Updated on December 7, 2025
It’s hard to see someone you care about hurting. Whether they’re grieving a loss, facing a health challenge, dealing with addiction in the family, or navigating a significant life change, it’s natural to want to say the right thing. But sometimes, the words don’t come easily.
You might worry about saying the wrong thing or making things worse. You may not know whether to bring it up or wait for them to mention it. But here’s what research and real experiences tell us: the worst thing you can say is nothing at all.
Offering meaningful support doesn’t require perfect phrases. What matters most is your presence, your willingness to listen, and your ability to meet them with empathy.
This guide explores what to say (and what not to say) across different situations, why specific approaches work better than others, and how to show up for someone over the long term, not just in the first few days.
Why Our Words Matter
What we say during someone’s lowest moments can stay with them for years. Research shows that emotional validation (acknowledging someone’s feelings without judgment) can reduce distress, strengthen relationships, and help the brain regulate stress more effectively.
One 2017 study in Social Cognitive and Affective Neuroscience found that participants who received emotional validation had reduced activity in brain regions linked to emotional pain, compared to those who were invalidated or ignored.
Validation doesn’t mean fixing anything. It means showing up and saying, “I see you. Your experience makes sense.”
What Works No Matter What They’re Going Through
Before we get into specific situations, these approaches work whether someone is grieving, dealing with illness, or facing a major setback.
“I’m here for you.”
This offers presence without pressure. It’s a reminder that they’re not alone.
Try saying:
- “I’m here if you want to talk or if you just want someone nearby.”
- “You don’t have to go through this alone.”
Don’t just say it. Show it. Send a check-in text that doesn’t require a response: “No need to reply, but I’m thinking of you.” Drop off a meal. Sit beside them without filling the silence.
“You’re not alone.”
Grief, depression, and significant life changes often come with intense isolation. Reminding someone that they’re not the only one experiencing pain and that you care can be grounding.
“It’s okay not to be okay.”
This normalizes distress and creates space for vulnerability. It interrupts the cultural message that people should always be “fine.”
Try adding:
- “You don’t need to hold it all together right now.”
- “Anyone in your shoes would be struggling too.”
Skip the toxic positivity. “You’ve got this!” or “Just stay positive” can feel dismissive when someone is deeply hurting.
“Can you tell me what this feels like for you?”
Instead of assuming what they’re going through, you’re inviting them to speak.
Follow-ups might include:
- “What’s been the hardest part?”
- “Do you want to talk, or would you rather just have some company?”
You don’t need to fix. Just listen. Respond with reflections like, “That sounds really heavy,” or “Thanks for telling me that.”
Be specific when offering help
“Let me know if you need anything” is too vague when someone is overwhelmed.
Better alternatives:
- “Can I drop off dinner on Thursday, or would Friday work better?”
- “I’m going to the grocery store. Text me your list, and I’ll grab what you need.”
- “Want to talk, vent, or just sit together?”
When Someone Loses a Spouse or Partner
Losing a spouse reshapes every part of daily life. They’ve lost their companion, their future plans, their financial partner, and often their social identity. Married people are introduced as couples. Widowed people suddenly don’t fit in anywhere.
Research shows that widowed people experience higher mortality rates in the first year after loss, partly due to the stress and isolation.
What helps
Use their spouse’s name. Say “How are you managing without James?” not “How are you managing without your husband?”
The National Center for PTSD research confirms that grieving people want others to acknowledge the deceased person by name. It validates that person’s life and shows you’re not afraid to talk about them.
Don’t avoid them at social gatherings. Include them in invitations even if they come alone now. Let them decide whether to attend.
One widow shared: “The worst part wasn’t losing my husband. It was losing all our couple friends who didn’t know how to include just me.”
Ask about practical challenges. Widowed people often struggle with tasks their spouse handled. “Do you need help figuring out the taxes?” or “Want me to come over and help sort through insurance paperwork?” can be more useful than emotional platitudes.
Check in on hard dates. The deceased’s birthday, their wedding anniversary, and holidays they celebrated together. Put these dates in your calendar and reach out: “Thinking of you today. I know this one’s tough.”
What makes it worse
“At least you had a good marriage,” or “At least you got to say goodbye.”
There’s no “at least” that makes losing your person acceptable.
“You’re young, you’ll find someone else” or “You’ll get married again.”
They don’t want someone else. They want their spouse back. And talking about remarriage when they’re in acute grief feels like you’re erasing their loss.
