Matthew Perry’s family and friends say the late actor was “struggling” ahead of his final TV appearance at the 2021 “Friends” reunion special.

“It’s tough to watch, because he’s just not himself,” his friend Kevin Pollak says in Netflix’s “The One About Matthew Perry,” documentary, adding that Perry hadn’t been on camera in awhile.

Pollak notes that at the time of the HBO Max reunion special, Perry was “struggling with sobriety” and felt “a lot of pressure.”

Matthew Perry (pictured with Jennifer Aniston at the 2021 “Friends” reunion special) was “struggling” during that time, his friends reveal in a new documentary. HBO MAX

The 2021 “Friends” reunion special (pictured with Perry, Matt LeBlanc, David Schwimmer, Courteney Cox, Aniston, and Lisa Kudrow) was Perry’s final TV appearance before his death. HBO MAX

In the documentary, Perry’s sister Mia Perry Bowick further explains, “Because his health was so bad, he hadn’t really been out in public since 2018.”

When Perry decided to participate in the 2021 reunion – which brought him together onscreen with former co-stars Jennifer Aniston, Courteney Cox, Lisa Kudrow, Matt LeBlanc and David Schwimmer – his sister explains that he was “very nervous about coming back out.”

“[He] wanted to be like, ‘I’m here. I’m good, everything’s fine,'” Bowick said. But, that “was only sort of half-true” at the time that the special was filmed, she says.

Perry (pictured with the “Friends” cast in 1994) hadn’t been out in public for a while at the time of the 2021 “Friends” reunion. ©Warner Bros/Courtesy Everett Collection

The actor, seen with the “Friends” cast at the 2021 reunion, was “nervous” and wanted to show everyone he was “good,” his sister explains. Terence Patrick/HBO MAX

Following the special, viewers expressed concern about Perry’s health on social media.

In the Netflix documentary, Bowick explains that her brother’s “energy and life force” were “diminished” following his 2018 near-death experience when his colon burst from opioid overuse.

The actor detailed the terrifying ordeal, in which he spent two weeks in a coma, five months in the hospital and had to use a colostomy bag for nine months to treat the health crisis, in his 2022 memoir “Friends, Lovers and The Big Terrible Thing.”

Perry (pictured at the “Friends” reunion) had “diminished” energy after he nearly died in 2018, his sister says. HBO MAX

The “Friends” star nearly died in 2018 after his colon ruptured. (Pictured in the reunion special with Schwimmer.) Terence Patrick/HBO MAX

Doctors told Bowick that Perry’s colon had ruptured in several places, causing “intense sepsis” throughout his entire body, she recalls in the Netflix doc.

The “Friends” star had multiple surgeries to repair his colon, and, “at one point the decision was made to put him on an ECMO machine, which is basically like an iron lung,” his sister adds.

“His fingertips were turning black. There was a possibility that he would lose his fingers,” she says.

Perry (pictured with his sister Mia) was in a coma on an “iron lung” and his fingertips were turning “black,” his sister says. Netflix/ Youtube

Bowick (pictured in “The One About Matthew Perry”) said it was a “slap in the face” to learn that opioid use caused the health scare. Netflix/ Youtube

Bowick says it felt like a “slap in the face” to learn the cause of Perry’s heath scare, explaing, “opioids can slow down your digestive track dramatically.” 

She adds, “There’s so much grief family members and friends have to sit with when their loved ones are struggling with substance abuse.” 

At the time, she was “angry at him” and thought, “You did this to yourself, man…That was really really really hard.” 

Perry hadn’t been on camera since nearly dying in 2018. (Pictured with the “Friends” cast in 1994.) ©Warner Bros/Courtesy Everett Collection

He stayed in the hospital for three months in 2018. (Perry seen above at the “Friends” reunion.) HBO MAX

Perry’s months-long hospital stay was the first time Bowick saw him and thought to herself that he wouldn’t wake up.

When “The Whole Nine Yards” actor went home from the hospital, “he was still in really really bad shape,” Bowick recalls. 

“He had a completely open wound in his gut that wasn’t fully and completely healed. He had a colostomy bag. He aged 20 years in three months. He could barely walk.”

Kevin Pollak (pictured with Perry in 2010) says Perry was “struggling” at the time of the 2021 HBO Max special. Getty Images

Perry (pictured with the “Friends” cast at the reunion) could “barely walk” when he left the hospital in 2018, his sister says. Terence Patrick/HBO MAX

The “Friends” reunion was his first big public appearance, following that ordeal. 

“In the reunion, I think Matthew… knew he couldn’t get to the place that everybody would want him to be…I think he was really aware of that.,” Jeff Strauss, a former “Friends” writer and producer, explains in the doc.

After filming it, Perry felt “relieved” and “tired,” according to Bowick. 

Perry (pictured in an undated photo from “The One About Matthew Perry) was “aware” that he couldn’t “get to the place that everybody would want him to be,” a former “Friends” writer explains. Courtesy of Netflix

Perry, seen above when he was younger, felt “relived” and “tired” after filming the reunion. Courtesy of Netflix

“He was kind of at this place of ‘How am I gonna keep going?’ I know he was really scared, I know he was really fighting for his life,” his sister says.

Part of him “did not think it was possible to live a sober life,” she adds. 

While she refused to give up “hope,” Bowick started thinking of his addiction “as a terminal illness.” 

Perry (pictured) was “fighting for his life” and “did not think it was possible to have a sober life.” matthewperry4/Instagram

Perry’s sister said she thought of his addiction as a “terminal” illness, his sister said in a new Netflix doc (pictured). Netflix

Perry died in his hot tub in his California home at 54 on Oct. 28, 2023. 

Per to the autopsy report, he died from the “acute effects of ketamine” and drowning.

“The One About Matthew Perry” is now streaming on Netflix.