I regret not working harder to create true friendships with other couples, not seeking out people with whom to go do things and go places — people with whom to have a few crazy, memorable bonding adventures. I even, sometimes, regret moving to New York City from the lovely town where our girls grew up, a town where friends lived right across the street and where I could expect, were I to become sick or bereaved, a constant flow of casseroles. There are no casserole brigades in Manhattan.
Then there’s the problem of my job. I’m a freelance writer, and I work alone at a big desk in the living room of my apartment. There are many days when I don’t utter a single word to anyone but my husband. On these days I think of Leo Gursky, the solitary old man from Nicole Krauss’s The History of Love, who goes out for a glass of juice when he’s not thirsty or shops for shoes he has no intention of buying, just for the human interaction. “All I want,” he says, “is not to die on a day when I went unseen.”
I’d always suspected that my glass-half-empty view of the world doesn’t help matters, either. But not until I started reporting a magazine article on the science of loneliness did I realize the extent to which it doesn’t help — and the way that loneliness and negativity strengthen and shape each other in a continuous feedback loop.
* * *
The lonely brain is different from the non-lonely brain, says John Cacioppo, director of the Center for Cognitive and Social Neuroscience at the University of Chicago and one of the nation’s leading experts on the neurobiology of loneliness. In people like me, who for various reasons are primed to define ourselves as lonely — more on those reasons later — the brain switches easily into self-preservation mode when we’re feeling loneliest, quick to see social danger even when it isn’t there.
In one MRI study, for instance, Cacioppo put subjects into a scanner and showed them negative images that had either a social or a non-social context. (A negative social image might be a picture of two men arguing; a negative non-social image might be of a shark.) Subjects who had been identified as lonely paid more attention to the negative social images. “The lonelier the brain,” Cacioppo said at a TEDx talk last year, “the more visual cortical activity is devoted to that negative social image.” Lonely people also showed less activation, when looking at negative social images, of the temporal parietal junction, the brain region involved in taking another person’s point of view.
In another study, Cacioppo brought lonely and non-lonely young adults into a sleep lab. The lonely subjects, he found, had more disordered, less restorative sleeping, with more micro-awakenings during the night, almost as though they were remaining vigilant for social rejection — or for threats of any kind — even as they slept. As a result they didn’t feel refreshed after sleep, and tended to get drowsy during the day.
A few years ago, Cacioppo and his colleague, Louise Hawkley, summarized a collection of psychological studies linking loneliness to a variety of mental health problems: increased negativity, depressive thinking, heightened sensitivity to social threats, and trouble with impulse control. As a result, they wrote, lonely people are impaired in their ability to control their emotions, make decisions, and interact with people. Ironically, the lonelier people were, the less well they functioned with others.
* * *
Experts estimate that one-fifth of Americans define themselves as lonely (a number that increases to about 35 percent, according to AARP, for people over age 45). About 20 percent of adults say they have only one friend to talk to about important, intimate things, and another 25 percent say they have no one. Even though loneliness is so common, though, people often find it embarrassing to admit. The lonely, despite all their company, feel stigmatized as unlovable, awkward, and socially isolated.
But many of the stereotypes we hold about loneliness turn out to be wrong.
For one thing, lonely people are no lower-status than anyone else. Research conducted in 2000 found that among more than 2,500 undergraduates at Ohio State University, those who called themselves lonely had just as much “social capital” — defined by physical attractiveness, height, weight, socioeconomic status, and academic achievement — as their non-lonely peers.
For another thing, lonely people are not necessarily more isolated. The students at Ohio State who were lonely belonged to as many clubs and had as many roommates as those who were “socially embedded.” And while some studies indicate that living alone puts people at greater risk for loneliness, living with a spouse is not necessarily any protection. In fact, researchers at the University of California, San Francisco, reported in 2012 that among nearly 700 Americans over age 60 who described themselves as lonely, 62.5 percent were married. (As a comparison, 72 percent of men over 65 were married in 2011, but just 42 percent of older women.)
What is different about lonely people is how they interpret their interactions with friends and acquaintances. In the Ohio State study, lonely people tended to feel put upon and misunderstood. They were, the researchers wrote, “more likely to attribute problems in social relationships to others,” and to see themselves “as victims who are already giving as much as they can to their relationships.”
In other words, people grow lonely because of the gloomy stories they tell themselves. And, in a cruel twist, the loneliness itself can further distort their thinking, making them misread other people’s good intentions, which in turn causes them to withdraw to protect themselves from further rejection — and causes other people to keep them at arm’s length.
