When you live in constant pain, or struggle with chronic illness, discouragement is just part of daily life.

The simplest tasks can be exhausting. You consistently worry that you’re becoming a burden. Pain often leads to intermittent sleep, so you rarely feel rested. It’s hard to stay upbeat and cheerful. Since chronic conditions persist for a long time, or are constantly recurring, you depend on friends to encourage and support you — and then to keep encouraging and supporting you over extended periods of time.

I’ve lived with post-polio syndrome for nearly twenty years now, and I’ve also tried to care for others with chronic health issues for decades, so I’ve learned from both sides what’s helpful, sustainable, and frequently overlooked. It’s a long and difficult road for everyone involved, and each situation is unique, but here are some lessons about what to do, what to say, and how to pray for our friends who are hurting.

1. Keep checking in, even when others have stopped.

In my experience, one of the most helpful ways to serve our hurting friends is to check in regularly to see how they’re doing.

People with chronic pain and illness often feel alone and forgotten, especially if their condition leaves them homebound. Friends may rush to help when symptoms first start, but with pressing issues in their own lives, many stop staying in touch. They assume others are still visiting and offering support, but few people stay engaged months afterward, even as needs persist and increase. The paralyzed man in Bethesda had no one to help him into the pool, perhaps because, after 38 years of disability, people had stopped showing up (John 5:2–7).

If you’re going to visit, consider offering concrete help at the same time — anything from stopping by the grocery store to running errands to bringing a meal. As James reminds us, it’s easy to say, “‘Go in peace, be warmed and filled,’ without giving them the things needed for the body” (James 2:16).

Even if you stay only for thirty minutes, you could offer to load the dishwasher, straighten up the kitchen, or give a back massage while you talk. Or you could ask if there’s anything else you can help with or projects you can come back to work on. People usually won’t initiate the conversation about their own needs, but they may respond well to specific questions. However you try to help, always ask first, because what is a welcome blessing for some might feel intrusive to others.

2. Be quick to listen and slow to speak.

While we all want to say something profound and comforting, sometimes listening is the most comforting gift we can give.

Friends with chronic illness may not mention their latest symptoms or struggles for fear of sounding like chronic complainers, but they may welcome the opportunity to share what’s going on. Strive to listen without immediately passing judgment. Resist offering them a “cure” for their sorrow. And don’t pry if they’d rather not talk more about it now. Instead of asking the general question, “How are you doing?” you might ask instead, “How are you doing today?” which is more personal and easier to answer.

Remembering what not to say is often more important than remembering what to say. I say that as someone who has too often said too much. Don’t minimize what they’re going through. Don’t compare their suffering to others who are doing it “better.” Avoid sentences that start with “At least . . .” Don’t throw out platitudes like, “Count your blessings.” Don’t tell them that you know their condition will improve or that they will be healed, because no one knows what the future holds. Again, I give these examples as someone who regrets having said them all before.

“Remembering what not to say is often more important than remembering what to say.”

Faithful friends weep with those who weep (Romans 12:15). They acknowledge how difficult their situation is. They let their sick friends vent for a time, and then encourage them to put their hope in the Lord Jesus. They assure them that God will never leave them, and reassure them that their suffering will not be wasted. They remind them of the glory that awaits in heaven, where there will be no more pain or tears.

Many of us in this generation have heard cautions not to use Scripture like a baseball bat, as if we could bludgeon suffering people into feeling better, but don’t be afraid to share God’s word altogether. Since God’s word gives true comfort, by all means, bring verses to share, but do so patiently and with care. Choose the verses that have been meaningful to you in your trials, and explain why. For example, I have found hope in passages like these:

Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid. (John 14:27)

We do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal. (2 Corinthians 4:16–18)

This I call to mind, and therefore I have hope: The steadfast love of the Lord never ceases; his mercies never come to an end; they are new every morning; great is your faithfulness. (Lamentations 3:21–23)

3. Take the most caring, most effective action: pray.

Pray consistently for your friends with chronic illness. They need prayer not only for their physical needs — including strength, healing, and reprieve from pain — but also for their emotional and spiritual needs. With chronic struggles, it’s common to feel discouraged, disillusioned, and depressed as days go by without improvement. While we can’t change their situation or outlook ourselves, God loves to work through our prayers.

