health

Having a close friend or two to talk to---someone on whom you can depend for emotional support---can be great when little things accumulate or you temporarily feel down in the dumps. But can a friend talk you out of depression or lessen its pernicious effects? A study recently published in the British Journal of Psychiatry examined the viability of "befriending" as a tool in the treatment of emotional distress and depressive symptoms. The findings suggest that friendships, even therapeutic ones, aren't necessarily substitutes for good treatment.

 

Keep in mind the researchers weren't talking either about the garden variety of befriending (a term that has become common parlance among Facebook or Twitter users) or about a mild case of the blues. For the purposes of their study, the team of primary care researchers at the University of Manchester, Manchester, UK defined "befriending" as social support that was "initiated, supported and monitored by an agency" expressly for one or more parties to benefit. It was, by definition, a treatment for depression or emotional distress that was "non-judgmental, mutual and purposeful."

 

The meta-analysis (a systematic statistical analysis) looked at more than 24 studies that covered a wide range of depressed populations, including caregivers of individuals with dementia, adolescents, lonely widows, men with prostate cancer, and pregnant women. The frequency of befriending varied among the studies as well as the ways in which the befriending took place. Some contacts were made face-to-face, others were by telephone, and some were a combination of both. Befriending was delivered both by trained and untrained volunteers.

 

The researchers found that the befriending intervention was less effective than cognitive behavioral therapy (CBT) in adolescents with depression and in medication-resistant individuals with schizophrenia. It was also less effective than nurse cognitive-behavioral problem solving in caregivers of people with dementia. It was similar in effectiveness to a nurse education and self-efficacy intervention in older adults recovering from myocardial infarction, to local community support groups for new inner-city mothers, and to systemic family therapy in depressed adolescents.

 

Based on their data, the researchers were unable to conclude that "befriending" is an effective, evidence-based treatment. Instead, they suggested that more rigorous study was needed to compare "befriending" head-to-head with standard treatments (such as CBT and medication), and that individual preferences should be considered in determining what works, for whom, and under what circumstances. This study relied on meta-analytic techniques to look at the friendship question but it would be worthwhile for researchers to design more large studies that look closely at whether and how friendships can alter the course and outcomes of various types of depression.

 

The conventional wisdom is that the presence of social supports can serve as a buffer against depression. Sounds logical enough: Friendships offer an outlet for people to express their emotions, to put things into perspective, to feel less alone, to reduce stress, and to encourage someone who's feeling distressed to seek out professional help when needed. But people with severe depression often have a hard time reaching out to anyone and it is often equally difficult for friends, even very good ones, to know what to do to help them recover. There's a lot more to learn.

 

Source:

Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis

Nicola Mead, PhD, Helen Lester, MB, ChB, MD, FRCGP, Carolyn Chew-Graham, MB, ChB, MD, FRCGP and Linda Gask, PhD, FRCPsych, NIHR School for Primary Care Research, University of Manchester
Peter Bower, PhD, National Primary Care Research and Development Centre, University of Manchester, Manchester, UK

The British Journal of Psychiatry (2010) 196: 96-101. doi: 10.1192/bjp.bp.109.064089

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How to Help a Friend or Relative Who is Depressed (From the NIMH)

If you know someone who is depressed, it affects you too. The first and most important thing you can do to help a friend or relative who has depression is to help him or her get an appropriate diagnosis and treatment. You may need to make an appointment on behalf of your friend or relative and go with him or her to see the doctor. Encourage him or her to stay in treatment, or to seek different treatment if no improvement occurs after six to eight weeks.

To help a friend or relative:

• Offer emotional support, understanding, patience and encouragement.
• Engage your friend or relative in conversation, and listen carefully.
• Never disparage feelings your friend or relative expresses, but point out realities and offer hope.
• Never ignore comments about suicide, and report them to your friend's or relative's therapist or doctor.
• Invite your friend or relative out for walks, outings and other activities. Keep trying if he or she declines, but don't push him or her to take on too much too soon. Although diversions and company are needed, too many demands may increase feelings of failure.
• Remind your friend or relative that with time and treatment, the depression will lift.

Facts about Major Depression

According to the National Institute of Mental Health (NIMH), major depression is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable activities. An episode may occur only once in a person's lifetime, but more often, it recurs throughout a person's life. , It is estimated to affect 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.

 

There is no pain greater than the loss of a child. Parents who have suffered such a tragedy say that they never get over it; at best, they get through it. Lynn Bozof of Atlanta, Georgia, lost her son Evan when he was 20. A junior at Georgia Southwestern University, Evan was an honor student and a pitcher on his college baseball team. Below Lynn shares her experience of how the friends she made through a support group helped her cope with this unimaginable loss.

