When’s the last time you thought of someone, saw a friend in passing, or online and said, “We’ve got to get together!” Then months, maybe even years go by, without hanging out or reconnecting.
Or maybe you’re in your 30’s, 40’s or 50s wondering if you’ve wasted the best years of your life, because things just haven’t turned out the way you’d hoped by now?
Loneliness is not just a problem for the elderly. Chronic loneliness is now a mental health and public health issue across several generations that has affected the mortality rate, due to technology, housing trends, telecommuting, increased in-home caregiving responsibilities, and other factors.
Fueled by my own experiences as a caregiver and a young widow, I did some research to uncover the root of social isolation in our modern society, and learn ways we can create and strengthen adult friendships and other relationships to truly connect in our hectic, technologically-driven world.
Why We Get Lonely
Maile Young Karris, MD, Associate Professor of Medicine at UC San Diego Health says there are three general periods of time in a person’s life where they are most at risk for being lonely. “Adolescence or early adulthood, from 15 to mid-20s, the 50s is a period of time when people are experiencing the midlife crisis, and then when you’re elderly, you experience it again. And this is not just something that is happening in the U.S., and we’re seeing this across the world.”
It’s not inherently wrong or bad to feel lonely sometimes– it’s a regular and natural part of life. But “regular” loneliness that comes and goes from time to time is very different from chronic loneliness. Your ordinary run-of-the mill loneliness is “driven by the fact that we are biologically wired for social connection. So it’s the normative experience of feeling alone, because our wiring is such that we are primarily proximity- or closeness-seeking organisms,” says Nakia Hamlett, Ph D, visiting assistant professor of psychology at Connecticut College. “Loneliness is part of the human condition. Regular loneliness is the temporary feelings that we experience, like when we’re used to being with friends; some people have a higher need to be around others, maybe an extrovert versus an introvert. And those feelings can come and go– they’re transient.”
You can also feel lonely just based on perception or the aforementioned cognitive discrepancies in your life. Karris says your level of loneliness is determined by “the difference between what you want from your social relationships and what you’ve actually perceived that you have.”
“After a certain point in life, many of us can relate to, feeling like we should further along, or have completed certain achievements. Dinorah Nieves, Ph.D, Behavioral Scientist and author of Love YOU: 12 Ways to Be Who You Love & Love Who You Are, explains this as the term cognitive discrepancy, which describes “the stress that people feel when they think about their lives and find that it’s dramatically different from what they had expected. It’s what happens when there’s a difference between what you think your life should look like and what it really is.” It’s a common reaction when we self-reflect, or when something we had really hoped for hasn’t come to fruition.
Chronic loneliness is actually more more serious–and common in industrialized society now, because it’s a state of loneliness that “just doesn’t go away,” Karris says. Hamlett explains it as “a persistent state of being,” so that it becomes normal. It also brings about thoughts and feelings such as:
* I’m scared to be alone
* Why am I alone?
* Am I not worthy of love and companionship?
“It’s a healthy practice to focus on things that bring you joy,” Hamlett says, “as opposed to dwelling on loneliness. There’s people who are feeling you’re lonely, and sit home and think about being lonely all day. If you feel lonely, and you make yourself go out and see a beautiful sunset, you probably feel a little better.”
Loneliness is “far more prevalent than we think it is across all age groups,” says Carla Marie Manly, Ph D, clinical psychologist, and author of Joy from Fear and Aging Joyfully in Sonoma County, California. “Research is showing that we are in the midst of a loneliness epidemic.” From a sociological aspect, “our ancestors were in very close, tight knit communities and tribes where we were in daily contact, eating with people, hunting with people, collecting berries, sewing, doing all of those things. And that was the way that we lived largely through the 1950s.”
“I think people are just starting to realize that other people might be lonely, and that it’s not just a thing that affects old people,” Hamlett says. “We know why it affects older people. But we kind of live in an age where people across ages are lonely.”
Manly says that too often, we retreat or allow ourselves to be sucked into a world that involves just ourselves and a screen. As technology has advanced and became more prevalent in society, “people started retreating into the home space. And instead of interacting with each other, they were interacting with their devices. So it’s our misuse of technology. Because as humans we often take the path of least least resistance. It takes more energy to pull out a board game and interact with people than it does to sit in front of a TV” or interact with a device.
