According to a 2018 national survey by Cigna, loneliness levels have reached an all-time high, with nearly half of 20,000 U.S. adults reporting they sometimes or always feel alone. Forty percent of survey participants also reported they sometimes or always feel that their relationships are not meaningful and that they feel isolated.
Such numbers are alarming because of the health and mental health risks associated with loneliness. According to a meta-analysis co-authored by Julianne Holt-Lunstad, PhD, a professor of psychology and neuroscience at Brigham Young University, lack of social connection heightens health risks as much as smoking 15 cigarettes a day or having alcohol use disorder. She’s also found that loneliness and social isolation are twice as harmful to physical and mental health as obesity (Perspectives on Psychological Science, Vol. 10, No. 2, 2015).
"There is robust evidence that social isolation and loneliness significantly increase risk for premature mortality, and the magnitude of the risk exceeds that of many leading health indicators," HoltÂLunstad says.
Who is most likely?
Loneliness is an experience that has been around since the beginning of time—and we all deal with it, according to Ami Rokach, PhD, an instructor at York University in Canada and a clinical psychologist. "It’s something every single one of us deals with from time to time," he explains, and can occur during life transitions such as the death of a loved one, a divorce or a move to a new place. This kind of loneliness is referred to by researchers as reactive loneliness.
Problems can arise, however, when an experience of loneliness becomes chronic, Rokach notes.
"If reactive loneliness is painful, chronic loneliness is torturous," he says. Chronic loneliness is most likely to set in when individuals either don’t have the emotional, mental or financial resources to get out and satisfy their social needs or they lack a social circle that can provide these benefits, says psychologist Louise Hawkley, PhD, a senior research scientist at the research organization NORC at the University of Chicago.
"That’s when things can become very problematic, and when many of the major negative health consequences of loneliness can set in." Last year, a Pew Research Center survey of more than 6,000 U.S. adults linked frequent loneliness to dissatisfaction with one’s family, social and community life. About 28 percent of those dissatisfied with their family life feel lonely all or most of the time, compared with just 7 percent of those satisfied with their family life. Satisfaction with one’s social life follows a similar pattern: 26 percent of those dissatisfied with their social lives are frequently lonely, compared with just 5 percent of those who are satisfied with their social lives. One in five Americans who say they are not satisfied with the quality of life in their local communities feel frequent loneliness, roughly triple the 7 percent of Americans who are satisfied with the quality of life in their communities.
And, of course, loneliness can occur when people are surrounded by others—on the subway, in a classroom, or even with their spouses and children, according to Rokach, who adds that loneliness is not synonymous with chosen isolation or solitude. Rather, loneliness is defined by people’s levels of satisfaction with their connectedness, or their perceived social isolation.
Effects of loneliness and isolation
As demonstrated by a review of the effects of perceived social isolation across the life span, co-authored by Hawkley, loneliness can wreak havoc on an individual’s physical, mental and cognitive health (Philosophical Transactions of the Royal Society B, Vol. 370, No. 1669, 2015). Hawkley points to evidence linking perceived social isolation with adverse health consequences including depression, poor sleep quality, impaired executive function, accelerated cognitive decline, poor cardiovascular function and impaired immunity at every stage of life. In addition, a 2019 study led by Kassandra Alcaraz, PhD, MPH, a public health researcher with the American Cancer Society, analyzed data from more than 580,000 adults and found that social isolation increases the risk of premature death from every cause for every race (American Journal of Epidemiology, Vol. 188, No. 1, 2019). According to Alcaraz, among black participants, social isolation doubled the risk of early death, while it increased the risk among white participants by 60 to 84 percent.
"Our research really shows that the magnitude of risk presented by social isolation is very similar in magnitude to that of obesity, smoking, lack of access to care and physical inactivity," she says. In the study, investigators weighted several standard measures of social isolation, including marital status, frequency of religious service attendance, club meetings/group activities and number of close friends or relatives. They found that overall, race seemed to be a stronger predictor of social isolation than sex; white men and women were more likely to be in the least isolated category than were black men and women.
Combating loneliness
While the harmful effects of loneliness are well established in the research literature, finding solutions to curb chronic loneliness has proven more challenging, says Holt-Lunstad.
Developing effective interventions is not a simple task because there’s no single underlying cause of loneliness, she says. "Different people may be lonely for different reasons, and so a one-size-fits-all kind of intervention is not likely to work because you need something that is going to address the underlying cause." Rokach notes that efforts to minimize loneliness can start at home, with teaching children that aloneness does not mean loneliness. Also, he says, schools can help foster environments in which children look for, identify and intervene when a peer seems lonely or disconnected from others.
In terms of additional ways to address social isolation and feelings of loneliness, research led by Christopher Masi, MD, and a team of researchers at the University of Chicago suggests that interventions that focus inward and address the negative thoughts underlying loneliness in the first place seem to help combat loneliness more than those designed to improve social skills, enhance social support or increase opportunities for social interaction (Personality and Social Psychology Review, Vol. 15, No. 3, 2011). The meta-analysis reviewed 20 randomized trials of interventions to decrease loneliness in children, adolescents and adults and showed that addressing what the researchers termed maladaptive social cognition through cognitive-behavioral therapy (CBT) worked best because it empowered patients to recognize and deal with their negative thoughts about self-worth and how others perceive them, says Hawkley, one of
the study’s co-authors.
Still, some research has found that engaging older adults in community and social groups can lead to positive mental health effects and reduce feelings of loneliness. Last year, Julene Johnson, PhD, a University of California, San Francisco researcher on aging, examined how joining a choir might combat feelings of loneliness among older adults (The Journals of Gerontology: Series B, online 2018). Half of the study’s 12 senior centers were randomly selected for the choir program, which involved weekly 90-minute choir sessions, including informal public performances. The other half of the centers did not participate in choir sessions. After six months, the researchers found no significant differences between the two groups on tests of cognitive function, lower body strength and overall psychosocial health. But they did find significant improvements in two components of the psychosocial evaluation among choir participants: This group reported feeling less lonely and indicated they had more interest in life. Seniors in the non-choir group saw no change in their loneliness, and their interest in life declined slightly.
There is a plethora of research about this given topic and it can be daunting and overwhelming. In short, when you feel that sense of loneliness or social isolation try to take that first step to identify your feelings, recognize that it is impacting your life and possibly adding to feelings of social isolation and embark on any of the following coping strategies. The bottom line is, YOU ARE WORTH caring for. Your physical, mental and emotional health matters! YOU MATTER! Put the shame aside because that is not yours to own and tell others, "I feel lonely and isolated" and ask for help. I'm doing this right along with you, so please let's do this together and create a social network of change to combat loneliness and social isolation in our lives and in the lives of others.
Reach out to friends or family
Join a group (start out online and engage with others)
Ask a friend, family member, or colleague to join you for a walk or coffee
Start a project that you have been wanting to do
Learn something new and share with others what you have learned
Attend a community event
Volunteer
Remember your value because YOU ARE WORTH caring for.