Friendships evolve with time. Sometimes chronic disease speeds up the process.
Romantic breakups are tough, but friendship losses can be just as heartbreaking, or even worse.
Friendship loss is a chronic theme for those of us with chronic disease. While romantic relationships generally end abruptly, friendships seem to gradually distance, then either end or remain further in the periphery.
I was pretty sick in my last year of college and was ultimately diagnosed with Crohn’s disease (CD). At the time, my friends were supportive. They drove me to appointments so I could avoid a taxi — there was no Uber or Lyft service back then. And they advocated for me when I was not doing well.
It took about 2 years to get into remission from my initial flare and start feeling like myself again. I did my best to stay positive, not complain, and live as “normal” of a life as I could while finishing college and starting medical school.
As much as I tried to support myself through nutrition, lifestyle, and medication, I still had unpredictable symptoms.
At times, I had to cancel or modify plans with friends unexpectedly. On many nights, I chose to either not stay out late or stay in altogether so I could support my body, knowing I had only so much energy and needed to study the next day to stay afloat in medical school.
Through the years, I certainly went through periods where my friends distanced themselves from me, excluded me, and planned events without me. It was so incredibly heartbreaking, much harder than any physical pain Crohn’s has brought me.
I went through all of the scenarios in my head, trying to determine why this was happening. Did I offend my friends in any way? Was I annoying? Did I talk about my symptoms too much? Did they just not like me anymore? Did I cancel plans too many times?
No matter how many scenarios I came up with, I never figured out what truly happened. With time, the pain lessened and our friendships changed.
I realized eventually that with some friends, no matter what hardships we go through, our relationship will remain strong and continue to grow. Other people, however, will be great friends at certain times in our lives, but these relationships may change.
With some people, it’s OK to let some distance set in, or even let go of friends if they no longer make you feel like your best self. You will have your inner circle of friends, who you will hold tight for a long time. This inner circle may change some, but generally, these are the people who will stick by your side forever.
You will also have a more distanced circle of friends — people who may not be as close as your inner circle, but whose company you still enjoy. You also probably won’t expect as much support from this group as you would from your inner circle.
This may include friends who may not be able to handle your illness at the moment, but with time, they may grow and realize the hurt they caused you.
With some people, it’s OK to let some distance set in, or even let go of friends if they no longer make you feel like your best self.
In a friendship, both parties should put in relatively equal amounts of effort. If you notice that you are contributing more to a relationship than your friend is and, despite discussing it with them, it still pains you, you may choose to scale the relationship back a little. With time, the relationship may strengthen, or it may continue to distance.
Recognizing this distance and placing those friends into a further circle may help prevent you from getting hurt. Distancing yourself from certain friends may make room for new friends. These new friends do not replace the old friends. They just increase your circle of friends.
It’s OK to grieve the loss of friendships, but always remember to cherish your remaining relationships and keep putting in the work to keep them going strong.
It helps if you take time to educate your friends about your disease, especially the unpredictability of your symptoms. Teach them about the importance of nutrition, sleep, and self-care in managing your symptoms. This small amount of education will help your friends understand your disease experience and may help them be more sensitive when you are going through tougher times.
When you are sick, you may be focused on your own health. Remember that your friends are fighting their own battles. We need to be sensitive to their issues, too, and we cannot expect them to always check in on us if we do not check in on them.
It is also important to make friends with others who have the same disease as you. You may meet them through support groups or on social media. Some of my closest friends are others with CD who I have met on Instagram. In many cases, I’ve either never met them in person, or have met them only a handful of times.
We check in on each other regularly and can chat about nearly anything, especially coping with our symptoms and going through CD hardships. These friends are on a similar journey, fighting the same disease, and will likely not tire of talking about it, whereas these conversations can be emotionally draining for others without your condition.
Others may not understand that chronic disease is chronic, and that you will have good days and bad days, periods of flare and remission. They may not understand as well as someone else who lives with the condition that symptoms are often unpredictable and may result in canceling or modifying plans.
It may also be beneficial to seek counseling. A counselor is someone who you can talk with about anything, and they can help you through your challenges in life, so this burden is not placed on your friends or family.
Friendship loss through chronic disease can be heartbreaking, and you are not alone. Stay as positive as you can, remember to check in with your friends often, and cherish your inner circle.
Medically reviewed on July 19, 2022
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