Balancing Friendships and Psoriatic Arthritis

Elizabeth Medeiros_Balancing Friendships and Psoriatic Arthritis_AR_Elizabeth Medeiros

Psoriatic arthritis (PsA) affects every part of your life, even in subtle ways – including your friendships.

After living with PsA since childhood, I assumed I knew everything there was to know about navigating friendships with arthritis. But after graduating from college and entering “the real world,” I was in for a huge shock. As it turns out, maintaining adult friendships is much more work than I anticipated.

It wasn't as simple as turning up for class every day and getting to hang out with my besties for hours. My arthritis became more severe as I left college and entered the workforce. After a whole day at work on top of commuting, chores, and cooking, I had little energy or desire to go out and see friends or even have a phone call. I desperately needed my weekends to be peaceful so I could rest the joints that were aggravated from the strain of my day-to-day life. And in those first couple of years, I learned some hard truths about what it takes to balance relationships and a chronic illness.

Honesty is the best policy

Be honest with your friends. I remind myself that people aren't mind-readers and need to be told what you're going through, even if you're limping and in visible pain directly in front of them. It sounds corny, but a real friend will understand; they don't know you are struggling unless you let them in.

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Another important thing to do that they will appreciate is problem-solving together. Let them know how you can address your symptoms so you can still enjoy your time together. I remember explaining to a friend that I'd love to go to a convention with her, but I wouldn't be able to last all day on my feet. I'd either have to rent a wheelchair or come for only a little while before I’d have to go home. She appreciated my straightforwardness, and we made a plan to go to the convention, have a long lunch to give me a break, and I would head home early while she stayed. It worked out well, and we've had plenty of other fun days out since.

Some people will understand more than others

Friends will come and go over time. While I do have many friends with chronic illnesses who understand where I’m coming from, they haven’t been the only ones who stayed true. Most friends who stuck around during the hardest times were the ones that understood we all have busy lives and difficult circumstances. They were the kind who understood when I texted, "hey, sorry it's been a few weeks – I'm struggling." In fact, they've probably hit me with the same text, too. I really needed friends who were okay with that bit of space and trust, and I think our relationships are stronger because of it.

You can only cancel so many times

Of course, having understanding friends is only one part of the equation. To maintain friendships, you do need to put the effort in and show that you care. And sometimes, you will hate every moment of it. By no means put yourself in agony or jeopardize your health, but there will be times when it is necessary to push as much as you can or show someone you made your best effort. You can only say “sorry, I can't make it” so many times before people stop sending invitations or take it personally.

I think it's even okay to take control of plans a little to make it work. For example, you could invite a friend to your house to watch a movie instead of going out to a theater. Or, you could just have a phone call if meeting up for coffee is too much (trust me, I've been there before). A real friend will appreciate the effort.

Technology has also been a saving grace. While it can be draining to be 'on' and available constantly, it gives you more opportunity to stay connected with others without as much hassle. I've had plenty of virtual craft sessions, coffee and FaceTime dates, and even Zoom movie nights to keep me connected with friends. We get to enjoy each other’s company, but I also get to stay in the comfort of my home and rest.

Not everyone is a forever friend

In the past, I’ve blamed myself for the natural end of a friendship when it felt like PsA was a factor. It seems like it happened a lot when I went through long-term flares. I’d think, if only I pushed myself more, or if only I was able to participate more in an activity that person enjoyed, maybe we’d still be close. However, I had to let go of those feelings. Over time, I realized that my health likely wasn't the only factor. Some friends drift apart over time because circumstances and even personalities change.

It is okay to let go of a friend who isn't supportive. If there comes a point when you are continually drained (physically or mentally) by someone, you need to take a hard look at that relationship and decide whether it's worth it. It might be. Sometimes, I have decided to push myself more to keep up with certain friendships, but I've also let go of ones that were too much to handle. I knew it was time to move on when my health suffered and I felt dread at the thought of spending my limited energy with this person.

Overall, maintaining friendships is a two-way street. When PsA starts to affect your life, it's vital to have empathetic friends. However, you also need to be willing to open up and let others in to make things work. I can promise you that although it's hard and uncomfortable at times, it's worth it for true friends.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 May 6
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THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.