Connections

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Epidemic of Loneliness

Loneliness is far more than a social misfortune.

It is what we say we value more than anything else. In surveys to determine the factors that contribute most to human happiness, respondents consistently rate connection to friends and family—love, intimacy, social affiliation—above wealth or fame, even above physical health.

This should come as no great surprise. We are social animals, descended from a common ancestor that gave rise to all the other social primates. It may well be that the need to send and receive, interpret and relay increasingly complex social cues is what drove the evolution of our expanded cerebral cortex—the reasoning part of the brain. After all, it is our ability to think, to pursue long-term objectives, and to form bonds and act collectively that allowed us to emerge as the planet's dominant species. Certainly, there is no other physical attribute—size, strength, speed, eyesight, smell, hearing—that accounts for our success.

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Despite their genuine, human desire to connect, millions of people are predisposed to undermine social connection. Despite their best efforts, they alienate rather than engage others. And yet these people are no more or less attractive than anyone else, and their problem is not lack of social skill.

Obviously, objective circumstances—the new kid at school who doesn't know anyone, the elderly widow who has outlived her contemporaries—can make meaningful connection more of a challenge.

And yet it is possible, for instance, to be miserably lonely inside a marriage, a situation that resonates in fiction from Flaubert to Jackie Collins.

It is possible—in fact, it is highly likely—to feel lonely in a bustling corporate office. Talent, financial success, fame, even adoration, offers no protection from the subjective experience. Janis Joplin, who was as shy and withdrawn off stage as she was raucous and explosive on, said shortly before her death that she was working on a tune called, "I just made love to 25,000 people, but I'm going home alone." Three of the most idolized women of the twentieth century, Judy Garland, Marilyn Monroe, and Princess Diana, were famously lonely people. And yet a fourth, Gretta Garbo, was famous for saying "I vant to be alone." Which serves to remind us that there is nothing inherently problematic about solitude in and of itself. Loneliness isn't about being alone, it's about not feeling connected.

The need for connection, and the enforcement power of withdrawing that connection, is evident even among chimpanzees. In chimp society, as in every human culture ever studied, infractions against the social order are punished by some form of ostracism. Well along the path of cultural development, banishment remained the most severe stricture, short of torture or death, imposed by kings and potentates. Even today, in modern correctional institutions, the penalty of last resort is solitary confinement.

In the past few years, laboratory research has examined the power of our need for contact with others and has, in fact, mapped its physiological roots. Cooperation, for example, activates the "reward" areas of the brain, much as those areas are activated by the satisfaction of hunger. When we confront social rejection, the experience activates the same areas that light up when we are subjected to physical pain. Functional magnetic resonance imaging shows that when we see unfamiliar human beings, or even pictures of human beings, our brains respond in a distinctly different way than they do when we see any other type of object. "Someone like me" is clearly a very important category in our neural wiring. Empathy, too, is traceable: images of humans displaying intense emotions, rather than neutral affect, register in the brain with correspondingly greater intensity. And more significant for where our story will take us, recent studies demonstrate that the social environment can actually modulate RNA transcription, influencing the way cells replicate. Social context also affects immune function.

Despite all the persuasive evidence of our need for connection, and the clear demonstration of the influence of connection on our physiology, there is today a worldwide epidemic of disconnection that until now has been regarded as little different than a personal weakness or a distressing state with no redeeming features.  Recent studies have found these notions to be wrong.

To call it an epidemic of loneliness risks having it relegated to the advice columns. Say the word "lonely" and people think dating services, "Miss Lonelihearts," "Only the Lonely," or Los Lonely Boys. But there is nothing trivial, or comical, or poignantly romantic about loneliness. What has emerged is the notion that loneliness is an aversive signal whose purpose is to motivate us to reconnect.  But over time if it is not addressed, loneliness can contribute to generalized morbidity and mortality.

Marriage is an imprecise marker of social connection, but the age-adjusted death rate for people who have never been married is 65.9 percent higher than for those who have been married at some time in their lives. Compared to those who are currently married, the age-adjusted death rate for those who never marry is 220 percent higher. Married couples tend also to be less lonely. When one also considers loneliness, much of the health protective effects of marriage disappear.

A generation ago, depression was poorly understood, woefully under diagnosed (it still is) and all too readily dismissed as moodiness or weakness. Most saw it as a character flaw rather than an as an illness.

Now we know that depression is a medical condition with physical manifestations in the brain, that it is to some extent genetic, and that it costs an estimated $44 billion in lost productivity each year for the U.S. economy. Neglected in that impersonal statistic, of course, is a vast amount of human suffering and unfulfilled human potential.

Loneliness is far more than a social misfortune, it is a significant problem of health and happiness that is distinct from but contributes to the likelihood of depression. In a forthcoming blog, we'll examine the relationship between loneliness and depression more closely.

John Cacioppo, Ph.D., is the Tiffany and Margaret Blake distinguished service professor at the University of Chicago.

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