The power and prevalence of loneliness

Charlotte S. Yeh, MD
Charlotte S. Yeh, MD, Chief Medical Officer, AARP Services, Inc., Guest Contributor

All the lonely people, where do they all come from?
All the lonely people, where do they all belong?
—The Beatles, “Eleanor Rigby”

A few years ago, when I was the attending emergency physician working in the emergency department, the senior medical resident asked permission to discharge an older man. The resident was convinced the patient was a malingerer, having been seen multiple times in the last week at the medical clinic with “shortness of breath.” The patient had multiple tests, scans, and more — all normal — and yet here he was again, in the emergency department complaining of continued difficulty breathing. “Wait,” I said. “There must be a reason that he keeps coming back. Let me take a look at him with you.”

We entered the room, and saw an old man, shrunken in the corner with no animation in his face. He looked forlorn, so I asked, “Are you sad?” He burst into tears and told me that his partner of more than 20 years had died a week ago; he was devastated.

His real condition? Not shortness of breath, not crying wolf to get attention, and certainly not a malingerer. What he had was pure and simple: loneliness.

The medical resident was stunned. As he admitted to me later, he learned a powerful lesson that day: that the pain of loss can be as profound as not breathing. And sometimes the symptom comes not from the body, but is a cry from the soul.

The epidemic — and health dangers — of loneliness

Loneliness affects 25% to 60% of older Americans and puts millions of Americans 50 and over at risk of poor health from prolonged loneliness. Loneliness is almost as prevalent as obesity. In a survey of members of the AARP Medicare Supplement Plans, insured by UnitedHealthcare, 27% to 29% were lonely; about 9% were severely lonely. Among those members representing the top 5% with the most chronic conditions, spending 5% of the healthcare dollar, loneliness rises to 55% of that population, half of whom suffer with severe loneliness.

Notwithstanding the impact on quality of life and life satisfaction, loneliness has an equivalent risk factor to health as smoking 15 cigarettes a day, shortening one’s lifespan by eight years.

Per the Harvard Study of Adult Development, a 75-year longitudinal study of men, loneliness is toxic. The more isolated people are, the less happy they are, and brain function declines as well as physical health. Note that isolation is the objective measure of how large your social network is, whereas loneliness is a subjective perception of how one feels. In other words, you can have many friends and be lonely, or no friends and not be lonely. Isolation, whether from becoming homebound, loss of mobility, absence of transportation, or losing a spouse or partner, are all risk factors for loneliness. Hearing loss, too, can foster isolation and miscommunication, and set the stage for loneliness.

Loneliness also can be contagious, just like a cold. According to a recent study, “Alone in a Crowd: The Structure and Spread of Loneliness in a Large Social Network,” lonely people tend to share their loneliness with others. Over time, a group of lonely, disconnected people move to the fringes of social networks. The problem is compounded because lonely people, those on the periphery, tend to lose the few contacts they have.

According to the UK Campaign to End Loneliness, more than half of lonely people simply miss having someone to laugh with. Their research also showed that simply being together with someone is missed most of all (52%), and 46% miss having a hug. Older people experiencing loneliness also miss simple everyday moments, such as sharing a meal (35%), holding hands (30%), taking country walks (32%), or going on holiday (44%).

“Treating” loneliness

Back to my patient. He was classically lonely, having lost his dearest friend of 20 years. We had to allow him to share his grief, support him in his loss, and acknowledge the pain, so he didn’t have to substitute a physical ailment to say he needed help. There is a huge stigma to admit to loneliness, and yet it is such a profound human condition that we all recognize, and yet so often turn our faces away.

Social connection helps us thrive and gives us resilience. The support of family, friends, colleagues, and caregivers allows us to celebrate our experiences, weather our pains, and face each day as we journey forward.

AARP Foundation recently launched a social isolation platform called Connect2Affect. The goal is to create a network that not only builds awareness about social isolation and its impact, but also identifies solutions. The Connect2Affect website features tools and resources to help users evaluate isolation risk, reach out to others who may be feeling disengaged, and find practical ways to reconnect to the community.

