More and more people — experts in their fields as well as watchful observers in general — are zeroing in on the existence and extent of what’s been called an “epidemic of loneliness.” An epidemic that, like certain other maladies, poses risk for a generalized deterioration in one’s health.
The topic gained a noticeable boost in attention when the U.S. Surgeon General, Dr. Vivek Murthy, released an Advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in our country. The Advisory called for a National Strategy to Advance Social Connection, something never before implemented in the U.S. It details recommendations that individuals, governments, workplaces, health systems, and community organizations can take to increase connection in their lives, communities, and across the country and improve their health. (See specifics at the end of this article.)
In his Advisory, Dr. Murthy wrote in part: “Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health. Our relationships are a source of healing and well-being hiding in plain sight — one that can help us live healthier, more fulfilled, and more productive lives. Given the significant health consequences of loneliness and isolation, we must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity, and substance use disorders. Together, we can build a country that’s healthier, more resilient, less lonely, and more connected. Addressing the crisis of loneliness and isolation is one of our generation’s greatest challenges.”
Loneliness affects a broad range of people
How widespread, and how dangerous, is this “epidemic”? Psychologists, clinicians, neuroscientists, demographers, and more have itemized the breadth of the problem and its perils. They largely agree on a number of key points. Such as that approximately half of U.S. adults report experiencing measurable levels of loneliness. And that disconnection affects mental and physical health, being associated with a greater risk of cardiovascular disease, dementia, stroke, depression, and premature death. Some researchers peg the health consequences of loneliness more specifically as a 29% increased risk of heart disease, a 32% increased risk of stroke, a 50% increased risk of developing dementia, and a more than 60% increase in the risk of premature death. The health risk for those lacking adequate connections has been said to be comparable to smoking several cigarettes daily. Lonely older adults also tend to have lower incomes, are less likely to be married, often live alone, and have poorer self-rated health and more physical limitations than their peers who don’t report being lonely.
Loneliness may have a biological cause
Writing on the subject in the New York Times (NYT), science journalists Eleanor Cummins and Andrew Zaleski looked into the question of how a “loneliness epidemic” can be treated. They found a growing body of research indicating loneliness is a biological phenomenon with extensive consequences.
“Neuroscientists have found that brain signals that should trigger someone to seek social connection are the same ones that, under different circumstances, can turn people defensive and vigilant and more apt to hunker down instead of reach out,” they wrote. They added: “Research has shown that a lonely brain is transformed. Neurotransmitters important for bonding and social connection go haywire.” Some studies done at the outset of the COVID pandemic in response to the social isolation people were experiencing demonstrated that the default network (the “haywire”) was larger in the brains of lonely people. So loneliness is not just a social failure but also something rooted in the brain. Which means, Cummins and Zaleski concluded, that “Loneliness may be a communal problem, but healing begins with the individual.”
Loneliness and isolation are related, but not identical
While some observers basically equate “loneliness” and “isolation,” many experts draw a distinction between the two. Journalists Cummins and Zaleski found that while sometimes mistaken for social isolation, loneliness is different. They wrote: “Social isolation is an objective state: Are you interacting regularly with other people or not? Loneliness, by contrast, is a paradoxical puzzle — an entirely subjective experience of distress at one’s perceived lack of social connection. That can be true whether you’re alone most of the time or at the center of a dance floor.”
What you can do about loneliness, for yourself or others
There has been some speculation that pharmaceuticals might alleviate loneliness, but this often comes with caveats. One physician researcher interviewed by Cummins and Zaleski conducted trials using a hormone. It seemed to reduce loneliness stress but had troubling side effects. In the course of her work, the researcher also discovered that walking, meditation, time spent in nature, and exercising in the outdoors were all activities that produced similar changes to those of her trial pill, with none of the downsides. “I stopped the clinical trial because I think that we can boost social connections naturally,” said the researcher.
Dr. Murthy suggests simply: See your doctor. A New England Journal of Medicine essay argued that clinicians should see themselves as being on the front line in reconnecting Americans. A Harvard University report agreed, saying doctors should ask patients if they are lonely as part of annual physicals.
