Posts in category: Dating Tips, Guide and Advice

Friendships come in all forms. While some of our friends may want to see or speak to us all the time, others may be okay with less contact. There’s no single “right” way to show up in friendships, but the way we do can say a lot about our attachment style,

Within friendships, those with an avoidant attachment style tend to struggle with giving and receiving support. However, these individuals still need close relationships full of love, respect, trust, and emotional intimacy. It’s important to understand avoidant behavior within our friends so that we can navigate these relationships effectively and with patience. Let’s take a look at what to keep in mind. 

Understanding Avoidant Behavior in Friends

According to Trisha Sanders, LCSW, owner of Wholefamily Therapy & Wellness, avoidant tendencies are rooted in our early experiences. “We learned that shutting down was an effective way to stay safe in emotionally threatening situations with our early caregivers,” she says.  

People who go on to develop an avoidant attachment style as adults experienced insecure relationships with the primary figures in their lives. Ciara Bogdanovic, LMFT, the founder and owner of Sagebrush Psychotherapy, says insecurity can manifest in various ways: “significant trauma such as the death of a caregiver, neglect, inconsistency in care, or intense criticism from caregivers.” These early experiences teach the individual that they can’t rely on or trust others, which makes them hyper-independent.  

So, how exactly does an avoidant attachment style manifest within friendships? Marisol Urrutia, LCSW, who runs a private practice in New York City, says, “the avoidant individual may have a harder time attuning to others’ emotional needs, pull away when someone gets too close, and appear less interested in pursuing a friendship.” An avoidantly attached person views dependency on others as weakness and may avoid being vulnerable. 

Avoidant behavior in friends can also show up as:

Not wanting to get too deep: An avoidant friend will have a hard time opening up about their deeper emotions, personal issues, or feelings about things. They might change the subject or set a hard boundary on more intimate subjects. They might even deflect with humor. 

Frequently canceling plans: An avoidant friend will be a lot more likely to cancel plans, oftentimes last minute. This makes them come across as flaky and can make you feel like you’re not a priority in their life. 

Shying away from conflict: Disagreements are bound to happen sometimes, in even the healthiest friendships, but an avoidant person will do everything they can to avoid conflict. If conflict occurs, they will do everything they can to avoid addressing the issue. They might give you the “silent treatment” because they feel so overwhelmed by emotional confrontation. 

Avoiding commitment: For an avoidant friend, the idea of being “locked in” or feeling obligated can trigger their discomfort with emotional attachment or dependency. Thus, they might resist making long-term plans or commitments, whether it’s for an event, a trip, or a future get-together.

Self-Reflection and Awareness

Taking the time to look inward can help us decide how to deal with an avoidant friend. We can start by considering our own attachment style. “Avoidant tendencies may heighten anxious tendencies in other insecurely attached individuals,” says Urrutia. “As in all relationships, it’s important to note why you’re friends with someone. Ideally, your friends make you feel positive and comfortable.” 

If we’re experiencing more anxiety around an avoidant friend, we can be curious about the behaviors that may elicit this feeling. Urrutia says these behaviors can simply be their way of operating in relationships, and has nothing to do with how they feel about us.

“If your anxiety about certain avoidant behaviors starts to interfere with your enjoyment of the friendship,” she says, “you might have to address it with your friend (ideally, in a constructive and friendly way), or you might have to assess whether this is truly a good friendship for you.” 

Strategies for Dealing with an Avoidant Friend

With patience, compassion (for ourselves and the other person), and open communication, healthy friendships with avoidantly attached people are possible. Here are a few things to be mindful of when navigating these relationships. 

Things to Consider

Avoidant friends may show up differently than our friends with different attachment styles, but this doesn’t necessarily indicate a cause for concern. Often, they can appear more distant and detached within the friendship.

Just like everyone else, avoidant friends need intimacy and closeness, though they might be less likely to express it, Urrutia reminds us. If we feel like reaching out, we should absolutely take initiative in doing so. “Another thing to remember is that an avoidant friend may have more tolerance for gaps of time between catching up,” says Urrutia, “which may contribute to a slower build in deepening the friendship.” 

