Learning to say no when you're not feeling well

When you have inflammatory bowel disease (IBD), there might be days when you simply don't have the energy to do everything you want to do.

Maybe your friends invite you out, your family has plans, or someone asks you to join an activity at school. You might want to say yes, but your body is telling you that you need to rest.

Saying no can feel difficult, especially when you don't want to disappoint anyone or miss out on something fun. You might worry that your friends will think you're boring, your family will be upset, or people will stop inviting you to things.

But here's something important to remember: you are allowed to put your health first, even when other people might be disappointed.

💭 Why is saying no so difficult?

There are lots of reasons why saying no can feel uncomfortable.

You might worry about:

• Disappointing your friends or family.

• Missing out on something everyone else is doing.

• People thinking you're making excuses.

• Having to explain your symptoms.

• Feeling left out when everyone talks about what you missed.

• Being seen as unreliable because you sometimes need to change plans.

You might even tell yourself that you should push through because you don't want IBD to stop you from doing things.

It's understandable to feel this way. You want to have fun, spend time with people, and enjoy being a kid or teenager. You don't want your health condition to make decisions for you.

But ignoring your body's needs doesn't mean you're stronger or braver. Sometimes, recognising when you need a break is one of the best ways to look after yourself.

💚 Listening to what your body needs

Living with IBD can mean that your energy levels and symptoms change from day to day.

You might feel great one day and exhausted the next. You might have plans you're excited about, only to wake up feeling unwell.

Learning to recognise when you need rest can take time.

Ask yourself:

• Am I feeling well enough to do this?

• Will this activity leave me feeling completely exhausted?

• Am I saying yes because I genuinely want to, or because I'm afraid of disappointing someone?

• Could I do a shorter or easier version of the activity instead?

You don't need to cancel everything whenever you feel a little tired, and you don't have to avoid activities because you have IBD. The aim is to find a balance between enjoying your life and looking after your health.

If you're unsure whether an activity is suitable when you're experiencing symptoms, ask your healthcare team for advice.

🗣️ How to say no without feeling guilty

Sometimes, the hardest part of saying no is finding the words.

You might feel as though you need a really good excuse or a long explanation to help people understand why you can't do something.

But you don't have to justify every decision.

Here are a few simple things you could say:

• "Thanks for inviting me, but I'm not feeling well enough today."

• "I'd love to come, but I need to rest tonight."

• "I'm having a rough IBD day, so I need to sit this one out."

• "I'm sorry, but I need to change my plans. Can we organise another time?"

• "I can't manage that today, but I'd love to do something quieter instead."

You can keep your explanation short. You don't need to share personal details about your symptoms unless you want to.

And remember, saying no to one activity doesn't mean saying no to the person. You can still care about your friends and want to spend time with them, even when you can't make it happen that day.

������ What if someone gets disappointed?

Sometimes, people will be disappointed when you can't join them. Your friends might have been looking forward to seeing you, or your family might have planned something special.

It's okay for other people to feel disappointed, but that doesn't automatically mean you've done something wrong.

You can acknowledge their feelings without ignoring your own needs.

For example, you could say, "I know we were both looking forward to this, and I'm disappointed too. I'm just not feeling well enough today."

You don't have to make yourself feel worse by apologising over and over or promising to do something you're not sure you'll manage.

If someone cares about you, they should want you to look after yourself, even if they're disappointed that plans have changed.

If someone regularly makes you feel guilty, pressures you to ignore your symptoms, or gets angry when you need to rest, it's worth talking to someone you trust about what's happening.

🌱 You don't always have to say no completely

Sometimes, there's a middle ground between doing everything and doing nothing.

If you're not feeling your best but still want to be involved, you could try changing the plan to make it more manageable.

For example:

• Go to a party for an hour instead of staying all night.

• Meet a friend somewhere close to home.

• Choose a quieter activity instead of something physically demanding.

• Join your friends online if you don't feel well enough to go out.

• Ask whether you can decide closer to the time, if the plans allow it.

• Take breaks during an activity instead of pushing through exhaustion.

You can also suggest another day when you're feeling better.

Of course, there will be times when resting completely is what you need. You don't have to find a compromise every time.

The important thing is that you have choices, and you can make decisions based on how you're feeling rather than what you think other people expect from you.

😟 What if people think I'm making excuses?

One of the hardest things about having an invisible illness is that people can't always see when you're struggling.

You might look fine, even when you're dealing with pain, fatigue, or other symptoms. Someone who doesn't understand IBD might assume you're exaggerating or simply don't want to join in.

That can feel frustrating and hurtful.

If you feel comfortable, you could explain that IBD symptoms aren't always visible and that your energy and health can change unexpectedly.

You might say, "I know I look okay, but I don't always feel okay. Sometimes I need to rest even when it isn't obvious that I'm unwell."

You don't need to convince everyone to understand your condition. You know how you're feeling, and your symptoms deserve to be taken seriously.

If someone continues to dismiss your health needs, remember that their misunderstanding doesn't mean your decision was wrong.

🩷 Saying no doesn't make you a bad friend

You might worry that if you cancel plans too often, your friends will stop inviting you.

It's understandable to want to be included. Friendships are important, and missing out can feel lonely.

When you're able to, try letting your friends know that you still want to spend time with them, even when your health sometimes gets in the way.

You could say, "I might not always be able to come, but please keep inviting me. I still want to be included."

You can also suggest activities that are easier to manage or arrange another time to catch up.

Good friendships allow room for people to have different needs. You shouldn't have to be available every time to prove that you care about someone.

And if a friend struggles to understand at first, a conversation might help them learn more about your situation.

⭐ Remember this

Learning to say no takes practice, especially when you want to make other people happy.

But you don't have to ignore your symptoms, push through exhaustion, or feel guilty every time you need to rest.

You can care about your friends and family while still making choices that protect your wellbeing. You can be disappointed about missing out without blaming yourself. And you can change your mind when your body needs something different.

Saying no doesn't mean you're giving up. Sometimes, it means you're listening to your body and giving yourself the care you deserve. 💚