The Fallacy of Real Life vs. Curated Social Media Feeds
“I think there was this fallacy that social media was going to make people more connected, and in fact, has made people feel more isolated,” Hamlett says. “The research shows that Generation Z, which is about ages 18-22, are among the people who report being the loneliest, which is ironic because they basically spend their whole lives on social media, supposedly interacting with friends, but yet they feel super isolated on their stats showing that one out of three Americans live alone. a large number, almost 30% of older adults live alone. So across the generations, there’s a group of people who are probably fairly isolated and feel lonely.”
“We are hardwired to be communal creatures for many reasons, including safety and protection, but also validation,” says Manly. So here’s where anxiety and depression come in. If my best friend is my cell phone, or my collective of friends that I never really see on Facebook, and I’m calling them my friends, but they’re not available to me, or talking me through my problems, or cooking dinner with me, or going on a walk with me, of course they’re not because they’re in cyberspace, then what is going to happen? I’m going to feel increasingly lonely. And when my phone is off, or my Facebook is off, or my Instagram is off, I’m going to be anxious. Where did my tribe go? But when we’re in cyberspace, it’s not real. Therefore, with the pictures that we’re seeing, and the fancy vacations, we are imagining that everybody else is living a much better, much happier life.” Thinking about all the fun things your friends are doing can cause you to have FOMO or feel resentful because they have something (such as a significant other or kids) that you don’t, or they are engaging in activities (like vacations and parties) without you.
My husband had Stage 5 kidney failure when he died at age 41. He was in remission from Non-Hodgkins lymphoma (NHL), later became a below-the-knee (BTK) amputee, and suffered from gangrene and other diabetes-related complications. When my husband was in his last days, we both used Facebook a lot to communicate his status and request help from friends. After his passing, I rarely used the “Home” page on Facebook; I just stuck to Groups and answered messages. It was too painful to see “Happy Anniversary,” weddings and other couple-related statuses while I was grieving. Many people sent condolences, cards, and money that helped me tremendously with funeral expenses. But I felt that my closest friends– those I knew IRL– weren’t really there for me. So when my rental lease ended four months after the funeral, I bought a home 600 miles away, in a city I lived in previously. This put my teenage daughter and I five miles away from family members who have always been there for us, but were out of physical reach before.
About Facebook, Hamlett says, “We all got to think of attachment and connection as ‘Oh, you like my picture? Oh, you sent me a heart, you sent me an emoji.’ And that’s a false sense of connection. And then people realize, ‘This is someone I have may have never talked to, or someone I haven’t seen in years. Someone who’s sharing, curating a perfect seeming life. And then now by comparison, I feel bad about mine. So now I don’t even want to look at their page.’ And then it just creates more isolation, because it’s not the authenticity of what real life is, which brings people together– I can lean on you and be vulnerable and let you know when I need help or support, and you can do the same. It’s this fake world we’ve created where everything’s happy, everything’s good. This is why I think there’s a growth– especially on Instagram– of people who follow people who are just out there with the reality of life. My life’s not perfect. It’s attractive to people and irresistible, because we’re looking for those real connections. And that seems a little bit realer online right now.”
This brings up the huge discrepancy in attitudes toward trusting others. Karris explains, “In one study in the U.S. that looked at trust in individuals, there was a question regarding whether or not the respondent had someone that they discuss important matters with. Back in 1985, about 10% of the respondents in that survey said that they did not have someone that they that they could discuss important matters with. But in 2004, that number increased to about 25%. I mean, certainly, The patients I see regularly will come to talk to me more than just to get medicine, diagnoses or things like that. I am the person that they come to so they can talk about these important matters– not friends, not really family, but they come to me for that. And why that [percentage in the study] has changed, is the big question. Why don’t we trust each other, as much as we used to? I think some of that has to is how we view ourselves internally. From my population, I can say there is a lot of internal HIV stigma. They perceive their HIV status will automatically cause them to be rejected, so they don’t reach out to others. But there’s certainly a lot of external stigma as well. And that extends beyond just people with HIV, people of color, poor people, and immigrants.”
