Throughout our health education, we are reminded to look for warning signs of abuse in our partners — but why are we never reminded to look for those same warning signs in our friends?

Emotional abuse is the cyclic pattern of tactics such as threatening, scrutinizing and bullying along with more subtle methods such as manipulation, humiliation and intimidation. Most abusers behave in this way to dominate their victim, thereby gaining a sense of control. It is important to recognize that emotional abuse can occur in any type of intimate relationship, not just romantic relationships. Psychologist Jenn Berman explains a “toxic friend” as someone who tears down your self-esteem instead of building it up, who is overly analytical of you and who is an emotional or fiscal burden on you. The hallmark of emotional abuse is its subtlety and wiliness, so much so, that most victims don’t even realize that they are in fact victims.

One of the most obvious signs of a toxic friendship is an overwhelming feeling of apprehension in the victim, colloquially known as “walking on eggshells.” This can lead the victim to anxiously leave each interaction wondering if they did something wrong and overcompensate to ensure stability. This feeling of apprehension builds on itself when the abuser invalidates their behavior upon confrontation, leaving the victim confused and silenced.

Other signs of an abusive friendship include blaming the victim for problems they did not cause, the abuser’s constant need to be right and to prove the victim’s mistake and belittling the victim. While there are even more manifestations of an abusive friendship, the simplest way to recognize this situation is by asking yourself: Do you feel worse about yourself directly following an interaction with your “friend” than you did before the interaction?

If the answer to that question is yes, it is time to start reconsidering the friendship. Scientists are discovering that the effects of emotional abuse go beyond the burden of emotional trauma. Researchers at UCLA have discovered that the stress from a toxic friendship causes an increase in the levels of inflammatory proteins that can lead to cancer, heart disease and diabetes. In fact, the state of your intimate relationships is so important to your health that Dr. Daniel Yadager has equated the value of good friendships to that of eating well and exercising. So, if you are the victim of an emotionally abusive friendship, your pain is real and tangible. The denial and invalidation of your abusive “friend” does not cancel out the emotional and physical toll they have inflicted upon your body.

In our society, there is this notion that while romantic relationships may come and go, friendships are meant to last a lifetime. The pressure and manipulation that the abusing friend applies on the victim to stay, usually by convincing them that they will never find any other friends, is combined with the societal expectation that friendship is meant to outlive any romantic relationship to create a situation of entrapment for the victim.

If you are the victim of a toxic friendship, know that you are in control of the relationships in your life and you can break the pattern of entrapment. A sign of strength is knowing when a problem is too big to tackle on your own and setting out to find support and strength in others.

Morgan Manganello is a junior majoring in integrative neuroscience.