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Loneliness

Transforming Our Lonely and Stressed-Out Global Community

How can we become more socially connected, happier, healthier and wiser?

there is a loneliness in this world so great

that you can see it in the slow movement of

the hands of a clock.

— Charles Bukowski, Love Is a Dog from Hell (1977)

The ongoing COVID-19 pandemic and the resulting physical isolation from family, friends, and casual acquaintances have only worsened the growing problems in our modern society: stress, loneliness, and burnout. In a recent study (Lee, et al., 2019), a staggering 76% of adults across the lifespan living in San Diego reported experiencing moderate to severe loneliness. And that was before the onset of the COVID-19 pandemic, which has reduced many people’s access to their social networks, especially for people who live alone or otherwise gain most of their social interactions outside of their homes.

Loneliness is subjective (how distressed you feel) while social isolation is objective (how many social relationships you have). Loneliness relates to a difference between how much (in terms of both quality and quantity) social connection we want and how much we currently have. Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, which is typically but not necessarily work-related. Loneliness and burnout are linked. Loneliness leads to anxiety, depression, depersonalization, and emotional fatigue — all key features of burnout. Loneliness is even higher among people with serious mental illnesses like schizophrenia.

The prevalence of loneliness overall has doubled during the last few decades. Surveys also show that there has been a 32% increase in the numbers of Americans who report “feeling exhausted often or always” over the last 20 years. A recent Gallup poll found a 25% increase in self-reported stress and worry in the US over the past 12 years.

Loneliness and burnout contribute to worse mental health in the form of suicidal behavior and substance use. According to the Centers for Disease Control and Prevention (CDC), rates of suicide increased by 30% from 1999 to 2017 while opioid-related deaths rose six-fold from 8,000 per year to 48,000 per year over the same time period.

Loneliness also predisposes to cardiovascular and metabolic disorders and dementia. Consequently, the average US lifespan, which had been rising progressively since mid-1950s, recently fell for the first time — two years in a row — and that was before the pandemic set in (Jeste, et al., 2020a). Now, the coronavirus and the mandated social distancing are greatly adding to loneliness, burnout, and stress in general, and so impacting our health on multiple levels.

What to do when you are lonely

The obvious strategy to take when you are experiencing loneliness would seem to be to connect with someone. However, sometimes this is easy (calling a friend to make plans) and sometimes rather difficult (needing to make new friends).

For people who have few social connections in the first place, it would be important to build up foundational skills through social skills training, social cognitive interaction training, and related therapies. These types of interventions have been found to be effective for people with social skill deficits due to a number of causes, including anxiety, schizophrenia-spectrum disorders, autism spectrum disorders, and brain injury.

Additionally, there are programs like Compeer that link people with a mental illness to volunteers in their communities to build friendships and increase social inclusion for those often marginalized. Other types of structured socializing programs like book clubs, community college classes, walking groups, and volunteer associations can similarly provide structured ways to meet and connect with others. These types of programs can also offer ways to build up social skills in structured environments that may feel more comfortable than other, more spontaneous ways of meeting new people.

One major problem is: What happens when social connection is hard to find? Sometimes it isn’t our own choices getting in the way; it’s about not having the ability to make that choice in the first place. There are methods of interacting with others through virtual spaces that you may find socially fulfilling, but depending on you, these may not meet all of your social interaction needs.

One solution is compassion training. We have found a consistently significant inverse relationship between wisdom and loneliness (Lee, et al. 2019). As we have described previously (Jeste et al., 2020b; Thomas, et al., 2019), wisdom is a complex personality trait with several components. The wisdom component with the strongest negative correlation with loneliness is compassion. This includes compassion toward others as well as self-compassion. It is also noteworthy that burnout is often called compassion fatigue. There is a growing base of evidence for compassion-based therapies (Kirby, et al., 2017).

A concept opposite of loneliness is “oneliness,” or “positive solitude,” meaning being alone but feeling contented. An option to pursue if you find that, despite your best efforts to increase social connection, you have run out of options, is to increase your sense of contentedness with being alone.

