A SINGLE FACE OF LONELINESS
“To have my vital signs checked,” she murmured.
I was her ER Doc and had asked, “Why are you here today?”
Twenty-three years on I still remember her — alone, early 30’s but appearing older, eyes downcast, slumped, rendered nearly mute by sadness, hair stringy and oily, clothing stained, emitting the vaguely sour odor of neglect.
She — as it turned out — was one small part of the avalanche of our society’s disenfranchised, beached and abandoned by her tribe, left to fend for herself when all the others moved on.
I’ve seen thousands, maybe tens of thousands of such people in my decades in medicine. All suffering from a vague sense of “dis ease” but without a definable, diagnosable, or treatable, physically-based disease.
They are the lonely.
They want to be vital. They want to matter to someone to anyone, so they do come to the ER — to “have their vital signs checked,” to have their chronic malaise investigated, their headaches, neck aches, backaches, and oddly disconnected, fleeting, or poorly characterized symptoms of various kinds checked. We do check them and for a time these people do matter to someone, to us. We pay attention to their complaints, record vital signs, do lab and x/ray investigations, sometimes even hospitalize for more testing.
And we find … nothing. Nothing physical that is.
WHAT DID I SEE IN THAT ENCOUNTER?
What did I see in that encounter, in so many of those encounters that failed to find an explanation for real symptoms, real pain?
In large measure, I now think I saw the physical, mental, and emotional downstream consequences of an epidemic. The epidemic of loneliness.
And, as an emergency physician, I saw but the narrowest slice of this epidemic.
THE MANIFESTATIONS OF LONELINESS ENGULF US
· nearly half of the population feels “sometimes or always … alone or left out”
· 27% consider themselves rarely or never understood by others
· about 40% sometimes or always feel their relationships lack meaning
· about 20% rarely or never feel close to others
· only about 50% have daily meaningful in-person social interactions
· those aged 18–22 are disproportionately affected by loneliness
SCOPE OF THE LONELINESS EPIDEMIC
A search of the National Library of Medicine database using only the term “loneliness” yielded 8,345 articles. In the last several years there has been an almost asymptotic spike in publications on this topic and its medical consequences.
Search terms “loneliness elderly,” “loneliness isolation,” “loneliness older,” and “loneliness scale” produced still more scientific articles.
As mentioned, we’re awash in an epidemic of loneliness and it’s harming us gravely.
WHY DOES THIS MATTER?
We’re all familiar with the negative effects of smoking or obesity on health. Loneliness has similar negative effects.
A 2020 large-scale survey of the medical literature found 114 studies examining the connection between loneliness and health outcomes. As the survey authors report “Loneliness had medium to large effects on all health outcomes …” — that’s “depression, anxiety, suicidality, general mental health, general health, well-being, quality of life, life satisfaction, physical health, functional disability, sleep, and cognition.” It may be that the largest effects are on mental health and overall well-being, but this is not yet clear from the available evidence. (2)
In short, it seems that loneliness is harming us and may even be killing us.
The survey authors wisely offered that “The adequate training of health care providers to perceive and respond to loneliness among patients should be prioritized.”
WHAT CAN YOU DO?
The same Cigna/Ipsos study referenced above offered these practical and helpful suggestions.
“Engage in frequent meaningful in-person interactions.” This will be a challenge while COVID-19 rages, but, with a bit of imagination this goal is achievable. Think of it this way; if you’re lonely, you’re likely surrounded by others in similar situations. Do what you can to reach out and change that.
Find “the right balance of sleep, work, socializing with friends, family, and ‘me time’.” Again, challenging for now in certain ways, but ultimately doable.
Spend the right amount of time with family. Too much and not enough are both potentially harmful. The key concept here is “balance.” The right amount of time is the time that helps your loneliness ease.
Get some physical activity. One easy solution, join a neighborhood group that walks each evening.
If you’re out of the workplace consider re-engaging. Being in the workplace guarantees social interactions. The work type is of secondary importance. Find the right fit for you.
MORE FOR YOU
Paradoxically, with half the adults in America lonely (and perhaps elsewhere as well), you are not alone. Mention your plight to family, friends, neighbors, clergy, healthcare professionals, and others.
There are ways out. It’s worth the effort. Do it for your good health and happiness. You’ll be glad you did.
Let’s connect with one another and conquer another epidemic.
All of you see other faces and facets of loneliness. Please share your observations in the comments. Thank you.