Avoiding a Sick Friend: Pulling Away When You Don't Know What to Say

Avoiding a sick friend, putting off the call for weeks, then feeling regret? Here are the reasons behind it and ways to reach your friend again.

Your friend's name is on your phone screen. Three weeks ago you heard they had received a serious diagnosis. On the first day you said, "I'll call right away," then you thought, "Let them rest, I won't disturb them." A week passed and you still did not know what to say. Two weeks passed, and now there was shame on top: "What will they think of me for calling so late?" Now every day your finger hovers over the screen, but you just cannot make the call. Avoiding a sick friend is a far more common experience than people think, and it usually stems not from indifference but, on the contrary, from an intense emotional burden. In this article I look at why this avoidance happens, how your friend may be experiencing it, and the small steps you can take to close the distance between you.

Why Does Avoiding a Sick Friend Happen?

People usually pull away from a sick friend not because they do not love them but because they cannot cope with the feelings the situation stirs up in them. Recognising these feelings is the first step towards understanding the avoidance.

Fear of saying the wrong thing: Thoughts such as "What if I say something that upsets them?" or "What will I do if they cry?" make not starting the conversation at all seem safer. When we cannot find the perfect sentence, we choose to say nothing.

Facing our own fears: When someone our own age falls seriously ill, the reality that "this could happen to me too" hits us in the face. Seeing our friend reminds us of our own vulnerability and mortality. Avoidance can be an unconscious way of protecting ourselves from this anxiety.

Helplessness: Knowing we cannot cure the illness or change the situation can lead to the conclusion "So there's nothing I can do." Yet being there is doing something.

Worry about being a nuisance: The thought "They're tired already, their family is with them, I won't add to their burden" is a well-meant retreat. But the patient often experiences it as being forgotten.

The traces of past losses: For someone who has previously lost a loved one to illness, being with a sick friend can reopen old wounds. The smell of a hospital, certain words or images can bring that old pain back to life.

The cycle of postponement and shame: The first postponement is a small step; but as time passes, the sense that it is "too late" to call grows. Shame feeds avoidance, and avoidance feeds shame. Unless this cycle is broken, the distance widens a little more each day.

The silence that follows the crowd

In Turkey, news of a serious illness often creates a wave of intense attention in the first days. The phones never stop, the doorbell keeps ringing, the hospital room fills with visitors. Some friends, amid this crowd, think "Everyone's there anyway, I don't need to go" and step back. Yet a few weeks later the crowd disperses; when the long, tiring period of treatment begins, the number of people still at the patient's side drops noticeably. So if you could not reach out in the first days, a message arriving in the second or third month may well come at the time it is needed most.

Something similar happens when someone you know from work, your neighbourhood or among school parents falls ill. The thought "We're not that close, it would be odd for me to call" is understandable. But a short, respectful get-well message does most people good, whatever the degree of closeness.

None of these reasons shows that you are a bad friend. But it is important to think about what the avoidance means not for you, but for your friend.

How Might Your Friend Be Experiencing This Silence?

Many people facing a serious illness say they were affected as much by the change in their social circle as by the illness itself. Some friends become unexpectedly close, while some of those thought to be closest quietly disappear.

Patients may interpret this silence in different ways:

• "So I wasn't that important to them after all."
• "Everyone is avoiding me; I'm just a patient now."
• "Maybe I did something, maybe I hurt them."
• "My condition is so bad that nobody wants to look me in the face."

These interpretations deepen the patient's sense of loneliness. For someone spending long hours at home or in hospital during treatment, even a message or a short phone call can be the most meaningful moment of the day. Many people who have been through a serious illness say, even years after recovering, "I never forgot who called during that time and who didn't."

On the other hand, remember that your friend may also understand your situation. Most people value a sincere message that arrives late far more than a message that never comes.

Instead of Avoiding a Sick Friend: Ways to Close the Distance

Don't wait for the perfect sentence

Waiting to find the right words usually ends in not speaking at all. What your friend wants to hear from you is not a flawless speech but the knowledge that you are thinking of them.

Acknowledge the delay openly

If you are late, there is no need to hide it or come up with complicated excuses. A short, honest explanation eases both your shame and their hurt.

Fictional example sentences:

• "I've been thinking of you ever since I heard the news, but I didn't know what to say, so I left it too long. I'm sorry; I'm here."
• "I wanted to call you, but I was scared; I was afraid of saying the wrong thing. How are you?"
• "I don't know what to say, but I've missed you so much."

Sentences it may be better to avoid:

• "I've been so busy, I haven't had a moment." (It can make your friend feel they have slipped down your list of priorities.)
• "I didn't want to bother you; I thought your family would be with you." (It may be partly true, but said on its own it sounds like an excuse; it is better to follow it with a sentence that shows interest.)
• "I felt awful too when I heard; I couldn't pull myself together for days." (It shifts the focus of the conversation to your feelings and may leave the patient having to comfort you.)

Start with small steps

If a long phone call or a hospital visit feels daunting, start with a short message. Then, depending on your friend's response, you can plan a call or a visit. A small step is enough to break the cycle of avoidance.

