What Not to Say to Someone Who Is Chronically Ill

Navigating conversations with someone who is chronically ill can be delicate. Chronic illness often comes with invisible struggles that aren’t always obvious to others, which makes it essential to approach these conversations with empathy and understanding. If you have a friend, family member, or colleague in this position, it’s important to ask yourself what not to say to someone who is chronically ill. Despite the best intentions, words can sometimes have unintended negative effects, reinforcing feelings of isolation or frustration for the person who’s experiencing the illness.

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The information in this blog post is provided for educational and informational purposes only and should not be construed as medical advice. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read online. The author of this post is not a licensed medical professional and does not assume any liability for any actions taken based on the information contained in this post.

”But you don’t look sick.”

Though this comment might seem like a compliment, it can be invalidating. Many chronic illnesses, from autoimmune diseases to fibromyalgia, are often invisible. Those of us living with these conditions may already feel misunderstood because their symptoms aren’t physically apparent. When someone is told they “don’t look sick,” it can feel like their struggles are being dismissed, as if their illness is only real if it’s visible to others. Instead of using this example of what not to say to someone who is chronically ill, focus on listening and showing support for what they’re going through, without questioning the legitimacy of their experience.

”At least it’s not cancer.”

While cancer is a devastating disease in it own right, comparing illneses minimizes the lived experience of someone with a chronic condition. Chronic illnes can involve constant pain, fatigue, or other debilitating symptoms that impact every part of a person’s life. It’s not a competition of who has it worse—each illness has its own unique challenges, nd trivializing someone’s condition by compring it to others can create unnecessary emotional disance.

There’s another reason that this is a key part of our “what not to say to someone with chornic illness” list—cancer itself can be a chronic illness! Certain diagnoses, such as myloproliferative neoplasms, are forms of cancer but are not terminal, as so many of those that might first come to mind. Conditions like essential thrombocythemia are cancers, but manifest must like other lifelong chronic illnesses. Empathy doesn’t need to be comparative—no one deserves more care or attention for one diagnosis or another.

”Have you tried (insert unverified remedy here)?”

Loved ones often want to offer solutions in the hope of alleviating discomfort, but unsolicitated medical advice—especially when it’s not grounded in sound science—can be just as harmful as any of these other things not to say to someone who is chronically ill. Spoonies are often already working closely with medical professionals and trying various treatments. Offering a remedy without understanding the complexities of their illness is absolutely a crucial addition to any list of what not to say to someone who is chronically ill. It can make your friend or family member feel as though they aren’t doing enough to care for themselves. Instead of recommending the latest fad treatment, focus on offering emotional support or practical help that aligns with their needs.

”You just need to stay positive.”

Toxic positivity can be just as isolating as negativity! Chronic illness brings challenges that require so much more than a positive mindset. Suggesting that someone just needs to change their outlook ignores the real struggles we face daily, both physically and emotionally—and is often more for the able-bodied person’s comfort than for the spoonie’s benefit. A person who is dealing with disabilities may already be doing their best to maintain a positive attitude, but they also need space to express their frustrations, pain, and fear without feeling guilty. Rather than encouraging an overly sunny outlook (something that you now know not to say to someone who is chronically ill), let them know that you’re here to listen without judgement.

”It could be worse.”

This is another phrase not to say to someone who is chronically ill. Even if you have good intentions, this comes off as dismissive more often than not. Chronic illness already feels like an isolating experience, and minimizing someone’s pain by telling them it “could be worse” doesn’t acknowledge the very real impact it has on their life. The reality is that living with chronic illness is hard, and it’s okay for us to express that! The most supportive thing you can do is acknowledge the difficulty of this situation instead of trying to reframe it.

”But you were find yesterday.”

Chronic illness is unpredictable—you might want to research the idea of “dynamic disabilities” to learn more. People can have good days and bad days, sometimes even within the same 24-hour period. What someone with chronic illness was able to do yesterday may be impossible today due to fluctuating symptoms like pain or fatigue. Suggesting that they should feel the same every day can add unnecesary pressure or guilt to an already challenging experience. Instead of questioning the changes, offer understanding and flexibility.

It’s especially crucial to consider this within the context of what not to say to someone who is chronically ill in the workplace. Concepts such as an ambitious daily quota—something I struggled with in a former full-time role—ignore the reality of fluctuating symptoms. Even a healthy employee has off days, after all. It’s important to remember that no one, chronically ill or otherwise, should be expected to be produce the same ambitious effort every single day.

