As Thailand’s society becomes increasingly aware of mental health challenges, especially post-pandemic, many are grappling with the often unseen social costs of depression. Recent global research and lived experiences—like that described in Slate’s recent advice column about a decade-old friendship tested by one friend’s withdrawal and history of depression—highlight a growing dilemma: when a person’s struggle with a common illness like depression begins to erode the very bonds that once provided support and joy, what are friends to do? slate.com
The heart of the matter is that depression isn’t simply an individual’s private affliction. Its effects ripple outward, fracturing close relationships and challenging even the strongest bonds. In the advice column discussed, one friend pulls away—canceling meetups, ghosting texts, and seeming ever more distant. The columnist acknowledges the profound sadness and confusion that this creates for those left behind, while recognizing that social withdrawal is both a symptom and consequence of depression.
Why does this matter for Thai readers? Mental illness, especially depression, is now one of the top health concerns across Thailand, with lifetime prevalence rates for major depressive disorder estimated at between 2-3% of the population—a figure thought to be underreported due in part to lingering stigma and lack of awareness. The Covid-19 pandemic, economic uncertainty, and shifting family structures have further exposed the fragility of adult friendships, long believed to provide emotional safety nets for Thais of all ages. Recent Thai Health Promotion Foundation reports underscore a sharp increase in self-reported loneliness and social disconnection, particularly among city dwellers and the elderly, but now increasingly among middle-aged working adults as well.
Key research published in 2025 by the US NIH found strong associations between depression and social withdrawal, with both behaviors reinforcing one another in a dangerous cycle (PMC11966788). Individuals experiencing depression were significantly more likely to isolate themselves, miss social appointments, and find it more difficult to maintain reciprocal connections. Another study in the journal “Current Opinion in Psychology” outlines how negative emotional biases—common among people with depression—persist even after episodes improve, causing affected individuals to fear judgment or perceive their friends as less supportive, which can hasten isolation (sciencedirect.com).
Social withdrawal is not a minor or passive process: it’s an active, often painful, disengagement that alters the emotional landscape of friendships. In a 2024 study tracking college students, researchers found depressed individuals not only went out less, but they also failed to experience the usual emotional benefits of socializing, further compounding their sense of separation and loss (PubMed). Such patterns resonate strongly in urban Bangkok, where informal social gatherings—shared meals, karaoke nights, LINE chat groups—are often the glue holding relationships together. When someone begins pulling away, friends may feel puzzled or even rejected, but research suggests this isn’t a choice so much as a byproduct of the illness.
Mental health specialists interviewed for this report emphasize the importance of understanding these dynamics, particularly in a Thai context, where collectivist values and “keeping face” often discourage open conversations about mental health struggles. According to a clinical psychologist at a leading public hospital in Bangkok, “We see many clients whose social worlds become smaller without anyone realizing depression is the cause. Friends might assume distance means offense or disinterest, and unfortunately, with strong taboos around discussing mental illness, outreach often stops just when support is needed most.” She adds, “The most powerful thing friends can do is maintain gentle, non-judgmental contact—ask how someone is doing, even if replies are short or slow to come.”
Thailand’s public health campaigns have begun to address these issues. Media features, temple-based wellness programs, and university workshops increasingly highlight the reality that just as friendships can buffer the impact of depression, they are often its first casualty. The Ministry of Public Health has launched new hotline services and local support groups; still, for many, the burden falls on family and friends to notice subtle changes—a drop in social activity, missed calls, excuses that signal more than busyness.
Such withdrawal may take many culturally inflected forms. In Thai society, where “kreng jai” (consideration for others, often leading to excessive self-effacement) prevails, depressed individuals may avoid socializing out of fear of being a burden or source of embarrassment to friends. Experts from the Thai Mental Health Department note that “losing face” due to visible emotional suffering is a key reason why some prefer to retreat than seek help, leaving friends feeling helpless or confused.
From a global standpoint, the “epidemic of loneliness” flagged in a recent US Surgeon General’s advisory (HHS.gov) is not unique to the West. It echoes similar warnings from Thai mental health officials who recognize that, despite popular imagery of Thailand’s communal festivals and close-knit family gatherings, isolation is on the rise—even among those with active social media lives.
For those on the receiving end of withdrawal, as described in the Slate article, the pain is real and often tinged with self-doubt. “Why do losing adult friendships feel so devastating? Because in adulthood, friendships are rare lifelines, as work and family obligations multiply,” observes the columnist. Yet, the latest advice from both mental health researchers and practitioners is to “detach with love”—to maintain compassionate interest, check in periodically, and offer practical support without overwhelming the suffering friend or losing one’s own sense of self-worth.
This approach requires “building a new muscle,” as the columnist writes—one grounded in self-awareness and the ability to balance care with healthy boundaries. Thai social workers routinely advise a similar middle path: stay open and available, but recognize that friendship dynamics may change for reasons beyond anyone’s control. For example, a teacher at a Chiang Mai university recounts how faculty communities were rocked by invisible waves of sorrow after several staff quietly began withdrawing from campus life, only to later reveal struggles with untreated depression.
Looking ahead, experts warn that unless the stigma attached to mental illness, especially depression, is addressed at the societal level, the problem may worsen. As noted by researchers in the field, proactive, non-confrontational support—such as inviting a friend to join a familiar group activity or simply sharing a meal—can play a vital role in alleviating feelings of isolation before they deepen (sciencedirect.com). Workplace wellness programs in several Bangkok-based companies are already experimenting with “buddy systems” and “check-in” routines during team meetings to encourage more frank conversations about mood changes and social withdrawal.
Historians might compare the present loneliness challenge with prior eras of rapid urbanization in Thailand, when traditional village ties gave way to more fragmented networks, making the cultivation of adult, non-familial friendships both more precious and more precarious. Yet, as the Buddhist notion of “anatta” (impermanence) teaches, change is inevitable—even in long-term relationships.
For individuals experiencing social withdrawal from friends with depression, practical steps matter. Mental health organizations recommend reaching out with simple check-ins, offering concrete help (like accompanying someone to a clinic or bringing food), and learning about depression through trusted sources such as the Department of Mental Health website (dmh.go.th). When appropriate, encouraging professional help is important, but so is recognizing when to release expectations and care from afar.
For Thai readers, the key takeaway is both compassionate and actionable: understand that depression often sabotages friendships unintentionally, and that not all losses are personal failures. By staying informed, sensitive to cultural nuances, and firm in one’s own boundaries, Thais can help ease the growing burden of loneliness—one small act of “detaching with love” at a time.
For those struggling or witnessing a friend’s withdrawal, resources are available—mental health hotlines, community support groups, and a growing public conversation about the realities of depression in everyday life. Take the initiative: connect, listen with empathy, and help reduce the stigma that still surrounds mental illness in Thai society.
Sources:
- My Friend Struggles With a Common Illness. I Don’t Know If It Can Explain Her Strange Behavior Lately.
- Associations between social isolation, withdrawal, and depressive symptoms
- The social cost of depression: Investigating the impact of impaired social cognition
- Our Epidemic of Loneliness and Isolation - US Surgeon General
- Social isolation and depressive symptoms among older adults