How Chronic Loneliness Affects the Brain
Attachment is a part of our biology from birth. “Early caregiving [of an infant] is what sets the structure in place, it makes the neurons healthy. Attachment research shows that a myelin sheath, which covers the neurons, protects the neurons as the brain is being developed, and when a parent is caring for a child, those brain connections are [still] being made,” Hamlett says. “And the myelination process is literally part of attachment. So it makes sense that from birth, our brains develop in the context of relationships. Then, when we are in a situation where we don’t have those close attachments, the areas of the brain involved in motivation, planning, problem solving, and emotion, they get activated more in, say, rats or mice that they isolate. So it activates them to actually seek out connections, and they get anxious about it. And they’re looking to make those connections. So when we experience chronic loneliness, those areas of the brain get what we call potential. The brain becomes hyper-aroused and we may start to grasp for answers when we have the feeling that ‘Something isn’t right with me being alone,’ or the thought of ‘I gotta fix it.’ And then the brain becomes more activated in that way.”
Solitary confinement is one of the most extreme methods of punishment used in the U.S. prison system. According to Psychology Today , “One of the most remarkable effects of chronic social isolation, as in the extreme case of solitary confinement, is the decrease in the size of hippocampus, the brain region related to learning, memory, and spatial awareness. The sustained stress of extreme isolation leads to a loss of hippocampal plasticity, a decrease in the formation of new neurons, and the eventual failing in hippocampal function. On the other hand, the amygdala increases its activity in response to isolation. This area mediates fear and anxiety, symptoms enhanced in prisoners in solitary confinement. And in addition to the effects that loneliness causes in the brain, solitary confinement also has an important component of sensory deprivation. The sensory deprivation contributes to important health impairments, such as alterations of circadian rhythms, the internal biological clock that regulates overall the proper functioning of our bodies.
How Loneliness Affects Your Overall Health
Chronic loneliness is a public health issue and can significantly impact our physical and mental health. While Hamlett notes that chronic loneliness is “linked to depression, anxiety and post traumatic stress disorder,” Karris says that it’s not taken as seriously in the U.S. as it should: “In the U.S., we view loneliness as a weakness; there’s a stigma against loneliness. But there was a study by Sigma Health that was one of the largest of its kind, and it found that the impact of loneliness, and overall health in general, is equivalent to smoking 15 cigarettes a day– similar to the obesity epidemic, so it [loneliness] should be a public health issue.”
“There’s also a 29% increase in heart disease, and a 30% chance of increasing stroke” with loneliness Hamlett adds, and that’s not all. “If you undergo coronary artery bypass surgery, and you’re lonely,” Karris says, “you’re less likely to survive both in the short term–30 days and in the long term, with five years survival. So it’s impacting health in a major way. Lonely people also have an increased risk of dementia later in life.”
The common denominator with all of these ailments is stress. “I would imagine there’s some stress hormones being released,” Hamlett says. “It’s related to inflammation, and inflammation is related to most chronic diseases. So if it’s a stressful experience to be lonely, and then it makes your body have these inflammation outbreaks that over time become diseases.”
“The AARP looked at loneliness and older adults to see if they could figure out the costs of loneliness, and they estimated that Medicare roughly spend about $6.7 billion more per year on older adults who are lonely, compared to older adults who are not,” Karris says.
“For older people, it’s a 45% increase in mortality, and that is a lot,” Hamlett says.
And it’s not just about the lonely elderly population. “In a literature review of 35 articles 77,220 participants, it showed for men and for women, loneliness shows a harmful effect for all-cause mortality,” Nieves adds. “Everybody knows that to be true, there’s a piece of them that really looks at not wanting to die alone. And the idea that if you are alone, you’ll die sooner, some of it is accurate, just in terms of our physical experience, that there are people around you that can help support you in your health, or move you forward if you fall, or if you need something. But some of it is really about this idea that you’re better off with anyone than being alone. And that’s the scary part. Because the same way that loneliness has a tie in a connection to a mortality rate, so do unhealthy relationships.”
“I think loneliness in marriages and relationships can be particularly poignant, and painful,” Hamlett says. “Because if you’re in a relationship, and you have what is supposed to be a warm, caring connection, but it’s not, I think that’s even more damaging. And there’s research to support this, that it can be more detrimental to your health than actually being alone and single. Statistics from a [special] issue of Time magazine that comes out every year that show that if you’re in a healthy, loving relationship, it’s so beneficial to your health: your mortality rate drops, your rates of heart disease drop, diabetes drops, and so many other health benefits. But if you’re in a bad marriage, it has the opposite effect– it makes all your health outcomes worse. If you come home from a stressful job, and it’s still stressful there, you literally have no time for your body to decompress.”