When friends share their prayer requests, pray with them right away, if possible. Not only does it reinforce your genuine care, but it also ensures that you really do pray. It’s easy to stop earnestly praying for people with long-term conditions, but our prayers have great power (James 5:16), so don’t give up. Remind people that they aren’t forgotten by occasionally texting them what you’re praying for them.

“Be especially quick to listen and slow to speak when your friends are hurting.”

You might offer to pray with them through a psalm of lament like Psalm 13, 43, or 142. Lamenting together is a beautiful way to acknowledge what’s hard and to cry out to God with them, while entrusting their situation to him. Read a few verses at a time, followed by spontaneous words of request or trust. If your friend would prefer just to listen, try inserting their name into a psalm like Psalm 23, 46, or 139 as you pray it aloud.

Now Is Not Too Late

Ministering to people with chronic pain or illness can leave us exhausted if we believe it’s all up to us. Or, if we’ve made mistakes in the past and ended up hurting someone we wanted to help, we may wonder if our efforts are worth it. But caring for our wounded friends is not all up to us, and our imperfect efforts really are worth it. God will give us fresh strength and wisdom as we wait for him and serve by the power he supplies (Isaiah 40:31; 1 Peter 4:11).

If you’ve grown weary and stopped checking in, don’t let guilt keep you away. Instead, go ahead and reach out now, because it’s never too late. We cannot fix our friends’ problems, but we can keep showing up, meeting their physical needs, listening to their struggles, encouraging them in Christ, and bringing them before the only One big enough to heal, sustain, and deliver them.

Audio Transcript

Our culture talks a lot about bucket lists: doing things, experiencing things, achieving things before the clock of life runs out. Mainly, it’s used to talk about travel, places to see, places to go. So, what about Christians talking about bucket lists?

That’s the question from a listener named Christine: “Pastor John, hello. Recently, you wrote this on Twitter: ‘Retirees pack in their bucket list quick before they die as if there is no glorious resurrection, no new earth, no wonders of the new world, no presence of Christ to sweeten every venture in eternity. It is a very strange way for Christians to act in a world of desperate need.’ That’s poignant.

“I feel this pressure as a twenty-year-old woman. All my friends have bucket lists, too, for places to see and travel to before they get married and have kids. I’ll admit I’m tempted here, to get all my adventuring in now. It’s not just a retiree temptation. Can you further unpack this point for me? It seems tied to your themes of not wasting our lives and ‘anti-retirement.’ But how do you balance this eternal hope for the next life while taking and enjoying vacations with your family in this life?”

Let me clarify at the outset that, yes, I am on a little crusade to motivate Christians over the age of 65 (and those who are planning to be over the age of 65 someday) not to waste their remaining healthy lives in bondage to the worldly mindset that earthly adventures are to be packed into our final years, as though on the other side of death, just a few years away, the adventures with Jesus will not be a thousand times better. Instead, they will probably be enhanced if we spend our final healthy years here serving other people rather than chasing earthly excitements.

I don’t know how you can read and believe the Bible and look at this pervasively broken, suffering world, this lost world, and think otherwise. I really don’t. Baby boomers, my generation — I’m the oldest baby boomer, just eleven days short (my birthday is January 11, 1946) — baby boomers own half of the nation’s $156 trillion in assets. Seventy-five million American boomers are expected to be retiring or to have retired seven years from now — all of us, more or less, retired by 2030.

And about 28 percent of those 75 million boomers call themselves evangelical Christians. That’s about 21 million people. If we had the will, we could finish the Great Commission before we were off the scene, both by hundreds of thousands of us going and by billions of dollars being given to send others to the least-reached peoples of the world.

