Everyone feels lonely sometimes. It’s an unpleasant feeling that can leave us isolated and yearning for connection and intimacy.
A growing body of evidence has found that loneliness is not only socially painful, but it is also bad for our health.
Perhaps unsurprisingly, loneliness is associated with an increased risk of mood disorders like depression and anxiety, as well as stress and problems with sleep.
But loneliness also affects us physically. It’s been found to increase the risk of high blood pressure, heart disease, and stroke. Older adults who feel socially isolated are at an increased risk of dementia.
Now, a group of researchers are sounding the alarm on the detrimental effects of loneliness and calling on communities, healthcare professionals, and government officials to treat loneliness as an urgent public health issue.
“To tackle the problem of loneliness, we require more than just individual approaches,” said Melody Ding, PhD, an epidemiologist and population behavioural scientist at the University of Sydney. “Elevating loneliness as a public health issue requires us to rethink the way we build our society, such as how we live, move, work and socialize.”
Ding and her colleagues recently published a study trusted Source in The BMJ that found problematic levels of loneliness in most countries throughout the world. Researchers analyzed data from 113 countries and territories spanning the period from 2000 to 2019.
Ding’s findings are not an anomaly. Levels of loneliness have been at concerning levels across the globe for years, prompting some experts to dub it the “loneliness epidemic.”
With the COVID-19 pandemic, many mental health experts fear the problem has only gotten worse.
Early data indicate that’s true. A recent study from the Harvard Graduate School of Education found that more than 1 in 3 Americans face “serious loneliness” during the pandemic, with young adults and mothers with young children being affected the most.
“By nature, humans are social creatures who crave interaction with others. Without it, our mental health can significantly deteriorate,” said Paraskevi Noulas, PsyD, a psychologist at NYU Langone Health. “Hence, why isolation in prisons is one of the cruellest treatments and leads to psychosis and suicidal ideation.”
And while physical distancing from others was a necessary step to protect ourselves and our families from COVID-19, the effects on our mental health are still playing out.
“The pandemic has had such an immense impact on our society, to the point where we still haven’t fully grasped the consequences yet,” Noulas said.
Whether or not the pandemic will lead to higher levels of long-term loneliness remains to be seen.
Ding says it could go both ways.
“On the one hand, the pandemic has disrupted our social life, which could lead to loneliness,” she said. “On the other hand, the pandemic has provided a unique opportunity for us to connect in different ways, so that geographical distance has become less of a barrier for us to build connections.”
Experts say it’s important to make the distinction between loneliness and social isolation.
“Loneliness is different from social isolation,” said Hillary Ammon, PsyD, an assistant professor of clinical psychiatry in the Perelman School of Medicine at the University of Pennsylvania. “Loneliness is a feeling of being alone, while social isolation is a lack of social connection to others.”
In that respect, people who interact with others daily, whether in their home or at work, can still feel lonely.
“They could be lacking more meaningful social connections due to limitations of the pandemic,” Ammon said.
Noulas points out that people who have been isolated from their families during COVID-19 can feel lonely, but in different ways from people who live alone.
“For those who live with others, I’d describe loneliness more as a craving to be part of society again,” she said. “This group of people live, see, and speak with others on a daily basis in their home. However, the typical norms of life that existed pre-pandemic are gone. So what people I believe crave most now is the desire to live life fully.”
Technology has played a huge role in how people stay connected during the pandemic.
“It has allowed many people the opportunity to work remotely, as well as connect with friends and family through platforms like Zoom,” Ammon said.
The pandemic also spurred greater adoption of telemedicine, which allowed people to see mental health professionals virtually to manage mental health issues.
“Yet, talking to someone through a video chat may not have the same positive effects of interacting with someone in person,” Ammon said.
There’s also social media to consider. Ammon notes that even before the pandemic, social media was likely playing a role in increased feelings of loneliness.
“For one, social media often makes us feel connected to others through common interests or by ‘liking’ posts,” she said. “However, that connectivity is not quite the same for many as interacting with someone in person.”
It’s also nearly impossible to keep social media from creeping into in-person interactions.
“Often, people are found scrolling Facebook or Instagram while out to dinner with others, attending a social outing, or even while conversing with their partner at home,” Ammon said. “It prevents people from being fully present and engaged.”
Historically, older adults have been more at risk of loneliness.
“The elderly in the U.S. have long suffered from a sense of loneliness,” Noulas said. “They’re often strongly encouraged to retire at a certain age, and as people enter their later years, you see less of a place in society for them. Many settle into older communities, assisted care facilities, and nursing homes.”
“They have shut away from society at large, in certain ways, for their health and protection, and in other ways, to make the younger generations feel more comfortable going about their life without the responsibility of caring for an elderly family member that typically takes up considerable time, money, and energy,” Noulas added.
This population was isolated further during the pandemic, causing even greater concerns over loneliness.
Young people and those living alone have also been at an increased risk of loneliness during the pandemic.
“Lack of face-to-face socialization is a concern for young adults, teenagers, and children,” Ammon said. “In-person socialization is important when considering development.”
Certain people with serious mental health conditions, those who have newly arrived to a country or newly relocated and are far from family and friends, and those who feel misunderstood or unwelcome by their society often feel lonely, Noulas said.
“Additionally, those with trauma symptoms and/or paranoia and distrust of others struggle significantly with feeling lonely,” she said. “In a sense, the people who need social support the most are often sadly the ones who struggle the most to find it.”
In an accompanying editorial to Ding’s BMJ study, Roger O’Sullivan, PhD, director of Aging Research and Development at the Institute of Public Health in Dublin, called for more research on what populations are most at risk of loneliness to better address it.
“Not everyone has the same risk of becoming lonely: poverty, poor physical or mental health, few community connections, and living alone have been shown to increase the risk of loneliness, both before and during the pandemic,” he and his colleagues wrote. “A better understanding is required of the intensity and impact of the experience of loneliness, as well as cultural differences and geographical variations.”
As COVID-19 restrictions continue to be rolled back, many people are choosing to reenter society in ways that may have felt out of reach for the past 2 years.
Experts say to manage loneliness moving forward, a multilevel approach is needed.
“Tackling loneliness fundamentally requires us to improve many aspects of our society,” Ding said. “Most fundamentally, at the systemic level, we need to draw our attention to our welfare structure, housing situation, transportation policies, inequalities, division, and polarities.”
She also calls for public awareness campaigns to reduce the stigma around loneliness.
On a personal level, mental health experts say there are plenty people can do to prevent loneliness in their own lives.
“It’s important to gradually make shifts in lifestyles as people begin to reemerge,” Ammon said. “On an individual level, it is still important for people to consider their personal risk and safety calculations. Can they strike a balance between safety and their need for socialization and, if so, what does that look like for them?”
Those calculations will look different for everyone. Some people may not feel ready to socialize indoors without masks but may be willing to see loved ones indoors while masked. Others may opt for seeing loved ones outside.
“As a society, we should be flexible and respectful of others’ choices and readiness to reemerge,” Ammon said.
When you are ready to take steps back to “normality,” experts say it’s natural to feel some anxiety.
“Balance is really key here, so what mental health providers generally encourage is finding a mix of enjoying time on our own, be it for work or personal pleasure, mixed with pushing ourselves past our comfort zones to reengage more with others,” Noulas said.
She encourages volunteering, signing up for clubs, joining local sports leagues, and spending time in nature.
“This will be yet another transition process for us but one we will quickly acclimate to given how resilient we are,” Noulas said. “It’s human nature to adjust and overcome great odds to survive and thrive, and this post-pandemic process will be no different”.