Reaching out and Reconnecting
Karris sees a fair number of patients with HIV that feel alienated and come to see her for social interaction, not just medical concerns. “There are persons that need a more intensive visit, to check in on them as a person, than me actually doing anything from a medical standpoint. A couple of examples: I have a patient that’s in a lot of chronic pain, but he’s also incredibly alone and isolated from his family who live in different states. As a survivor of the AIDS epidemic, he doesn’t have a lot of friends. This population is unique in that there are are a pretty significant number of deaths, and those who are still here didn’t think they were going to live, so they didn’t make new friends. They also didn’t make new friends because they were afraid of further loss. I know someone in the community told me that he went to 45 funerals in one month– they were all dying of AIDS. So it was really devastating for a lot of those folks that survived, and they’re just really isolated. Some of them are punishing themselves, by isolating themselves, and they’re not seeking out more.”
I pointed out to Dr. Karris that in many ways she has the role of a therapist, and she agreed. “But it’s unique in that respect, and many of them also have the HIV stigma attached to them. So it’s not like they feel like they can just go to their neighbor, or go to their church, and talk about what’s going on. Many of them don’t want to disclose that they have HIV, because they’re afraid of further rejection. So they keep a lot inside, and they don’t share. But that’s kind of what I do.”
So what can we do to reach out to each other more, and become more aware of the signs of chronic loneliness?
“Loneliness is a fairly understudied topic, but we can extrapolate from other work that’s already out there,” Karris says. So for example, in the U.K., doctors are doing social prescriptions. So if they are recognizing that one of their patients are lonely, they’re specifically telling them, you need to go and interact with a group of people that you have something in common with and make relationships, or call your daughter– those sorts of things. And I’ve been trying to do that on a patient-to-patient basis.”
Karris also mentions a rise in “cross-generational housing.” She explains, “It’s when you’re housing college students with retirees, for example, and having them communicate and interact with each other, and help each other in different ways. Retirees can provide more of a mentorship to a lot of these college students and the things that they’re going through. And the college students can just be there and provide in physical services, like helping carry their laundry up and down the stairs.
“The other thing is, we need to talk to more people and talk to more diverse people,” Karris says. “And be open to see you know, where those conversations go, don’t always come into a conversation with an agenda.”
Creating and Strengthening Adult Friendships
When I moved back to an area I had previously lived in after being gone for 8 years (now as a widow), most of my friends still lived there, but didn’t try to connect with me. A year later, I decided to be the one to reach out. So now, I am very intentional about connecting with people. I schedule reminders to reach out to friends for lunch and to visit so we can chat and catch up.
“I think you hit the nail on the head– we need to be intentional,” Karris agrees. “We shouldn’t be afraid to be vulnerable, and we need to invest time, which I know as Americans is our least resource. We need to also listen to each other, instead of talking over each other and trying to show each other up. Purposely engaging in frequent, meaningful, in-person interactions, is the key.
“But part of that goes against our culture. I will admit that I am a workaholic,” she continues. And I used to think that this Gen Z concept of work/life balance was weak and unnecessary, if you love the job that you do. But I’m beginning to realize, as I’ve struggled with some things recently, but also with my colleagues, my friends, struggle with in the world that we live in. We’re supposed to be bosses at our job, we have to be the best mom and wife ever, and be supportive of our friends and active in the community. It’s a lot, and it’s too much. I’m now at the point where I’m like, ‘This is too much, and this is not a sustainable lifestyle.’ So you have to figure out for yourself the right balance of sleep, work, socializing with your friends and your family.”
Hamlett has a lot of thoughts about ways we can re-connect with each other (for real– not with tech). “I don’t know if this is just related to the comparisons that happen on social media. And seeing the Kardashians and people on TV who seem just beautiful and rich and happy that I think everyone’s focused on striving, some people are obviously surviving, [because] you need money to live, you have to work. I think in addition to kind of the escape of the internet, I think we all pretty much live in a rat race at this point, where everyone’s rushing around, [with] no time for themselves, trying to take care of kids trying to take kids to every sport the school has, trying to keep up with work trying to keep their marriage and relationship together, and trying to see family. It becomes this thing where we’re on autopilot, running around and not really spending time together the old-fashioned way.”
