All the Lonely People

Have you ever thought about the fact that being alone can lead to a fatal illness? What should we know about the worldwide epidemic of loneliness, and what can we do to help someone who may be suffering from this debilitating condition?

Most people accept that smoking cigarettes is bad for you. And there’s good reason for that. After decades of research, the US Centers for Disease Control and Prevention warn that smoking “harms nearly every organ of the body, causes many diseases, and reduces the health of smokers in general.” The United Kingdom’s National Health Service is more direct, declaring that “every cigarette you smoke is harmful.”

Less widely known—in part because the research has not been as widely reported—is that loneliness may be just as damaging to human health. Douglas Nemecek, chief medical officer for behavioral health at Cigna, writes that “loneliness has the same impact on mortality as smoking 15 cigarettes a day, making it even more dangerous than obesity.”

To better understand loneliness as a worldwide problem, let’s consider some of its aspects—definition, reach, triggers, effects—as well as some antidotes to an illness that has potentially fatal consequences.

We need to address loneliness. It is literally killing us.”

Will Wright, TEDxBirmingham

What Is Loneliness?

Dictionary definitions of loneliness provide concise yet vague understandings of the term. Oxford Living Dictionaries, for instance, defines it as “sadness because one has no friends or company.” As loneliness becomes more widespread, scholars have worked toward a more precise definition, providing a better grasp of the term while also identifying its root problem. An encyclopedia offers a bit more information than the average dictionary. Louise Hawkley, a Senior Research Scientist and contributor to Britannica.com, defines loneliness from a psychologist’s perspective as a “distressing experience that occurs when a person’s social relationships are perceived by that person to be less in quantity, and especially in quality, than desired.” Sadness can be a “distressing experience” when a person’s loneliness equates to not having meaningful relationships.

It’s important to understand that loneliness affects millions and is not concentrated in any single geographic region. Nemecek asserts that “most Americans are considered lonely,” while an international survey by the Kaiser Foundation shows that although only about 9 percent of people in Japan report loneliness, the severity of the problem is worse. An Australian organization, Jean Hailes for Women’s Health, notes that “as an indicator of what a global problem loneliness has become, [in 2018] Britain appointed its first Minister for Loneliness to address the growing problem, while in Australia, the Federal Government recently announced $46.1 million in funding for the national Community Visitors Scheme to help tackle loneliness and social isolation.”

Such comments barely begin to highlight the problem’s worldwide reach, but they clearly underscore not only the severity of what some see as a growing health issue but also the level of commitment shown by the health community and national governments toward countering it.

Loneliness Triggers

As is often the case in life’s problems, a proactive approach to prevention is far better than a reactive attempt at treatment. That means taking charge of a situation before loneliness sets in rather than just responding to it after the fact.

For example, when an elderly person loses a spouse after decades of marriage, it can trigger loneliness almost immediately, and the condition can spiral downward very quickly. From time to time we hear that “he died not too long after she did,” and the cause can often be traced in part to the intense feeling of abandonment commonly experienced by a bereaved spouse in the days and weeks after everyone has left the funeral service. A proactive friend or relative, seeing the potential for loneliness, could provide consistent, authentic interaction while the bereaved person copes with the significant life changes that follow loss. Such a response might well extend a life. What if this were repeated on a global scale? How many people could be helped?

Of course, not all situations are identical. Not all individuals who lose a spouse are elderly, for instance. Not all marriages last for decades. The British Red Cross, together with British consumer group Co-op, commissioned a 2016 study titled “Trapped in a Bubble: An Investigation Into Triggers for Loneliness in the UK.” The study found that the triggers are individual and multifaceted, and that they can lead to a chronic condition.

The researchers established four drivers—individual, connections (e.g., friends, family and colleagues), community and society—each encompassing a number of factors that, when altered or compromised, can contribute to the problem. For example, a person’s sense of self may be fractured after losing a friend who has been a key part of his or her social life. That one severed friendship can affect opportunities for other connections, since habits may be disrupted that once bound the individual to the community’s social and cultural circles. And then loneliness sets in. Other life transitions can likewise cause barriers to connection. The study notes, “We saw a complex interplay across these drivers (individual, community, society level), and across factors within each driver.”

