They might get on your nerves at times, but good friends have bigger benefits than you may realize.
By Tom Valeo
WebMD Feature Reviewed by Brunilda Nazario, MD
"You got to have friends to make that day last long," sings Bette Midler. But good friends may help your life last longer, too, according to an Australian study. Conducted by the Centre for Ageing Studies at Flinders University, the study followed nearly 1,500 older people for 10 years. It found that those who had a large network of friends outlived those with the fewest friends by 22%.
Why is this so? The authors suspect that good friends discourage unhealthy behaviors such as smoking and heavy drinking. And the companionship provided by friends may ward off depression, boost self-esteem, and provide support. Also, as people age, they may become more selective in their choice of friends, so they spend more time with people they like.
Close relationships with children and relatives, in contrast, had almost no effect on longevity. Lynne C. Giles, one of the four researchers who conducted the study, emphasized that family ties are important; they just seem to have little effect on survival.
The Health Benefits of Good Friends
Lots of research has shown the health benefits of social support.
One such study, reported in the journal Cancer, followed 61 women with advanced ovarian cancer. Those with ample social support had much lower levels of a protein linked to more aggressive types of cancer. Lower levels of the protein, known as interleukin 6, or IL-6, also boosted the effectiveness of chemotherapy. Women with weak social support had levels of IL-6 that were 70% higher in general, and two-and-a-half times higher in the area around the tumor.
In 1989, David Spiegel, MD, a professor of psychiatry at Stanford University, published a landmark paper in Lancet. Itshowed that women with breast cancer who participated in a support group lived twice as long as those who didn't. They also had much less pain.
Sheldon Cohen, PhD, a psychology professor at Carnegie Mellon University, in Pittsburgh, has shown that strong social support helps people cope with stress.
"Friends help you face adverse events," Cohen tells WebMD. "They provide material aid, emotional support, and information that helps you deal with the stressors. There may be broader effects as well. Friends encourage you to take better care of yourself. And people with wider social networks are higher in self-esteem, and they feel they have more control over their lives."
Other studies have shown that people with fewer friends tend to die sooner after having a heart attack than people with a strong social network. Having lots of friends may even reduce your chances of catching a cold. That's true even though you're probably exposed to more viruses if you spend a lot of time with others.
"People with social support have fewer cardiovascular problems and immune problems, and lower levels of cortisol -- a stress hormone," says Tasha R. Howe, PhD, associate professor of psychology at Humboldt State University. "Why? The evolutionary argument maintains that humans are social animals, and we have evolved to be in groups. We have always needed others for our survival. It's in our genes. Therefore, people with social connections feel more relaxed and at peace, which is related to better health."
Friends Can Be Stressful
Friends can be a source of stress, though. In fact, friends can cause more stress than others precisely because we care so much about them.
Julianne Holt-Lunstad, PhD, an assistant professor of psychology at Brigham Young University, has found that dealing with people who arouse conflicted feelings in us can raise blood pressure more than dealing with people we don't like.
"My colleagues and I were interested in relationships that contain a mix of positivity and negativity," she says. "For example, you might love your mother very much, but still find her overbearing or critical at times."
By attaching people to portable blood pressure monitors, Holt-Lunstad and her colleagues found that blood pressure was highest when people were interacting with someone they felt ambivalent about.
What she found really surprising was that these interactions caused higher blood pressure than those with people the research subjects felt completely negative about. "We suspect that people we feel positive toward can hurt us that much more when they make a snide comment or don't come through for us because they are important to us. Friends may help us cope with stress, but they also may create stress."
So would we be better off having no friends at all?
Hardly. "One thing research shows is that as one's social network gets smaller, one's risk for mortality increases," Holt-Lunstad says. "And it's a strong correlation -- almost as strong as the correlation between smoking and mortality."
The Impact of Loneliness
What about loners? Are they at greater risk of dying because they prefer to be alone?
Only if they feel lonely. One study found that drug use among young people was higher among those who said they were lonely. Older lonely people tended to have higher blood pressure and poorer sleep quality. They also were more tense and anxious.
Another study found that college freshmen who had small social networks and claimed to be lonely had weaker immune responses to flu vaccinations. They also had higher levels of stress hormones in their blood.
Unfortunately, Americans have fewer friends than they used to, according to a recent study, "Social Isolation in America," published in the American Sociological Review. The authors found that from 1985 to 2004, the number of Americans who feel they have someone with whom they can discuss important matters dropped by nearly one-third. The number of people who said they had no one they could discuss such matters with tripled to nearly 25%. The authors suspect that long work hours and the popularity of the Internet may contribute to the decline in close relationships.
The study also found that the percentage of people who talk about important matters only to family members increased from 57% to 80%. Those who depend solely on their spouse for these talks increased from 5% to 9%.
How Women's Friendships Are Different From Men's
In general, women are better at maintaining friendships than men. Women "tend and befriend," says Shelley E. Taylor, PhD, a psychology professor at UCLA. They respond to stress by protecting and nurturing others ("tending"), and by seeking support from others ("befriending"). This pattern regulates the seeking, giving, and receipt of social support, Taylor says. It produces health benefits by reducing psychological and biological stress.
And Margaret Gibbs, PhD, a professor of psychology at Fairleigh Dickinson University, found that men and women relate to others differently throughout life.
"We found that women seemed more geared to empathy, while male friendships are more geared to companionship and altruism," she tells WebMD. "Male friendships are more about helping each other -- mending the lawn mower, that sort of thing. Women's friendships tend to have a more emotional content -- listening to friends' stories and coming up with helpful solutions."
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