In terms of interventions, Hamlett recommends reaching out to people, calling them, having gatherings and social activities, and provide transportation. “Just invite people old school, making connections– like when we use used to go over to our neighbor’s house and bring them a cake [after they moved into the neighborhood], or you go and borrow some sugar, and you would talk for a minute.” How many of us really know our neighbors anymore? I don’t know any of my neighbors by name.
Make a task or schedule a commute or two per week to re-connect with friends via phone or video chat. “The idea that someone has you in their mind, and that they could surprise you and let you know that [you were on their mind],” Hamlett says, “and then you’re like, ‘Wow, they actually think of me even though I’m not in front of them,’ is so powerful. So I think that’s the sum of it. If you know a lonely person, just keep them in mind. That’s the intervention: reach out to them in a real way– not the most convenient way.
The Quality of Your Relationships and Friendships is Key
One of the most important relationships we’ll ever have, is our often overlooked relationship with ourselves. We have to get comfortable with being alone sometimes and learn to enjoy our own company. Whether you’re in a relationship or not, or have children or not, it’s ok to put yourself first. Self-care is not selfish.
“Because socially, we’re conditioned in such a way where, because we’re a communal society, we benefit from depending on one another for survival and for sustenance and for support,” Nieves says, “we have almost an intrinsic obligation to one another– a duty, a connection. And I think we then condition people to prioritize that above self care, as opposed to saying, ‘Look, that’s important. But so is this!’ “
When it comes to who we choose to spend our time with, Nieves says we should be more picky about those people. “When we talk about decreasing social isolation, it’s not just about making connections, and having all these people that you’re tight with. We need to strengthen our connections so that our relationships are healthy. Analyze the health of your relationships. It’s about being honest, being vulnerable, being humble, and finding ways to connect all of those to your relationships, so that the people that you’re connected to, are not just filling a place, but they’re actually will be contributing to your improvement and your well-being.
“When I talk to people about being picky, their automatic reaction, no matter how it’s phrased, is something like ‘Who am I to be picky? Who am I to have that kind of criteria? I’m not better than them.’ But you would not go to the store and be like, ‘Okay, I’m gonna take whatever clothes you got.’ I don’t pick relationships on the basis of whether or not I think I’m better than somebody, I’m not better than anyone, but I know for sure that there are people with whom I am a better fit. And that is perfectly legitimate. We don’t have to run around trying to squeeze a square peg into a round hole. If you are taking more time to figure out what you want in your chai at the coffee shop then you’re taking to figure out what you want in your friendships [and other relationships], you may want to rethink that.”
“This isn’t to be discouraging to people who are single,” Hamlett says. It’s about “doing things with friends, meeting new people, going to activities that are hobbies that you like, and engaging with people who like the same thing you do. That’s the one good thing about all our online connections, is that you can find book clubs” and meet people with similar interests. “It doesn’t mean you’re in trouble if you don’t have a partner. It’s just more about making intentional effort to seek out activities, and there’s plenty of other people who are in the same position and people have a lot have fun in these meetups.”
My takeaways from my conversations with Drs. Hamlett, Karris, Manly and Nieves distilled down to their simplest form are:
We are all instrinically and biologically drawn to connect with others.
Be picky with your relationships and remove yourself from toxic relationships.
Engage in, and initiate conversations IRL with your neighbors, friends, and those who don’t look like you.
“I think the key here,” Nieves says, “is that the experience of emptiness that someone feels when they’re alone is detrimental, but not the state of solitude– that you can be alone and still be healthy, happy, functional. And that’s what I think we need to focus on. Because otherwise people are running around out of a fear of loneliness, and getting themselves into relationships that are just as harmful and just as dangerous as or even so even more dangerous or more harmful than any impact that loneliness could have ever had.”
You don’t have to suffer in silence or die slowly inside from the pain of loneliness. Seek out positive acquaintances, friends, and even a therapist if you need to talk, or ways to get out and have some fun.
I’d love to hear your thoughts on this topic and how you keep yourself from getting socially isolated. Please leave a comment below or reach out to me on social media @DareeAllen.