 

Can you briefly tell us about the circumstances leading to Evan's death in 1998?

 

Evan was away at school when he complained of a horrible headache, the worst he'd ever had. He was nauseated and couldn't hold anything down. We told him to get a friend to take him to the emergency room. When he arrived at the ER, the doctors thought he had a virus but kept him overnight so that he could get some extra rest.

 

I called my son about 7AM the next day but he was too sick to talk. I had the nurse put the phone up to his ear and asked if he wanted us to pick him up to come home for the weekend. He did. Before we could even leave home, we received a call from the hospital saying that Evan had meningococcal meningitis and was in critical condition.

 

When you get a phone call like this, your mind can't fully absorb what you're being told. My husband and I drove three hours to see Evan, not knowing if he would be alive when we got there. A few hours later, the doctors transferred him to a larger hospital, better equipped to handle bacterial meningitis. As he was taken to the ambulance, I told him, "Love you, Evan." As weak and sick as he was, he said, "Love you, Mom." Those were the last words he said to us.

 

Before long, all of his organs started to shut down. His fingers, his toes, his ears, and his nose all turned black, then his entire hands and feet, and the gangrene kept spreading up his limbs. We watched Evan fight to breathe, fight to live. Two weeks later, he was transferred to a third hospital. His arms had to be amputated above the elbows and his legs above the knees. We signed consent forms allowing the doctors to amputate as much as was necessary to save his life. Several days later, he had grand mal seizures for 10 hours that caused irreversible brain swelling, leaving him brain-dead.

 

Our son Evan, whom we loved more than we can ever put into words, had to be disconnected from the machines that were keeping him alive. He was placed in a body bag in front of our eyes.

 

Were your friends at home a source of solace and support after the death? How did they react?

 

Many friends offered support and were great, but some tried to avoid me. They probably didn't know how to handle it. I felt different and alone, as if were wearing a sign, "Mother who lost her son." Not only was I dealing with grief-but also somehow I felt guilty that I had allowed this to happen.

 

After Evan's death, what drew you and your husband to get involved with a support group?

 

At that time, my husband and I never knew that college students were at increased risk for meningitis. When we found out that a meningitis vaccine existed, we realized that our son didn't have to die. And if we didn't know about the vaccine, we were sure there were other parents who didn't know either.

 

We met other parents who had similar stories: The common denominator was that none of us knew that this disease was potentially vaccine-preventable. To have more of an impact, we banded together to form a national organization, the National Meningitis Association (NMA). Along the way, I met other moms, never knowing how closely our shared tragedies would bond us together.

 

Can you describe the special bond between you and other Meningitis Moms? Do you consider them friends?

 

There's a line from a Charles Dickens book, "It was the best of times, it was the worst of times." Losing a child is, by far, the worst of times; there is nothing worse. For me, the "best of times" came into being with the wonderful friendships I formed within NMA, especially with a group we call Moms on Meningitis (M.O.M.s).

 

Meningitis swoops down and robs you of someone you love. Friends can empathize and share your grief, but there's something so pernicious about the infection -- its relentlessness, the way it invades your child's body -- which only a mom who has gone through it, can understand. Through this common bond, we formed great friendships. We've laughed together, cried together, shared stories of children and grandchildren. We were tied together at first by grief, then by determination to not let this happen to other families. In the process, many of us became close friends.

 

Have you learned any lessons about female friendship through your family's tragedy?

 

I've learned that when you find friends, as bad as things may seem, you aren't alone. I know that when my feelings of grief start to overwhelm me, that I can reach out to one of the moms, and share my feelings. She isn't going to think I'm "overdoing it" or that it's time to "get over it." They know what I'm going through.

 

Just today, I "facebooked" another mom who is going through a holiday slump. While you miss your child each and every day, certain times of the year, when you expect your whole family to be together, the loss seems greater. I said that I was going through a slump, too, and just knowing that each of us wasn't alone, made us both feel better and feel closer. While I don't want anyone else to lose someone they love to meningitis and become a part of our support group, I'm very grateful for the friendships I've formed while dealing with the loss of my child.

 

* Lynn Bozof has been the President of the National Meningitis Association since 2002.

* After writing several magazine articles about meningococcal disease and meeting the moms, the author joined the volunteer NMA Advisory Committee.

 

Information about meningococcal disease

Information about the National Meningitis Association

Information about the M.O.M.s program

In my experience, whatever the problem, giving it a name is a first step in solving it. That’s why I was pleased that Merriam-Webster included the word “fren-e-my” (plural: fren-e-mies) in the list of 100 new words it announced today that were added to the Collegiate Dictionary, Eleventh Edition.