“I know how you feel” (unless you’ve also lost a spouse).
Even if you’ve experienced other losses, losing a spouse is different. Better to say: “I can’t imagine what you’re going through.”
The dinner table problem
Many widowed people say the hardest time is dinner. They used to have someone to talk to about their day. Now they eat alone.
If you live nearby, consider a standing weekly dinner invitation. Not a big thing. Just “Come over Wednesdays. We’re eating at 6:30.” It gives them one night a week where they’re not alone at dinner.
When Someone Loses a Child
Child loss violates the natural order. Parents expect to die before their children. When that doesn’t happen, the grief can feel unbearable.
A 2012 study in JAMA Pediatrics found that parents who lost a child had significantly higher rates of depression, anxiety, and complicated grief compared to parents who hadn’t experienced this loss. The elevated mental health risks persisted for years.
If you need guidance on supporting children through grief, we have resources to help.
What helps
Say their child’s name. Often. Parents whose children died tell us that the worst thing is when people act like their child never existed.
“I was thinking about Emma today. Remember when she dressed up as a dinosaur for Halloween three years in a row?” These memories matter.
Don’t put a timeline on their grief. Child loss doesn’t follow the “stages of grief” model. Parents may grieve intensely for the rest of their lives, and that’s normal.
Acknowledge all their children. If they have other kids, those children didn’t replace the one who died. Don’t say, “At least you have your other children.” Each child is irreplaceable.
Support them through trigger moments. The deceased child’s birthday. The first day of school. Graduations. Weddings of their child’s friends. These milestones can hit hard.
What makes it worse
“Everything happens for a reason,” or “They’re in a better place.”
These statements can feel cruel. Parents want their child here, not in a “better place.”
“I can’t imagine what you’re going through.”
While well-intentioned, some bereaved parents say this phrase makes them feel more alone. Try instead: “This is every parent’s worst nightmare. I’m so sorry.”
Comparing losses. “I lost my grandmother, so I understand grief.”
Child loss is different. Don’t compare.
The sibling grief nobody talks about
When a child dies, parents aren’t the only ones grieving. Surviving siblings often feel invisible because all attention goes to the parents.
If you’re close to the family, check in with surviving kids separately. “How are you doing with all this?” They need their own space to grieve.
When Someone Loses a Sibling
Sibling loss is often called “forgotten grief” because people focus support on parents or spouses. But losing a sibling means losing your shared history, your childhood witness, and often your future.
What helps
Acknowledge the unique relationship. “I know you and Marcus were really close,” or “You two had such a special bond.”
Siblings often describe feeling like part of their identity died with their brother or sister. Validate that.
Don’t assume they’re “less affected” than parents or spouses. Grief isn’t a hierarchy. Their loss is profound.
One woman whose brother died said, “Everyone asked how my parents were doing. Almost nobody asked about me. I lost my best friend, but I felt like I wasn’t allowed to fall apart because my parents needed me.”
Check in months later. Initial support fades quickly for siblings because they’re not the “primary” mourners. But they’re still devastated.
What makes it worse
“At least your parents still have you.”
This makes the surviving sibling feel like a replacement or consolation prize. They’re not.
Treating them like a support system for parents rather than a mourner in their own right.
Yes, they may need to help their parents through this. But they’re also grieving and need support themselves.
Living with Chronic Illness
About half of Americans have a chronic health condition. Supporting someone through ongoing illness requires different skills than supporting acute grief or temporary setbacks. Chronic conditions don’t end. They need daily management, often for life.
Understanding what chronic illness actually means
Chronic conditions last a year or longer and need ongoing medical care or limit daily activities. This includes diabetes, fibromyalgia, rheumatoid arthritis, Crohn’s disease, multiple sclerosis, chronic migraine, POTS, lupus, and hundreds of other conditions.
Most chronic conditions are invisible. Your friend might look fine while experiencing severe pain, fatigue, or other debilitating symptoms. They’ve learned to function while suffering.
What helps
“That must be really hard,” or “That sounds incredibly frustrating.”
Simple validation matters. You’re not minimizing or trying to fix it.
“Can you tell me more so I can understand better?”
Asking questions shows genuine interest and lets them know you do not feel burdened by them. Let them decide how much detail to share.
Offer specific help, not vague support.
Chronic illness involves daily tasks that become difficult:
- “I’m going to H-E-B on Thursday. Can I pick anything up for you?”
- “Would it help if I drove you to your appointment next week?”