Drivers of Loneliness and Barriers to Connection

1. Individual

  • Sense of Self
  • Health
  • Income
  • Energy
  • Confidence
  • Emotions
  • Perceptions

2. Connections

  • Friends and Acquaintances
  • Family
  • Colleagues

3. Community

  • Social Activities
  • Funding Cuts
  • Statutory Services
  • Transport
  • Neighborhood Safety

4. Society

  • Social and Cultural Norms
  • Work-Life Balance
  • Stigma
  • Digital Age
  • Insular Communities
  • Political Landscape
  • Financial Hardships

Effects

As already noted, once loneliness has been triggered its effects can be severe. An article on the Cleveland Clinic website quotes clinical psychologist Amy Sullivan: “When you’re experiencing loneliness, your levels of cortisol, a stress hormone, go up. Cortisol can impair cognitive performance, compromise the immune system, and increase your risk for vascular problems, inflammation and heart disease.” The article adds, “Loneliness is also a risk factor for more serious mental health problems such as depression and anxiety.”

The authors of the Red Cross–Co-op study concur: “Loneliness affects the physical health and well-being of an individual experiencing it, it impacts on how an individual thinks and feels and it influences how an individual acts. Loneliness either caused or exacerbated serious symptoms such as physical and mental illness, anxiety and negative emotion, self-isolation, stress, and so on. At worst, loneliness was linked to suicidality for some participants.”

But it’s more complicated. According to a 2018 survey, “reports of physical and mental health conditions are much more common among those experiencing loneliness than others.” The question is, what causes what? Do the physical and mental health conditions cause the loneliness or is it the other way around? In an article discussing the report, The Economist suggests that “maybe sick people are more likely to be lonely.” It goes on to say, “Research led by Marko Elovainio of the University of Helsinki and colleagues, using the UK Biobank, a voluntary database of hundreds of thousands of people, suggests that the relationship runs both ways: loneliness leads to ill health, and vice versa.”

Potential Solutions

Just as loneliness can be triggered in myriad ways, there are many approaches to countering the problem. Various proposed solutions are worth considering.

Pack Health is a digital health-coaching platform designed to help people manage chronic illness. On its homepage is a simple message that reads, “Better Health Begins with Basic Conversations.”

Founder Will Wright, who had suffered from chronic illness himself, noted in a March 2017 TEDx talk that lonely people are often advised to “put down your phone, send fewer e-mails, turn off social media, and go outside and meet people.” He found this not only insensitive and inconsiderate but also unrealistic considering how embedded technology is in our lives. Rather, he said, his team set out to fight against chronic illness and the loneliness that comes alongside it by embracing the digital connections that are already available to people. Pack Health’s coaches sent empathetic text messages, phone calls and e-mails to their clients, and amplified the effect by holding them accountable to take positive steps toward making good health choices.

By their own calculations, their efforts added an average of 1.2 years to the life of each person they had worked with. They credited their success to using technology to provide the lonely and chronically ill with meaningful, authentic relationships.

In Europe, an organization called No Isolation has also embraced the use of technology to counter loneliness. A few months after Wright’s talk, No Isolation founder and CEO Karen Dolva explained, also in a TEDx talk, that her contribution to ending loneliness is “developing technology for smaller groups that takes into consideration their actual needs and capabilities—technology that can foster face-to-face contact.”

We as humans are fundamentally built to be a part of a group. We’re fundamentally built to depend on others and to have others depending on us.”

Karen Dolva, TEDxArendal

In that pursuit, No Isolation has developed a telepresence robot known as AV1, designed to be “the child’s eyes, ears and voice in the classroom” when being physically present at school is impossible because of a long-term health condition.

For older people, specifically those who have challenges with technology, No Isolation offers an award-winning product called KOMP (resembling a vintage television), which allows tech-savvy children and grandchildren to share photos and digitally keep in touch with parents and grandparents who have little or no experience with such technology.

These tools bridge generations and counter loneliness by, again, providing meaningful relationships with authentic interactions.

The Antidote to Loneliness

It’s easy to say that those suffering from loneliness just need to work harder at seeing past their problems and to put themselves in the path of other people. But those who have been lonely themselves will likely say it just isn’t that easy.

The most effective antidote to loneliness is for the rest of us, at the local level, to do what we can to offer meaningful, authentic relationships to those within our sphere of influence who are (or are in danger of becoming) lonely. According to the 2018 Cigna U.S. Loneliness Index, “those who engage in frequent meaningful in-person interactions have much lower loneliness scores than those who rarely interact with others face-to-face.” Those who are not lonely themselves are in the best position to take the first step.

This brings to mind a line from Genesis: “It is not good that man should be alone.” And it reminds us of another age-old principle, also from the Bible, that we are our brother’s keeper and that we as human beings, irrespective of gender, nationality, race, etc., have a responsibility to look after one another as we would want to be looked after.

Current scientific research supports these ancient principles, each of which implies the ultimate antidote to the worldwide loneliness epidemic: Be there for others. Interact with them. Look out for their needs. Help them to know they aren’t alone as they struggle with whatever challenges they may be facing in life.