”Just push through it.”

This phrase earns its place on our list of things not to say to someone who is chronically ill because it implies that they aren’t already doing enough to manage their illness. Spoonie life requires a careful balance of energy and rest, and pushing through can lead to severe burnout, flare-ups, or exacerbation of symptoms. For someone with limited energy or physical capacity, being told to push through can feel dismissive of the immense effort we’re already puttign into simply getting through each day. Instead of encouraging them to push harder, offer to assist with their needs so they can better pace themselves or just be there to listen.

”You’re too young to be that sick.”

Believe it or not, chronic illnesses don’t ask for ID before they strike. Young people with chronic conditions often face skepticism because they don’t fit society’s exepctations of what “sick” should look like. Comments like this can make someone feel alienated or like their illness isn’t being taken seriously. Young people with chronic illnesses are already dealing with the loss of a “normal” life in terms of career, socializing, and personal goals. A more supportive response than this or other examples of what not to say to someone who is chronically ill might be to acknowledge how difficult it must be to face those challenges at their age.

”You just need to exercise more.”

While exercise is often considered a universal remedy for various health issues, for many of us, it’s not as simple as this phrase not to say to someone who is chronically ill makes it seem. Conditions like myalgic encephalomyelitis (commonly called chronic fatigue syndrome), multpile sclerosis, or arthritis can make exercise difficult, painful, or even harmful. Suggesting exercise as a cure-all without knowing the complexities of someone’s condition can feel dismissive of the very real physical limitations they face. Instead, respect their bboundaries and understand that they’re likely already doing everything their body can handle.

”At least you get to stay home all day.”

There’s a misconception that because those of us who are chronically ill spend a lot of time at home or might not work full-time, they have an easier or more relaxed life. In reality, being stuck at home can be incredibly isolating and frustrating, especially when the person is homebound because of pain, fatigue, or other debilitating symptoms. Chronic illness can rob people of the abilitiy to do the things they once enjoyed. Instead of commenting on what seems like a “perk,” acknowledge the challenges of being forced into a more limited lifestyle.

”It’s all in your head.”

This comment is one of the worst offenders within these things not to say to someone who is chronically ill, especially when directed to those of us with invisible or otherwise misunderstood conditions. Many spoonies already struggle with feeling like their symptoms aren’t believed or taken seriously. Suggesting that their illness is “just” psychological reinforces stigma and can cause them to doubt their own experience. Even if an illness has a psychological component, it doesn’t make the symptoms any less real. Instead offer validation and trust that we know our own bodies and what we’re going through.

”You should be grateful for the good days.”

While encouraging gratitude can seem like a positive thing, it can also come across as dismissive when said in the wrong context. Chronic illness often comes with a rollercoaster of good and bad days, and the pressure to feel grateful on good days can add emotional strain. Someone who is chronically ill may already be thankful for moments of relief, but it doesn’t negate the overwhelming nature of their condition. Rather than pushing your loved one towards gratitude, simply be present in both their good and bad moments without making them feel like they need to put a positive spin on everything.

”I wish I could nap all day.”

Statements like this may be intended to be lighthearteded, but they can be hurtful to someone with a chronic condition, especially if fatigue is one of their primary symptoms. For many, naps aren’t a luxury—they are a necessity due to overwhelming exhaustion that doesn’t improve with rest. Chronic fatigue can leave people feeling as if they are never fully awake or alert, even after a nap or a full night’s sleep. Joking about napping minimizes the seriousness of their fatigue and the limitations it imposes on their daily life. A better approach would be to acknowledge how exhausting it must be and offer to help lighten their load, rather than defaulting to this key phrase not to say to someone who is chronically ill.

”You’re just stressed out.”

While stress can certainly exacerbate symptoms, chronic illness is far more complex than a simply reaction to stress. Dismissing someone’s condition as just a response to stress downplays the seriousness of what they’re experiencing. Many chronic illnesses, including autoimmune disorders, are deeply rooted in physical dysfunction that no amount of stress management can fix. Instead of assuming their symptoms are merely stress-related, acknowledge that their condition is valid and likely has layers of complexity that go far beyond stress.

This is another double example of what not to say to someone who is chronically ill as well. At its core, chronic illness itself is stressful! By suggesting that they are just stressed—and that they need to do something about that stress—you’re inherently overlooking the intrinsic stress of spoonie life. Rather than assure them that they’re “only” stressed out, find areas where you can help mitigate the layers of stress.

