How loneliness harms our health (2023)

You haven't seen friends the way you used to in two years. He missed his colleagues, even the barista on the street.

where you alone are we all been

Neuroscientists think this is what happens in your brain.

The human brain, which evolved to seek safety in numbers, registers loneliness as a threat. Centers that monitor danger, including the amygdala, kick into action, triggering a "fight-or-flight" release of stress hormones. Your heart rate increases, blood pressure and blood sugar rise to provide you with energy when you need it. Your body produces extra inflammatory cells to repair tissue damage and prevent infection, and fewer antibodies to fight viruses. Subconsciously you begin to see 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 or less susceptible to the vaccine because you have fewer antibodies to fight it.

New York City, where a million people live alone, has been an experience of loneliness for two years: nine million people are isolated with smartphones and 24/7 home delivery, cut off from places they used to be The therapists were hired, as tens of thousands of New Yorkers mourned the loss of a best friend, a spouse, a partner, a parent.

For Julie Anderson, a documentary filmmaker, it happens every day at 5pm. – the time she was contemplating dinner with friends, making plans for the night and now relegating herself to watching TV alone. Stephen Lipman, a Bronx visual artist, feels it in his idle hours: once a precious moment to work on his art, now without ideas or motivation. Eduardo Lazo, whose wife died of pancreatic cancer early in the pandemic, feels every minute is the end of the world they created together.

"Who doesn't see suicide as an option at this point in life?" he says. "But I'm religious and that would deprive me of any chance to be with my wife or loved ones when I die. I can't risk 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 talking," she said of her life before the pandemic. "Chicken soup at the Mansion Diner. We went to Zabar's on the West Side every week, ate a bagel, sat down, talked. who was home I've never been home. Then all of a sudden it all stops."

As some pandemic restrictions are finally lifted and New York returns to some semblance of normalcy, one can only marvel at the lingering impact of two years of extended isolation and the loneliness that has come with it. Some people cut off almost all physical interactions, others were more social, but few made it through the various obstacles and spikes without feeling the loss of the human connections they lacked.

For Solod, who believed that "people are my air," one of the biggest blows came just before the pandemic when she had to be separated from her faithful companion, a rescued Shih Tzu named Annie. Ms Solod, 67, has health issues that keep her in a wheelchair and she eventually found she could no longer look after the dog.

"Now Annie lives on Long Island and it feels very lonely without her," she said. "I've never had a dog. The environment I've always lived in was my dog, the park, people with dogs in the building. That was the connection. Everything has changed."

biology of an epidemic

Loneliness, as defined by mental health professionals, is a gap between the level of connection you want and the level of connection 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. You can have a lot of contact and still be alone, or you can be completely content with yourself.

For many New Yorkers, the pandemic has brought a lot of contact with other people, in crowded apartments, at work or on the subway. But the contacts weren't necessarily satisfying or desirable, and perhaps felt dangerous. This is also a condition for solitude.

In small doses, like hunger or thirst, loneliness is a healthy sign that something is missing and you need to get what you need. But prolonged loneliness can be detrimental not only to mental health, but also to physical health.

Even before the pandemic, US surgeon General Vivek Murthy said the country was experiencing a "loneliness epidemic', driven by the fast pace of life and the ubiquity of technology in all our social interactions. With this acceleration, he said, efficiency and convenience have "overcome" the time-consuming mess of real relationships.

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

The pandemic has only reinforced those feelings. in a recentsearch the whole cityAccording to the New York City Department of Health, 57% of people said they had felt lonely at some or most of the time, and two-thirds said they had felt socially isolated in the past month.

"Loneliness," said Dr. Murthy, "has real implications for our health and well-being."

Being alone, like other forms of stress, increases the risk of emotional disorders such as depression, anxiety and substance abuse. Less obviously, it also puts people at greater risk of seemingly unrelated physical illnesses, such as heart disease, cancer, stroke, high blood pressure, dementia, and premature death. insidelaborexperiment, lonely people exposed to a cold virus were more likely to develop symptoms than people who weren't feeling lonely.

an often quoted oneMeta-Analyseby Julianne Holt-Lunstad of Brigham Young University compared the risk effects of loneliness, isolation and poor social connections to smoking 15 cigarettes a day.

"The general public is realizing how loneliness can affect our stress levels, emotional or mental health," said Dr. Holt-Lunstad. "But we probably don't see the strong evidence of the effects on our physical health."

We also do not recognize the economic costs.

Social isolation and loneliness is associated with an additional $6.7 billion in Medicare spending and costs employers more than $154 billion annually in stress-related absenteeism and more in employee turnover, according to studies.AARPand the insurance giantZigna.

Still, culture has slowly moved to deal with the epidemic, Murthy said, treating loneliness as an uncomfortable emotion rather than a public health crisis. "There are more adults who struggle with loneliness than with diabetes," he said. "However, consider the discrepancy in the attention we give to these two conditions."

Mrs. Solod wasn't worried about that before the pandemic. She lived alone, which put her at greater risk of isolation, but she was always surrounded by people. "A million friends," he said.

He owned an electrolysis business, cut hair at Bergdorf Goodman, and held a real estate license. She even worked as a hostess at Chippendale.

"It was more than dynamic," he said.

But New York can destroy someone's social network. Friends bury themselves at work, move, find lovers, change dog parks. Men are more likely to be socially isolated, while women are more likely to be lonely.

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

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

Despite this, he continued to enjoy the city with friends or with his 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. It was a bond he could not replace, a role no one else could fill. He still had plenty of social contacts, but he lacked a meaningful connection that he needed. The name of this gap is loneliness.

