The surprising impact chronic illness can have on your social life—and how to deal

If you are like the millions of Americans who have a chronic illness (a disease like fibromyalgia, diabetes, or MS that often has no cure and requires ongoing treatment), you’re probably well-familiar with the medical side of your illness. You’re frequently in pain, spending lots of time at the doctor’s office or on the phone with your insurance company, and often feel physically weak—even though from all physical appearances you “look” totally fine.

However, certified life coach, wellness entrepreneur, and chronic illness advocateNitika Chopra says there’s one surprising place where your condition can have a big impact: your social life. The reality is that sometimes having (and treating) a chronic illness often impacts your ability to do otherwise “normal,” day-to-day activities—like meeting up with your friends after work, going on a weekend trip with your family, or even going to work. It can be extremely isolating.

And that was true for Chopra. She was diagnosed with a very bad case of psoriatic arthritis (a form of arthritis that includes flareups of red, scaly patches on the skin along with joint pain and inflammation) when she was 10 years old. In the 27 years since her diagnosis, she says there have been many periods of her life where she’s been in so much pain that she literally hasn’t been able to leave the house. In Chopra’s experience, you sometimes miss out—and it can really take a toll on your well-being. Here, she shares what has gotten her through the times where it feels like her illness has hijacked her life.

Be as up front as possible about what’s going on

Few things feel worse than being the person who constantly has to bail on plans and invitations. But Chopra says it’s key to tell people what’s going on with you in advance (especially when it comes to big events like wedding or work functions), so that they understand—and are less surprised if you have to cancel. “If you tell the person, ‘I want so much to go to this and the only thing that would stop me is if my health isn’t doing well,’ right when you RSVP, then they are more likely to understand if you do end up not being able to make it in the future,” she says.

Even if you have to break plans with someone last minute—like if you’re meeting them for dinner or a yoga class—Chopra says it’s important to say why. “With close friends who know about your illness, you can be honest and say something like, ‘Oh my god, I’m really flaring up right now and I’m so sorry, but I can’t leave my apartment’ and they’ll likely understand,” she says. “They did probably already plan their day around you, got dressed, and were looking forward to it, so it’s important to honor that when you communicate with them.” (So, they should have a little more notice than a one-sentence text canceling five minutes before you were supposed to meet up.)

Does this mean you have to tell everyone you know that you have a chronic illness on the off chance that you’ll make plans with them? Nope. If it’s someone you don’t know as well, Chopra suggests saying something like: “I was really looking forward to meeting you today, but something came up and it turns out I’m not going to be able to make it. Would you be willing to switch to another day? I really appreciate you being flexible and I’m super sorry for the inconvenience.” That’s a lot easier to receive last-minute, she says, than a vague text saying you have to reschedule.

Catch up on things first-hand—not through Instagram

When you do have to cancel on something, Chopra has one major piece of advice: Stay off of Instagram. Avoid falling into the FOMO trap and instead call your friends on the phone the day after to hear how the event actually was.

“There have been so many times where I saw something on social media and it made me feel so bummed out to miss it,” Chopra says, “but then I call my friend and she’s like, ‘Girl, you have no idea. The line to get in was so long. It was so crowded. We didn’t get our drink tickets.’ All these things. But everything looks so perfect on social media that you have no idea what it was really like.” Plus, Chopra says calling her friends the morning after to get the deets helps her still feel part of the experience even though she wasn’t able to be there IRL.

Let your friends be there (literally) for you

The next time you have to cancel on movie plans because you’re feeling poorly, ask your friends to come Netflix and chill with you instead—yes, even if you’re curled up on the couch clutching a hot compress. “I will never forget when I had a really bad flare-up and I was in so much pain that I was literally wailing on the phone to my friend,” Chopra says. “She wanted to come over, but I didn’t see the point. It’s not like she could do anything to take my pain away! But she came over and we didn’t talk about health. We talked about boys and random things—and we laughed so much. In that moment, laughter was the best medicine I could have received.”

Hanging out with your squad isn’t just good for you. Your friends want to be there for you, pain and all—and it’s important not to inadvertently cut them out. “There was another time when I mentioned to a friend that I had been home in my apartment for a week because I was in pain and she was pissed I didn’t call her—like actually pissed!” Chopra says. “The people who love you want to be there for you.” But it’s on you to let them in.

Know when you’re truly sick versus just isolating yourself

The irony: When you have chronic illness, Chopra says “it’s easy to isolate yourself and not want to show up to things.” That’s why she says it’s important to recognize when you’re accidentally sabotaging yourself. Or as Chopra puts it: “You have to recognize when your health is legit causing you to stay home and when you’re using it as a convenient excuse.” Getting out of the house and seeing friends can be just as important to your well-being as it is to stay in when you’re feeling poorly (just look at all the research that shows being social can help you live longer and be healthier!). Yes, it might take you extra effort to get to get dressed and meet your friend for coffee or go to that birthday dinner, but Chopra says getting out there—if your health truly is in an okay place at the time—is key.

Here are some scientifically-backed happiness tips, for when you need them the the most! Or, you know, you could just have sex.