The Mental Health Effects Of Toxic Friendship

A close friendship can be highly beneficial to your health and well-being—but only if the other person actually treats you like a friend. Some so-called friends may display abusive, manipulative, or hostile behaviors, which can lead to a great deal of emotional distress. So how exactly can you tell if someone in your life is a toxic friend, and what can you do about it?

Determining when a friendship is wrong for you is ultimately a personal decision, but certain negative behavior patterns can be strong hints that it might be time to re-evaluate your relationship. When you notice that someone you consider a friend consistently ignores your needs and boundaries, provokes negative feelings, or takes advantage of you, putting some distance between you could be the right choice. Below, we’ll discuss some possible warning signs of a toxic friendship and some possible ways for you to respond to these behaviors. 

Why healthy friendship matters

How toxic relationships can affect your health

While some interpersonal friendships can support wellness and happiness, others may have the opposite effect. A 2019 paper published in Perspectives in Social Science describes the many ways that stressful relationships may negatively impact health, which include higher blood pressure, worse cardiovascular health, and diminished immune function as a result of stress and disconnection.

Friendships of this kind may have detrimental effects on psychological health as well. For example, one study reports that negative or ambivalent bonds (those prompting a mix of strongly positive and strongly negative emotions) may be correlated with a higher risk of depressive symptoms. Other potential mental health outcomes of toxic relationships include anxiety, low self-esteem, and in severe cases, post-traumatic stress.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources. 

Can a clinical psychologist diagnose toxic relationships?

Current mental health guidelines don’t categorize friendships as “healthy” or “toxic,” as these aren’t scientific terms with precise definitions. We’re using them here to distinguish between relationships that have mostly positive and mostly negative mental health effects, but you may want to keep in mind that they’re not strict or easily definable categories. 

However, a mental health professional may still be able to help you recognize when someone in your life is displaying hurtful or abusive behavior. Although they might not use the term “toxic friendship,” most psychologists and clinicians acknowledge that some kinds of interpersonal connections can do more harm than good and have expertise in recognizing the signs.

If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.

Recognizing selfish behaviors

Many people believe that being supportive and going out of their way to help a friend when they need it is the right thing to do. Toxic friends, in contrast, may expect help from others but rarely offer it themselves. This can take a variety of forms, some obvious and some subtle. 

Here are a few possible examples of toxic selfishness from a friend:

• They always want to talk about their problems but never listen to yours
• They expect you to always be ready to offer emotional support and comfort and become angry and resentful if you need space
• They frequently borrow money or expect you to pay for things without paying you back
• You’re always the one making plans or expending effort to hang out with them
• They’re only interested in spending time together on activities they’ve chosen
• They don’t express gratitude for your help and support
• They ignore your stated interpersonal boundaries
• They do what they want even if they know it will have negative consequences for you

While you might overlook occasional instances of selfishness in healthy friendships, a repeated pattern of this kind of behavior can make you feel used and unappreciated. Some studies have identified persistent selfishness as one of the most common reasons why friendships end. If you’ve brought up these behaviors to your friend more than once and they haven’t demonstrated any interest in improving the way they treat you, it could be a sign that it’s time to step away.

Recognizing manipulative behaviors

Some individuals, particularly those who display high levels of a personality trait psychologists call “Machiavellianism,” manipulate their friends for their own gain or amusement. Some potential signs that this could be happening in your friendship include:

• When the two of you disagree, they always seem to get their way
• They often get into conflicts with others but always have a reason why it’s not their fault
• Their version of events rarely matches your memories, but they insist that they’re right
• The details of their stories frequently change
• They often tell you that you’re misunderstanding things because you’re “confused,” “emotional,” “paranoid,” etc. (a possible abusive behavior known as gaslighting)
• They often instigate conflict between you and your other friends 
• They become angry and hostile when you disagree with them

Recognizing undermining behaviors

Playful teasing can be a part of some healthy friendships. However, when mocking remarks are repeated or excessively harsh or pointed, they can harm your self-esteem and happiness. Some common undermining behaviors from toxic friends include:

• Frequently critiquing your appearance
• Repeatedly saying insulting things but dismissing them as “just a joke”
• Downplaying your accomplishments, skills, or positive qualities
• Mimicking your speech patterns or physical behaviors
• Commenting on things they know you’re insecure about
• Disrespecting your values and life choices
• Claiming others are saying negative things about you behind your back

Although toxic friends may claim you “should know they’re not being serious” because you’re friends, the reality for many people is that cruel remarks hurt more coming from those close to them. 