"The Jewish holidays were the worst," he said, as all his losses seemed to be piling up. "I already had a life. She had a husband, she had a mother, neighbors, friends and relatives. Likewise, when the focus of the mother, that central person, disappears, it ceases to exist. When this is over, nothing can bring the holidays back."

Then came the pandemic.

loneliness in the genes

Turhan Canli, a professor of integrative neuroscience at the State University of New York at Stony Brook, wondered if there's a gene that turns on or off when a person is alone. Previous researchers have shown that loneliness, like other forms of stress, is associated with depression, inflammation, cognitive decline and heart disease. But how? Which pathways were opened or closed when people were alone, which genes were turned on or off? InRush University Aging and Memory Projectin Chicago, he harvested brain tissue from older adults who were asked questions about their loneliness in their later years.

Their analysis provided insight into the physical and cellular nature of loneliness. found it differentDifferences between the brains of lonely and non-lonely people. Some genes that encourage cancer cells to multiply were more activated in lonely people, while genes that regulate inflammation were turned off.

"We found hundreds of genes that were expressed differently depending on how lonely these people were feeling," he said. "These genes have been linked to cancer, inflammation, heart disease and cognitive function."

He cautioned that, like many studies of loneliness, his could not prove that loneliness caused these differences in gene expression; it may just have been more common in people who have had them.

For Solod, who was struggling before Covid, the pandemic has brought several new levels of loneliness. Chance encounters with neighbors, shopkeepers, waiters at your favorite restaurant or diner came to an abrupt end. There were the friends who used to visit her, but suddenly it was just voices on the phone.

In December 2021, he was admitted to the Covid unit at Memorial Sloan Kettering Cancer Center for two weeks to receive treatment for cancer and the coronavirus. Since that experience, she has said, "I'm scared."

Even when she saw the neighbors returning to any social activity, she remained extremely cautious. Sometimes he would wheel his chair into the building's lobby to tend to the dogs, then come back upstairs missing his own dog. And always, he said, he was aware of how many people die.

"I talk to my friends all the time," he says. "You call me. But it's something very different, that kind of connection. You don't have the same emotions, the same feelings as when you see someone in person. And when you can hug someone, it's also very different."

The pandemic has underscored the importance of even casual relationships in emotional well-being, said Anne Marie Albano, director of theColumbia University Clinic for Anxiety and Related Disorders. "Even small things like making room for someone to sit next to you on the subway or having someone do that for you, those things just don't happen," Albano said. "And that causes a person who tends to feel lonely to feel lonely more intensely."

The new normal?

Even as the number of cases in New York remains well below its peak, Solod's loneliness has not abated. In fact, she said, seeing people go about their business without masks made her feel even more isolated.

"A lot of people I know are like, 'Oh, don't worry,' and they start quoting the mayor and talking about the kids at school. But even putting cancer and my illness aside, I would say I'm still very scared of the virus. I don't want to have to go back to that world of isolation."

During the Iranian New Year in late March, an Iranian friend brought her food, for which she was grateful. "But people don't like to stay," he said. “It's almost like we're rooted in sales. It's a short hello and see you later. In my world, nobody really does.

Even if life returns to the way it was before the pandemic, it's unclear how much the loneliness of the past two years will diminish or what scars it might leave behind. In accordance withStephanie Cacioppo, assistant professor of psychiatry and behavioral neuroscience at the University of Chicago, like other forms of stress, loneliness can leave permanent damage.

A leading indicator is life on college campuses, said Dr. Cacioppo. “Now that the students have returned, we hear a lot about loneliness and isolation combined with disappointment. College isn't what the kids expected.” So social isolation has been reduced, but a form of loneliness has remained, in the gap between the social life people want and the social life they have.

The moonshot against loneliness

Four years ago the UK Government appointed aMinister of Solitudeto address growing public concerns. One city put up "Happy to Talk" benches with signs that read, "Sit here if you don't mind if someone stops to say hello." The model became popular and spread across England, Canada and Poland.

In the United States, the health care system has focused on the social isolation of older people, but has been slower to address loneliness as a broad public health problem.

However, there are interventions that can help, said Dr. Cacioppo.

"For years, people thought the best thing they could do for a lonely person was to support them," he said. “In fact, we've discovered that it's as much about receiving as it is about giving back. Therefore, the best thing you can do for someone who is lonely is not to help them, but to ask them for help. This is how you give them a sense of worth and a chance to be selfless. Even when we receive the best care, we still feel lonely when we have nothing to give back. Attention is extremely valuable, but it is not enough.”

He also suggested a regular practice of gratitude and altruism that counteracts the mindset of seeing others as a threat.

But the real cures for the problem of loneliness, Dr. Murthy, must address not only lonely people, but also the culture that makes them lonely.

"We urge people to exercise, eat healthily and take their medication," he said. “But if we really want to be healthy, happy and fulfilled as a society, we need to redesign our lives around people. Right now our lives are centered around work.”

The US Surgeon General, this is a call to reverse the cultural patterns that have been building for decades and are benefiting some of the country's largest corporations.

Robert Putnam, in his 2000 book Bowling Alone: ​​The Collapse and Revival of American Community, chronicled a steady erosion of social ties since the 1950s.

Hannah Arendt called widespread loneliness a basic condition of totalitarianism.

dr Murthy's goal required a complete shift in societal priorities. But the alternative, he said, is to literally kill people. Connected people live longer, happier and healthier lives. So changes are needed, starting with our homes and workplaces.

"We have this powerful power to improve the health and wellness in your relationships," he said. "But how often do we invest in it?"

For Robin Solod, alone in her East Side apartment, it's a need she's met the hard way.

She's always too busy walking around to think about how much she relies on her connections with people and how fragile they can be, she said. "But if you take that away, what's left? What are you replacing it with?

She answered her own question. "Without the connection to other people," he said, "you have bupkis."