This letter is a continuation of the author’s article regarding the essentiality of social support in chronic pain management and for patients who feel hopeless because of their sickness or poor medical condition [1]. As I reflected on this, it dawned on me that there are instances where social support does not benefit the patient but instead can worsen their condition and cause more stress in dealing with pain or other illnesses. Thus, my discussion dwells on the negative effects of social support. In addition, this paper will propose what appropriate behavior or action should be taken if the patient does not want any interaction with others, whether online or face-to-face.

Social support is commonly viewed as beneficial to chronic pain management. It causes a buffering effect on patients by a decreased pain experience and pain-related stress [2]. As highlighted in the author’s previous article, while pharmacological and surgical procedures deal with the physiological aspect of chronic diseases, social support addresses significant psychosocial issues. It helps heal by lifting the patient’s morale, encouraging them, and boosting their confidence in coping with pain [1]. However, this non-pharmacological element may not always be applicable at all times. It can sometimes turn into a negative experience, resulting in social isolation and deteriorating health. In a study conducted with people who suffer from inflammatory bowel disease (IBD), the authors highlighted that social support, either in face-to-face or online communication, could also be a source of stress and strain in two ways — unwanted confrontation and undesirable reactions [3]. Some patients expressed being overwhelmed and wished not to think about their condition during unwanted confrontations with family and friends. During such times, they felt annoyed if others kept asking about their condition. Sometimes, even support groups do not help. Some patients who share extensively about their condition cannot avoid recalling the pain that they have experienced, which may lead to discomfort and anxiety. This is not helpful, especially to those who are starting to recover and the disease's symptoms are reduced. Undesirable reactions like being pitied and overreacting may also not contribute to the patient’s recovery and pain management. Some patients want to be treated normally, and being pitied for their condition makes them feel like a different or changed person, making them weaker. Families and friends who overreact to a patient's manageable condition and make it a “big deal” can also lead to the patient feeling burdened and anxious. With this, it is important for families and friends to remain calm and manage their emotions when facing their sick relative. They must learn to control their emotions instead of letting their emotions control them. Nobody wants to add or contribute to any cause of worry that can trigger negative emotions in the patient.

During these times when the patient does not want to interact or receive any means of social support, either during chronic pain management, dealing with treatment or rehabilitation procedures, or in the process of recovery after surgery, the proper attitude is to give one's utmost respect. Patients who are in unhealthy situations need more understanding since they are more sensitive than their usual self. Their aching bodies affect not only their physicality but also the emotional, psychological, and mental aspects of their being. One must show empathy by being patient with the behavior of those experiencing pain, and not show irritation when they act indifferently. It is appropriate to give the patient ample time to achieve a full recovery. Listening is another integral way of dealing with our patients. Ask them what is going on, let them talk whatever they want to talk about without forcing them, and just reflect on what they say. Help them feel heard and understood [4]. If the patient is capable, encouraging them to move and engage in approved physical activity is beneficial. Physical activity reduces chronic pain by building muscle strength and flexibility, reducing fatigue, pain sensitivity, and inflammation. Engaging in activities that involve more movement and less sitting will lead to the desired health benefits and possibly help manage or reduce chronic pain [5]. Lastly, families and relatives of patients must continue to ensure that pharmacological treatment is continuously administered and that utmost primary care, even in "secret or unseen" ways, is given if the patient still feels too irritable to interact. Being patient with patients in pain helps them realize their importance in our lives.