What not to say to a sick friend, and why can kind words still hurt? Read which phrases to avoid with a seriously ill friend and what you can say instead.
You have found out that a friend you have known for years has been diagnosed with a serious illness. You open your messages, type a few words, delete them. "What if I say the wrong thing?" This worry is actually a sign of how much you care. But the same worry can sometimes lead you to say nothing at all, and sometimes to blurt out the first comforting sentence that comes to mind in a panic. That is exactly why what not to say to a sick friend is such a commonly searched question. In this article I look at sentences that are said with good intentions but can unknowingly hurt an ill friend, why they can be hurtful, and what you can say instead. The aim is not to speak perfectly; it is to be able to stand by your friend without wearing them out.
Why Can Well-Meant Words Hurt?
When we talk with someone facing a serious illness, most of us feel a kind of helplessness. We cannot make the illness go away or take the pain from them. This helplessness pushes us to quickly come up with sentences aimed at "fixing" things. Yet these sentences often serve to calm our own anxiety rather than the other person's.
Words that can be hurtful have the following in common:
- They shrink the feeling. Sentences such as "This too shall pass" or "It could have been worse" ignore the fear and sadness your friend is experiencing right now.
- They put responsibility on the patient. Words that link the illness to the person's mood, way of thinking or lifestyle create guilt.
- They turn the conversation towards the speaker. Talking about your own experiences or other people's stories can push your friend's troubles into the background.
- They create the burden of replying. Long questions and messages constantly asking for updates load yet another task onto a tired patient.
Knowing this matters not so that you blame yourself, but so that you can build more mindful language.
What Not to Say to a Sick Friend: Common Hurtful Sentences
The sentences below are fictional examples, but they are the kind that patients and their families say they hear often. Under each one, I have explained why it can be tiring.
"Everything happens for a reason."
Faith and spirituality are an important source of strength for many people. However, when this sentence is said at the very start of an illness, while the person is struggling with fear and anger, it can give the feeling that their suffering is being rendered meaningless. If your friend wants to find such meaning themselves, you can accompany them in it; but do not put that meaning in place for them.
"Be strong, you'll beat this."
This sentence is said to give courage. However, framing the illness as a "battle" can lead the person to feel "defeated" or "not strong enough" if things get worse. The course of an illness does not depend on a person's willpower.
"Think positive, keep your spirits up."
This is perhaps the most frequently heard sentence. Your friend has the right to be sad, to be afraid, to cry. The pressure to be positive all the time can lead them to hide their true feelings and feel lonelier. I have discussed the effects of this pressure in more detail in the article on the pressure to think positive.
"I was really ill last year too, I know what you mean."
It is said to build empathy, but it often turns into comparison. For someone living with a serious illness, being compared with an experience of flu or a minor operation can feel like their experience is being belittled.
"My aunt's friend had the same illness…"
Other people's stories, whether they ended well or badly, are usually unhelpful. Stories that ended badly magnify fear; those that ended well can create the pressure of "If she made it, you have to make it too."
"Have you tried this herb? Go and see that doctor."
Suggestions about treatment drive the patient and family into confusion. Medical decisions are made together with the person's own doctor. Unless your friend asks you for information, not making treatment suggestions is the most respectful approach.
"How did it happen? Were you smoking, were you skipping check-ups?"
Questioning the cause of the illness carries an unintentionally accusing tone. When the person is already struggling with the question "Why me?", hearing these questions from those around them as well can feel very heavy.
"You look so well, you don't look ill at all."
Even if it is said as a compliment, this sentence can ignore the invisible difficulties the person is going through. Some patients worry that looking well will be taken to mean "it's not really that bad after all".
"When will you be better?"
For someone living with uncertainty, there is often no answer to this question. It puts on the person a burden they cannot respond to.
What Not to Say to a Sick Friend at Different Ages
The age and stage of life of your friend with the illness can determine which sentences are more sensitive.
To a young friend: In adolescence or young adulthood, peers are the most important source of support. Sentences such as "Once your hair grows back you'll be just like before" or "Who gets ill at this age?" can deepen a young person's worries about identity and appearance. For a young friend, the most precious thing is often to be included, as before, in the jokes, the gossip and the group's plans.
To an adult who works or is raising children: Saying "Don't worry about work" or "Don't think about the children, look after yourself" can be perceived as making light of the person's most important concerns. People in this age group are often thinking about both their own illness and their family's future.
To an older friend: Sentences such as "These things happen at this age" can diminish the person's feelings by presenting the illness as an ordinary part of old age. In addition, talking with an older friend's relatives instead of with them can damage their dignity. It is important to address them directly and respect their own decisions.
So What Can You Say? Alternatives to Hurtful Sentences
Knowing what not to say is important, but knowing what to put in its place is even more so. The sentences below are fictional examples; you can adapt them to your own way of speaking.
- Acknowledging their feelings: "This is really hard. Whatever you're feeling, you have every right to feel it."
- Honest and simple: "I don't know what to say, but I think about you a lot."
- Giving them a choice: "Would you like to talk about the illness, or shall we talk about other things today?"
- Without the burden of replying: "You're on my mind. No need to reply, I just wanted you to know."
- Keeping the bond going: "I watched the series we talked about last week. Let's chat about it once you've seen it too."
