At Flowly, we believe chronic pain management should include honest conversations about how illness impacts more than just the body. It reshapes relationships, identity, and emotional wellbeing, especially when the condition is ongoing and invisible.
This month, we’re discussing a recent piece from USA Today:
“Chronic illness can be hard on marriage. Studies show it's worse when the wife is sick.”
Read the full article here.
The article explores the emotional and relational toll of illness, particularly how caregiving stress and gender dynamics play out in long-term partnerships when chronic disease enters the picture. While the stories focus on cancer, the issues raised are just as relevant to those living with nonstructural chronic pain conditions like fibromyalgia, rheumatoid arthritis, and lupus.
The Caregiver Role Isn’t Always Shared Equally
One of the article’s central findings is that women who become ill are at greater risk of divorce than men who become sick. Studies showed that in couples aged 50–64, the likelihood of separation increased significantly when the wife reported poor health, but not when the husband did.
Why the imbalance?
“We often assign women as primary caregivers,” said Lena Nguyen, a family lawyer. “When those roles are reversed, I think couples really struggle with that adjustment.”
The expectation that women will provide care, even when they are the ones suffering, has deep social roots, and it's particularly problematic in chronic pain conditions that are already under-recognized and misunderstood.
While the article does a great job of bringing this imbalance to the public domain, it doesn’t provide any specific recommendations or advice on countering it. Flowly’s lead therapist, Lauren Flynn, PHD LHC, recommends utilizing individual, couples, and/or family therapy to help navigate changes and challenges. Illness impacts not only you, but your partnership and your family system, so it is natural to seek support and guidance to address evolving needs.
“You’re So Strong” Doesn’t Always Feel Like a Compliment
Jennifer Whitlock, who cared for her husband through his battle with blood cancer, described the caregiving experience this way:
“People will say, ‘You’re so strong. You’re so brave.’ You don’t feel like you’re any of those things when it’s happening. But what other choice do we have as humans?”
This quote captures the emotional labor that caregiving requires, and it echoes the quiet strength many people with chronic pain exhibit every day. Strength is often required, but rarely replenished.
The article points out how both patients and caregivers can suffer in isolation as initial support systems fade over time, what Dr. Arif Kamal calls “cancer ghosting.” This is just as applicable to chronic pain, where family and friends may lose patience or interest after the first wave of concern passes.
According to Flowly’s lead therapist, Dr. Flynn, instead of saying "you're so strong," make an effort to validate their experience and offer support. For example:
- Offer practical support with the following statement: "I can't imagine how difficult this must all feel, and I would like to help take something small off your plate..." then offer a practical means of support, such as running an errand for them or making a meal.
- Provide emotional support with this statement: "I can only imagine how heavy this all is to carry, and I don't want you to feel like you have to carry it alone. What do you think about us doing a weekly check-in so I can support you and you can vent?"
A Shared Diagnosis Doesn’t Always Lead to Shared Support
The story of Jamil and Fredric Rivers, both diagnosed with different forms of cancer while raising three kids, illustrates that even mutual illness doesn’t guarantee mutual care. Despite sharing profound medical challenges, their marriage deteriorated. Jamil described supporting her husband through his illness, even during her own treatment, while feeling largely unsupported.
“I didn’t want him to have to worry about taking care of me,” she said. “So, I think the fact that he was just still present, you know, he thought that he was being supportive.”
Fredric offered a similar perspective, believing he’d done all he could emotionally, even while their communication had broken down.
This part of the article raises an important question: What does “being supportive” actually mean in the context of illness? Support is highly personal, and mismatched expectations can lead to distance, even when both partners are trying in their own way.
While it’s easy to believe that both parties will be supportive “in health and in sickness” during times of good health, our lead therapist believes it’s essential to recognize that needs evolve after a diagnosis, extending beyond the physical needs of the person with the illness.
For instance, for the ill partner, what they need in order to feel grounded, secure, or emotionally safe may evolve in response to their life feeling uprooted by their illness. Meanwhile, what the caregiving partner needs in response to shifts in their roles and responsibilities, and their emotional response to their partner's illness, will change throughout the course of the illness. Therefore, transparency, vulnerability, and communication are necessary at every step in order to allow partners to feel connected and to address their individually evolving needs.
Emotional and Structural Support Are Both Essential
The article makes a strong case that caregivers need care, too. Whether it’s access to paid family leave, emotional support, or better integration into the healthcare process, caregiver wellbeing is often overlooked, despite its direct impact on patient outcomes.
Dr. Kamal of the American Cancer Society says we need to shift how we view illness:
“We’ve spent many decades defining it as the journey of a patient who happens to have a bystander who’s the caregiver. I think we need to redefine it as a shared journey.”
This is a vital message for our chronic pain community. The dynamics of caregiving and of being cared for are central to the patient experience. In nonstructural pain, where diagnosis and treatment are often delayed or minimized, emotional stress and relational strain can become chronic, too.
Dr. Flynn states, “Caregivers often devote so much energy to others that they can neglect their own wellbeing. Some ways caregivers can take care of themselves include: (1) Learn to set boundaries and allow others to complete tasks without guilt. (2) Delegate by letting others run errands, cook meals, or take a shift in caregiving. (3) Remember that self-care isn’t selfish, it’s survival. Take time to step away to nurture yourself and regulate your nervous system”.
Final Thoughts
While this article focuses primarily on cancer, the themes resonate powerfully for anyone living with long-term, often invisible conditions. It highlights the emotional cost of caregiving, the complex dynamics of support in illness, and the social structures that make it harder for women, in particular, to receive care when they need it most.
It’s a reminder that chronic pain isn’t just physical, and neither is healing.