According to Guy Winch, a New York psychologist and author of Emotional First Aid, lonely people can become “overly defensive and come across to others as detached, aloof, or even hostile — which only pushes them further away.” Loneliness can create its own self-defeating behavior.
* * *
Most scientists define loneliness subjectively — if you consider yourself lonely, you are. As UCSF geriatrician Carla Perissinotto put it, loneliness is “the discrepancy between one’s desired relationships and one’s actual relationships.” That’s why pencil-and-paper self-assessment quizzes such as the UCLA Loneliness Scale are considered the best way to identify lonely people.
Even simpler is a newer self-test that asks just three questions, which sociologist Mary Elizabeth Hughes of Duke University says is all you need:
- How often do you feel that you lack companionship — hardly ever, some of the time, or often?
- How often do you feel left out — hardly ever, some of the time, or often?
- How often do you feel isolated from others — hardly ever, some of the time, or often?
Ask me and I’ll tell you: Often, often, and often.
* * *
Even though loneliness affects so many of us, it has gotten scant research attention compared to related conditions like depression or anxiety. When I did a search through the National Institutes of Health’s database of active projects in mid-July, I got 3,529 hits for the word “depression,” compared to just 46 hits for the words “loneliness” or “lonely.” It’s not a precise comparison, because loneliness is not recognized as a clinical disorder, but the disparity gives a sense of how few scientists take the condition seriously.
They should, though, because loneliness can have some real public health consequences. It puts people at risk for a host of problems: symptoms of depression, elevated blood pressure, sleep disorders, lowered immune resistance, and increased levels of the hormones associated with stress.
One study in Chicago found that old people who were lonely had twice the normal risk of developing Alzheimer’s disease. Another study linked loneliness to increased levels of inflammation in response to stress, placing people at higher risk of various conditions. And the UCSF study, using data that followed more than 1,600 people over age 60 for six years, found that during that time one-quarter of those who were lonely had developed problems with bathing, feeding, dressing, or otherwise taking care of themselves — twice the rate of those who were not.
Interviewing Cacioppo for my magazine article a few months ago, I naturally took many of his observations personally. One especially fraught time for lonely people, he told me, is when they are in a social setting and feel subject to ostracism or ridicule; it’s then that their brains go haywire, sensing social danger even where none might exist. “We’re screwed,” I thought at the time. What we most crave is the company of other people, but it can be that very company that sets us off.
But when I said something to that effect to Cacioppo, he said he didn’t see it that way. Of course he didn’t; he’s a normal person, not a lonely, glum pessimist like me. He gives uplifting advice to the lonely, telling us that if we’re aware of our tendency to feel aggrieved and unappreciated, the awareness itself is an important first step in conquering loneliness, allowing us to grab hold of our negative thinking and turn ourselves into someone that others will want to have around.
“Most anyone can emerge from the prison of distorted social cognition and learn to modify self-defeating interactions,” he wrote in Loneliness: Human Nature and the Need for Social Connection, which he co-authored in 2008 with William Patrick. It takes time and effort, they acknowledged, as well as patience until the people in your circle realize that you actually have managed to change.
It all sounded a bit glib to me. If the lonely brain really is primed to see social dangers where they don’t exist, it’s not as simple as telling yourself to line up more dinner dates. Self-talk might work for getting yourself out of other negative emotional states, but loneliness seems different: it’s hard to talk yourself out of a hole when self-talk is what got you into that hole to begin with.
I know I have a lot to fight against — not only whatever tricks my brain is playing on me with every social interaction, but long-standing objective difficulties like my isolated job, my high standards for friendship (people who sit around talking about their ailments or their kitchen remodeling don’t cut it; I often think I’d rather be alone than in the middle of a deadly-dull conversation), and living in New York, where people are busy and where socializing takes effort, planning, and a certain amount of inconvenience. But if I feel bad enough about my loneliness — and writing about it has succeeded in making me feel bad enough, thanks — maybe I’ll be able to turn anti-loneliness into a project.
First step: training myself to read the conclusion to Cacioppo and Patrick’s book without rolling my eyes: “The simple realization that we are not passive victims, that we do have some control, and that we can change our situation by changing our thoughts, expectations, and behaviors toward others can have a surprisingly empowering effect.”
Okay then. I have taken that very seriously, and now I need a drink. Would anyone like to join me?
Originally appeared on July 27, 2014 on The Archipelago, a collection on the Medium web site edited by my daughter Jess Zimmerman, under the headline "Guess I'll Go Eat Worms." I'm putting this note here so no one is surprised to find out that this essay already appeared in full, and in exactly the same form, someplace else.