As with any relationship, communication is key. Sanders suggests having “friendship temperature check-ins” every now and then. These “can include what’s going well, what you appreciate about one another, any hurts that may be lurking, and anything else that feels helpful.” These check-ins can make our friendship stronger and help the avoidant person practice having healthy, open conversations in a safe setting. 

Things to Avoid

Bogdanovic reminds us to avoid a few key things, as they can perpetuate avoidant behaviors:

• Pressuring our friend with guilt or intense emotions (“You don’t care about me” or “I can’t live without you”)
• Being highly demanding of their time and energy 
• Using absolutes (“We never hang out” or “You never call me”)
• Setting unrealistic expectations of the other person
• Putting in too much effort, to the point where the dynamic feels imbalanced

Elyse Andrews, who runs the lifestyle blog Daisy in the Dust, lives with an avoidant attachment style. She emphasizes the importance of not taking things personally, such as interpreting emotional distance as a sign of not caring or being a good friend.

“Taking things personally will only damage the friendship, and could even lead to the friendship coming to an end,” she says. “Try to understand that it’s not personal. We’re just trying to protect ourselves the only way we know how!” says Andrews.

Building a Supportive Network

When coping with an avoidant friend, other friendships and forms of support are essential. “It’s important to diversify our support system so we don’t over-rely on one person,” Bogdanovic says. We can reach out to other friends and family members, and perhaps join a class or hobby-based activity to expand our circle. 

Sanders says mutual friends can relate to our experience, as they also care for the avoidant friend and understand the challenges such a dynamic can bring, which can be validating. However, she reminds us, “try not to use each other to complain about the avoidant [friend], as this can be damaging.” 

Focusing on Personal Growth

Ultimately, we can only control one person: ourselves. Making sure our own needs are met can help us better show up in all of our relationships. Working on our personal growth should always be paramount. Here are a few ways to do so:

• Get enough sleep each night
• Find an enjoyable form of exercise and stick to it consistently
• Engage in relaxation techniques (breathwork, meditation)
• Journal out your feelings and pay attention to recurring patterns
• Eat a balanced diet
• Confide in a loved one 
• Speak to a therapist 

Keep in Mind

Each of our friendships will be unique and require effort on our part to keep alive. Friendships with avoidantly attached individuals can be nourishing, supportive, and fulfilling. With a bit of self-awareness, patience, and commitment to our own personal growth, we can navigate them effectively.

Living with a chronic condition like atopic dermatitis is more than skin deep—it affects every aspect of our well-being. Atopic dermatitis (AD), the most common form of eczema, is a lifelong inflammatory skin condition characterized by irritation and redness. The National Eczema Association estimates that 16.5 million adults and roughly 9.6 million children in the U.S. live with AD. 

From managing social interactions and body image issues to battling flare-ups and sleepless nights, the skin condition presents far beyond just physical symptoms.

In this spotlight, we’re helping readers navigate the emotional struggles that come with their skin condition. Through personal stories and helpful tools from experts, we hope to make those dealing with AD or other skin conditions feel less alone in their experiences.

Atopic Dermatitis and Your Mental Health

Coping with AD can feel isolating. For both Chee and Leonna, support from loved ones has been key. Chee says his family never made a big deal about his condition and helped him put on cream or go to the doctor as a kid. “Friends and people I met who validated the impact [of AD] were also helpful,” he says. 

Similarly, Leonna mentions the care from her friends, family, and partner in helping her cope. “My partner and friends reassure me that it’s okay and doesn’t look as bad,” she says. Leonna says her doctor has helped determine what else can be done to manage her condition. Finally, she mentions Facebook groups and Reddit as sources of support. “They show me how to deal with recurring symptoms and remind me that I’m not alone, that other people are fighting this, too,” she says. “There are ups and downs. It’s not a linear progression to getting better.” 