Being alone provides you with opportunities and time to read your favorite author’s book, watch the movie you have loved since your youth, listen to music of a brand new type that you have never heard before, or just lie down and plan a creative venture. It’s possible that increasing components of wisdom like self-reflection, emotional regulation with positivity, and pursuit of meaning in life will help decrease loneliness by reducing the dependence on others for one’s well-being. Our previous post discusses some ways to increase these components of wisdom.

Societal level interventions to make our world connected, less lonely, and wiser

We shouldn’t see the loneliness epidemic as a problem for each individual to face alone, but rather something for us as a society to change and improve together. The loneliness epidemic is posited to have started due to rapid globalization and ultra-fast growth of technology, resulting in social anomie, greater competition, information overload, and ever-increasing levels of stress, which decreased in-person close connections. So, loneliness and burnout are societal, not just individual level, problems.

We need to increase the advantages that technology offers in building social connections, especially for those who have trouble connecting in person, like older adults, people with mental or physical disabilities, people who are immunocompromised, and people living in rural areas, while decreasing technology’s disadvantages such as its complexity and high costs. Technology companies need to be involved in this venture, creating products that are user friendly, accessible, and affordable for these disenfranchised groups.

We should build in more opportunities to strengthen social and emotional development and skills in our existing structures. For example, children in K-12 education would benefit from explicit training in soft skills such as empathy and compassion, emotion regulation, and conflict resolution as well as social skills training. Post-high school education and workplace settings are also ripe for such facilitation of personal growth that helps decrease loneliness and burnout.

Expansion of programs like the Compeer that increase the development of friendships and social connections for those most vulnerable to social isolation is also important. This type of programs would also be appropriate for people at key points in life that are most vulnerable to isolation and loneliness. For example, as older adults retire, and experience increased health issues, they often face decreased social interaction. Young adults similarly experience more isolation and loneliness as they enter the workforce following high school or college. Many groups would benefit from increased structured methods to grow their social circles as they transition in stages of life or move to new locations.

The United Arab Emirates appointed a Minister of Happiness in 2016. The UK appointed a Minister of Loneliness in 2018. These developments suggest welcome efforts by governments to pay attention to people’s mental well-being. Given how lonely, burned-out, polarized, and stressed the world has become in recent decades, we all need to come together and begin thinking about how to transform it into a happier, healthier, more socially connected, and wiser world. Of course, this is easier said than done. However, if we don’t dream big, we will never achieve big goals. Initiatives to promote empathy and compassion– including self-compassion — at all levels would be an excellent initial focus that could help reduce loneliness and burnout.

References

Jeste, D. V., Lee, E. E., & Cacioppo, S. (2020a). Battling the modern behavioral epidemic of loneliness: Suggestions for research and interventions. JAMA psychiatry, 77(6), 553-554.

Jeste DV, Lee EE, Palmer BW, Treichler EBH (2020b): Moving from Humanities to Sciences: A New Model of Wisdom Fortified by Sciences of Neurobiology, Medicine, and Evolution. Psychological Inquiry, 31:2, 134-143. doi: 10.1080/1047840X.2020.1757984.

Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions. Behavior Therapy, 48(6), 778–792. https://doi.org/10.1016/j.beth.2017.06.003

Lee EE, Depp C, Palmer BW, et al. (2019): High Prevalence and Adverse Health Effects of Loneliness in Community-dwelling Adults Across the Lifespan: Role of Wisdom as a Protective Factor. International Psychogeriatrics, 31(10), 1447-1462. doi: 10.1017/S1041610218002120

Thomas, M. L., Bangen, K. J., Palmer, B. W., et al. (2019). A new scale for assessing wisdom based on common domains and a neurobiological model: The San Diego Wisdom Scale (SD-WISE). Journal of Psychiatric Research, 108, 40–47. https://doi.org/10.1016/j.jpsychires.2017.09.005

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