Catherine was living the dream.
Mediterranean island. Beach 100 meters from her house. Thriving business as a purpose coach. Dream partner.
And then everything crashed.
It wasn’t one thing. It was everything at once.
A miscarriage. Hormones completely out of whack. Work stress from launching a book. Family visiting (which, if you know, you know… even good visits are exhausting). Packing her entire house for a two-month trip.
Then a flight with zero sleep. 36 hours awake. A family barbecue where she learned her grandfather had just been hospitalized.
Her system couldn’t take it. Her body shut down.
“I went into a complete freeze state,” Catherine told me. “My body was shutting down everything. I had no energy left to brush my teeth. I had no energy left to look after myself, like get myself food. I was just… gone. I was like a shell of myself.”
And it didn’t end after a week.
It went on for months. Then years.
She slid into chronic illness. Over 30 symptoms. Brain fog so bad she couldn’t find words. Inflammation. Anxiety. Panic attacks. Depression. Gum disease. Chronic back and neck pain. Insomnia. At one point, she didn’t sleep for almost a week.
“I thought I was going to die,” she said.
She’d been a healthy person for 38 years. Barely caught a cold. And suddenly, she couldn’t trust her body to do anything.
And one by one, her friends stopped calling.
What Happens to Friendships When Chronic Illness Hits
Here’s what nobody tells you about chronic illness:
It doesn’t just take your health. It takes your friendships, too.
Catherine’s experience: “I felt like I’d lost my business because I couldn’t work anymore. I’ve lost my financial stability. I’ve lost my family. I’ve lost my friends. And I was about to lose my partner.”
Her partner had become the sole income earner, her massage therapist, her psychologist, the person bringing her drinks and food because she couldn’t manage basic tasks.
He was beyond exhausted. At one point, he said, “I think we have to break up.”
Not because he didn’t love her. Because he was drowning.
That’s how intense it gets. That’s how much chronic illness takes from you.
And her friends? Most of them stopped calling after a few months.
“You know, when they call you and for the 10th time you say ‘Well, I’m not really well today,’ they’re going to stop calling,” Catherine said.
They did stop calling.
Why Friendships Fall Away (And It’s Nobody’s Fault)
Before we go any further, I need to say something important:
When friendships fall away during chronic illness, it’s usually not because anyone is a bad person.
It’s because chronic illness creates an impossible situation for everyone involved.
From the Sick Person’s Perspective:
Catherine explained it perfectly: “Being on the phone with somebody was exhausting. If I had a phone call, I had to go lie down for two days.”
Even phone calls (the most basic form of connection) were too much.
And what do you talk about when you’re chronically ill?
“I didn’t have anything else to talk about anymore,” Catherine said. “I tried to accommodate my friends by saying, ‘I’m okay, how are you?’ So we would switch topics to them. But listening is also a task. It takes energy out of you.”
Everything takes energy when you have none.
You feel like a burden. You feel like you’re bringing everyone down. You feel guilty for not being able to reciprocate.
So sometimes, you stop reaching out too.
From the Friend’s Perspective:
Imagine calling your friend every week for months. Maybe years.
Every time you ask, “How are you?” the answer is some version of “not well.”
You want to help. But you don’t know how.
You can’t fix it. You can’t make it better. Doctors can’t even figure out what’s wrong.
After months of this, you start to feel helpless. Burned out. Like, your calls aren’t making a difference anyway.
So you stop calling. Not because you don’t care. Because you don’t know what else to do.
And here’s something else Catherine said that broke my heart:
“Some friends would call, and I’d say, ‘Yeah, I’m a little better.’ And they’d go, ‘Oh that’s great! So what else is going on with you?”
They’d gloss over it. Change the subject immediately.
Because even the good news (“I’m a little better”) was too much. They didn’t want to hear about the illness anymore. Not the bad OR the good.
Nobody’s the villain here. It’s just… really hard.
The Two Friends Who Got It Right
But Catherine had two friends who did something different.
They lived far away, in Munich. And they kept calling.
For three years, they kept calling.
“They sort of understood that I was not able to… I did not have the energy or the right mental state,” Catherine said, getting emotional. “But when they called, and I picked up, I always felt better.”
Here’s what they did differently:
They asked “how are you?” and genuinely wanted to know.
They didn’t try to fix it. They just held space.
One of them had experience with depression. The other had a partner who went through depression.