The physical aspect of AD can be tough on affected individuals’ mental health. Here are several ways challenges in social and emotional functioning can manifest. 

How I Was Blindsided By Adult Eczema

Eczema was something writer Keyaira Boone had watched several kids face at school while growing up but had no idea it could sneak up on her later in life. She was completely caught off guard by its appearance.  

Keyaira felt uncomfortable discussing her eczema until she couldn’t put it off anymore. She was even nervous to bring it up with her doctor. But when the irritation went from barely noticeable to consistently annoying, she sought out medical advice. Read how AD affected Keyaira’s body image and self-perception, and how she dealt with the embarrassment and shame along the way.

The Vicious Stress and Flare-Up Cycle

External AD triggers can be easier to manage. But when your mental state leads to flare-ups, it can require a different course of action.

“When I am stressed, I will get eyelid eczema [and] I often wake up with itchy, red eyes,” says Dr. Khanna, fellow of the American Academy of Dermatology and a medical advisory board member at Codex Labs. She experiences what over 31 million people in the United States may already know — stress can severely affect eczema symptoms.

Stress can wreak havoc on the body in many ways, and eczema can cause problems from the inside out. Making the effort to remove potential flare-up triggers and usher in a more calming and relaxing atmosphere can be a worthwhile investment. Read more about the stress-eczema connection and how to relieve your symptoms thus reducing your stress (and vice versa).

AD as the “Third Wheel” in Your Relationship

Intimacy requires exposure and vulnerability, which can be a challenge for people with AD when the physical and emotional symptoms of their skin condition are top of mind.

Shelby Smith, 33, shares how eczema appeared in her romantic life during a formative moment in middle school. Smith’s crush was about to make a move but paused when he saw visible symptoms of eczema on her wrists. “He was about to grab my hand, and he stopped,” she told us during an interview. “His commentary towards me was ‘What is the alligator skin on your wrist?’” she adds, mimicking a disgusted tone.

The experience changed how Shelby presented herself to the world as she got older. “My initial thought was to cover it up. You can’t say anything about what you don’t see,” says Shelby.

Since then, Shelby has overcome the way she approached her eczema with potential partners and learned how to build confidence in her love life–but her journey wasn’t easy.

Why Sleep Disturbance and AD Go Hand in Hand

Trying to sleep when you have atopic dermatitis can leave you feeling like you’re waging a battle against your own body. The constant itching creates discomfort and irritation that leaves you tossing and turning–which is why so many people with AD report having sleep difficulties.

The itching that characterizes the condition is a major culprit behind such sleep disturbances, but AD can also affect sleep in other ways, including how much sleep you get and how restorative that sleep actually is. Keep reading to learn more about why AD can make sleeping so tough, factors that might make your nighttime symptoms worse, and–last, but certainly not least–how to find a nighttime routine that will manage your symptoms and help you get the sleep you need to feel refreshed.

Self-Care Routines From People Who Know the Struggle

The National Eczema Association reports that 20% to 40% of school children and teens with atopic dermatitis experience bullying because of their skin condition. Hence, managing one’s AD is not only about skincare, but self-care—having rituals to guard against negative self-talk when your skin seems out of your control.  

For Bea, seeing a dermatologist and allergist has been life-changing for understanding her AD. It has helped her spot what is an allergic reaction versus what is an eczema flare-up, but “sometimes they go hand in hand, which is probably why transitional periods are when my AD flares up the most,” she says. Check out the self-care rituals that have helped Bea and others with AD find comfort, physically and mentally.

How I Came to Accept My AD

One of writer Sian Ferguson’s earliest memories is sitting on the edge of her mom’s bed, crying as she gently rubbed lotion onto the itchy, stinging rash behind her knees. She was 5. And that was the moment she realized that something as “small” as a skin condition could make everyday life feel a lot harder.

The turning point came at 24, during a particularly difficult week. Sian was burned out, grieving, and struggling to sleep through the night. One early morning, she found herself crying on the porch—exhausted, overwhelmed—and felt an itch in her neck. Again, her AD was flaring up.  

