Living with long-term conditions requires adaptation and coping. It is unclear how young adults – often still in unstable social relationships – and their partners or friends cope with the challenges of a long-term condition. Our study aimed to explore how young adults and their friends or partners arrange themselves with this situation. In a comparative design, we interviewed 24 young adults with differing long-term conditions and 30 of their friends or partners in episodic interviews, which we analyzed with thematic coding. We identified four patterns of dyadic arrangements of coping for both sides: Joint Management and Supportive Arrangement show congruence and cooperation in dealing with the condition. Divergence and Diffusiveness illustrate conflicts and tensions. Our results show the importance romantic partners or close friends can have for dyadic disease management in young adulthood and suggest including friends and partners in training courses on long-term conditions and in professional support.