”You’re so strong, I don’t know how you do it.”

Though meant as a compliment, this statement can unintentionally place yet another emotional burden on someone with a chronic illness. People often feel pressured to appear strong, even when they’re struggling. While recognizing their resilience is important, it’s also crucial ot give them permission to be vulnerable. Chronic illness can be overwhelming, and hearing how “strong” we are can make us feel like we have to hide the moments when they don’t feel strong at all. Instead, remind them that it’s okay ot have bad days—and that you’ll be there for them no matter what.

”Everything happens for a reason.”

This phrase can be one of the most painful among these things not to say to someone who is chronically ill. It implies that someone’s suffering has a greeater purpose, which can feel dismissive or invalidating. For many of us, chronic illness is random and unjust, not something that fits into a neat narrative of personal growth or cosmic reasoning. Suggesting that an illness serves a “higher purpose” may add emotional strain, as it implies they should find meaning in their suffering. Instead, offer a more grounded response, such as recognizing the unfairness of their situation and simply being there for them.

”Stop making excuses.”

This comment invalidates the very real struggles that come with chronic illness. When someone’s physical or emntal state prevents them from fulfilling obligations or participating in activities, it’s not an excuse—it’s a reflection of their current reality. People with chronic conditions already battle feelings of guilt or frustration when they’re unable to meet expectations and hearing that they’re “just making excuses” compounds that emotional burden. What may appear as an excuse to someone on the outside is often a necessary boundary to protect their health—or a hard limitation imposed by their condition. Instead of assuming the worst, avoid this example of what not to say to someone who is chronically ill and recognize that managing chronic illness(es) requiresmaking difficult decisions about what they can and cannot do on any given day.

”I know how you feel.”

Unless you also live with the same chronic illness, it’s impossible to fully understand what someone else is going through. Even those of us who have the same diagnoses experience them differently! Even if you’re experienced acute illness or pain in your own life, chronic conditions are unique in their unrelenting nature. Saying something like “I know how you feel” can minimize the individual’s experience, unintentionally shifting the focus to your own story. A better approach is to ask how they’re feeling and listen openly without trying to relate.

One grey area with this particular addition to this list is that many neurodivergent folks use similar statements to show how we an directly empathize with the person we’re talking to. In this context, too, it is easily misconstrued—many neurotypicals interpret this well-meaning comparison to one’s own life as an attempt to turn attention to oneself. Here, like many of these phrases not to say to someone who is chronically ill, require a clear, gentle form of communication.

”Maybe it’s just in your diet.”

While diet and lifestyle changes can play a role in managing chronic illness, they are not cure-alls, especially if recommended by someone outside of someone’s actual medical team. Those of us with chronic illnesses are often bombarded with advice about changing their diets, eliminating certain foods, or following specific nutrition plans. For instance, many spoonies are falsely assured that a vegan diet will “cure” them. Ironically enough, I’ve been vegan my entire adult life and get the opposite accusation!

Additionally, many chronic conditions have little or nothing to do with diet. Instead of offering unsolicited advice, you could ask how they’re managing their illness and whether there’s any way you can offer support for whatever treatment they’ve chosen.

”You must be lying because you were able to [insert activity].”

This type of accusation is one of the most hurtful and damaging because it assumes that chronic illness is predictable and consistent, which it rarely is. Chronic conditions often fluctuate dramatically ,and someone may be in severe pain or fatigued one day but feel a bit better the next—thought hat doesn’t mean eman they’re “cured” or were exaggerating their symptoms before. Living with chronic illness often involves balancig responsibilities and tryingt o make the most of the days when symptoms are more manageable. Accusing someone of lying because they were able to do something enjoyable after a difficult day or eriod ignores the reality of how unpredictable chronic illness can be. A better appraoch isto offer understanding and recognize that their ability to participate in certain activities doesn’t negate the seriosuness of their condition or the challenges they faced the day(s) before.

”You need to get out more.”

Encouraging someone with a chronic illness to be more active or social misses the mark more often than not. People with chronic conditions may already want to be more social or active, but their symptoms may limit their ability to do so. Fatigue, pain, and other complications can make even the simplest outings a challenge. By suggesting they should “get out more,” it can feel like you’re overlooking the physical and emotional toll their illness takes on them, Instead, offer to spend time with them in ways that accommodate their need, whether that’s a quiet visit at home or another option that isn’t too physically demanding.

