How Difficult Friends Can Sabotage Your Health

Poor health and poor relationships: What comes first?

Complicating matters, our health affects our relationships and the quality of our interactions — not just the other way around.

Sometimes people who are already in poor health or depressed “might be more likely to perceive that their relationships are more negative — or might be drawn to other more negative people,” points out Flegge, who was not involved in the hasslers research. For that reason, there could be “two-way link,” she adds. Health can affect relationship quality, just as relationships can impact our health.

Although the hasslers study didn’t prove negative ties cause accelerated aging, the researchers took pains to account and adjust for other factors, such as a person’s chronological age and whether individuals smoked. They also acknowledged that those in poorer health and those who experienced potentially traumatic events before age 18 (called adverse childhood experiences, or ACEs, which range from witnessing violence in the home to abuse) were more likely to have hasslers in their networks.

But such factors still didn’t explain away the link found between hasslers and accelerated aging. Even after adjusting for other variables “that might be explaining the association we see … the association still remains,” notes Brea Perry, professor of sociology at Indiana University in Bloomington and senior author of the PNAS study.

Helpful, harmful or both: the relationship between social ties and chronic disease

To better understand how relationships might be a boon, a bust or both for our health, it helps to look at specific, nuanced examples. One study of postmenopausal women, for example, found that social support put women at lower risk for developing type 2 diabetes, while social strain put them at higher risk.

The researchers, who published their 2019 findings in The Journals of Gerontology: Series B, described social strain as “the negative aspects of social relationships such as friends or family who are critical or demanding.” While exactly what causes the link wasn’t clear, they noted relational strain may have physiological repercussions, such as increasing inflammation in the body that could promote insulin resistance. Previous research found social strain was also associated with a higher risk of obesity, which increases risk for diabetes.

Supportive relationships have the opposite effect

The researchers in the gerontology journal said that healthy social relationships among older women not only can possibly encourage behaviors such as healthy diet and increased physical activity but may also be important in the prevention of diabetes.

Public health experts point out that while difficult relationships might be a drag on health, preserving healthy connection is still critical. The World Health Organization notes that loneliness and social isolation increase risk for stroke, heart disease, diabetes, cognitive decline and premature death. That’s in addition to mental health consequences, including higher rates of depression and increase suicide risk.

Women disproportionately affected

Whether you stick it out in a difficult relationship, set boundaries, reduce your exposure to that person or cut ties altogether could have everything to do with who you are and how you were raised. For better or worse, those with large social networks are more likely to have at least one difficult relationship, and women tend to be more affected than men.

“Women are often socialized to prioritize harmony and be accommodating and maintain relationships even when they’re stressful,” Perry says. “So I think that can make it particularly hard for women to distance themselves from people who cause problems.”

Women are also more likely to be caregivers for children, partners and aging parents or other relatives, she notes.

“I do think it’s just so important for their health for women to try to make time for themselves, and to try to get distance from people who are difficult however they can do that,” Perry says. That includes trying to get help from others if, for example, you’re a family caregiver.

“I think women often feel like they have to do it alone or they’re the ones responsible for this, and I think that’s really to the detriment of their own physical and mental health,” Perry adds.

For anyone struggling with difficult relationships, she says, talking to a therapist about strategies like setting boundaries with difficult people could help. Experts also recommend taking time for self-care after encounters with difficult people and leaning into more supportive friendships and family ties.

“Family therapy can be helpful if [a hassler] happens to be a family member,” Perry says.

Beware of darker personalities: Not everyone is trying to lighten your load

Should you choose to seek professional help, whether you involve the other person — friend, romantic partner or family member — in therapy depends on the specifics of that dynamic and your comfort. In some instances, such as in cases of abuse, it might not be appropriate to come together.

Where many difficult and frustrating people might be relatively benign (save for the ill health effects resulting from regular interactions), others may have more nefarious intent. So-called dark personality traits are captured most notably in what’s known as the Dark Tetrad, interrelated personality features that include narcissism, psychopathy, Machiavellianism and sadism.

“All of these traits exist on a continuum — from very low to very high,” says Leanne ten Brinke, associate professor of psychology at the University of British Columbia and a psychopathy expert. While a limited few meet the clinical definition for a personality disorder, research suggests that around 10 to 20 percent would score in elevated ranges on these traits, says ten Brinke, author of Poisonous People: How to Resist Them and Improve Your Life.

Although certainly not all hasslers exhibit dark personality traits, ten Brinke suggests some would. The hasslers research did not find a significant link between spouse hasslers and accelerated aging, “possibly because spousal ties mix negative and positive exchanges,” the researchers posited. Still, “what they found really dovetails with some other research, which suggests that people who report romantic relationships with dark personalities also report experiencing things like digestive problems, headaches, emotional fatigue and stress,” ten Brinke says.

Dark Tetrad personality trails “overlap in the sense that all of them share a kind of callousness, manipulativeness and antagonism, so they’re hostile to other people,” she explains. The point isn’t to play psychological sleuth but to better understand people in your network — where personalities tend to come into clearer focus over time — so you can engage with them accordingly.

“I think it’s really helpful to try to understand the personality of another person as best you can in order to make that decision with eyes wide open about whether you want to stay or go,” ten Brinke says. If you decide to stay, having this understanding can help you better manage your interactions with them.

In addition to paying attention to patterns, trusting your gut and getting professional help as needed with difficult people (dark or not), there’s one more strategy experts say helps: Increase your circle of friends and deepen the friendships you have.

Expand your network

When you’ve been burned is not the time to self-isolate or let someone pull you away from supportive family and friends.

“Having relationships with other people is actually a really powerful tool against the handful of people who weaponize our relationships with them. Definitely don’t cut yourself off from other people because you are afraid of the toxic few,” ten Brinke encourages. “Because research suggests that the vast majority of people are kind and compassionate and honest, and it would be damn shame to cut yourself off from the vast majority of people in order to avoid the malevolent few.”