So they knew: keep asking. Keep showing up. Don’t be afraid of the answer.
“That was such a gift,” Catherine said. “And those are friends I still talk to. I still value them deeply. Now I can hold space for them again. They did it for me first.”
Small. Consistent. Just holding space.
That’s what worked.
My Own Journey (Because I’m Living This Right Now)
I need to be vulnerable with you for a minute.
I’ve been dealing with health issues for the past year. Actually, longer than that. But it got really bad about a year ago.
Multiple days a week, stuck in bed. Debilitating migraines. Fatigue so intense I could barely function. Insomnia. And about 10 other symptoms.
For a long time, I didn’t talk about it publicly.
I didn’t want to “bring the vibe down.” I show up here trying to be positive, encouraging, and helpful.
But here’s what I realized: I deserve to exist as a full human. Not just the positive, productive version.
I’m seeing a specialist tomorrow. My doctor thinks it’s a chronic illness I’ll have to manage for the rest of my life.
And I’m terrified. And exhausted. And so, so grateful for the friends who’ve kept showing up.
Because Catherine’s story? I’m living a version of it right now.
The friends who text regularly just to check in. The ones who offer to bring food. The ones who say, “let’s just hang out on your couch” instead of expecting me to go out.
The ones who don’t take it personally when I have to cancel last minute because my body decided today is not the day.
Those friends are saving me right now.
And I’m trying to figure out how to be a good friend when I have so little to give.
What Actually Helps (Guidance for Friends)
If you have a friend who’s chronically ill, here’s what I want you to know:
1. One Small, Consistent Thing Is Better Than Grand Gestures
You don’t need to fly across the country and move in with them. You don’t need to solve their medical mystery.
Pick one small thing and do it consistently.
Examples:
- ▪️ Text every Tuesday: “Thinking of you today. No need to respond.”
- ▪️ Call once a week for 10 minutes
- ▪️ Drop off a meal once a month
- ▪️ Send a funny meme when you think of them
The consistency matters more than the size of the gesture.
Catherine’s friends? They just called. That’s it. But they did it for three years.
2. Hold Space: Don’t Try to Fix
When you ask “how are you?” and they tell you… just listen.
You don’t need to offer solutions. You don’t need to make it better.
Just be there. Just listen. Just let them know they’re not alone.
“Holding space is healing in so many ways,” Catherine said.
Your presence is the help. Not your advice.
3. Don’t Gloss Over the Good OR the Bad
This one surprised me, but it’s so important.
When your friend says “I’m a little better”… that’s huge. Sit with that. Celebrate that.
Don’t immediately change the subject. Don’t gloss over it.
They’re trusting you with their journey. Honor that.
4. Tag-Team With Other Friends
Here’s something I’ve seen work in my own friend groups:
When one friend needs to tap out, tell the others.
Chronic illness is long-term. You WILL get burned out if you’re the only one checking in.
So create a system:
“Hey, I’ve been talking to [friend] a lot lately, and I need a little break. Can someone else check in regularly for a bit?”
This way, the sick person always has someone. And no one friend burns out.
It’s not a “follow train.” It’s a “hold space train” where you take turns.
5. Accept That the Relationship Will Change
Your friend is different now. Their needs are different. Their capacity is different.
You might have been restaurant-hopping buddies. Now maybe you’re couch-sitting buddies.
The details you know about them are changing rapidly. Their favorite foods might be off-limits now. Their routines are different. Their energy levels are unpredictable.
The friendship isn’t ending. It’s transforming.
And if you can meet them where they are instead of mourning what it used to be, the friendship can survive.
Catherine and I talk through even more practical strategies in the complete episode, including how to have the hard conversations about what’s changed and how to rebuild trust when illness has created distance. If you want to be a better friend to someone who’s chronically ill, listen here.
What Actually Helps (Guidance for the Sick Person)
If you’re the one who’s chronically ill, here’s what I’m learning:
1. Professional Help Is Part of Your Network
Catherine said something that really stuck with me:
“I do not expect my partner or my friends to do that work for or with me. I’m not putting that on my friends to know what to do with somebody who has depression.”
Your friends are not trained professionals. They don’t know how to navigate your medical condition.
And that’s okay.
Your therapist, your doctor, your coach. They’re part of your support system too.
Not friends, but vital pillars.
Don’t expect your friends to fill that role. It’s not fair to them, and it won’t give you what you need.