That moment didn’t feel like a grand epiphany. But it was the moment she felt truly fed up with her situation. She knew she couldn’t “fix” everything, but she could try to make herself a little more comfortable.

Living with atopic dermatitis “can genuinely feel uncomfortable to be in your own skin,” as described by Ethan Chee, a master of social work student at Columbia University.

Atopic dermatitis (AD), the most common form of eczema, is a chronic inflammatory skin condition that leads to irritation and redness. The National Eczema Association estimates that 16.5 million adults and roughly 9.6 million children in the U.S. live with AD. 

Researchers haven’t yet pinpointed a specific cause for AD, but they’ve determined that the immune system, environment, and genes play a part. Though AD typically manifests in childhood, adolescents and adults can develop it, too. Those living with this condition experience a lot of itchiness, which can then result in swelling, scaling, fluid release, and crusting. Symptoms can ebb and flow, with flares followed by periods of clearer skin, known as remission.

The physical aspect of AD can be tough on affected individuals’ mental health. Here are several ways challenges in social and emotional functioning can manifest. 

The Psychological Impact of Atopic Dermatitis

AD and stress can have a cyclical response, with one exacerbating the other, and vice versa. “Chronic stress makes AD symptoms worse by activating the stress response system, which in turn, leads to increased inflammation and flare-ups,” says Dr. Rostislav Ignatov, chief medical officer at The Haven Detox. 

AD can also have a pronounced impact on self-esteem and body image. Chee says “Having eczema has lowered my self-esteem. It makes me feel like there’s something wrong with my physical appearance, like a flaw.” As a kid, he was bullied for his eczema. Even though his symptoms are relatively under control now, he still tends to hyper-fixate on his physical appearance. 

Mental health discomfort is another outcome of AD. Dr. Arjun Dupati, a double board-certified dermatologist and Mohs surgeon at Apollo Dermatology weighs in: “In dermatology, we refer to a phenomenon known as the ‘itch-scratch cycle,’ he says. “Rashes that itch are further worsened by the act of scratching through the release of additional inflammation-inducing proteins.” This can result in frequent scratching and discomfort, which can negatively impact a person’s self-confidence. 

Visible symptoms can also impact social interactions, as is the case for Leonna, a full-time professional in her late 20s. For Leonna, having eczema has made her feel self-conscious when shaking people’s hands, or less confident when wearing clothes that expose affected areas. “It makes it hard for me to express myself,” she says. “With eczema being physical, I always think of covering it. It kind of translates to me covering part of my personality, as well.” 

Mental Health Conditions Associated With Atopic Dermatitis

Certain mental health conditions are more likely to co-occur with AD. Here are three commonly observed in those living with this skin condition. 

Depression

A 2020 study in the Journal of Allergy and Clinical Immunology: In Practice found that people living with AD are 14% more likely to develop depression than those without the condition. Many factors can contribute to this link, including chronic pain, social stigma, bullying, loneliness, and lack of sleep due to discomfort. 

Anxiety

The same study found that those living with AD are also 17% more likely to develop anxiety than those without the condition. For individuals living with AD, anxiety-induced symptoms can often manifest around stressful life events, such as moving, going through a breakup, or dealing with challenges at school or work. 

Sleep Disorders

A 2022 study found that AD is associated with sleep disturbances in 47-80% of children and 33-90% of adults. Typically, the more severe the physical symptoms, the greater the negative impact on sleep. These disturbances include difficulty falling asleep, frequent nighttime or early morning awakenings, trouble waking up, and daytime sleepiness.

Sleep deprivation is linked to many detrimental mental health outcomes. Those who have difficulty sleeping on a regular basis tend to struggle with irritability and poor stress resilience. Studies have also shown that sleep disturbances are linked to mental health conditions such as depression, anxiety, PTSD, and eating disorders.

AD’s Effect on Different Age Groups

Children and Adolescents

AD is associated with increased absenteeism from school. A 2021 study in the Journal of the American Academy of Dermatology found that among children living with the illness, 67.7% miss school more than one day a year because of the condition, while 3.9% missed more than 15 days.