The term frenemy, seamlessly blending the words fri(end) and enemy, refers to someone who pretends to be a friend but actually is an enemy---a proverbial wolf in sheep’s clothing in the world of friendships. If you think about it, most of us have had a frenemy at one time of another, either at school, at work, or lurking in our neighborhood.

She (or he) is likely to be a friend who is filled with ambivalence and jealousy. She admires you and wants to be close but feels like she can’t hold a candle to you because (she thinks) you’re smarter, thinner, richer, or more successful. Ostensibly, she is a friend---but her covert hostility is an attempt to kick you down a notch and put you in your place. For example, she might be the master of the backhanded compliment who says something like, “You have such a pretty face. If you lost twenty pounds, you would really be attractive.”

"You know a friend is really a frenemy if she brings out the worst in you and leaves you feeling drained,” say Andrea Lavinthal and Jessica Rozler, co-authors of Friend or Frenemy?. “A sure sign you have a frenemy is when that person cancels plans with you, you're relieved instead of disappointed."

While most research on friendship and health has focused on the positive relationship between the two, a frenemy is a potential source of irritation and stress. One study by psychologist Dr. Julianne Holt-Lunstad found that unpredictable love-hate relationships characterized by ambivalence can lead to elevations in blood pressure. In a previous study, the same researcher found that blood pressure is higher around friends for whom we have mixed feelings than it is when we’re around people whom we clearly dislike.

The term frenemy has been around for a while, reportedly coined by a sister of author and journalist Jessica Mitford in 1977, and popularized more than twenty years later on the third season of Sex and the City. But like “staycation, “earmark” and “physiatry” it was never legitimized by an entry in the dictionary. Now that it has been, assess that friendship that has always made you feel queasy and uncomfortable and give it a name. Then you’ll realize it’s time to let go or to find a way to fix it.

An article in New York Daily News today had a catchy headline that attracted my attention. It read: Women who gossip can live a happy and healthier life, study finds.

Every blogger is acutely aware that, regardless of content, the title of a post strongly influences whether or not a post will be read. To be honest, I wish I were better at composing titles for my own blog. Even the title of this one isn’t very good. However, the Daily News title really irked and insulted me. Why? First, it implies that all talk among women is gossip. Second, the study had nothing to do with gossip, as it is conventionally defined. Here's the real story: 

In the June issue of Hormones and Behavior, assistant professor of internal medicine Stephanie Brown of the University of Michigan Medical School reported on a study that found that women who bonded together emotionally had higher levels of the hormone progesterone than those with more tenuous ties.

While a number of prior studies have linked strong social supports to better health outcomes, the underlying basis for this connection hasn’t been clear. This new study suggests that a hormone associated with social bonding, specifically progesterone, may play a role in protecting women’s health and enhancing their longevity.

 

Read more about the study in ScienceDaily.com/

What will they think of next? Now there is a therapeutic robot designed as a BFF for people who yearn for companionship but aren't able to take care of living things because they reside in a hospital or nursing home.

The PARO robot takes the form of a baby harp seal. Priced at around $6000 and available in the states in January,2009, the robot is covered in synthetic fur. Its artificial intelligence provides psychological, physiological, and social stimulation, responding to light, sound, temperature, touch and posture, and over time develops its own character. As a result, it becomes a "living" cherished pet that provides relaxation, entertainment, and companionship to the owner.

That there is a market for these high-priced HURI HUMIs, which were introduced in Europe in 2003, shows how important friendship is to healing and wellness.

Source: Press Release, PARO Robots US, Inc., November 20, 2008
PARO Robots U.S. Inc. Brings Hi-Tech Friends to Life

In a recent post on her Psychology Today blog, research psychologist Dr. Bella DePaulo, author of Singled Out, raises the issue of what it means to be “just friends.”

Unlike marriage (and same-sex unions in some States), friends have no legal ties to one another. Unlike siblings, they have no blood ties. Yet one of the most unique and defining characteristics of a friendship is that it is a totally voluntary relationship that exists simply because two people “just” want to be friends.

Ironically: “Friends are marginalized as ‘just’ friends,” writes DePaulo. “Now that Americans spend more years of their adult lives single than married, friendship is more important than it used to be,” she adds. “As family size decreases, so, too, do options for family care in old age or any other age - fewer people have siblings or adult children to care for them (or if they do, those family members may live many miles away). Again, it is friends who come to the rescue.”

Whether single or married, it is often difficult for women to strike the right balance between their friendships, family ties, careers, and needs for time alone. Yet DePaulo’s remarks remind us that---in sickness and in health, for better or for worse---it’s always a treasure to be surrounded by strong, caring female friendships.