Now that the holidays have come to an end, our friends and family have returned to their everyday lives while others have retreated into hibernation during these cold months. As you ponder these next few weeks and months, think about who you know who recently lost a loved one, who might be going through a divorce, an empty nester, or someone who might still be lonely even though surrounded by friends and family. They may well be sad, isolated, or feeling lonely. Reach out to them. As the old ad jingle says, reach out and touch someone. You can ease the loneliness and isolation and be a bright spot in their lives. You can laugh with them, reminisce, and thank each other for just being there.

Let us not forget, now that the holidays have ended, the power we each hold in our hands — the power of connection, friendship, and being human. Hold a friend’s hand today and every day. You will have just contributed to life itself.

Comments:

  1. William K Larkin

    Thank-you for drawing attention to the amazing statistics of loneliness and the impact of its relationship to health issues. However, loneliness is a not a problem to be associated only with aging. Take a closer look at the statistics and the studies; loneliness is in every part of our culture and the world.

    Loneliness is not an issue of being alone; it is an inability to “connect” in meaningful ways that give us a sense of sense of significance and belonging. The lonely are wealthy and they are young and they are married and many have very busy jobs. It is not that loneliness simply comes when we experience loss; it is that many experience a loss they can’t name or identify. Being alone is not loneliness until we experience it as loneliness; they are not the same.

    It is oftentimes the “cover” for loneliness that we lose and without the cover, experience the reality of a life without real “connection”. That is actually the realization that we are not “connected” with our “selves”. It is a stark awakening to become aware that it is connection to my own self that I have abandoned or never found or considered. Loneliness has many covers, like MD, for example. Try to connect meaningfully with yours and see where you get.

    Dr. William K Larkin,
    Director
    Applied Neuroscience Institute

  2. Theresa Gaignard

    Thank you for this article.

  3. Roo Bookaroo

    Loneliness is not a “cry from the soul”. The soul does not cry.
    Loneliness is a feeling, and the brain can give expression to this feeling as it can to any other kind of feeling, with the tools at its disposal.

    Coming from a trained MD, this kind of presentation is misleading and only spreads wrong ideas about imaginary entities. Ask any psychologist or brain researcher about this.

  4. maurice smith

    Seems like a phenomenon for older people after retirement. Work is the social denominator that connects adults. A few years after that it can get dicey. Society is more alienated now with friends, family, past co-workers. Seems like everyone is busy doing their own thing and desires privacy; therefore, one feels imposing to others an then limits visits. I love working out at any age. I was alway very active. And, as I got older…66 in a few weeks my health changed. Arthritis in my feet, ankles, knees, shoulders; a bulging disc that incrementally flares up keeps me more inactive than I choose to be. If I leisurely walk in the community or fitness club, my flat feet, heel and ankles hurt. Besides that society is a bit more dangerous these days and being a Senior one feels more vunerable an a easy target to the criminal element; driving is not as fun either as you get older. And, if your are single, it is difficult finding a compatible mate.

  5. Diane

    I am 65, and worked in NYC for many years as a psychologist. Why so much depression? It seemed obvious to me that loneliness was a huge and unacknowledged cause. Our individualistic culture holds independence as the highest value but we pay a terrible price. Young people and their parents are ashamed of multigenerational living although our preindustrial society considered that the norm. My practice consisted of mostly young professional people who came to nyc to live the dream. But there loneliness was epidemic. Remember the Autora, Colorado mass murderer graduate student ? I recall thinking- who in his family thought it was a good idea for this unbalanced young man to be living alone (with his own sick thoughts and guns and bombs as his only friends,?)His parents were probably proud that their son was “independent.” Adam Lanza ( sandy hook , ct. school shooter) shot his mother too, who left him alone with his sick mind because she could not accept that he could not be “mainstreamed,” and being with others in a group setting where he may not have developed his malignant form of disconnection and loneliness , was anathema to her. We need as a culture to reassess our obsession with so-called “independence.” Ned Hallowell, author of many books on ADD, writes of the paramount need for a sense of “connectedness.” Not all “progress” is positive and we would do well as a culture to revisit our inordinate pride for “living on your own.” Being dependent on others and responsible to others in a community is essential for a healthy mind and body. It must be a focus moving forward and as the article suggests and as I have observed throughout my years as a psychologist, loneliness leads to more than just loneliness, physical health, mental and emotional health and many social ills are the tragic but preventable result.