- “Can I pick up your kids from school on Tuesdays?”
Believe them about their symptoms and limitations.
If they say they can’t do something, believe them. Don’t say “But you did it last week!” Chronic conditions fluctuate. Good days and bad days are normal.
Keep inviting them to things.
They might cancel at the last minute due to symptoms. Invite them anyway. Let them know they’re welcome, and you understand if they can’t make it.
One person with chronic fatigue syndrome said, “My friends kept inviting me even though I canceled half the time. That meant everything. When I could go, I went. When I couldn’t, I didn’t feel guilty because they made it clear there was no pressure.”
What makes it worse
“Have you tried [cure/supplement/diet]?”
They’re seeing medical professionals. They don’t need your health advice. This comes across as “you’re not doing enough to fix yourself.”
Exception: If you have the same condition and they specifically ask what works for you, then share.
“You don’t look sick.”
Most chronic conditions are invisible. This invalidates their experience.
“At least it’s not terminal,” or “At least you can still walk.”
Stop. There’s no “at least” that makes chronic pain okay.
“Get well soon.”
Chronic conditions don’t go away. This shows you don’t understand what “chronic” means.
Better: “I hope today is manageable,” or “Thinking of you.”
Treating them only as their illness.
Yes, acknowledge their condition. But also talk about books, movies, shared interests, and other parts of life. They’re still a whole person with thoughts beyond their diagnosis.
The energy accounting problem
People with chronic illness often describe “the spoon theory.” They have a limited amount of energy (spoons) each day. Every task costs spoons. Getting dressed costs spoons. Making breakfast costs spoons, going to work costs most of their spoons.
When they cancel plans, it’s not personal. They’ve run out of spoons.
Don’t say “You just need to push through” or “Everyone’s tired.” Their fatigue is fundamentally different from typical tiredness.
When Someone Gets a Cancer Diagnosis
A cancer diagnosis throws someone’s entire life into chaos. Suddenly, they’re facing mortality, grueling treatment, financial stress, and loss of control over their body and schedule.
Research in World Psychiatry shows that cancer patients experience high rates of depression and anxiety, particularly during treatment. Social support significantly improves both mental health outcomes and physical recovery.
What helps in the early days
“I’m so sorry. This is scary.”
Acknowledge the fear without minimizing it.
“I’m here. What do you need right now?”
In the first few days after diagnosis, they might be in shock. Some people want to talk constantly. Others need quiet. Follow their lead.
Offer to go to appointments.
Medical appointments after a cancer diagnosis are overwhelming. Information comes fast. Having someone take notes helps.
“I’d like to come to your oncology appointment and take notes. Would that help?”
Handle specific tasks without asking.
“Let me know if you need anything” puts the burden on them. Better options:
- “I’m bringing dinner on Tuesday. Any dietary restrictions?”
- “I’m mowing your lawn Saturday morning.”
- “I’m going to email you about setting up a meal train. You don’t have to respond.”
What helps during treatment
Show up for the hard parts.
Chemo sessions can last hours. “Can I sit with you during chemo?” gives them company during difficult treatment.
Don’t expect them to entertain you. Bring a book. Sit quietly. Be there.
Understand that treatment is exhausting.
Chemo, radiation, and surgery take a massive physical toll. They might sleep 16 hours a day. They might not respond to texts. That’s normal.
One cancer patient said, “My sister texted me every morning: ‘Good morning. No need to respond. Just want you to know I love you.’ Those texts got me through treatment.”
Keep showing up months into treatment.
Initial support floods in, then fades. But treatment often lasts months. The person needs support in month six as much as in month one.
What makes it worse
“You’re so strong,” or “God only gives you what you can handle.”
They don’t want to be strong. They do not want to have cancer. These statements put pressure on them to show strength rather than letting them be scared.
“Everything happens for a reason.”
They didn’t get cancer for a reason. Cancer just happens. This statement can feel cruel.
“My aunt had that cancer, and she’s fine now.”
Every cancer is different. Every person’s experience is different. Your aunt’s outcome doesn’t predict their outcome.
Better: If they ask about others’ experiences, share. Otherwise, don’t.
Disappearing because you don’t know what to say.
They notice when people vanish. It hurts. Show up awkwardly if you have to, but show up.
The hair loss conversation
Many cancer treatments cause hair loss. Some people are devastated by this. Others don’t care much.
Don’t tell them “It’s just hair” or “It’ll grow back.” For many people, losing their hair feels like losing part of their identity.
