9 Signs of Toxic Friendships That Can Lead to Health Risks

March 21, 2018

 Unhealthy friendships can cause feelings or resentment and insecurities, and can even harm our health.  According to the Journal of Health and Social Behavior, unhealthy friendships can cause a rise in cortisol (the stress hormone) and can increase our heart rate and blood pressure, which can lead to a variety of other health issues such as heart disease, gastrointestinal problems, weight problems, asthma, depression and anxiety, and memory issues. The opposite is also true, research has found that people with positive relationship interactions have fewer health issues and are more likely to survive after serious health complication such as a heart attack. Relationships affect us behaviorally , physically, and psychologically. If the relationship is unhealthy it will have adverse affects on our behavior, physical, and mental well being. The important thing is, to understand the differences between healthy and unhealthy relationships, keep the ones that foster growth, good feelings, and provide us a sense of satisfaction.


As a mental health professional, I often find myself having “quality of relationship” conversations with my clients. Friendships are essential to our existence and should provide us with a sense of belonging as well as love, and support. Unfortunately, this is not always the case and we may find ourselves cultivating friendships that are causing us more harm than good. We may find ourselves spending time with people who don't make us feel good, which can lead to feelings of confusion and frustration, leaving us wondering if we are being "too harsh or critical." We may ignore our feelings and continue to spend time with these friends, potentially making excuses for them, taking the blame, or giving them multiple chances. If the situation I am describing was a romantic relationship, we would be considering a break-up,  but when it comes to friendships, break-ups are harder to consider. For many reasons, friendships are harder to let go of, however there are times when letting go is necessary. 


Below are nine questions to ask your self to help determine if you are in an unhealthy friendship. Keep in mind that we may encounter these qualities in any healthy relationships from time to time, so don't rush to dismiss your friend just because they met one of these categories.The most important thing you can do is communicate and listen to each other. No one is perfect and relationships take time. If one or more of the questions below has you thinking about your friendships, I encourage you to be open and honest. Talk to your friend, be respectful, and open minded and you may be surprised  at how well the conversation can go. We can't fix what we are not aware of and sometimes all it takes is a conversation. 


1) Are you sensing passive aggressive behavior ? 

Passive aggressiveness can be had to pick up on due to the "attacks" being subtle. Passive aggression can come off as sarcasm or as a joke but it is intended to get a point across. Many people will behave in a passive aggressive manner because they want to avoid direct confrontation of what is really bothering them. Passive aggressive behavior is an easy way for them to let out their frustrations and can it can leave you feeling confused and hurt. 

A healthy friendship includes open and honest communication, even in uncomfortable situations. Healthy friends compliment each other but also know when to talk to each other when something is bothering them. Being open and honest encourages growth and builds trust.


2) Do you feel like you are not being supported? 

Your friends do not have to agree with everything you are doing however, providing support is important regardless of their opinions. There may come a time when we find ourselves having to make a decision that not everyone agrees with; a supportive friend can express their viewpoint but will offer support no matter what your decision is. Positive friendships are supportive and encouraging. A healthy friend will stand with you or encourage you to follow your dreams and goals, even if their viewpoints are different. 


3) Are you being ignored or left out?

It’s okay to have time apart from your friends and/or have various friend groups to spend time with, but if you are continuously or deliberately feeling left out of plans it can start to get you down. Healthy friends spend time together cultivating a relationship but also understand that time apart is just as important. Having alone time encourages you to work on yourself, work towards your goals, and grow as an individual. 


 4) Do you leave their company feeling bad about yourself?

Hanging out with friends should be a positive experience. This is not to say that there will not be disagreements and that you will feel bad from time to time. However, if leaving their company is continuously contributing to your negative emotions, it could be a sign of an unhealthy friendship. It's important to assess the relationship as a whole and ask yourself if you usually leave this persons presence feeling good or feeling bad. Healthy friends are encouraging, supportive, and loving which contribute to feelings of happiness when we spend time with them. 


5) Do they "call you out" in front of others or expose you?

Trust is essential in any relationship including friendships. There is this saying "Trust takes a lifetime to build and second to break.”  If a person breaks that trust by exposing something personal about you or by making you feel bad in front of others, it can be hard to open up again. A healthy friend will be sensitive to you and will guard your personal issues and come to your defense if someone else exposes you. 


6) Is your friend jealous or envious? 

Your friend should not see you as their competitor but rather as their teammate. Your success should not challenge or threaten their success and a true friend will understand that. Healthy friendships are encouraging, supportive, and want you to become the best you can be. In a healthy friendship both parties are aware that successes may come at different times and in different ways. There is a time for your success and a time for their success and you should be each other’s greatest cheerleaders. 


7) Does this person get upset when you can't spend time with them?

Life gets busy, and there may be weeks, months, and sometimes even years where your schedules clash and you are unable to spend time together. Friendships that put pressure on you to spend time with them or pressure you to do something you don't want to you can hurt you in the long run. Healthy friendships will not hold grudges or guilt trip the other person into spending more time together. Healthy friendships pick up right where they left off after a long break, they meet when they can, catch up, and understand that life can get busy.


8) Does this person constantly talk negatively about others? 

We have all participated in some negative conversations about others and sometimes we need to "vent" but there is a line between getting it off your chest and gossiping.  The truth is, is someone is very comfortable talking behind other peoples backs, then what's to stop them from doing the same to you? This is especially true, if they are criticizing someone you are close to, like another friend or a family member. 


9) Is this person needy or clingy? 

 Clinginess can point to insecurities in a person, so if you find your friendship requires more attention that you can give, it may be doing you more harm than good. There is no formula for what the "right" amount of time is to spend with a person so you will have to assess what you are comfortable with and as long as you are happy then you are on the right path. 



Umberson, D. & Montez, J.K. Social Relationships and Health: A Flashpoint for Health Policy (2010). Journal of Health and Social Behavior Vol 51, Issue 1_suppl, pp. S54 - S66.










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