Girls' Friendships and Depression: A Double-Edged Sword?

How do girls' close friendships both help and harm their mental health?

Source: Michael Neel/Flickr

It is alarming that girls’ level of depression increased by 50 percent during the years 2012-2015, and increased by a total of 66 percent between the years of 2007-2017⁽¹⁾.Fully 41 percent of girls ages 12-17 reported persistent feelings of sadness and hopelessness during the past year⁽²⁾. The most recent National Study of Drug Use and Health shows the rate of depression in adolescent girls has increased from 13.1 percent in 2005 to 20 percent in 2017, with most of the increase occurring in the years between 2010-2017 ⁽³⁾. In another national study, the 2017 Youth Risk Behavior Survey also showed that 20 percent of all teen girls had experienced an episode of Major Depressive Disorder (MDD), and 22 percent said they had seriously considered suicide⁽⁴⁾.

It is also alarming that these increases in depression occur far more often in girls as compared to boys. In childhood there is no gender difference in the rate of depression, but by age 13 the difference increases by two-fold. This 2:1 gender difference persists throughout adolescence and early adulthood. There are many biological, psychological, and sociocultural factors linked to depression onset that contribute to these large gender differences⁽⁵⁾ and I review many of them in my book on depression in girls and women across the lifespan. Here I will focus on just one of these factors: How girls involved in tight-knit friendships can become vulnerable to depression.

How Friendships Promote Positive Mental Health

As girls transition to adolescence, they begin to feel an increased need to belong to a peer group and they also develop an increased drive to feel close to others. Gradually, this sets the stage for closeness in romantic relationships; therefore, friendships can be the testing ground for how a girl develops relational resilience—how she is able to balance closeness with others with maintaining an authentic and stable sense of self. Girls may spend hours sending hundreds of texts to friends on group chats or messaging them on social media (replacing the hours of phone chats that occurred during previous generations). With constant on-line contact, they are able to share every thought and feeling that comes to mind. When girls are highly invested in their friendships and this investment is reciprocated, this can bring increased social support and a sense of belonging. Clearly, this type of social support can be an important aspect of positive mental health for girls.

How Friendships Can Contribute to Depression

However, at the same time, it can cause girls to become vulnerable when there is conflict in a relationship. When a girl invests heavily in a relationship, she is that much more distressed when something goes awry—including things like when her friend excludes her from an event, ignores her messages, avoids her at lunch, gossips about her, repeats her secrets, or makes fun of her on-line. Unfortunately, when she shares details of her life with a close friend, that same friend can use this information against her in harmful ways. This type of conflict in friendships can be far more damaging to a girls’ self-esteem that it is for boys’ esteem. This is because girls are more likely than boys to base their self-esteem on the quality of their relationships, so that their self-esteem is heavily based on whether their relationships are going well or not at a given moment in time.

In addition to the pain of perceived betrayal by a friend, the psychological concept of sociotropy is also helpful in understanding girls’ vulnerability: When a girl displays high levels of sociotropy (i.e. she is highly concerned with others’ opinions of her and her standing in current relationships) this can cause her to sacrifice her own needs and desires in order to please others. She may do everything she can to avoid conflict or to “keep the peace” in her relationships. She learns to suppress her opinions and go along with whatever she believes will keep her friends happy. She may never learn what she really thinks or believes because she is accustomed to doing what everyone around her wants from her. When a girl keeps quiet about her anger or remains passive about her needs, she becomes vulnerable to depression. She can start to feel powerless and helpless when she is does not feel empowered to give voice to her feelings or opinions. Another consequence is that if she cannot express her needs or opinions in her friendships, it will be that much harder for her to be able to assert herself in romantic relationships in the future.

Because tight-knit friendships can be a double-edged sword for girls that can serve as a risk factor for depression, here are a few prevention strategies for parents and others who work with girls and who care about their mental health:

1. Evaluate Friendships.

Help her to think about both the positives and negatives of close friendships. It is healthy for her to want to belong with a friend group or to bond with a particular friend. However, she may need to take a step back to evaluate her relationships. She can ask herself:

• Has this person demonstrated that she is loyal to me? Does my friend stand up for me and consistently have my back?
• Can I tell my friend “no” without fear of her rejecting me?
• Is the friendship conditional? Is my friend only nice to me if I do or say certain things in a certain way?
• Do I feel good about myself after spending time with this person, or does my friend bring me down with criticism or even cruelty?

2. Question if She Is A Friend Versus An Acquaintance.

If she answers “no” to any of these questions, ask what she is getting out of the friendship. What role does the relationship play in her life? What problems is it causing? If there are several “no” answers, help her evaluate whether the person is possibly an acquaintance rather than a friend. And how can she choose to relate to this acquaintance in a way that might be quite different from how she would relate to an actual friend?

3. Solidify an Authentic Sense of Self.

When a girl spends time reflecting on who she is, what she believes, and what she values, and when she is validated for expressing this unique sense of self, she learns that she is acceptable just as she is; her self-approval does not have to come only from the approval of others. If she can learn that it is impossible to please everyone all of the time, she can start to learn that her worth is not based upon how friends are pleased with her (or not) in a given moment. She can learn that she does not need every friend’s constant approval in order to be okay.

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4. Encourage assertiveness.

Help her to practice speaking up for herself, encouraging her to express her opinions directly. Remind her that assertiveness is about asserting your rights and effectively expressing yourself in order to get your needs met—in a way that does not trample on the rights of others. Viewed in this way, it is valuable for her to practice self-advocacy that also honors the rights or needs of others. If she is to become assertive to protect herself in future romantic relationships and even in her future career, it is important for her to learn assertiveness skills now and to practice them within her friendship groups.