For Leonna, living with AD while trying to get good grades and apply to colleges was an added challenge. “My skin freaking out meant another thing to stress about,” she says. She also mentions the physical impact of having AD. “In high school, it would be on my hands. I wouldn’t be able to write, because the pencil or pen would rub on the area.” 

Adults

Living with AD also comes with its share of workplace challenges for adults. A 2021 study in the Journal of Asthma and Allergy found that 33.9% of workers living with AD felt discriminated against because of their condition. The same study found that AD was associated with an estimated 10.9 days missed from work per year. Furthermore, AD symptoms, especially during flare-ups, significantly affect individuals’ abilities to perform at work.

The social impacts can be their own challenge to navigate. For Chee, AD impacts the way he feels when meeting new people (such as friends of friends) for the first time or when dating.

Coping Strategies and Treatments

Several medical treatments for AD are available. “Biologic treatments and JAK inhibitors help prevent the inflammatory response that causes AD flare-ups,” says Dr. Geeta Yadav, a board-certified dermatologist and founder of FACET Dermatology. “There’s evidence that these treatments can also help reduce the anxiety and depression associated with AD.”

Topical steroids, topical JAK inhibitors, and other non-steroidal anti-inflammatory medications are also commonly prescribed to treat AD, according to Dr. Yadav. “Controlling flare-ups as well as reducing itch and lesions can go a long way towards improving the mental health and self-esteem of those with AD,” she says.

Finally, lifestyle changes and self-care practices can make a significant difference. Stress reduction plays a major part. Practices such as yoga, breathwork, journaling, and exercise can help. Dr Yadav also suggests the following, if possible: 

Support Systems and Resources

Living with AD can feel isolating. For both Chee and Leonna, support from loved ones has been key. Chee says his family never made a big deal about his condition and helped him put on cream or go to the doctor as a kid. “Friends and people I met who validated the impact [of AD] were also helpful,” he says. 

Similarly, Leonna mentions the care from her friends, family, and partner in helping her cope. “My partner and friends reassure me that it’s okay and doesn’t look as bad,” she says. Leonna says her doctor has helped determine what else can be done to manage her condition. Finally, she mentions Facebook groups and Reddit as sources of support. “They show me how to deal with recurring symptoms and remind me that I’m not alone, that other people are fighting this, too,” she says. “There are ups and downs. It’s not a linear progression to getting better.” 

Speaking to a therapist or joining local support groups can also be useful. Mental health professionals can provide objective insights and help address maladaptive beliefs and coping skills. Connecting with others living with AD can alleviate loneliness and offer tips for how to deal with symptoms, social situations, and other challenges related to the condition.

Additionally, there are several ways to seek support online:

• The National Eczema Association: an organization that offers comprehensive resources through its website, such as a blog and podcast
• Eczema Exchange: an online discussion community and support group that has channels for discussing eczema news, treatment modalities, and alternative healing methods
• Support for Eczema Caregiver Program: a program specifically for parents of children living with eczema, put on by The Global Parents for Eczema Research

Finally, the Asthma and Allergy Foundation of America offers a list of U.S-based support groups for people living with allergy-related conditions, such as eczema. It can also be helpful to ask a healthcare provider if there are support groups hosted locally. 

Bottom Line

Atopic dermatitis is a chronic skin condition that results in redness and irritation. Symptoms of the condition, such as chronic itch, can negatively impact individuals’ mental health. This type of eczema is also associated with academic challenges in children and work-related issues in adults. 

It’s important to bear in mind that AD is a lifelong condition. While treatments and lifestyle changes can improve symptoms or even lead to remission, there is no cure. 

 If you or a loved one is living with AD, it’s important to seek help for both the physical symptoms and emotional challenges that result. Plenty of resources are available, including online and in-person support groups. With the right support and treatment regimen in place, it’s possible to live a healthy and fulfilling life with AD.