. Why would I want to drive for miles volunteering in a stranger's garden doing work I can't so in my own? He obviously thought I just needed to get out more! If only.

New G.
W. C11 months ago

Thank you the information.

Heidi W.
Heidi W11 months ago

Most people only feel sorry for you if you have cancer or had a severe (car) accident: that they can SEE.
Chron's, UC, MS (early stage)... not written on your face.

2 years ago, after years of feeling terrible without obvious reasons, I finaly got diagnosed: fibromyalgia, CFS, and spasmophilia.
Reactions from: go to sleep earlier and you won't feel tired during day time (yeah right) to exercise more (as if I had energy left) to you don't look sick so you must be parasiting on the social security system. And no, not strangers but even my own family, my mother in pole position.
Yes, people can be very nice indeed...

Beverly C.
Bevery C11 months ago

Been really sick all week; just got on to check email and catch a couple articles. This was a very interesting one. And so very true. I know because I have COPD and heart disease, in addition to this sudden sick spell I acquired May 1st! Leaving now....goodnight and God bless everyone. Pleasant dreams!

Helga Ganguly
Helga Ganguly11 months ago

Trish K. I'm obviously not as generous a soul as you are. When people tell me to "suck it up and smile." (Or take this vitamin or that, drink tea, pray harder, stay away from pagans, be a softer person, stop thinking about it, as if I could, get out more, take a hot bath, meditate, whatever) I DON'T wish that they are never struck with a chronic illness. I hope that they are struck with exactly the same pain(s) -all of them. I used to want them to experience them for just 1 day but now I'd like them to have it for just as long as it takes for them to feel the endless despair of being trapped forever in a pit of pain that never ends, that eats up your youth,destroys your "golden years" robs you of friendship, holidays, relationships, kindness, pride, accomplishment, graduations,respect, hope,travel, everything you struggled for.Gone. Then they can go back to their normal lives. But not me.No not me. My jaw hurt so much early on I considered having all my teeth pulled.