If you haven’t yet realized it, graduation from high school or college can be a friendship-killer. When you are no longer living side-by-side or seeing each other every day, it will never be quite as easy to keep up once-close female friendships or to make new ones.

With more than $55 million in domestic box office sales, Sex and the City made its mark as the highest-grossing chick flick in history on its opening weekend. Why did working women and working-at-home women leave their boyfriends, husbands, and kids behind, flocking in droves to see a movie that will likely be available on Netflix and pay-per-view in the blink of an eye? They wanted to see each other.

Sex is the ultimate excuse for a girl’s night out---something that women are desperately craving as our multi-tasking lifestyles leave less discretionary time for female friendships. The march of Stilettos to movie houses across the country was nothing short of a surge. Women clicked on Fandango and lined up for tickets because they were eager to redress their friendship deficit. Regardless of our age or stage in life, many women simply don’t have enough friends to meet their needs for understanding and being understood.

Sex, both movie and the series, hit the nail on the head when it comes to female friendships. We all covet the close friendships like the ones mirrored by Carrie, Miranda, Samantha and Charlotte. Women went to see Sex but they were more excited about the before and after cocktails, dinners and parties they had planned with each other. They wanted to walk in the footsteps of the foursome.

Getting back to my commencement remarks---Graduation often means going home or moving away, leaving the familiar and making new starts. As a result, it is a time when many of us lose touch with women whom we see every day and call and text in-between---both besties and entire friendship circles that are meaningful parts of our lives.

Make yourself a promise to keep up with your school chums---especially the ones with whom you have been able to share both happiness and heartbreaks. As you age and life becomes more complex and demanding, you’ll realize that you have given yourself the most wonderful treasure. A few of the basics:

1) Always make friendship a priority (right up there after family). If you need a rationale to convince you, here it is: Research shows that social support and close friendships are linked to improved health and emotional well-being.

2) Get rid of toxic friendships that are consistently negative and emotionally draining. We all have one or two gal pals that are annoying to be with, people we feel ambivalent about and who probably feel ambivalent about us. Just let go of them.

3) Find any excuse to create rituals to stay in touch with the good friends. It shouldn’t be a one-time affair. Make a plan to get together every month or at least several times a year. It can be on milestone birthdays or periodic girlfriend getaway jaunts. Or even the opening of a long-awaited chick flick!

4) In-between, use every way possible to stay connected---via cell phones, Blackberries, and old-fashioned letters until the next time your see each other.

Female graduates: Congratulations---Go forth with your friends!

 

This post also appears on The Huffington Post. Sign up to become by fan at www.huffingtonpost.com/living and receive my posts directly in your in-box. 

Need another reason to nurture your friendships? Every year, about 15 million Americans undergo surgical procedures. Whenever anyone goes under the knife, even for an elective procedure, it is likely to be a time of great stress.

Whether the surgery is for breast cancer, an ovarian cyst or a cosmetic procedure, female friendships can help ease an otherwise difficult journey. Friends can provide physician referrals, listen when you need another set of eyes and ears to interview a doctor, and provide a potent dose of caring and cheer at your bedside. A new study published in the Journal of the American College of Surgeons confirms that a strong network of family and friends can even ease postoperative pain and anxiety---and speed recuperation.

“Strong social connectedness can have a tremendous impact on patient recovery by helping blunt the effect of stress caused by postoperative pain, as well as ease concerns about health, finances and separation from family members,” says Allison R. Mitchinson, MPH, who works with the Ann Arbor (MI) Healthcare System and was one of the co-authors of the study.

The researchers studied more than 600 patients undergoing major thoracic or abdominal operations at two Veterans Affairs’ medical centers. Prior to surgery, the patients responded to a questionnaire that elicited the numbers and frequency of their social contacts. Patients with smaller social networks reported significantly higher preoperative pain intensity, unpleasantness, and anxiety.

Like exercising regularly and eating a balanced diet, maintaining meaningful friendships is one of the things we can all do to improve health, prevent disease and extend life,

A recent article by Chris Crowley and Dr. Henry S. Lodge on MSN.com, Why Love Heals: How Friendships Keep You Healthy, discusses the findings of a study that examined the correlation between friendship and good health.

“A study of more than 4,000 women and men in Alameda County, California, showed a direct link between the size of one's social circle and survival, with larger circles bringing ever-greater longevity. Women with fewer than six regular contacts outside the house had significantly higher rates of blocked coronary arteries, were more likely to be obese and have diabetes, high blood pressure, and depression, and were two and a half times more likely to die over the course of the study than those with an extensive social network.”

The article goes on to say that both good friendships and a good number of them are associated with good health; a combination of the two is the best prescription of all.

What are your thoughts about why friendship is linked to good health?