A Sick Teen and Their Friends: Friends Who Drift Away, Hurt and New Bonds

Why do a sick teen's friends drift away? For young people left lonely during illness: hurt, communication, building new bonds, plus advice for families.

In your first week in hospital, your phone would not stop buzzing. Get-well messages in the class group chat, hearts, flower emojis… A few weeks later the messages grew sparse. Two months on, you struggle to remember when your best friend's last message arrived. This experience is a story shared by many young people living with a serious or long-term illness. A sick teen's friends sometimes really do drift away, sometimes pull back because they do not know what to do, and sometimes the young person feels so different that they open up the distance themselves. This article is written for young people who feel they have lost their friends during illness and for families who want to stand by them. I look at why friends may drift away, how to cope with the hurt and loneliness this creates, and how new bonds can be formed.

Why Do a Sick Teen's Friends Drift Away?

A friend drifting away usually rests on more complicated reasons than it seems at first glance. Understanding these reasons does not make the hurt disappear, but it can help you step back a little from seeing what has happened as a personal rejection.

• Not knowing what to say. Many young people come close to a serious illness for the first time. Afraid of upsetting their friend by saying the wrong thing, they may choose to say nothing at all.
• Their own fear. Seeing someone their own age fall ill can trigger the worry "This could happen to me too". The easiest way to cope with that worry is to stay away from the subject and the person.
• The flow of everyday life. School, tutoring, exams, sport… As friends run at their own pace, they may start putting off making time for a hospital visit or a long phone call.
• Physical separation. In the months when you cannot go to school, shared memories and shared topics dwindle. Not knowing the joke the class laughed at or what happened at break time can make a young person feel cut off from the group.
• Limits set by the family or the treatment team. Restrictions on visits because of the risk of infection can lead friends to think, "Let's not go, we'll be a bother."

None of these measures your worth or how real your friendship is. Still, the hurt you feel is real and deserves to be seen.

The Feelings a Young Person Goes Through During Illness

Being cut off from friends can be a loss that feels even heavier than the illness itself. In adolescence, peers are the most important source of a sense of belonging. When this bond weakens, it can stir up different feelings. Age also shapes this experience: for a young person of middle-school age, the greatest loss is often break-time friendships and shared games, whereas for someone at the end of high school or of university age, being unable to go through the same life stages as their friends, that is, missing experiences such as exams, graduation, a first job or life in student halls, can create a more marked sense of grief.

Feeling excluded and forgotten

Seeing on social media that your friends have celebrated a birthday together, gone to a concert or simply had an ordinary dinner can make the feeling "Life goes on without me" painfully sharp. This feeling is often carried in silence.

Anger and hurt

The thought "I'd have done anything for them, and they won't even send one message" can give rise to intense anger. This anger is legitimate. Noticing your anger and naming it is the first step in deciding how you will express it.

Feeling different

The experience of illness may have carried you to a place different from your peers. The things they talk about may seem shallow to you, and what you are going through may seem remote to them. The feeling "I have nothing in common with them any more" sometimes leads the young person to withdraw before their friends do.

Blaming yourself

Thoughts such as "Maybe I talked about my illness too much" or "Maybe they got fed up with me because I was always down" are common. These thoughts often do not reflect reality, but the lonelier you become, the more convincing they seem. For a broader look at the experience of loneliness in adolescence, you may want to read the article on loneliness in teenagers.

Reconnecting with a Sick Teen's Friends

A friendship drifting away does not always mean it is broken for ever. Sometimes a small step can open the door that both sides are waiting at.

Taking the first step

It may feel unfair; you are the one who is ill and they are the ones not calling. But sometimes friends wait because they do not know when or how to reach out. A short, light message may be enough to break the ice:

• "We haven't talked for ages, I miss you. What's going on at school?"
• "I'm a bit better this week. Shall we video call?"
• "I'm tired of talking about being ill, tell me something ordinary."

Saying clearly what you want

Friends often try to guess what you need and get it wrong. Some ask about the illness all the time, some never ask. Saying what you want makes things easier for them:

• "You can ask about my illness, it doesn't bother me. But I don't want to talk only about that."
• "I don't want you to look at me with pity. You can tease me like before."
• "Even if you can't come, it helps when you message now and then."

Putting the hurt into words

In some friendships, talking openly about the hurt can deepen the relationship. Non-blaming language is important here. Instead of "You never called me, you're so selfish", saying "When I didn't hear from you during all this, I felt really alone" makes it easier for the other person to hear you without getting defensive.

Allowing some friendships to change

Not every friendship comes out of this process in the same way. Some friends drift away and do not come back. This is a loss and deserves to be grieved. At the same time, noticing the people who stayed by your side in hard times can give you a new perspective on your relationships.

Illness tests some friendships; it ends some of them and deepens others far more than you ever expected.

New Bonds: Making Friends During Illness

While some old friendships weaken, it is also possible to form new bonds. These bonds often appear in unexpected places.