One limitation here is that health care providers have yet to come up with criteria that describe when a person is sufficiently lonely to the point that physicians should do something about it. Unlike depression or anxiety, there are not clear diagnostic criteria for chronic loneliness. Nonetheless, doctors may be able to connect their patients with organizations that can aid them on their journey, including classes and support groups.
Family and friends can also be key
Another suggestion is to coach social interaction through mindfulness therapy or cognitive behavioral therapy because it is known the brain has a capacity to rewire itself. One physician says that training people on processing emotional cues or social interactions on a regular basis can lead to adaptations in regions of the brain that govern social interaction. He notes activities that reinforce social bonds, such as exercising together and eating together, may be part of a response.
Friends and family must also be proactive about engaging with lonely people on terms that work for them. Finding ways to support others gives lonely people a chance to connect — and can help them break out of a kind of self-centered thinking that loneliness can exacerbate. Finding ways to help people reset their expectations, possibly through therapy, while coaching them on new ways to engage with the people around them could be helpful. As is helping people understand where their loneliness is coming from and why it keeps returning.
It’s been said that loneliness will never be cured but can probably be treated. Medicine may play a role in recovery, and social reform is essential to prevent future generations from succumbing to chronic loneliness. But the most important source of change are the lonely people themselves. Lonely people must remember that while they are not necessarily responsible for the conditions that plunged them into loneliness, they can take steps to pull themselves out of it. This may involve forcing themselves to connect — even when they don’t feel like it.
(Note: For additional ideas on how to address loneliness and access helpful Colorado resources, see our related article on the subject by clicking the link provided below.)
Closing notes from Dr. Murthy
Dr. Murthy wrote about “medicine hiding in plain sight.” “It could be spending 15 minutes each day to reach out to people we care about,” he said, “introducing ourselves to our neighbors, checking on co-workers who may be having a hard time, sitting down with people with different views to get to know and understand them and seeking opportunities to serve others, recognizing that helping people is one of the most powerful antidotes to loneliness.”
This man who drew so much new attention to loneliness pointed out that social connection is not only beneficial for individual health but also improves the resilience of our communities, making them safer, more prosperous, and more civically engaged. In his Advisory, he laid out a framework for the U.S. to establish a National Strategy to Advance Social Connection based on six foundational pillars:
- Strengthen Social Infrastructure: Connections are not just influenced by individual interactions, but by the physical elements of a community (parks, libraries, playgrounds) and the programs and policies in place. To strengthen social infrastructure, communities must design environments that promote connection, establish and scale community connection programs, and invest in institutions that bring people together.
- Enact Pro-Connection Public Policies: National, state, local, and tribal governments play a role in establishing policies like accessible public transportation or paid family leave that can support and enable more connection among a community or a family.
- Mobilize the Health Sector: Because loneliness and isolation are risk factors for several major health conditions (including heart disease, dementia, depression) as well as for premature death, health care providers are well-positioned to assess patients for risk of loneliness and intervene.
- Reform Digital Environments: We must critically evaluate our relationship with technology and ensure that how we interact digitally does not detract from meaningful and healing connection with others.
- Deepen Our Knowledge: A more robust research agenda, beyond the evidence outlined in the Advisory, must be established to further our understanding of the causes and consequences of social disconnection, populations at risk, and the effectiveness of efforts to boost connection.
- Cultivate a Culture of Connection: The informal practices of everyday life (the norms and culture of how we engage one another) significantly influence the relationships we have in our lives. We cannot be successful in the other pillars without a culture of connection.
Coloradans are addressing loneliness
In varied ways, Coloradans are studying loneliness and intervening to help people affected by it. For more on this, see our related article on the subject at Coloradans Are Taking Steps to Address Today’s Loneliness Crisis – AgeWise Colorado Other informative articles are available at: The Dangers of Social Isolation and Loneliness for Older Adults – AgeWise Colorado and Ways to Fight the Isolation Foe – AgeWise Colorado