    • F Wood

      I agree with you wholeheartedly! I work closely with people in Nigeria and being there, it is easy to see what a sharp contrast it is to being here in the US. There, people are almost never left alone, especially the elderly, and isolation is no virtue. Not to overgeneralize, but generally speaking people are happier and less susceptible to depression and the like because social and familial connections are prized and prioritized over all else. It would really do us well to take a lesson, as you’ve said.

  6. Camille

    Having given up my psychology profession due to illness, as I age, 75, and it becomes harder to do things, I too find myself feeling lonely. My daughter and her two children have lived with me for three years and are now going out on their own since it was for her health reasons they were living with me and she is now able to get on with creating her own life for which I am very grateful. I realize it is empty nest syndrome also since none of my family will be living close to me. I recognize the feeling which I experienced when she, my youngest, went away to college. But I am unable to fully participate in life as I was doing then so there is a degree of fear due to my health situation. I do intend to find situations where I can belong. It is hard because I started a “singles” club where I live and my supposed best friend started making up untruths about me and starting rumors which spread as we all know. Of course, by the time I found this out, people were avoiding me. I was on chemo at that time and unable to manage the betrayal by continuing with the group. I am proud that I was able to start this group because women live longer than men and there are over 5000 people living in my 55+ community so the venue I set up is still going strong with over 500 members! I have to find the courage to face up and start going back again but my gut says no. There are other organizations so I will find a few that fit my likes I hope since I am limited with energy. Anyway, thanks to all of you who have not given up and are still looking for solutions.

  7. miriam cohen

    A fter my husband died I found weekends to be the most difficult times. My friends and family were extremely supportive but i did not wish to become a millstone round their neck. I decided to continue to attend synagogue on Saturdays and holidays and to spend a good part of Sundays visiting shut-in friends.I found that making others happy rebounds on me and makes me feel better.Being involved in one’s own i nterests (in my case, art and art teaching) is also very important and enriches life in so many ways.
    Miriam Cohen

  8. Estelle

    Volunteer

    • Edward 'Ed' Latson

      Volunteering does help-believe me-but it remains a band-aid. And there are those souls who cannot get out of the house due to lack of transportation, their fears and anxieties. It appears that many have no idea of available services and help, others remain so grief stricken and/or depressed that the thought of something like volunteering may as well be something on the moon for them. The link to the English website (as noted in Dr. Yeh’s article):
      http://www.campaigntoendloneliness.org/laughter-really-could-be-the-best-medicine/
      I have been in email contact with the director of a Suffolk (county) program called: Rural Coffee Caravan ( this is also their website). They travel from small, remote rural village to village dispensing free coffee, tea and cakes combined with companionship and the RCC volunteers also can provide bulletins and forms to people who need services. They also have some of the specialists from needs organizations travel with them–providing an intimate and much needed linking of people to people. Many smaller communities–and even urban centers–are seeing the disappearance of the local store or shop, the pub and post office which have traditionally been our meeting places.
      I whole heartedly agree with volunteering …….if and when one is able to see through their curtain of loneliness and isolation.

  9. Edward 'Ed' Latson

    Dr. Yeh- Excellent article-congratulations for a spot on assessment! I, too, am 65 and my Bride of 42 years died last April here at home–peacefully and quietly. I have been involved with caregiver counseling for over 18 months and this has been and continues to be my salvation. There are 60,000,000+ of us informal caregivers (the term noted by the American Psychological Association for those of us who are untrained, not professional and caring for our beloveds) in this country—and with those numbers climbing. Our lives are circumscribed by the ‘7 Deadly Emotions of Caregiving’ —-https://www.caring.com/articles/7-deadly-emotions-of-caregiving : guilt-resentment-anger-worry-loneliness-grief-defensiveness…..and these are the emotions while you are caregiving much less following a beloveds death! My hat is off to you and your kindness and gentleness Dr. Yeh….
    Ed Latson Ithaca NY

