As if the pain, fatigue, fluctuating symptoms and limitations of arthritis – no matter what type – weren’t enough, you may also have to cope with changing relationships. Family and friends may underreact, overreact or make insensitive comments, making a tough situation even more painful. If your arthritis diagnosis is affecting your relationships, try these strategies to keep them strong.

Challenge 1

Needing help with things you used to do yourself: “It’s hard to say, ‘I want to do this. Can you help me?’ Or to hear your spouse to say, ‘I can’t help you all the time,’” says T. Byram Karasu, MD, chairman of psychiatry at Montefiore Medical Center in the Bronx, N.Y.

Try this: “Take your spouse to medical appointments,” says Dr. Karasu. “Most don’t understand the limitations of arthritis. It helps to hear those from the doctor.” Once your partner understands your condition, you may feel more confident asking for help, and he may be more willing to offer it.

Challenge 2 

A helicopter spouse: Your husband or wife may constantly hover and nag you to remember medications or avoid overexertion.

Try this: Gently remind him that taking medicine, keeping medical appointments and exercising are your responsibility, not his, says Tina Tessina, PhD, author of Money, Sex, and Kids: Stop Fighting about the Three Things That Can Ruin Your Marriage (Adams Media, 2008). “That will make you both feel better.”

Challenge 3

Social isolation: Your biking/tennis/running buddy no longer calls. “Friends may move away because you can’t do the same things they do,” says Dr. Karasu.

Try this: Explain your limitations, but let them know you still can sometimes do less strenuous activities – for instance, doubles tennis instead of singles, or biking three miles instead of 15. If you're not up to it, suggest other activities, such as getting together for dinner or a movie.

Challenge 4

Goodwill burnout: No one wants to be around someone who talks about his problems all the time.

Try this: Ask about her life, listen attentively and be empathetic. “Genuine friendship is not using someone for a purpose,” says Dr. Karasu. “It’s emotional intimacy.”