Falling out with friends can be more traumatic than a break-up. Fiona Gibson investigates

My bottom lip trembles as I try to finish my Thai meal - my friend and I have argued. She glares at me over her wine glass. I feel like crying and hurrying out of the restaurant. It's much like arguing with a partner. Correction: it's far worse than that.

Friendship fall-outs are traumatic. We just don't expect conflict with friends. We love them dearly but don't sleep with them - surely, the perfect recipe for lifelong, tiff-free relationships. And we need these people. Our families are scattered all over the place; in a survey by Red magazine, eight out of ten women admitted that friends are, at least, as important as family. 'People are concerned with keeping up connections,' says Rachel Claire, Senior Consultant at The Henley Centre. 'We lead much more fragmented lives than our parents did. We move around geographically and switch jobs more often - and it's stressful.'

Which may be why we dread falling out with our friends. Back to disastrous night out with best friend: I felt she was picking fault with my thrown-together outfit, making patronising remarks about my non-too-perfect relationship. She implied I was a soft touch. I bit back, immediately on the defensive, tearing chunks out of her relationship too. We left the restaurant, said cool goodbyes - and I hurried home feeling strangely distraught.

In this instance, the friendship survived. I called the following day to tell her how angry I was; she apologised, filling me in on the various factors that had put her in a stinking mood. Sometimes you ask yourself: do I want to remain friends with this person? In this instance, I did (she wasn't usually like this; blame it on men, weather, hormones, British Rail - the usual suspects). But sometimes, a friend is destined for the ex-pile.

Natasha, 33, recalls the day when her friend was promoted over her. 'We had both gone for a more senior position and she'd got it - but that wasn't the reason we fell out. On her first day in her new job, she called me into her office and announced that despite our 10-year friendship, she was boss, I was not, and that things were going to change between us. I felt utterly betrayed and, although I managed to cope on a professional level, our friendship died that day.'

Other friends merely drift away when our lives take different paths. We figure out ways to avoid them. We book them in for a Monday night drinks (if we must) then cancel, rearrange, and invent migraines. A colleague admits, 'Zoe is my oldest friend; we grew up three doors apart.' Now, at 37 and well past the swapping dolls' clothes stage, Lisa finds Zoe, 'depressing and negative. She makes no secret of the fact that she thinks I have everything - a child, a successful husband, a supposedly great job as a copywriter - and implies that I don't appreciate what I have.' In turn, Lisa finds herself bouncing back by being 'patronising' - reassuring her that she will meet a suitable man, and will get out of her rotten temping job and the exasperation. The friendship faltered further when Lisa had a baby. 'Zoe would fill an entire evening with moans about her boyfriend, who would only allow her to call him on his mobile - and not mention my baby once.'

So Lisa ditched her. Simple as that. She didn't return calls and, when Zoe became persistent, told her she was too busy with the baby to see her for the next few months. Bingo: friend, surplus to requirements, Tip-pexed out of the Filofax.

Sounds harsh? According to Professor Stephen Palmer, Director of the Centre for Stress Management, 'You should ask yourself why you feel so drained after seeing certain friends. Then fix it, or cut them out.' But don't be too ruthless. Professor Palmer adds, 'It's good to have a wide circle of friends - each with different qualities - who aren't too demanding or possessive. In fact, a support system of friends is a good buffer against stress.'

And as for the friend you've argued with - the one you miss terribly? Well, you know her number.

Have you fallen out with a friend? Talk about it on the Overcoming Friendship Problems message board.