Go at their pace

Your friend may want to talk about their illness in detail, or may not want to talk about it at all. The question "Would you like to talk about the illness today, or shall we talk about other things?" gives them a choice. Sometimes recalling an old memory, chatting about a series you are both watching or sharing news of a mutual friend reminds them that they have a life outside the illness too.

Offer concrete help

The sentence "Let me know if you need anything" is well meant, but most patients find it hard to take up. Instead, make concrete offers that are easy to accept: "Can I drop off some food for you on Thursday evening?", "I could take the children to the park on Saturday." When it comes to visits, it is also important to respect the patient's energy and wishes; for details on this, you can look at the article on hospital visit etiquette.

Keep it going

Calling once and then disappearing again can be more hurtful than not calling at all. Regular contact, even at long intervals, such as a short message once a week, lets your friend feel they have not been forgotten. As treatment drags on, people's attention fades; continued interest during this period is all the more valuable.

You cannot cure your friend's illness; but you can make sure they do not walk this road alone.

Differences by Age

Children whose friend falls ill

Children may react to a classmate's illness with fear, curiosity and sometimes avoidance. They may ask questions such as "Can I catch it?" or "Is he going to die?" It is important for parents to answer these questions in a calm, age-appropriate way and, where needed, to work together with the teacher. Drawing a picture together for the sick friend, writing a card or sending a voice message helps the child express both their fear and their attachment to their friend.

Teenagers whose friend falls ill

Peer relationships are central for teenagers; one of their friends falling seriously ill can shake them deeply. Some young people do not know what to do and fall silent on social media, while others experience intense anxiety. Having a safe adult with whom the young person can talk about these feelings also makes it easier for them to support their friend. For the sick teenager, too, not being cut off from peers and keeping school and friendship ties going are important during recovery.

Adults and older people

In adulthood, work, family and moving cities already put friendships under strain; a serious illness tests these relationships further. In old age, being with a sick friend often also stirs up a person's fears about their own health and losses. Visiting an elderly friend and talking with them about old times can be meaningful for both of you. I have discussed how friendships can be maintained in adulthood in the article on friendship in adulthood.

What to Do With Regret?

Sometimes the avoidance lasts so long that there is no opportunity left to get back in touch with your friend. Your friend may have recovered and moved on, the relationship may have cooled, or sadly you may have lost them. In this case it is very understandable to feel intense regret and guilt.

To cope with regret:

• Show yourself compassion. Remember that the fears that pushed you into avoidance at the time were human.
• Make amends if possible. If your friend is alive, an apology and sincere interest, even if late, can repair the relationship.
• Make room for your grief. If you have lost your friend, writing the letter you wanted to write but could not, offering condolences to their family or doing something meaningful in their memory can help turn guilt into grief.
• Learn for the future. This experience can be an important teacher for behaving differently next time.

It also helps to remember that guilt has a function: this feeling shows how much you valued the friendship. But if guilt only ties you to the past and leads you to punish yourself constantly, it is no longer helping you. Keeping it as a lesson and a reminder of your values, and allowing yourself to forgive yourself, matters for your own health and for the health of the relationships you build with the other people around you.

When Should You Seek Professional Support?

Feeling anxious and wanting to avoid a sick friend is normal. However, support from a mental health professional may be helpful in the following situations:

• Strongly avoiding every situation related to illness, hospitals or death
• Constant worry about your own health after your friend's illness
• A past loss coming back to life and a grief beginning that affects daily life
• Intense guilt and regret that do not ease for a long time after losing your friend
• Sleeplessness, low mood and withdrawal lasting for weeks

If you or your friend express a wish to die or thoughts of self-harm, take it seriously; in an emergency call 112 (emergency services).

How Are Avoidance and Guilt Addressed in Therapy?

Within cognitive behavioural therapy, the thoughts underlying avoidance ("If I say the wrong thing, I'll ruin everything", "It's too late now") are noticed and looked at from a more realistic perspective. Facing the avoided situation step by step, for example first writing a message and then making a short phone call, can help reduce anxiety. Personal fears about death and illness, past losses and their effect on the present are also topics that can be talked about in therapy.

Individual therapy can offer a safe space both for understanding the reasons behind avoidance and for working with feelings of regret and guilt. Sessions can take place face to face or online.

Frequently Asked Questions

I haven't called for months. Won't it be strange to call now?

It may feel strange, but a late call is usually far more valuable than one that never comes. Starting with a message that briefly and honestly acknowledges the delay helps to break the ice.

My friend isn't replying to my messages. What should I do?

Tiredness, treatment side effects or a wish to be alone may be why they cannot reply. You can keep sending short messages that make clear you are not expecting an answer: "You don't need to reply, I just wanted you to know I'm thinking of you."

What happens if I cry in front of my sick friend?

Being moved now and then can show your friend how much you care about them. But if your crying goes on for a long time and your friend has to comfort you, it is helpful to find somewhere else to share your feelings.

Instead of avoiding a sick friend, I want to visit, but the hospital setting makes me very tense. What can I do?

The hospital environment makes many people anxious. Keeping the visit short, taking a mutual friend with you or choosing to go when your friend is at home can reduce this anxiety. If a visit is not possible, a video call or a handwritten note are also lovely ways of keeping the bond alive.

• #friendship
• #ill friend
• #avoidance
• #patient psychology

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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