What to Say to a Friend Who's Ill

You want to help but don't know how. Experts, patients and friends who've been there tell you how to show empathy and give concrete assistance

by Donna Jackson Nakazawa
Photograph: Illustration: Christopher Silas Neal

When I was in my forties, I was paralyzed twice with Guillain-Barré syndrome (GBS), an autoimmune disorder that damages the nerves carrying signals to the brain. During my second bout of GBS, I was bedridden for half a year, with no way of knowing if I’d ever walk again. Even though I needed the proverbial village to continue functioning, I feared asking anything of friends who were already stressed by their hectic lives.

Despite being busy, my friends really stepped up. As one, Tracy Greenfield, recalls, “We hoped we could be the clones you’d need for the tasks you normally did each day.” A “clone” stopped by every morning to put coats and backpacks on my young kids and drive them to school. Another made me grilled cheese sandwiches. Some days, when there was nothing to be done but embrace dark humor, friends simply sat in my room and cracked bad jokes. These friends became the sisters I’d always wanted, women for whom I’d drop anything anytime (and since I got better, I have).

But other friendships frayed. One woman committed to bringing lunch once a week and then almost always canceled, asking, “You’ll be OK until dinnertime?” I understood how busy she was. What I didn’t understand was why she’d volunteer and then renege at the last minute, knowing I couldn’t even get myself a small glass of water.

When a person is sick, close friends can contribute to the healing process. For instance, studies from the U.S. and Australia show that strong, positive relationships may improve outcomes for women with breast cancer and multiple sclerosis. That’s partly because positive situations help mitigate the stress that can boost damaging inflammation in your body. If inflammation reaches a high enough level, it “contributes substantially to diseases, including some cancers, cardiovascular disease, diabetes, osteoporosis and arthritis,” says Janice Keicolt-Glaser, PhD, professor of psychiatry and psychology at the Ohio State University College of Medicine. Conversely, when a friend does something hurtful to a sick person, that additional layer of emotional stress “can translate into damaging physical responses such as increased inflammation,” says Keicolt-Glaser.

How can you help rather than harm a friend’s healing process? For answers, I spoke with dozens of women who have been ill, friends who have cared for sick friends and experts who have studied what happens between friends when illness enters the picture.

Accept That You’re in Uncharted Territory
As we grow older, more of our friends will become ill. Rates of chronic disease in the U.S. are skyrocketing: 133 million Americans have at least one chronic condition, a number that’s predicted to rise 37 percent by 2030. And the odds that someone you know will come down with a serious condition such as breast cancer or heart disease rise significantly after the person passes age 50.

Many women who are ill prefer to be helped by friends rather than family members. In a national sample, almost 20 percent of women said that if they were sick, their first choice for intimate help—bathing, dressing, toileting—would be a close female friend. “For many women, their friends are really their closest connections, perhaps especially for single women,” explains health sociologist Emerson Smith, PhD, a clinical research professor at the University of South Carolina School of Medicine in Columbia.

First published in the April 2014 issue

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