If they choose to wear wigs, don’t comment on whether they look “real.” If they go bald, don’t stare or make a big deal of it.
Just treat them normally.
When Someone Is Caring for Someone with Dementia
Dementia caregiving is often called “the long goodbye.” The person is physically present but mentally fading. Family members grieve while still caregiving, which creates a unique type of pain.
What helps
“How are you holding up?”
Caregivers often focus entirely on the person with dementia and neglect their own needs. Asking specifically about the caregiver gives them permission to talk about their own struggles.
“Do you want to talk about your mom, or would you rather talk about literally anything else?”
Sometimes caregivers need a break from the constant dementia conversation.
Offer respite.
Dementia caregiving is 24/7. Offering to stay with their loved one so they can have a break is incredibly valuable.
“I can sit with your dad Saturday afternoon if you want to get out of the house for a few hours.”
Don’t take it personally if they can’t make plans.
Dementia is unpredictable. They might have to cancel at the last minute because their loved one is having a bad day.
What makes it worse
“At least they don’t know what’s happening.”
Many people with dementia have periods of clarity where they’re painfully aware of what they’re losing. And even if they don’t fully understand, the caregiver is watching someone they love disappear.
“When are you putting them in a facility?”
This assumes institutional care is inevitable or preferable. Many families choose to keep their loved ones at home as long as possible. Don’t judge their choices.
Sharing advice unless asked.
“Have you tried [supplement/activity/approach]?” usually isn’t helpful. They’re working with medical professionals.
The grief that nobody recognizes
Dementia caregivers experience anticipatory grief. They’re grieving while the person is still alive.
They might grieve the loss of conversations, shared memories, or recognition. Their parent might not remember them. Their spouse might not know their name.
This grief is real and valid even though the person hasn’t died.
One daughter caring for her mother with Alzheimer’s said, “People kept saying, ‘At least she’s still here.’ But she’s not. The woman who raised me is gone. This person looks like my mom, but doesn’t know who I am.”
When Someone’s Loved One Relapses After Addiction Recovery
Addiction affects entire families. When someone relapses after a period of recovery, family members often feel devastated, angry, scared, and helpless all at once.
What helps
“I’m sorry. This must be really hard for you.”
Validate their feelings without judging the person who relapsed.
“How are you doing with this?”
Let them express their own emotions. They might be furious, terrified, exhausted, or numb. All those feelings are valid.
Don’t make them choose between you and their loved one.
Statements like “You need to cut them off” or “Why are you still helping them?” force them into an impossible position.
They get to decide how to handle their relationship with the person who’s struggling.
Understand that this isn’t their fault.
Family members often blame themselves for relapses. “If I had just…” or “I should have known…”
Addiction is a chronic brain disease. Relapse is often part of the process. It’s not their fault.
What makes it worse
“You should have seen this coming.”
Hindsight is useless and cruel.
“They’re choosing drugs over you.”
Addiction isn’t a choice in the way most people think. This statement oversimplifies a complex disease.
“Just stop enabling them.”
“Enabling” is a loaded term. Unless you’re intimately familiar with their situation and the nuances of addiction, don’t use it.
Talking about the person who relapsed as if they’re worthless or disposable.
They’re still someone’s child, parent, spouse, or sibling. The family member loves them, even while hating the addiction.
The emergency plan conversation
If you’re very close to this person, ask: “Do you have Narcan? Do you know how to use it?”
Overdose deaths are increasing. Having Narcan available saves lives. Offering to help them get some and learn to use it is practical support.
“Would it help if I went with you to an Al-Anon meeting?”
Al-Anon and Nar-Anon are support groups for families of people with addiction. Offering to go with them shows support without judgment.
When Someone Is Facing Terminal Illness
Terminal illness brings up everything at once: fear, loss, unfinished business, financial stress, and the reality that time is limited.
Research shows that patients and families who openly discuss death and dying experience less anxiety and depression than those who avoid the topic.
What helps
Don’t avoid them.
Many people disappear when someone is dying because they don’t know what to say. But dying people and their families consistently say that abandonment hurts more than awkward conversations.
Show up. Even if you’re uncomfortable.
Ask what they want to talk about.
Some people want to talk about their fears and feelings about dying. Others want to talk about anything but death.
“Do you want to talk about what you’re going through, or would you rather talk about the game last night?”
Let them lead.
Help with legacy work.
