Why Friends Abandon You When You’re Sick (And How to Cope)

First published by URevolution on April 4, 2020. Publisher commentary added in March 2025. Editorial labels and copyediting updated on September 15, 2026.

URevolution editorial introduction

Publisher’s note: The introduction and the commentary after the letter were written by Brendan McDonald for URevolution. They were added in March 2025 and are separate from Alice’s account. The letter has been lightly copyedited for clarity and consistency.

When illness lasts longer than people expect, invitations can stop and messages can go unanswered. The loss can be hard to explain, especially when you still care about the friends who have drifted away.

In the letter below, Alice describes what happened to her friendships when she became ill. She writes about hurt, but also about the friend who kept showing up. Our commentary follows her signature and pseudonym note.

Alice’s letter is one person’s experience of chronic illness and friendship. It does not offer a single explanation for why friends withdraw, or suggest that making new friends is easy when you are already exhausted.

A letter from Alice

Dear Friends,

I am not angry with you, and I never have been. I understand you never intended to hurt me. There was no malicious intent. But what unfolded was a by-product of the thoughtlessness that is pervasive in our society. In all honesty, if the situation had been reversed, I cannot say I would have done any better.

After I became very ill, the friendships I had built disappeared in stages. There was the initial drop-off, the friends with whom there has been no contact since I became ill. Most of them were just friendships on the peripheries, but a few had been close enough to have come to my birthday party three months prior.

The fact that they disappeared immediately actually made their absence less noticeable because, when I first became sick, I believed without a shadow of a doubt that I would be better soon, and our friendships would return. Sadly, time went on, and I did not get better, and so our friendships never returned. 

I had no cause to miss them at the beginning, and, by the time it became clear my illness was not short-term, their absence had become the norm. It seemed my friendships had no room for a long illness.

There were so many times when I’d reach out to them online, and, while they would answer, they made no effort to continue the conversation. I’d try to keep the conversation going but eventually would give up. Trying to reach a friend and feeling as though they did not care only made me lonelier.

On the occasions they did reach out to me and wanted to visit, I would get excited, but then they’d disappear for months. It was as if they had gotten their fix and went back to their lives until they missed me again. I doubt they stopped to think that while they had other friends to fill their lives, I didn’t.

If you know a person who has become suddenly ill or disabled, reach out to them in any way you can while also respecting their needs and privacy. Doing this on a consistent basis has the best effect. In our technology-filled world, this is easy to do. Texting, email, and social media make it easy to contact people, and our smartphones allow us to set reminders, say every month, to make sure we do so. If your ill or disabled friend reaches out to you, make an effort to have a conversation.

Reaching out when you’re sick can be difficult and there is nothing that makes you feel more alone than when you try to alleviate that feeling and get nothing in return. If it is possible to spend time in person, from the perspective of both parties, that is wonderful. When you are there, realise that although the person is not entirely the same as they were before, they are still your friend.

I know it can be hard to see someone you care about when their health has changed. Believe me, I even have trouble seeing myself this way. But try to acknowledge their differences and limitations while remembering the friendship you have built over the years. 

Small acts of kindness go a long way. Bringing small gifts or food can mean a lot. Inviting them to events, even if you know they won’t be able to come, will make them feel as though they haven’t been forgotten.

If you have become suddenly disabled or ill for an extended time, I hope you realise that it is not your fault, nor is it the fault of those around you. Illness puts a strain on friendships. 

I believe my friends could have done better, but I don’t believe they intended to hurt me. I only believe in blaming people when they act on purpose. When people make a mistake, we shouldn’t punish them. Instead, we should ask them to become conscious, understanding, and thoughtful. That is how we can help people do better next time, as I believe they can.

Does this empathy towards the people who unintentionally let me down make me feel better? In some ways, yes, and in others, no. It has allowed me to find clarity about the reality I find myself in. It has stopped me from wasting energy on useless and illogical emotions. 

It has left an emotional wound. Still, none of that lessens the loneliness I feel. There are times when the loneliness is so strong it can be physically felt. The obvious fix to this suffering, making new friends and spending time with them, is something out of the question.

Making a friend means meeting someone, then putting time and effort into building a friendship through shared experiences. I do not have the energy to do that. The only other option for me is to rekindle the friendships I lost, something I am not comfortable with due to the broken trust. 

I hope the next person in my situation, through having more aware and informed people around them, will be able to keep the friendships they have, so they can feel a little bit less alone.

For now, I take comfort in the connections I have left. Maybe one day, I’ll make some new friends who will see me for the person I am now and will like me all the same.

Sincerely,

Alice*

*Alice is a pseudonym 

URevolution editorial commentary — Brendan McDonald

Alice’s letter ends above. The following commentary, recommendations and product placements are from the publisher.

Friends should not have to face a long illness alone.

Alice leaves room for two feelings that can be difficult to hold together: understanding why friends withdrew and being deeply hurt that they did. Neither feeling cancels the other. Advice about friendship needs to leave room for both.

Some friends may be unsure what to say. Others may keep waiting for life to return to normal, or leave the person who is ill to arrange every conversation. Those are possible explanations, not things we can know about someone without asking.

Alice describes friends whose attention faded and one who continued to make time. Her account is more useful than a blanket judgment about who was a “real friend.” Whatever the reason for someone’s absence, its effect can still hurt.

The missed visit matters. So does the energy spent looking forward to it. Alice describes feeling lonelier after trying to keep a conversation going with someone who made little effort in return.

It can be tempting to search for something you did wrong. Needing shorter visits or being unable to go out does not make the friendship less deserving of care. Understanding another person’s limitations does not oblige you to pretend their absence has been painless.

If you have the energy, ask for something specific: a short visit, a message that does not require an immediate reply, or an invitation even when you may have to decline. A friend may find that easier to act on than a general request to stay in touch.

You do not have to keep making the same request indefinitely. It is reasonable to put your limited energy into the relationships that offer something back.

Online groups can offer contact without the demands of going out, but joining a group takes effort too. Alice is clear about that. Making new friends should be an option, not another task assigned to someone who is already exhausted.

If you are the friend reading this, start small. Send the message. Offer a visit with a clear understanding that it can be short or cancelled. Then keep in touch after the first few weeks have passed.

For specific ways to offer contact without adding pressure, read our guide to checking in on a sick friend.

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