You’re home, social distancing. You know that avoiding direct physical contact with people at this time will help slow the spread of a deadly disease that’s projected to kill thousands to millions of people—and those projections are based on our collective behavior. But you live alone, and you’ve been in watching Netflix, checking Facebook, and trying to find other things to do for a week, and it’s starting to feel hard. You usually like having time to yourself, but spending all this time alone is really starting to wear on you.
Loneliness is a serious health risk. Recent research suggests that in industrialized countries, about 1 in 3 people feel lonely to some degree, with 1 in 12 feeling it severely. Lonely people tend to be more irritable, depressed, and self-centered.
Loneliness also increases the risk of death, operating through physical pathways. Lonely people are more likely to have coronary heart disease and stroke, and the increased risk of death in lonely people is more severe than the risk associated with hypertension or obesity.
There is an immediate public health crisis going on related to the transmission of an infectious disease. But with many people living alone and being asked to stay quarantined for extended periods, there may be secondary psychological health effects to consider. Large numbers of people will be upsetting their normal social rhythms, disrupting patterns in their daily interactions, and potentially feeling less connection in their relationships.
As the quarantine extends over time, this could develop into loneliness. Identifying ways to quarantine effectively, therefore, means not just physical measures, like washing hands properly or wiping down surfaces more frequently. It also involves finding ways to stay socially connected to others.
Loneliness appears to cause problems through two mechanisms. First, lonely people experience the same events as more psychologically stressful. This can translate into the way their cardiovascular system responds to stressful tasks—but also to resting patterns of blood circulation. (More specifically, a study found that people’s blood vessels got tighter, and the amount of blood being pumped through the circulatory system increased). Second, lonely people appear to get less rest and recovery, primarily because their sleep is disrupted.
These findings imply that there’s a strong psychological component to loneliness. It’s not just about spending time alone. It’s about whether you feel connected to and supported by others.
A meta-analysis (a statistical summary of many studies in an area) examined the effectiveness of different treatments for loneliness. They found that the treatment proving most effective in reducing loneliness was not improving social skills, increasing the opportunity to spend time with others, or even improving social support. It was social cognitive training interventions, meaning teaching people tools for how to think about their interactions with others.
I started researching this post thinking that the best recommendation for combating loneliness would be to just reach out to people. If you’re alone, try to make contact with others. If you know someone who’s alone, spend time talking to them. And the evidence suggests that this helps.
But the best way to combat loneliness is to help people change the way they perceive the world. This means that we don’t just need good Samaritans going out of their way to check in on others. We need mental health professionals working with clients.
I lived alone for five years during graduate school, and there were times, especially when I first started living alone, when I felt lonely. Ultimately, I found some strategies that helped. I got a cat, and I started going out to coffee shops to work more often. But if I were in the same situation now, with the quarantine in place, one of my major strategies for fighting loneliness—getting out of the house—would be off the table. And so now is the time when I would start reaching out to mental health professionals to find out if I could schedule some online sessions.
The quarantine can fight off physical illness, but we need to remember to take care of ourselves mentally, too.
Masi, C. M., Chen, H. Y., Hawkley, L. C., & Cacioppo, J. T. (2011). A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review, 15(3), 219-266.
Holt-Lunstad, J., & Smith, T. B. (2016). Loneliness and social isolation as risk factors for CVD: implications for evidence-based patient care and scientific inquiry.
Cacioppo, J. T., & Cacioppo, S. (2018). The growing problem of loneliness. The Lancet, 391(10119), 426.
Cacioppo, J. T., Hawkley, L. C., & Berntson, G. G. (2003). The anatomy of loneliness. Current directions in psychological science, 12(3), 71-74.