Tend and Befriend: The Health Benefits of Female Friendships

The human acute stress response is often referred to as the "fight-or-flight" response. The term describes the physiological hyperarousal that occurs when we perceive a threat and that gets us ready to react by either fighting or fleeing. The term is actually an oversimplification, as that hyperarousal state can also make us freeze, fright, fawn, or faint, for example [1,2]. Furthermore, despite getting all the attention whenever stress is discussed, this is not the only possible stress response in humans. 

In this article, we’ll discuss another type of stress response that is equally (if not more) important and that has not received as much attention from research and science communication: the “tend-and-befriend” response [3,4]. We’ll also learn how it may relate to women’s health and longevity.

Tend-and-Befriend Stress Response

The “tend-and-befriend” theory postulates that, when faced with a threat, humans may respond to stress by tending to offspring to ensure their survival and by seeking positive social relationships (befriending) for joint protection and comfort [3,4]. The establishment of cooperative, friendly associations between individuals based on kinship or personal attachment is known as affiliation in psychology and is regarded as a fundamental human desire.

From an evolutionary standpoint, it makes sense that tending and befriending behaviors may play a part in how we respond to stress. Human ancestors would not have survived as a species had they not developed stress responses that protected not only themselves but also their offspring, as this would be necessary to ensure their offspring would grow to adulthood and reproduce. Furthermore, responding to threats by coming together as a group rather than fighting or fleeing could be more advantageous for their defense and finding shared resources [4].

Whereas fight-or-flight is under the control of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS), the tend-and-befriend response is believed to be under the control of oxytocin (nicknamed “the love hormone”) and the endogenous opioid system [4], which can promote prosocial behaviors and social affect and attachment [5–7]. 

Sex Differences in Stress Responses

Human stress responses are believed to have evolved in an era when females were the primary childcarers and foragers and males primarily took on protection and hunting tasks. Because protecting their offspring and affiliating with a social group for joint protection would have had substantial survival benefits, the development of tend-and-befriend stress responses may have been particularly favored in women, whereas fight-or-flight responses may have been favored in men [4]. 

Accordingly, although both men and women turn to their social support groups for protection and comfort when under stress, research has indicated that women are somewhat more likely to do so [8,9]. 

An important aspect of this difference is that it can have health implications. The fight-or-flight response involves the production of stress hormones and other mediators that, with repeated or recurrent stress, have long-term costs for stress regulatory systems and general health [10]. When you hear about the health impact of persistent stress, or about strategies to combat it, such as breathwork or yoga nidra, it’s most likely related to the fight-or-flight response. 

On the other hand, turning to social contact during times of stress (and even just hugging a loved one), as women may tend to do, may not only avoid those long-term detrimental effects of stress mediators but even protect against them and support health and longevity. 

Health Benefits of Social Support 

Although research has been accumulating on how important social relationships are for human well-being, social support is still an undervalued aspect of health. But the fact is that both tending to offspring and befriending other people play an important part in human development, physical and mental health, and emotional regulation throughout life [8,11–15].

For example, social support has been linked to reduced psychological distress, increased resilience to stress, healthy cognitive function, and several aspects of physical health, including cardiovascular and metabolic health [8,14–18]; it has even been linked to longevity [19].

The Role of Female Friendships in Stress Support and Health

In addition to family, friends are the main source of social support. Given how women more reliably turn to their friends in times of stress, particularly their female friends, are female friendships a secret weapon to maintain health and well-being into old age? It’s possible! The authors of the tend-and-befriend theory argue that the difference in primary stress responses between men and women may partially contribute to the greater life expectancy consistently observed for women [4]. 

A 2024 study on the health benefits of friendship supports this view. The study, which included 553 adults aged 13 to 77, indicated that positive relationships with our friends may yield health benefits over time. Interestingly, women reported more friendships over time; in turn, more friendships predicted better health 23 years later [20].

So, regardless of your gender, remember that nurturing your friendships and reaching out to your social support group can be a simple and happy way to support your health. 

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