So, maybe you can see why I am on a crusade to say to Christians, “Don’t waste your final two decades chasing earthly excitements when excitements a thousand times better await you just over the horizon of this life.” That would be like a person on the way to inherit a million dollars spending the last mile picking up shiny pennies. It seems to me that it would make a lot more sense to spend the last mile emptying your pockets for lost and needy people.

Focus on Mindset

Now, I know Christine did not ask me about what I’ve just talked about — namely, the retiree. She asked me about twentysomethings who have bucket lists of adventures to pack in before they get married. And then more generally, she asks about the relationship between eternal hope and family vacations.

“Death is not the end of your bucket list. It’s the beginning.”

The reason I have spent half my time now talking about the final twenty years of life is because I think if I could win over some of the Christian twentysomethings to this way of thinking about future decades, then it would inevitably have a powerful impact on their present decade. It would. The reason people waste the last decades of their lives is because the world has taught them to for the previous sixty years, including their twenties.

So, I would say the same thing about globe-trotting at age 25 as I do at age 65: Is the mindset governing this way of life a biblical mindset? That’s the question. “Is it a biblical mindset?” is a different question than whether it’s right to take a family vacation or whether it’s right to buy your rail pass and spend the summer after college visiting every country in Europe. Both of those decisions may be right. The question is, What’s your mindset? Is it biblical?

That’s a different question, because we can’t spend every hour of every day or every day of every year in focused, productive, valid work, whether in Christian ministry or some other vocation. It is biblical and wise to build respite, rest, from work into our lives, both for the sake of recreation and for the sake of legitimate enjoyment of God’s world. Those two impulses are very different from a worldly mindset that is oblivious to the needs of the world, the shortness of life, the joys of service, and the preciousness of the glory of Christ.

Not only is respite from work wise and biblical, so that vacations and days off are totally legitimate, but the adventures themselves — the ones you might do during those times when you’re not working — the adventures themselves need not be merely self-gratifying.

For radically Christ-exalting Christians, adventures (whether in your twenties or seventies) won’t be conceived merely as checking off earthly excitements before you marry or before you die. These adventures will be conceived as adventures with God — on the lookout for his handiwork and his glory, eager to build experiences into our lives for greater usefulness in Christ’s cause, eager to approach every amazement worshipfully, eager to cross paths with people providentially placed there for you to bless.

So, my main desire for twentysomethings and seventysomethings is that they think like the Bible and not like the world, that they think God’s thoughts more than man’s thoughts, that they look at the world through a biblical lens. This would include at least these seven perspectives, which I’ll just name.

Seven Ways to Think God’s Thoughts

1. God “has delivered us from the domain of darkness and transferred us to the kingdom of his beloved Son” (Colossians 1:13). Therefore, we are sojourners and exiles here.

2. This earth is not our home. “Our citizenship is in heaven” (Philippians 3:20).

3. Life is a vapor, with many troubles here, and eternity is endless, with no trouble there — only joy (James 4:14; Psalm 16:11).

4. We are called to have a healthy, heavenly mindset, having our priorities and desires shaped by things that are above, things that are unseen, things that are eternal (2 Corinthians 4:18).

5. “To live is Christ, and to die is gain” (Philippians 1:21) — far more gain than anything obtained on earth. Death is not a threat to happiness. You don’t need to squeeze happiness in here because death is coming. That’s ridiculous — I mean, ridiculous. Death is not a threat to happiness. It’s the door to happiness. It’s not the end of your bucket list. It’s the beginning. Come on, we’re Christians.

6. Many people are lost, broken, and more important to help than places are to visit (Galatians 6:10).

7. Finally, life exists, old and young, for the sake of Christ, to make him look supremely valuable (Philippians 1:20). “Only one life, ’twill soon be past; only what’s done for Christ will last.”

I think if we embrace these seven biblical perspectives, God will show us how to use our earthly early and later years.

Imagine that the angel Gabriel has been recording your prayers for the last year. Every request for yourself or others has found its way into his heavenly ledger. What might such a record reveal?

