The Paradox of Friendship: How Friendships Paint Our Health and Well-Being in Shades of Joy and Vice (Part II)

The Art of Friendship: More Than Meets the Eye

Imagine friendships as paintings in an art gallery – each one with a different story and emotional palette. Some evoke a sense of calm and serenity, like a peaceful landscape. Some friendships are like intricate portraits, revealing layers of understanding and empathy. Others still might resemble a stormy seascape, challenging yet … deeply enriching?? In this gallery of relationships, each friendship can leave its own distinct imprint on our health and well-being.

From Canvas to Lab: Quantifying Friendship's Impact

Now let’s swap our berets for lab coats and consider the potential impact that a 'peaceful Sunday' vs. ‘stormy night at sea’ friend might have. To do so, we harnessed data from 12,998 adults aged >50 in a nationally representative dataset, and created a friendship score that assessed: 1) Friendship network size, 2) Frequency of contact with friends, and 3) Quality of friendships. We then evaluated how changes in this friendship score might be associated with health and well-being outcomes over four years. Please see my prior post for a fuller description of our methods and results.

In a nutshell, we observed 14 interesting null results, but the majority of our findings showed that higher friendship scores are beneficial for health and well-being (e.g., reduced mortality risk and stroke, higher psychological well-being on all 7 (out of 7 measures), reduced psychological distress on all 5 (out of 5 measures), higher social well-being on 4 (out of 5) measures). ?

Pathways to Health and Well-Being: Soulful Pep Talks, Juice Gurus, and Misguided Mountain Hiking?

Why might friendships lead to health and well-being benefits? Well, picture this: A group of friends, gathered around, sharing laughs, advice, and comforting words during these hard times. This isn’t just a merry time, but a living breathing example of what scientists might call ‘social and psychological support.’ Or, imagine your friend, suddenly becomes a self-anointed 'juice guru,' and shares secret tips to make your homemade vegetable juices not taste like sadness (an example of increased diffusion of information about health). Around last New Year's, my partner, suggested we tackle the Grouse Grind. If you're not from Vancouver, it's a trail known as 'Nature's StairMaster' and it's just about as fun as it sounds. I laughed off the suggestion with a nervous chuckle. Come Spring, we found ourselves panting up the mountain. It's like climbing an escalator the wrong way. After a while, every step becomes a mix of awe and 'why are we doing this again?' Yet, surprisingly over time, we started loving it (I guess an example of maintaining healthy norms through social reinforcement). These instances underscore the beauty of friendships – a source of joy, information-sharing, and support which scientists have theorized as some of the pathways through which friendships can benefit health and well-being.

The Friendship Paradox: Boosting Health or Brewing Vices?

But here's an interesting twist: our study also found that higher friendship scores can stealthily foster vices. Surprisingly, high friendship scores were linked to a 43% increased likelihood of smoking and a 48% uptick in heavy drinking [although this latter association did not reach conventional levels of statistical significance]. Like other social factors, friendship might act as an “amplification system” for both beneficial and harmful outcomes depending on the social context by magnifying whatever they are seeded with (e.g. attitudes, norms, behaviors).

As an illustration of friendship’s dualistic nature on health outcomes, friends can be a source of emotional and social support for one another, yet if the exchange of support occurs in social contexts where there is smoking and/or excessive drinking, the impact of friendship on health and well-being outcomes may be both positive and negative. It's a bit like having a friend who’s a passionate pastry chef – delightful, yet also potentially a danger to your waistline.

Diving deeper, our analyses also highlighted specific aspects of friendships that sway our health. Frequency of in-person interactions, for instance, mostly swayed towards the positive (See Appendix Table 4 in the journal article). On the flip side, the amount of strain friends place on us was associated with a range of negative health and well-being outcomes (See Appendix Table 8 in the journal article). This measure was created by asking people the following:

?”How often do they [friends] make too many demands on you?”

?“How much do they [friends] criticize you?”

?“How much do they [friends] let you down when you are counting on them?”

?“How much do they [friends] get on your nerves?”

Curating Your Social Gallery and Reflecting on the Artist Within

If we're being brutally honest, haven't we all been on both ends of these interactions? It's a human thing – to err, to demand, to annoy. The key lies in recognizing these patterns and striving for healthier, more supportive friendships. Perhaps it's time to 'unfriend' those who weigh us down too much or too often. And on the other hand, introspect and mend the ways we might inadvertently strain our bonds.

As we navigate the complex waters of friendships, it's worth pondering: How do our friendships shape us? Are we nurturing relationships that uplift or those that inadvertently pull us into unhealthy habits? The paradox of friendship, it seems, is as intricate as it is influential and necessary in our lives.

*Here’s our study: Kim, E.S., Chopik., W.J., Chen, Y., Wilkinson, R., & VanderWeele, T.J. (2023). United we thrive: Friendship and subsequent physical, behavioral, and psychosocial health in older adults (An outcome-wide longitudinal approach). Epidemiology and Psychiatric Sciences.

#researchfindings?#socialconnections?#friendship?#psychology?#epidemiology