  10. Susan

    I am 65. What really made me realize that my depression may be partly attributed to loneliness is trying to think of someone’s name for those forms that ask for emergency contact, health care proxy, executor, etc. With only an aging Mother (who is in her 90’s, also lonely and lives 3000 miles from me, and won’t move so I can take care of her), no significant other, no siblings, few relatives and none that I share anything in common with, and having moved many times in my life, the people I do know are all superficial relationships. I try to stay active in clubs and do volunteer work but the sinking feeling always returns. My favorite part of the day is bedtime and the worse part is having to get up in the morning. I really don’t know if this situation has a solution!

    • Dkw

      Dear Susan,
      I felt deeply moved by your post. The last sentence tugged at my heart. I don’t know whether this is of any use, my response, but I felt strongly want to reach you.
      I lost my father 1 and a half years ago, but I have my own family at least part of it around me. Yet at times, I feel l am so lost in this world. So, as mentioned in the article, even among others, one could feel lonely. Perhaps knowing that we are not alone in our loneliness helps….? I do not know.
      Just know that someone living far away, in a different country and may never ever get a chance to be friends with you is wishing you a happy life. I pray you meet people with whom you can form true lasting relationships.

    • Lu

      Susan, I understand exactly what you have written. I too hate having to think of a name to fill in the ’emergency contact’ box. All my family lives more than 300 miles away. I have no children, my father passed away a little less than a year ago and my mother won’t consider moving to where I live. I do have my work which I love but am getting near retirement so I’m not sure what to do. The one thing that has helped me more than anything is finding things, anything, for which to be thankful. For example, I thank my Heavenly Father for little things like the beauty of a colourful fall leaf on the wet pavement which leads to being thankful for the ability to see it. Even when I don’t feel like it, I try to remind myself to be thankful, out loud, on purpose and when I do, I feel better. Another source of comfort to me is reading my Bible and attending Bible study and listening and sharing with others what we have learned from our individual studies. Also, I have had a few people in my church family extend a hand of friendship and welcoming which has meant a great deal to me. I even found a single smile to be encouraging. It reminds me that people can make a difference so I should try to extend myself to others as well. I never expected to be in this situation either. I’m sending you a hug across the miles and I’ll be praying for both of us as we continue on.

  11. Dianne Goode

    I have read lot about loneliness most of it is about elderly ones. I am 60 not old but not young either. It is often suggested lonely people join a club ect. Or we reach out to friends or family. What of those with no friends or family? Families no longer live close some are separated by many miles. The people I know are just to busy to find time for me too. I have limited money l have no car so must rely on local transport. To cap it all I suffer from social anxiety. I do go to christian meetings twice a week but l feel lonleir there because I am in a crowd. I wish people would realise the reasons a person is lonely are as varied as the people themselves. There is no quick fix one size solution to this problem.

    • Aparna Mehrotra

      Loneliness is an epidemic globally – increasingly so as continents age and the workforce methods are disrupted by technology. It behooves us as individuals, governments and corporations to contribute to countering it. Societies have to remain mentally and physically healthy for any of its aspects including productivity to thrive.
      Loneliness is the feeling of being left behind. The young and not so young everywhere need to work now to counter it – identify it, commit to action to alleviate it. It will be upon all of us otherwise, sooner or later.

  12. Michael Skinner

    Thank you Dr. Yeh for this insightful article, and for taking the time to talk with the man impacted by loss and grief. Sadly, so many people who have been impacted by trauma, abuse and mental health concerns suffer in this silence of loneliness and are many times blamed or given another diagnosis for being sad, lonely and in grief for the loss of family, friends, and society shunning them. We still have a long ways to go in extending the hand of friendship and a kind listening ear to others who are in pain…

  13. Giancarlo

    I appreciate the publication of this article on this very important topic and growing crisis in our older population. Loneliness or Social Isolation has devastating psychological effects on millions of people in our nation. It is gratifying to know that some medical professionals see this as a paramount crisis to resolve. I will share this article and information with others. Thank you Dr. Yeh.