How many petitions would fall under the heading of physical health? How long would be the column tracking requests about your relationships? How many tallies would you find next to “Work” or “School” or “Church”? How many vague prayers for “blessing” might you find?

I’ve been asking myself such questions lately, in part because of a striking observation from Tim Keller’s book Prayer. If you study the prayers of the apostle Paul recorded throughout his letters, Keller says, you may notice something striking: among the many requests Paul makes on behalf of the churches, he never once asks God to heal their bodies, fill their wombs, prosper their vocations, or lift their persecutions. In fact, Keller writes, “Paul’s prayers for his friends contain no appeals for changes in their circumstances” (20).

I fear that if I set my own prayer record next to Paul’s, some of my first prayers may appear last, and my last prayers first.

Heart-Deep Prayers

Now, we should beware of stating the case too strongly. Even though Paul’s prayers for others contain no appeals for circumstantial changes, the apostle clearly had a category for such prayers.

He invites the Philippians to “let [their] requests be made known to God,” without limiting the requests to a certain kind (Philippians 4:6). He calls Timothy to pray “for kings and all who are in high positions” (1 Timothy 2:1–2). When asking for prayer himself, Paul sometimes mentions personal safety and success in travel (Romans 15:31–32; 2 Thessalonians 3:1–2). He also pleaded three times for God to take his thorn (2 Corinthians 12:8).

Yet such requests form the background, not the foreground, of Paul’s recorded prayers; they are q’s and z’s in the alphabet of his intercessions, present but not frequent. Instead, Paul displays a relentless focus on the inward life, the Christian soul, the hidden realm of the heart — or, to use a phrase from Ephesians 3:16, the “inner being.”

So, for example, Paul prays that the Romans might “abound in hope” and know the presence of “the God of peace” (Romans 15:13, 33). He wants the Ephesians to have “the Spirit of wisdom and of revelation in the knowledge of him”; he wants Christ to “dwell in [their] hearts through faith” (Ephesians 1:17; 3:17). Paul yearns for the Philippians to abound in discerning love (Philippians 1:9) and for the Colossians to give thanks like heaven-bound saints (Colossians 3:12). He asks that the Thessalonians might be holy through and through (1 Thessalonians 5:23).

Even when Paul prays for outward matters like public obedience or visible unity, these always flow from somewhere deeper, somewhere inner. Paul’s prayers cut to the heart.

Why He Prayed What He Prayed

God gave us Paul’s prayers, in part, so that by rehearsing them our own requests might grow in biblical balance and substance. Like the Psalms, Paul’s prayers train our tongues in the language of heaven. They give us words before the throne of grace.

At the same time, growing in Pauline prayer means more than simply repeating his requests. As D.A. Carson notes, Paul’s prayers spring from a robust “biblical vision,” a vision that “embraces who God is, what he has done, who we are, where we are going, what we must value and cherish” (Praying with Paul, 43). If we abstract Paul’s prayers from the biblical vision that inspired them, they may feel unnatural (like a second language we can’t quite learn). But once we catch his vision, we find ourselves slowly becoming fluent in Paul’s heart-deep prayers.

What, then, was Paul’s vision? Among the several areas we could explore, consider how Paul’s prayers were shaped by past grace and future glory.

Prayer Furthers Faith and Love

The first part of Paul’s vision comes from the past. “He remembers the grace we have received in the past, and thinks through the direction of our lives,” Carson writes (42). In other words, Paul considers the “good work” God has already begun in the lives of his people, and in prayer, he aims to partner with God in “[bringing] it to completion” (Philippians 1:6). He sees the seeds of grace, and prays them into flowers.

And what is the good work God has begun? What grace does he intend to grow? Again and again, Paul thanks God for two signs of grace among the saved: faith and love. “Because I have heard of your faith in the Lord Jesus and your love toward all the saints, I do not cease to give thanks for you” (Ephesians 1:15–16). To Paul, faith in Jesus and love for God’s people were more precious than all the world’s silver and gold. Our body may be broken, our dreams undone, our relationships fraught — but if we have faith and love, God has lavished us with grace (Ephesians 1:7–8).