”You’re lucky you don’t have to work.”

This remark completely disregards the fact that many people with chronic illness wld love to work but can’t due to their condition(s). Being forced out of the workforce, especially from a career you love, can lead to feelings of isolation, financial insecurity, and a loss of purpose or identity. Far from being lucky, many people with chronic illnesses mourn the loss of their careers, struggle with accusations of not contributing to society, and are left to figure out how to afford to live without a steady income. A better approach, from an outsider’s perspective, is to ask how they’re feeling about their current situation and acknowledge the difficulties of managing a life-altering condition.

”You need to do [insert responsibility here] regardless.”

This is yet another example of what not to say to someone who is chronically ill beause it ignores the limitations that chronic illness imposes, suggesting that responsibilities should take priority over health and well-being. While everyone has responsibilities, people with chronic illnesses often have to balance these with the need to manage their symptoms, wic can be overwhelming or debilitating. Insisting that they push through regardless is dismissive and can lead to feelings of failuer of shame when they simply can’t meet the demand. A more compassionate approach would be to acknowledge the challenge they’re facing and ask how you can help or support them in managing their responsibilities ina. way that aligns with their current capabilities.

This is an especially rampant dismissal as a chronically ill entrepreneur. Even if we’re upfront about our limitations and the potential problems they could cause, it can seem to others that we’re shirking responsibilities for the heck of it. It’s obviously disappointing to a customer, client, or colleague if something falls through due to our illness, but it’s crucial to know that the spoonie in question is probably feeling devastated for letting you down already—on top of dealing with their symptoms.

”Have you thought about seeing a therapist?”

While therapy can be beneficial for anyone, this comment can be problematic if it’s said in a way that implies the illness is “only” psychological or that the person’s suffering is due to their inability to cope—or worse yet, that they’re just making it all up. Chronic illness is often physically driven, and while the emotional tll is significant, suggesting therapy as a solution can feel dismissive of the physical reality they facr. Instead, acknowledge that managing chronic illness an be emotionally draining and if they express interest then support them in seeking resources for their mental health. But always remember that mental health support is ultimately a personal choice, not something implied to be a necessity because of their illness.

”You don’t have [condition].”

This phrase is an essential addition to this list of what not to say to someone who is chronically ill because it is particularly hurtful when it comes from someone with no medical knowledge, dismissing a diagnosis or symptoms because they don’t understand or believe them .Medical conditions can be complex and difficult to diagnose, but it is not up to friends or family members to question the validity of someone’s illness. Telling someone they dno’t have the condition they’ve been diagnosed with—or even questioning the possibility—nudermines their experience and can lead to greater feelings of isolation or self-doubt. Instead of playing armchair doctor, trust that their healthcare professioals are guiding their care and offer your support without questioning the reality of their diagnosis.

”You just need to get more sleep.”

While adequate rest is essential for everyone, chronically ill or otherwise, sleep alone cannot cure or significantly improve most chronic illnesses. Conditions like fibromyalgia, chronic fatigue, or autoimmune diseases involve complex physiological issues that aren’t resolved by more sleep. In fact, many people with chronic illnesses struggle with both sleep disturbances and extreme fatigue. Suggesting that they need more rest can feel like you’re oversimplifying their condition. A more supportive response would be to acknowledge their fatigue and ask if there’s anything you can do to make things easier for them.

“At least you don’t have to worry about (work, kids, etc.)”

Statements like this, even when meant to put a positive spin on things, can be incredibly invalidating, making for another key addition to our list of things not to say to someone who is chronically ill. Chronic illness doesn’t free someone from responsibilities—it adds a layer of difficulty to every aspect of life. While they may not be juggling the same responsibilities as someone who is healthy, the burden of managing their condition can be overwhelming. Suggesting they are “lucky” to have fewer traditional responsibilities minimizaes the often all-consuming nature of chronic illness. A more empathetic approach is to recognize that their daily life is most likely filled with its own set of challenges and uncertainties already.

”You just have to fight it.”

Chronic illness is not always something that can be fought or beaten through willpower alone. Many conditions are lifelong, and framing it as a “battle” can create additional pressure on the person to constantly push against their illness, even when they’re exhausted or need rest. I think this is part of why variations of “chronic illness warrior” doesn’t sit well with me, personally. This particular instance of a phrase not to say to someone who is chronically ill can lead to feelings of failure inadequacy when symptoms persist despite their best efforts. Instead, acknowledge the strength they already show in managing their condition from day to day, and let them know it’s okay to rest and take care of themselves.

