Positive Psychology: How Loneliness Is Damaging Our Health

How Loneliness Is Damaging Our Health

Even before the pandemic, there was an “epidemic of loneliness,” and it was affecting physical health and life expectancy.

By John Leland

April 20, 2022

For two years you didn’t see friends like you used to. You missed your colleagues from work, even the barista on the way there.

You were lonely. We all were.

Here’s what neuroscientists think was happening in your brain.

The human brain, having evolved to seek safety in numbers, registers loneliness as a threat. The centers that monitor for danger, including the amygdala, go into overdrive, triggering a release of “fight or flight” stress hormones. Your heart rate rises, your blood pressure and blood sugar level increase to provide energy in case you need it. Your body produces extra inflammatory cells to repair tissue damage and prevent infection, and fewer antibodies to fight viruses. Subconsciously, you start to view other people more as potential threats — sources of rejection or apathy — and less as friends, remedies for your loneliness.

And in a cruel twist, your protective measures to isolate you from the coronavirus may actually make you less resistant to it, or less responsive to the vaccine, because you have fewer antibodies to fight it.

New York City, where one million people live alone, was for two years an experiment in loneliness: nine million people siloed with smartphones and 24/7 home delivery, cut off from the places where they used to gather. Therapists were booked up, even as tens of thousands of New Yorkers were grieving for a best friend, a spouse, a partner, a parent.

For Julie Anderson, a documentary filmmaker, it sets in every day at 5 p.m. — the hour when she would be thinking of dinner with friends, evening plans, now shrunk to watching television alone. Stephen Lipman, a fine artist in the Bronx, feels it in the idle hours — once a cherished time to work on his art, now drained of ideas or motivation. Eduardo Lazo, whose wife died of pancreatic cancer early in the pandemic, feels it every minute, as the end of the world they made together.

“Who doesn’t see suicide as an option at that juncture of life?” he said. “But I’m religious, and that would terminate any chance I have of being with my wife or my loved ones when I’m dead. I can’t jeopardize that possibility.”

Robin Solod, who lives alone on Manhattan’s Upper East Side, thought she was an unlikely candidate for loneliness.

“I was too busy schmoozing,” she said of her life before the pandemic. “Chicken soup at the Mansion Diner. We would go to Zabar’s on the West Side every week, get a bagel, sit, schmooze. Who was home? I never was home. Then all of a sudden, everything comes to a halt.”

As some pandemic restrictions now finally lift, and New York returns to some semblance of normal, one unknown is the lasting effects of two years of prolonged isolation and the loneliness that came with it. Some people cut off nearly all physical interaction, others were more social, but few got through the various lockdowns and spikes without some sense of loss for the human connections they were missing.

For Ms. Solod, who believed “people are my air,” one of the hardest blows came just before the pandemic, when she had to part with her loyal companion, a rescue Shih Tzu named Annie. Ms. Solod, 67, has health problems that keep her in a wheelchair, and eventually she felt she could no longer care for the dog.

“Now Annie lives out in Long Island, and it’s so lonely without her,” she said. “I never didn’t have a dog. The environment that I’ve always lived in has been my dog, the park, the people with dogs in the building. That was the connection. Everything has changed.”

Loneliness, as defined by mental health professionals, is a gap between the level of connectedness that you want and what you have. It is not the same as social isolation, which is codified in the social sciences as a measure of a person’s contacts. Loneliness is a subjective feeling. People can have a lot of contact and still be lonely, or be perfectly content by themselves.

For many New Yorkers, the pandemic brought too much contact with others — in crowded apartments, workplaces or subways. But the contacts were not necessarily fulfilling or desired and maybe seemed dangerous. This, too, is a condition for loneliness.

In small doses, loneliness is like hunger or thirst, a healthy signal that you are missing something and to seek out what you need. But prolonged over time, loneliness can be damaging not just to mental health, but also to physical health.

Even before the pandemic, the United States surgeon general, Vivek Murthy, said the country was experiencing an “epidemic of loneliness,” driven by the accelerated pace of life and the spread of technology into all of our social interactions. With this acceleration, he said, efficiency and convenience have “edged out” the time-consuming messiness of real relationships.

The result is a public health crisis on the scale of the opioid epidemic or obesity, Dr. Murthy said. In a 2018 study by the Kaiser Family Foundation, one in five Americans said they always or often felt lonely or socially isolated.

The pandemic only exacerbated these feelings. In a recent citywide survey by New York’s health department, 57 percent of people said they felt lonely some or most of the time, and two-thirds said they felt socially isolated in the prior month.

“Loneliness,” Dr. Murthy said, “has real consequences to our health and well-being.”

Being lonely, like other forms of stress, increases the risk of emotional disorders like depression, anxiety and substance abuse. Less obviously, it also puts people at greater risk of physical ailments that seem unrelated, like heart disease, cancer, stroke, hypertension, dementia and premature death. In lab experiments, lonely people who were exposed to a cold virus were more likely to develop symptoms than people who were not lonely.

An often-cited meta-analysis by Julianne Holt-Lunstad of Brigham Young University compared the risk effects of loneliness, isolation and weak social networks to smoking 15 cigarettes a day.

“The general public recognizes how loneliness might influence our levels of distress, our emotional or mental health,” Dr. Holt-Lunstad said. “But we probably don’t recognize the robust evidence of the effects on our physical health.”

Nor do we recognize the economic cost.

Social isolation and loneliness are associated with an additional $6.7 billion in Medicare spending and cost employers more than $154 billion annually in stress-related absenteeism, plus more in job turnover, according to studies by AARP and the insurance giant Cigna.

Yet the culture has moved slowly to address the epidemic, Dr. Murthy said, treating loneliness as an unpleasant feeling rather than a public health crisis. “There are more adults struggling with loneliness than have diabetes,” he said. “Yet think about the discrepancy in the attention that we give to these two conditions.”

Ms. Solod, before the pandemic, was not concerned about any of this. She lived alone, which did put her at higher risk of isolation, but she had always immersed herself among people. “A million friends,” she said.

She had run an electrolysis business, cut hair at Bergdorf Goodman and had a real estate license. She’d even worked as a hostess at Chippendale’s.

“I was beyond dynamic,” she said.

But New York can chip away at one’s social network. Friends get buried in work, move away, find lovers, change dog parks. Men are more likely to be socially isolated, but women are more likely to be lonely.

For people over 60, like Ms. Solod, who are one of the highest-risk groups, the isolation often begins with their health.

Six years ago, Ms. Solod began treatment for lung cancer, then multiple myeloma. Suddenly her life revolved around medical treatments, not socializing, and she needed a wheelchair to get around.

Yet she was still enjoying the city with friends or with her mother, who lived nearby. “I could hear my mother’s voice: ‘Don’t stay home,’” she said. Then a year before the pandemic her mother died. That was a connection she could not replace, a role no one else could step into. She still had lots of social contacts, but she was missing a meaningful connection that she needed. The name for that gap is loneliness.

New York Had an ‘Epidemic of Loneliness.’ Covid Made It Worse. - The New York Times (nytimes.com)