Paul’s prayers run like rivers from this fountain of past grace, flowing with faith and love. If God has begun the good work of faith, then Paul will pray (in a dozen creative ways) for faith to grow, for God to give “the Spirit of wisdom and of revelation in the knowledge of him” (Ephesians 1:17). And if God has begun the good work of love, then Paul will ask (again with wonderful creativity) for love to “abound more and more” (Philippians 1:9).

Paul’s prayers remind us of an easily forgotten truth: in this age, the character of our inner being is far more important than the circumstances of our outer being. As Paul writes elsewhere,

We do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. (2 Corinthians 4:16)

One day, God will raise and glorify our “outer self” and banish every bad circumstance. But in the meantime, his good work happens mostly in the “inner self.” He aims to deepen our faith, love, and every other grace until we see him face to face. So, while Paul sometimes prays for the outer self’s welfare, he fastens his attention on the inner self’s renewal.

When Earthly Requests End

If Paul’s prayers keep one eye on the past, they keep another eye on the future — and not just the future vaguely, but one future moment in particular. Repeatedly, Paul returns to one future day, when God’s good work will finally come to an end: “the day of Jesus Christ” (Philippians 1:6).

Five times in Paul’s recorded prayers, he explicitly mentions the day of Christ’s return (Philippians 1:10; 1 Thessalonians 3:13; 5:23; 2 Thessalonians 1:9–12; 2 Timothy 1:18). He prayed, it seems, in the shadow of the second coming, with the returning Christ standing at the door of his prayer closet. And the power of that future promise governed what he asked of God.

When Jesus appears, the mists will rise, the fog will clear, and the true priorities of this age will stand forth in startling clarity. Our circumstances in this life, which are by no means insignificant, will bow before matters far weightier still. Healthy or sick, did we glorify God with our bodies? Arms empty or full, did we abound in thanksgiving to him? At peace or in conflict, did we display the patience of Christ? In success or failure, were we “filled with the fruit of righteousness that comes through Jesus Christ, to the glory and praise of God” (Philippians 1:11)?

What if we prayed, for ourselves and our friends, under a sky ready to split before the glory of Christ? We might ask more often, and with greater fervor, that God would establish our hearts “blameless in holiness before our God and Father, at the coming of our Lord Jesus with all his saints” (1 Thessalonians 3:13). We might pray less for circumstances to change, and more for a heart that loves Christ in all circumstances.

Our Hearts His Home

When we kneel with Paul between past and future, grace and glory, Christ’s cross and Christ’s second coming, we find ourselves saying new words, praying fresh prayers. At the bottom of our prayers, we ask for faith and love, inward strength and heart-level holiness. Or, Paul writes in Ephesians, we plead for Christ to make our hearts his home.

According to the riches of his glory [may he] grant you to be strengthened with power through his Spirit in your inner being, so that Christ may dwell in your hearts through faith. (Ephesians 3:16–17)

Paul asks that Christ would take up his residence within, filling every hallway and room with his brilliance. He asks that we would have what Keller calls a “powerful sense of God’s reality” — a sense that transcends our present situation and even survives the grave.

“Without this powerful sense of God’s reality,” Keller writes, “good circumstances can lead to overconfidence and spiritual indifference. Who needs God, our hearts would conclude, when matters seem to be so in hand?” (Prayer, 21). But when Christ makes his home in our hearts, then we can make our home in every circumstance: in “plenty and hunger,” in “abundance and need” (Philippians 4:12).

So then, pray for healing, but pray also (and most) for holiness. Pray for relational peace, but pray also (and first) for relational patience. Pray for dreams still distant and hopes still deferred, but pray also (and chiefly) for Jesus to walk with you even among the ruins of the life you wish you had. Then, whether outward circumstances flourish or wither, all will be well within. For Christ will still dwell within.