Recognizing negative influence

Some friends may be toxic because they make it harder for you to be the kind of person you want to be. For example, research indicates that having friend groups who aren’t supportive can hamper recovery from substance use disorders. Other kinds of unhelpful influences from friends can include:

• Encouraging you to make unhealthy or risky decisions
• Pressuring you to spend more than you can afford
• Pushing you to mock, insult, or exclude others
• Isolating you from other relationships that are important to you
• Co-ruminating (encouraging you to dwell on negativity and unhappiness)

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Other warning signs of toxic friendship

In practice, recognizing the toxic behavior patterns described above isn’t always easy. Very few people want to believe that someone they’ve befriended could be a cruel, manipulative, or selfish person, so you may be inclined to give them the benefit of the doubt. As such, you may find it easier to identify toxicity by looking for its effects on you. Here are a few possible warning signs of a toxic friendship to watch for.

You’re anxious about hanging out with them

When you know you’re going to see your friend later, are you excited and happy, or do you have a sinking feeling or a sense of dread? If you’ve come to rarely look forward to the prospect of seeing someone you consider a friend, you may want to ask yourself why this might be.

You feel stressed and drained after you see them

Spending time with toxic friends may put you on edge. On some level, you may be constantly anticipating a cruel joke or an explosion of temper. Alternatively, you may feel exhausted because they’re expecting you to provide continual emotional support while giving nothing back.

You often make excuses for their behavior

A manipulative friend may be able to convince you that their behavior is normal, but others may not see it that way. When you find yourself frequently defending or excusing their behavior, you may want to consider whether the people they’ve hurt or offended have a point. 

This is your only remaining friendship 

As noted above, certain kinds of toxic friends may attempt to isolate you from positive friendships with other people. If your friendship with this person has cost you some or many of your other connections or if they often display bitterness, judgment, or jealousy toward your other friends, it could be a sign of abusive or manipulative tendencies.

You don’t feel you can be honest with them

When you have a friend who responds to any disagreement or criticism with hostility, you may find yourself censoring your opinions to avoid triggering an aggressive response. A friend with whom you can’t share your honest thoughts and feelings may not be someone you want in your life. 

You’ve adopted negative health behaviors

Has spending time with this person led to potentially destructive habits like binge drinking or using addictive drugs? Whether or not it’s intentional on their part, this might be a sign that the friendship isn’t beneficial for you.

You’re experiencing mental health challenges

Depression, anxiety, and other mental health conditions can be warning signs that something in your life is causing you excessive stress. If your emotional well-being has diminished since you became close to this person, it could be time to reassess their role in your life.

Addressing a toxic friendship

When you notice signs that your friendship might be toxic, one option is to simply walk away. Or, if you think the friendship may be salvageable and you’re not sure you want to end it, your best option may be to clearly and directly address their problematic behaviors as long as it’s safe to do so. This kind of conversation can be difficult, because your friend may not want to acknowledge that there’s a problem. You may have more success if you limit your side of the discussion to explaining how their actions have made you feel and setting firm boundaries around what you won’t tolerate in the future.

What happens next may be up to the other person. If they show that they value your friendship, make efforts to change, and respect your boundaries, the relationship may continue and even grow stronger in time. However, if they continue to violate your established boundaries, you may need to end the toxic friendship for your own health and well-being.

Therapy can help repair the damage from a toxic friendship

Connect with a mental health professional

Finding a clinical psychologist for mental health challenges

Recovering from a toxic friendship—or preparing to end one—may be easier to navigate with support from a mental health professional. Techniques like cognitive behavioral therapy (CBT) may help you restore your self-confidence and happiness if they’ve been undermined by a false friend. 

There are many potential avenues you can use to locate a therapist to do this healing work with. You can ask your primary care doctor for a referral or consult one of several online databases of mental health care providers, such as those available through the American Psychological Association or the Anxiety and Depression Association of America. 

Another option is to use an online therapy platform like BetterHelp. Many people find working with a therapist online to be more convenient due to factors like greater scheduling flexibility and the ability to attend sessions from home without any commuting. If you’re unsure how to fit mental health treatment into an already crowded calendar, internet therapy may be a helpful resource. 

Studies have repeatedly suggested that online psychotherapy may be an effective way to treat a variety of common mental health challenges. For example, a meta-analysis from 2019 looked at the existing scientific literature and concluded that web-based therapy “demonstrated good efficacy in treating anxiety and depression” in addition to being cost-effective and convenient.