The Health Benefits of Friendship

“This article was first published in 2010. The Cleveland Clinic Wellness newsletter published in again this month. This is more than listing health benefits; it discusses how to make friends. Be deliberate and see out relationships.” Bill Chesnut, MD

 The Health Benefits of Friendship     By Victoria Moran            Cleveland Clinic Wellness newsletter_Published 6/29/2010

No doubt you’ve heard the good-health prescription: Eat a colorful, natural diet; exercise regularly; manage your stress with relaxation, recreation and meditation; get enough sleep; and have the proper checkups and screenings for your age and history. Recently, a host of research has added another, perhaps surprising, to-do to that list: Make friends, and keep those friendships in good repair.

”Researchers have found that having even one close friend that you confide in can extend your life by as much as 10 years,” says sociologist and relationship coach Jan Yager, PhD, author of Friendshifts.“Numerous studies also show that recovery from a major health challenge, such as a heart attack or cancer, is enhanced because of friendship.”

The Friendship Advantage

A landmark UCLA study in 2000 showed that, for women, having a circle of friends actually provides an alternative to the traditional fight-or-flight response to stress. The researchers called this response “tend-and-befriend” and showed that when women gather with other women (and with children), they release more oxytocin, the mother-love hormone associated with breast-feeding, which has a marked calming effect.

But women aren’t alone in attaining measurable health benefits from friendship. The Australian Longitudinal Study of Aging looked at nearly 1,500 seniors — women and men — for a full decade. Among their findings was that having good friends is more likely to increase longevity than even close relationships with adult children and other family members. The study subjects with the largest number of close friends outlived those with the fewest by 22 percent. Even major life changes such as the death of a spouse could not erode the “friendship advantage.” What makes these findings exciting — and practically applicable — is that while anyone’s number of family members is limited, we can expand our network of friends for as long as we live.

Friends may also add to the quality of those extra years by helping us maintain brain function. A Harvard School of Public Health study that looked at older adults across the country provides evidence that social integration — through marriage, volunteer work or frequent contact with children and neighbors — delays memory loss in elderly Americans.

While it’s clear that having friends is a healthy habit, the verdict is still out on the precise reasons why this is so. The Australian researchers speculate that, in addition to the emotional support friends provide one another during difficult times, positive peer pressure may also play a role — encouraging the adaptation of healthy lifestyle practices, such as joining a gym or a smoking cessation program together — as well as the stress-reduction benefits that derive from feeling connected to other people.

Friends in Health

Stress management is, in fact, one of the great gifts of friendship. One 2009 study found that clients with the fewest friendship connections were those most likely to be dealing with depression, anxiety and heart disease. Stress is known to encourage a host of maladies, from the common cold to the arterial inflammation that contributes to cardiovascular disease.

That might explain the results of a two-year study that looked at 500 women with suspected coronary artery disease. Those with a strong support system were not only more likely to be alive after two years, but their rates of hypertension and diabetes were lower, and they were less likely to have an excess of abdominal fat.

The Friend-Weight Dilemma

It is in the area of excess fat, however, that a single dark cloud may lurk in the bright sky of friendship and health. A study reported in 2007 in the New England Journal of Medicine suggests that there could be a connection between the rise of obesity and our social interactions. In other words, obesity may “spread” through a network of friends as members of that network become more tolerant of obesity and the behaviors that lead to it.

Reflecting on this study, Michelle P. Gallant, MS, RD, of Harvard University Health Services, says, “Because we want to fit in with our peers, we might go along with their way of eating. If we’re out with people having appetizers, drinks and desserts, the brain is stimulated by that, and it can trigger us to eat more than we’re really hungry for.”

Curiously, it’s our same-gender friends that appear to be the culprits here. The New England Journal report suggests that we’re influenced more by those who “resemble us.” Even spouses, who presumably share a kitchen and routinely dine together, may not affect each other’s weight gain as much as mutual friends do.

These same friends can also exert another kind of unhelpful peer pressure, especially among young women, when they overemphasize and idealize thinness. “I see the damage friends can cause each other about body image,” says Gallant. “Too much ‘diet talk’ can cause women to be preoccupied with body size in a negative way.”

The secret seems to be choosing well-balanced, health-conscious friends and engaging together in health-promoting activities. Good habits, as well as bad, may be “contagious” when we’re in the company of people we care about and whose company we genuinely enjoy. A University of Pennsylvania study reported in the Archives of Internal Medicine looked at 344 African-American women and men, and found that exercising with a family member or friend led to more weight loss than going solo, but only if the buddy-cisers enrolled together. Being assigned an exercise partner who wasn’t a “real friend” had a negligible effect.

Making Friends 101

As positive friendships vie with dark, leafy greens as the good-health superstars, how do we get more of them, especially if we’re not the life-of-the-party type? Some ideas:

Make the first move: According to Dr. Yager, showing an interest in another person is the first step on the road to friendship.

Branch out: “Since having shared interests is an obvious way to begin a relationship that might become a friendship, get active in sports or cultural activities where you’ll meet people. If someone seems interesting, suggest getting a cup of coffee before or after the next session.”

Be interested: Once a nascent friendship is underway, be genuinely interested in learning about this person. Keep things light and allow for humor. Although strong friendships can develop in support groups and other places where people go for help, more often the person who’ll be there for you when things get rough entered your life through shared good times.

Show your appreciation: Finally, cherish the friends you already have. It’s no easy matter to stay in touch these days, especially if you’ve lived in seven cities, had a dozen jobs and your face-to-face friends are in competition with a hundred Facebook friends you may not have seen since childhood (if you’ve ever met at all). While it can be fun to “know” a lot of people, acquaintances aren’t the same as friends. Stay close to the tried-and-true by getting together in person when you can, sharing a phone call every so often and making e-mail contact or even sending a real note — on paper with a stamp! Handwritten notes were always special, but now that they’re so rare, they’re worth their weight in friendship gold.

Finally, be there for the people you care about when they could use a friend. Most of us will never save a life by running into a burning building or jumping into a churning sea, but science now tells us that we just might extend someone’s life simply by being a part of it.