”It’s probably just because you’re getting older.”

This one’s the reverse of “you’re too young…” on our list of what not to say to someone with chronic illness! Aging and chronic illness are two very different things. Many of us develop chronic illnesses at a young age or while still in the prime of their lives, so attributing their symptomsto aging can feel dismissive. Chronic illness comes with a unique set of struggles, and simply chalking it up to aging doesn’t do justice to the severity of their condition. Instead, you could ask more about their specticic symptoms or how their condition has evolved, giving them space to share their experience without oversimplifying it.

”You can’t let the illness define.”

While this sentiment is often meant to encourage resilience, it can come across as dismissing the reality of living with a chronic condition, a key indicator that it is something not to say to someone who is chronically ill. For many spoonies, their illnesses are unavoidable parts of their daily lives, dictating what they can and cannot do. Suggesting they not let it “define” them can add pressure to act as though the illness doesn’t have a signficiant impact. Instead, let them know that it’s okay to acknowledge the ways an illness affects their life and reassure them that you value and see them for who they are—illness and all.

”It’s always something with you.”

Like a few of these phrases not to say to someone who is chronically ill, this comment carries an undercurrent of frustration or impatience, as if the person is exaggerating their condition or constantly seeking attention. For someone with a chronic illness, there often is always something going on because their health is in constant flux. Symptoms can flare up unpredictably, ad they may be dealing with a range of issues simultaneously. Hearing that “it’s always something” can make them feel like a burden, as fi they are being judged for the reality of their condition. Instead, show patience and understanding, and if you’re feeling concerned, ask how you can help them through the difficult times.

”You’re not trying hard enough.”

This is quite possibly the most hurtful things you should not say to someone with who is chronically ill. Living with one or more chronic conditions often emans spending significant amounts of time and energy just trying to get through the day. The idea that they could “try harder” to improve their situation is not only dismissive but also places blame on them for something beyond their control. What may look like a a lack of effort fromthe outside could be the result of severe fatigue, pain, or other symptoms Instead of focusing on what htey should do, ask how you can support the in what they’re already doing.

”You’re always sick.”

Though it may come from a place of concern, saying this can feel like criticism or frustration with the person’s condition. Chronic illness is, by nature, ongoing and unpredictable, and people living with these conditions are liekly already grappling with the mental and emotional toll of being sick “all teh time.” Comments like this can make them feel like a burden or reinforce feelings of guilt. A more helpful approach would be to offer patience and understanding, acknowledging the ongoing nature of their illness without judgement.

”Then maybe you shouldn’t [insert habit here].”

This type of comment implies that the person is somehow repsonsible for their illness or condition because of their habits, choices, or lifestlye. Whether it’s related to diet ,activity level, or personal preferences, palcing blame on someone’s actions can be incredibly hurtful, especially when they are already doing everything in their power to manage their illness. Chronic illnesses often ave no clear cause and can be unpredictable, so suggesting that they caused or worsened their condition with a particular habit is oversimplifyig the complexities of their health. A better approach is to ask how you can support them in managing their illness, rather than focusing on perceived mistakes.

“You’re not really disabled.”

This example of what not to say to someone who is chronically ill is not only dismissive but can also be deeply damaging. Disability can manifest in many ways, and just because smoeone doesn’t fit a stereotypical image of what disability “looks like” doesn’t mean their experience is any less valid. Many of us wtih chronic illnesses deal with invisble disabilities—conditions limit our ability to function biut are not immediately apparent to others. Saying they’re “not really disabled” disregards their challenges, making them feel as though they must prove their illness to others. Instead, a more spportive approach would be to trust that they know their bodya nd what they’re experiencing, and acknowledge their disability without questioning.

Spoonie life means constantly navigating limitations, fluctuating symptoms, and the perssure to meet both personal and external expectations. The various comments on this list of what not to say to someone who is chronically ill can exacerbate feelings of guilt, isoaltion, and inadequacy. Chronic illness is not something that can be push aside or ignored, but rather require flexibility, understanding, adn empathy from those around us.

By choosing words that show care, rather than judgement, you help create a space where any loved one with chronic illness can feel respected, supported, and valued, not pressured or dismissed. Ultimately, a little patience and understanding can make all the difference!