As a therapist, I sometimes find myself leaning into therapist mode a little too hard when talking with friends. Most of the time it's not a problem but there are times where I find myself asking questions that feel a little too clinical. So a few years ago when a friend told me that she was starting to attend therapy my first reaction was, "Why? You have me!"

I'm a little embarrassed by that now. But I think a lot of people have some version of that thought. Maybe you've had it about yourself. You're struggling, but you're not that bad. You have people you can call. Isn't therapy for the people with really serious problems?

It's a fair question, and I don't think there is one correct answer that fits for everyone. Sometimes a good friend is exactly what you need. Sometimes it isn't, and professional help is the answer. But how do you know if what you're needing is a friend or if you need a therapist?

First, let's give friendship some credit

We talk a lot about therapy and mental health, but I don't think we give friendship nearly enough credit.

In 2010, researchers pulled together 148 studies that followed more than 300,000 people for an average of about seven and a half years. The people with strong social relationships were around 50% more likely to still be alive at the end than those who were more isolated (Holt-Lunstad et al., 2010). That's a bigger effect than many of the health habits we worry about. In 2023, the U.S. Surgeon General went so far as to issue a public advisory on loneliness, warning that a lack of social connection is associated with a risk of premature death comparable to smoking up to 15 cigarettes a day (Office of the Surgeon General, 2023).

Then there's the Harvard Study of Adult Development, which has followed the same group of people (and later their children) since 1938. And one of the biggest takeaways from all those years of research? Our relationships matter. A lot. (Waldinger & Schulz, 2023).

So no, that cloud nine feeling you get after spending time with friends that you love is not just in your head. Hanging out with friends isn't just fun, it's genuinely good for you.

If making friends as an adult has been the hard part, especially after a move or finishing school, we run a friendship group in Orem for women ages 18 to 30 called Save Me a Seat.

So where do friends fall short?

Friends hold biases, for better or for worse. Your best friend is going to have opinions about your partner and your sister has her own history with your mom. Even the most loving people in your life have a lot of feelings about the good and the bad in your life, so it's hard for them to stay neutral. A therapist isn't personally involved in your relationships, which gives them a different perspective. You can talk about your marriage, your family, or the things you're ashamed to admit without worrying about how it might affect those relationships.

Another thing, friends want you to feel better right now. And sure, that's really nice of them! But it isn't always helpful. A friend will usually reassure you, agree with you, or tell you that you did nothing wrong. A good therapist will sometimes ask uncomfortable questions like, "Have you noticed this happening in other relationships, too?"

Next, over-talking through problems can actually backfire. Psychologists have a name for this: co-rumination. It's when two people go over the same problem again and again, picking apart every detail, dwelling on how upsetting it is, without really moving forward. In a 2021 review of research that mostly followed kids and teens, psychologist Amanda Rose found that while co-rumination can strengthen friendships and help people feel closer, it's also associated with higher levels of anxiety and depression (Rose, 2021). So, if you've ever spent two hours on the phone rehashing the same breakup and hung up feeling worse than when you started, you know exactly what this looks like.

Lastly, friends aren't trained for some things. Trauma, panic attacks, an eating disorder, OCD, and depression aren't problems a caring conversation can fix on its own, and they tend to be really heavy for someone not trained in how to navigate them, no matter how much that person loves and cares about you. There are specific treatments that can help, including CBT, EMDR, and exposure-based therapies. Not every treatment works for every problem, which is why having someone who knows what they're treating matters.

A few questions to ask yourself

No quiz can make this decision for you, but these questions might help. If you'd like to go through them one at a time, try our 60-second check-in.

  • How long has this been going on? A hard week after messing up at work is part of being human. Feeling low, anxious, or numb most days for more than two weeks is a sign something deeper might be happening.
  • Is it getting in the way of your life? Are you sleeping badly, missing work, pulling away from people, or losing interest in things you used to love? When your daily life starts to shrink, it's worth bringing in a professional.
  • Do you feel better after talking to friends, or just briefly relieved? If the same worries are back an hour later, every time, talking may be soothing the feeling without doing anything about the root cause.
  • Is there something you can't tell anyone you know? If there's a part of your story you've kept from every single person in your life, that's often exactly the part a therapist can help with. Therapists are trained to handle sensitive topics with a lot of care and the feeling you get after unloading those secrets can't be beat.
  • Do you keep ending up in the same place? Same kind of relationship, same fight, same burnout. Patterns are hard to see from the inside, and a therapist's whole job is helping you notice them.
  • Are you having thoughts of hurting yourself, or of not wanting to be here? If so, please don't wait on this one. In the U.S. you can call or text 988 any time to reach the Suicide & Crisis Lifeline. Outside the U.S., your local emergency number or crisis line can help.

It doesn't have to be one or the other

For a lot of people, there's room for both. Your friends know your history, your weird sense of humor, and probably more about your life than you'd like to admit. A therapist helps you understand yourself and gives you tools you can use when things get hard. They do different jobs, and you're allowed to have both.

And if you're not sure? Try a few sessions. At Lotus Rose Counseling we offer a free 15-minute consultation call so you can see how it feels. Going to therapy doesn't mean you're broken, and it doesn't mean the people in your life have failed you. Sometimes it just helps to have someone outside your circle to talk to.

Sometimes a good friend is exactly what you need. Sometimes you need a therapist. And sometimes you need both. I certainly wouldn't want to live without either.

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