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Two people sit on a staircase having a serious conversation.
Two people sit on a staircase having a serious conversation.

The Best (and Worst) Ways to Support a Friend With a Serious Illness

How to Be Supportive and Compassionate to Someone With a Serious Illness

Finding out a loved one has a serious illness like cancer can be distressing, sad, and even devastating. It can leave you wondering what you can do to help. Remember that there's no rule book when it comes to supporting your friend through a life-changing diagnosis. Consider your relationship with them, and try to help in ways that your friend or loved one will understand and appreciate. You might feel a little uncomfortable at first, maybe even scared, but it's important to treat the person the same way you treated them before the diagnosis. It's also important to fight through your own uncertainty so you can be there for them.

"People are often feel uncomfortable talking to a loved one with a serious illness, but it's important to express your genuine feelings to that person rather than taking the byroad and avoiding the conversation," says Sheehan D. Fisher, PhD, a psychologist at Northwestern Medicine.

No matter how you communicate, whether it's in person or by phone, email, card or text, what you say (and how you say it) is so important. Here are some do's and don'ts when it comes to choosing your words.

Helpful Things to Say to a Person With a Serious Illness

Don't be afraid to talk with your friend who has a serious diagnosis, even if you're not quite sure what to say. Just being there and saying something is important. Here are some good options to guide your conversation.

  • "I don't know exactly what to say, but please know how much I care."
  • "What can I do for you?" Dr. Fisher says to make sure you actually can offer the person practical support before asking them what they need. It's good to offer concrete and practical ways to help, including taking them to their medical appointments, helping them get their affairs in order, running errands for them, or helping them keep up with the things they loved to do before getting sick.
  • "I'm always here if you ever want to talk."
  • "I'm so sorry this happened to you."

Unhelpful Things to Say to a Person With a Serious Illness

Of course, you would never want to hurt your friend's feelings, but sometimes you might say something that you don't even realize is offensive or insensitive. Here are some general phrases to avoid.

  • "I know exactly how you feel." Even if you've experienced a serious illness yourself, you don't know exactly how your friend is feeling, so don't pretend you do. This can make the person feel that their situation is not that big of a deal, when to them, it may be the biggest deal in the world.
  • "When (fill in the blank) had this diagnosis, (fill in the blank) happened." The last thing a person with a serious illness wants to hear is someone else's story. You may think you're being helpful or hopeful, but you never know how a person with a serious diagnosis is going to internalize your well-intentioned anecdotes.
  • "You're so brave" or "You're so strong." You might think this is an encouraging thing to say to a friend with a serious illness, and maybe in some cases it is. However, telling someone they are brave and strong might pressure them to act differently than they are feeling. While a person with a serious illness might be strong most days, some days they won't be, and that's OK. This also could make them feel like it's their fault if they are not getting better. For example, if they fought harder and were stronger, then they would be getting better. It's unfair to put this undue pressure on them for something that's out of their control.
  • "You look different." Or even jokingly saying something like, "Well at least you're losing weight!" Chances are, someone with a serious illness is well aware of how they look, and weight loss (or gain) may not be looked at positively.
  • "I'm sure you'll be fine." This may seem like an encouraging, hopeful thing to say, but telling a person with a serious illness that they'll be fine, or telling them not to worry, can be misconstrued as making light of a serious situation. It also promotes a false sense of certainty during an uncertain time. A person with a serious diagnosis should be able to experience feelings like fear and uncertainty, as unpleasant as they may be.
  • Questions or statements about time. When a good friend or close family member has a terminal illness, the topic of death might come up, and that's OK. Make sure you follow the person with the terminal illness' lead and ask questions that are appropriate to the conversation.
  • "This was God's plan," or "God will take care of it." This oversimplifies the situation and can give the person a false sense of hope. It also can make the person feel like they have no control over what's happening to them.

Now that you know which phrases to lean on and which to avoid, Dr. Fisher offers other tips for how to treat a loved one with a serious diagnosis or illness.

  • Meet the person where they are. If the person is struggling with their diagnosis, don't approach them in an overly positive manner. Instead, meet them where they are and help them work toward acceptance. For example, if the person is diagnosed with a terminal illness and they need to get their affairs in order, the first conversation you should have with them should be about how they are doing, not a conversation about what they need to do to prepare for death.

If you're talking to someone who has been in treatment for cancer and just received news that they are in remission, check in with them to see how they are doing with the news instead of approaching them in a celebratory manner. They may not be emotionally ready to manage the news that they will likely be OK, so meet them where they are and slowly approach celebrating the good news.

  • Don't put them at fault. Dr. Fisher explains that this is not the time to make the person feel like they are at fault for their diagnosis or illness. For example, if the person has lung cancer and smoked for most of their life, it's not the time to criticize them for the decision to smoke that may have caused the cancer.
  • Don't make their diagnosis their identity. "When you make the diagnosis the person's identity, the person becomes captive to that identity and can feel helpless or hopeless," says Dr. Fisher. "Treat them as a person with an illness, not an ill person."
  • Don't treat them as helpless. Instead, ask them what you can do to help instead of assuming how they want you to help.
  • Drop the stigma. Certain diseases have a societal stigma, such as HIV/AIDS and cirrhosis of the liver. If your loved one has a disease with a stigma, don't distance yourself from them. They need you now more than ever.
  • Include them. Don't shun your loved one or assume that they don't want to be included in activities because of their disease. The person may not feel comfortable with the physical and visible manifestation of their disease, but one way to show your support is to keep inviting them to gatherings and activities.
  • Give them (a reasonable level of) grace. Your loved one will likely be dealing with a lot of stress and may also be on medications and other interventions that affect their mood and hormones. Give them grace within the context of what they're going through. They may not be in the best of spirits, and they may not be act like the person you knew before their diagnosis.

Steering Toward Acceptance

Supporting someone who has a serious illness can help them start to accept their situation and fully engage in their treatment for it. 

"Psychotherapy is a great way to help people with serious diseases develop a level of acceptance for their situation," adds Dr. Fisher. "The goal is to help the person live a full life within the context of their diagnosis or disorder."