Dying people often want to leave something behind. This might mean:
- Recording stories for their children
- Writing letters for future milestones
- Organizing photos
- Planning their memorial service
“Would it help if I helped you record some stories?” or “Want help organizing photos?”
Be present in the silence.
You don’t need to fill every quiet moment with words. Sometimes sitting together without talking is the most meaningful thing you can do.
What makes it worse
“Don’t talk like that” when they mention dying.
If they want to talk about their death, let them. Shutting down these conversations robs them of the chance to process and prepare.
“You have to stay positive,” or “You have to fight.”
They’re allowed to be sad, angry, or scared. They’re allowed to stop fighting if they choose.
Offering false hope.
“You’re going to beat this.” If it’s terminal, they’re not going to beat it. False hope can prevent meaningful end-of-life conversations.
Making it about you.
“I can’t imagine losing you,” or “I don’t know what I’ll do without you,” puts an emotional burden on the dying person to comfort you.
Save those feelings for your own support system, not the person who’s dying.
The practical stuff nobody mentions
Terminal illness involves a mountain of logistics: medical appointments, insurance paperwork, advance directives, funeral planning, and financial decisions.
Offering help with these tasks is incredibly valuable.
“Would it help if I made a spreadsheet of all your medications and appointments?”
“Want me to research hospice options with you?”
“Can I help you fill out these insurance forms?”
When Someone Loses a Pregnancy or Faces Infertility
Pregnancy loss and infertility involve grief for a future that won’t happen. The loss is often invisible to others, which makes the grief feel isolating.
What helps
Acknowledge the loss.
“I’m so sorry. This is a real loss.” Don’t minimize it by saying it was “early” or “just a miscarriage.”
Use the term they use.
If they call it their baby, use that word. If they say “the pregnancy,” use that term. Follow their lead.
Don’t ask when they’ll try again.
This question suggests they should move on quickly or replace what they lost.
Understand that pregnancy announcements can be painful.
If you’re announcing your own pregnancy, consider telling them privately before you announce publicly. Give them space to process their feelings.
“I wanted you to hear this from me first. I’m pregnant. I understand if you need some space, and that’s completely okay.”
What makes it worse
“At least you know you can get pregnant,” or “At least it happened early.”
There’s no “at least” in pregnancy loss.
“Everything happens for a reason.”
No. Miscarriage happens because of biology, not because the universe had a plan.
“You can always try again,” or “You’ll have another baby.”
They don’t want another baby. They wanted this one.
Suggesting they “just adopt” or “just do IVF.”
These aren’t simple solutions. Both involve complex emotions, logistics, and often significant financial cost.
When Someone Comes Out
Coming out (as LGBTQ+) is often presented as a happy moment. Sometimes it is. But for many people, coming out involves fear of rejection, loss of family support, or discrimination.
What helps
“Thank you for trusting me with this.”
Coming out requires vulnerability. Acknowledging that shows you understand what it took for them to tell you.
“I love you. This doesn’t change how I feel about you.”
For many LGBTQ+ people, the biggest fear is losing essential relationships.
Ask questions if you don’t understand, but don’t make them your educator.
“I might not get everything right immediately, but I want to support you. Can you tell me what would be helpful?”
Then do your own research. Don’t expect them to teach you everything about LGBTQ+ experiences.
What makes it worse
“I always knew” or “It’s so obvious.”
This can feel dismissive, as if you weren’t really listening when they shared something meaningful.
“Are you sure?” or “Maybe it’s just a phase.”
These questions invalidate their identity and suggest you know them better than they know themselves.
“I love you anyway,” or “I still love you.”
The word “still” or “anyway” implies that their identity is a flaw you’re graciously overlooking.
Better: “I love you. Thank you for sharing this with me.”
Asking invasive questions about their body, sex life, or medical choices.
These questions are usually inappropriate. If they want to share those details, they will.
Your Presence Matters More Than Perfect Words
You don’t need to have all the answers. You need to be present, listen, and create a sense of safety for the people you love.
When someone’s hurting, what they’ll remember isn’t a perfectly crafted phrase. It’s how you made them feel. Did you show up? Did you stick around? Did you let them be messy and human without trying to fix them?
Those are the things that matter.
If you or someone you love could use extra support right now, we’re here to help. Connect with a therapist at Firefly Therapy Austin and take the next step toward healing.
Firefly Therapy Austin offers affordable, effective therapy in Austin, Texas.
Find out more about our Therapists and Specialties.