Things to keep in mind with messages and social media
Today, support is often given not face to face but through a phone screen. Because written communication lacks tone of voice and facial expression, sentences can come across as harsher or colder. When messaging, there are a few extra answers to the question of what not to say to a sick friend:
- Do not share your friend's illness on social media or in shared groups without their permission. Even a well-meant post such as "Let's all pray for her" can make them feel their privacy has been violated.
- When they read your message and don't reply, don't keep writing "Why aren't you answering? We're worried." They may be tired, in pain or simply not want to talk.
- Instead of long voice messages, leave short notes that don't expect a reply.
- In shared friendship groups, avoid conversations about your friend that they don't know about. Information should circulate only as far as they want to share it.
Building a shared language
In some friendships, humour plays a very important part. Illness does not have to wipe that humour out overnight. If your friend makes jokes about their own situation, joining in shows that you still see them as a "friend" and not as "a patient". However, the joke about the illness should be started by them, not by you. Over time, you will learn from their reactions which topics can be joked about and which are sensitive.
When your words are not enough, silence is a language too. Sitting with them, holding their hand, watching something together is often the most meaningful support. Concrete offers of help are a separate subject; many people say "Let me know if you need anything", but this offer is usually not taken up. Suggesting a particular day and task instead works better.
You don't have to find the right sentence to be a good friend; continuing to stay by their side is often enough.
What Should You Do If You Said the Wrong Thing?
We all say the wrong thing sometimes. What matters is being able to repair the relationship once we notice.
- Offer a short, sincere apology. "I said that the other day, and when I thought about it I realised I may have hurt you. I'm sorry." There is no need for long explanations or to defend yourself.
- Learn from it, but don't let it turn into tense, guarded talk. Realising that a sentence was hurtful helps you be more careful in later conversations. But weighing every word and speaking stiffly also takes away naturalness. Your friend is most likely expecting not perfect sentences from you, but your old warmth. Let's say you have a friend you've watched football with for years; continuing to message them after the match as usual, after their illness too, may do them more good than carefully chosen words of comfort.
- Don't blame yourself excessively. Showing after your apology that you feel bad for a long time can load your friend with the burden of comforting you.
- Don't pull away. Distancing yourself from your friend out of fear of saying the wrong thing often hurts more than a wrong sentence. Friends disappearing during an illness is one of the hurts patients most often voice. This topic is also discussed in the article on avoiding a sick friend.
Your Feelings Matter Too
Being with a seriously ill friend can be hard for you too. Fear, sadness, helplessness or worries about your own health may come up. Some people feel selfish for having these feelings; yet they are natural reactions to the illness of someone close.
A healthy way to carry your own feelings is to share them not with your ill friend but with another circle of support. It is fine to become emotional with your friend from time to time; but constantly crying or telling them about your fears can leave them having to comfort you. Talking to mutual friends, keeping a diary or, when needed, seeing a mental health professional can do good both for you and for your relationship with your friend.
For the general attitude of family and friends, the article on how to treat a family member with cancer may also offer guidance; many of the principles described there apply to other serious illnesses as well.
When Should You Seek Professional Support?
Your friend's illness may affect you more than you expect. In the following situations, talking to a professional may be helpful:
- Feeling intense anxiety or panic whenever you think about your friend
- Completely avoiding contact with them and feeling intense guilt about it
- Worries about your own health affecting your daily life
- Marked changes in your sleep and appetite
- Thoughts about the possibility of losing your friend constantly occupying your mind
If you notice hopelessness in your friend, words such as "There's no point in living any more", or thoughts of self-harm, do not brush this aside; without leaving them alone, share it with their family and treatment team, and in an emergency call 112 (emergency services).
How Is Supporting an Ill Loved One Addressed in Therapy?
Psychological support can make room both for the person living with the illness and for those around them. When working with someone who has an ill friend, frequently discussed topics include:
- Understanding the source of the worry "I'm going to say the wrong thing"
- Rehearsing difficult conversations in advance
- Noticing the fear behind avoidance behaviour
- Working with one's own anxieties about death and illness
- Making sense of anticipatory grief about the possibility of losing your friend
Cognitive behavioural therapy can help in understanding the thought and behaviour patterns involved in these issues. Individual therapy offers a space where you can talk both about your feelings regarding your loved one's illness and about how to look after yourself during this process.
Frequently Asked Questions
I'm hesitant to call my sick friend. Would it be better not to call at all?
Not calling at all often hurts more. Even honestly saying that you don't know what to say is valuable. You can start with a short message and go from there depending on how much your friend wants to talk.
Is it right to ask questions about their illness?
Curiosity is natural, but your need for information should not take precedence over your friend's wish to tell. Saying "If you'd like to tell me, I'll listen" leaves control with them. If they want to share the details themselves, listen; if they don't, don't insist.
My friend is very angry and gets angry with me too. What should I do?
Anger in the face of a serious illness is an understandable reaction and is often directed not at you but at the situation. Try not to take it personally, stay calm and gently protect your boundaries. If you become very tired yourself, it is also possible to step back for a while and then come close again.
Wouldn't it be better never to mention the illness?
Some friends prefer to talk about things other than the illness, while others want to share what they are going through. The soundest approach is to ask them and respect their preference. Ignoring the subject entirely, on the other hand, can leave them feeling abandoned.
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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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