2. You’re Responsible for Your Own State
This doesn’t mean you have to do it alone.
It means: your friends aren’t there to make you feel better. You are.
Your friends can support you. Hold space for you. Be there with you.
But they can’t fix you. And it’s not their job to try.
When Catherine realized this, it changed everything: “My friends are not there to make me feel better. I am responsible for making myself feel better.”
3. Communicate What You Need
Your friends can’t read your mind.
If phone calls are too much, tell them: “I love hearing from you, but I don’t have energy for calls right now. Texts are better.”
If you need them to just listen, say that: “I don’t need advice, I just need you to hear me.”
If you need them to keep checking in even when you can’t respond, tell them that too.
The clearer you are, the easier it is for them to show up in ways that actually help.
4. Accept That Some Friendships Won’t Survive
This is brutal, but true.
Some friends will fall away. And it’s not necessarily because they’re bad people.
Maybe they don’t have the capacity. Maybe they don’t know how to handle it. Maybe the friendship was built on activities you can’t do anymore.
Grieve that. It’s a real loss.
But also know: You will build new friendships with people who understand this version of you.
Catherine found her people in healing communities. People who’ve been through similar experiences.
“I have friendships now that are so deep and meaningful,” she said. “We’ve cried together. I consider myself very lucky.”
The Rebuilding Phase (Because You Will Get There)
Here’s something else nobody tells you:
If you do heal, or even just stabilize, you’re a different person now.
Catherine said, “I’m a whole new person. My personality is completely different.”
Which means: friendships have to be rebuilt.
What details did people know about you? Changed. Your routines? Different. Your needs? Different. Your capacity? Different.
It’s like your friends have to learn about a new person.
And that’s work. On top of everything else.
I’m experiencing this right now. Foods I used to love? Can’t eat them anymore. Activities did I use to do? Too exhausting now.
My friends are having to update everything they know about me.
And I’m having to communicate all of that while also just trying to survive each day.
It’s a lot. For everyone.
But here’s what Catherine realized: “I started saying ‘I love you’ to friends. I’ve never done that before.”
The friendships that survive this? They’re transformed. They’re deeper.
Because you’ve been through something together. You’ve seen each other in the hardest moments.
Those friendships are built on something real.
What I Want You to Take Away From This
Whether you’re the sick person or the friend, here’s what I need you to know:
This is hard. For everyone. And that’s okay.
If you’re sick:
- ▪️ It’s not your fault your friends are struggling
- ▪️ You’re not a burden for needing support
- ▪️ Professional help is part of your network
- ▪️ Some friendships won’t survive, and that’s not a reflection of your worth
- ▪️ You will rebuild. It just takes time.
If you’re the friend:
- ▪️ You can’t fix this, and that’s okay
- ▪️ Small, consistent actions matter more than grand gestures
- ▪️ Holding space IS helping
- ▪️ It’s okay to tap out sometimes (just communicate with other friends)
- ▪️ The friendship will change, and that doesn’t mean it’s ending
For both:
- ▪️ Grace. So much grace. For yourself and each other.
- ▪️ This is probably the hardest thing either of you has been through
- ▪️ There’s no “right” way to do this
- ▪️ Communication helps, but it’s also exhausting
- ▪️ It’s okay if you don’t get it perfect
The friendships that survive chronic illness aren’t perfect. They’re just persistent.
Small. Consistent. Showing up even when it’s hard. Holding space even when you can’t fix it.
That’s what saves friendships. That’s what saves people.
A Final Note
I’m recording this episode while dealing with intense fatigue symptoms. I don’t know what my diagnosis will be tomorrow. I don’t know how my friendships will change as I navigate this.
But I know this: I’m not alone. And neither are you.
If you’re chronically ill and you’ve lost friends, I see you. It’s not your fault. You’re not too much. You’re not a burden.
If you’re a friend watching someone you love suffer, and you don’t know what to do, I see you too. You’re not failing. You’re not doing it wrong. Just keep showing up however you can.
We’re all doing our best in an impossible situation.
And sometimes, that has to be enough.
Sending support to everyone navigating this impossible situation. You’re doing better than you think. ~ Alex
This is one of the most personal episodes I’ve ever recorded. Tune into the full episode to hear Catherine’s complete story and my own experience losing friends to chronic illness. Whether you’re the one who’s sick or the one trying to figure out how to show up, I think this conversation will change how you see things.