• Peers going through the same process. Young people you meet in a hospital corridor, a treatment room or an outpatient waiting area can understand you without any need for explanation. Some hospitals and associations organise meet-ups or activities for young people with chronic illness; you can ask the treatment team about these opportunities.
• Bonds formed around shared interests. A gaming community, a book club, an online drawing group… Settings where the illness is not in the foreground let you feel like someone with interests and ideas, not only a "sick teen". In online spaces it is important to be careful when sharing personal information and to talk with your family about meeting people you do not know.
• New classmates when you return to school. When you go back to school after a long break, your old group may have changed. Hard as this is, it can also offer an opportunity to meet new people.

New friendships may not fully take the place of old ones, and they do not need to. The aim is to increase the number of people in your life who see you, laugh with you and stand by you on hard days.

Social Media, Class Group Chats and Visibility

Today, young people's friendships are largely lived out on a phone screen. During illness this can be both a bridge and a wound. On the one hand, writing to the class group chat from a hospital room, playing games with friends or laughing at a video together keeps the bond alive. On the other hand, constantly updated stories put every event you cannot join right in front of your eyes.

A few small steps can help you manage this dilemma:

• Observe your own relationship with the screen. Noticing which accounts leave you feeling worse after you look at them can help you mute them for a while. This is not running away; it is a way of protecting yourself.
• You decide how much to share. Whether or not you share your illness is entirely your choice. Some young people find it a relief to talk openly about what they are going through; others want to keep social media as a space the illness never enters.
• Staying quiet in group chats is also an option. You do not have to reply to every message. On tired days, just reading is still a way of staying connected.

A sick teen's friends may also not know what to do in this setting: should they comment on the story, send a private message, or not touch it at all? Giving your friends a little guidance on this, for example saying "Even you liking my posts makes me feel better", can reduce their hesitation.

For Families and Friends: How Can You Support Them?

What can parents do?

Parents feel deep sadness at seeing their teenager left alone and sometimes want to step in directly to fix the situation. For example, calling a friend's mother to ask "Why doesn't your daughter call ours?" can leave the young person embarrassed and feeling even more helpless. Instead:

• Ask your teenager how they feel about their friendships and listen without judging.
• Make friends' visits easier to the extent the treatment team allows; try to turn your home or the hospital room into a setting where young people can feel at ease.
• With your teenager's consent, give their friends' families brief information about visiting or keeping in touch. Sometimes friends stay away simply because they do not know the answer to "Can we come?"
• Avoid comments such as "If they were real friends, they'd call." This sentence can deepen the young person's hurt and weaken the chances of repairing the relationship.

What can friends do?

If a young person with a sick friend is reading this, I would like to say a few words to you too. You do not need to find perfect words. Saying "I don't know what to say, but I'm thinking of you" is far better than not writing at all. Talking to your friend about school, the class and ordinary things makes them feel connected. I write separately about what young people go through when a friend falls ill in the article on when a teenager's friend is seriously ill.

When Should You Seek Professional Support?

Changes in friendships can be a natural part of the illness process. However, in some situations support from a mental health professional can be useful:

• The young person not wanting to talk to anyone for weeks and giving up their phone and social media completely
• Prolonged sadness, crying spells or emotional numbness
• Statements such as "Nobody loves me" or "If I disappeared, nobody would notice"
• Intense anxiety or avoidance when it is time to go back to school
• Changes in sleep and appetite that treatment cannot explain

If your teenager talks about thoughts of ending their life, do not put it off; in an emergency call 112 (emergency services) and inform the treatment team. Where depressive symptoms are marked, an assessment by child and adolescent psychiatry may also be requested.

How Are Lost Friendships and Loneliness Addressed in Therapy?

Therapy offers a space for a young person to make sense of the changes in their friendships and to express their hurt in a safe setting. When working with a cognitive behavioural approach, overgeneralising thoughts such as "Nobody wants me" are examined, and how these thoughts affect the young person's behaviour is noticed together. A message to a friend, or the first conversation on returning to school, can be rehearsed through role play.

Small steps that support the young person's social skills and their courage to form new relationships can also be planned. Adolescent counselling makes it possible to work on the challenges of illness and on adolescence's questions of identity and belonging at the same time. For young people who cannot leave the hospital or home, sessions can also continue online. In sessions with the family, the focus is on how parents can accompany their teenager, and when to step back and when to offer support.

Frequently Asked Questions

My best friend hasn't called once since I got ill. Should I write to them?

This is entirely your decision. If you want to write, a short message that describes how you feel without blaming them can open the door. If you do not want to write, that is an understandable choice too; what matters is that you do not carry your hurt alone.

Is it a good idea to form bonds with friends I met in hospital?

Bonds formed with peers going through the same process are often very valuable; you can understand each other without explanations. These relationships can sometimes bring difficult feelings too, for example when a friend's treatment goes badly. At such times it is important to share your feelings with someone you trust.

What can I do if my friends treat me differently when I go back to school?

In the first days there may be strange looks or questions. Preparing a short answer in advance, such as "I went through a long treatment, and I'm better now", can put you at ease. Talking to your teacher or the school counsellor before you return can also help.

Do online friendships count as real friendships?

Bonds formed behind a screen can also be real and meaningful; they are an important source of support, especially during periods when you cannot leave home. Taking care to protect your personal information and telling your family when something makes you uncomfortable provide a sufficient safety framework.

• #adolescence
• #friendship
• #chronic illness
• #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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