Social Loneliness May Make the Depressed Even More So

Loneliness is a state that may affect everyone at some point in his or her life. It is not necessary to go on a trek across the continent, or row alone across the Atlantic to feel lonely. Sitting by oneself in a crowded movie theater or restaurant, or walking on your own on a lovely spring afternoon in a park filled with couples, families and friends can feel just as isolating.

Sometimes social isolation is a matter of choice or temporary circumstance. A relative of mine, who had to rewrite a 500-page thesis in order to turn it into a book, willingly isolated herself for months in order to accomplish this task. A parent unable to leave the house because of weather and sick children may not speak to anyone over the age of six for a few days, but knows that eventually this will change. A computer coder may shun company for days in order to finish a time dependent task; so too may anyone involved in a creative act.

Others are alone too much, but not by choice or a temporary situation. It is a fact of their lives. The groups one thinks about first are the elderly, and those we call “shut-ins.” They weren’t always so alone but sickness, frailty, lack of easy transportation, death of spouses, friends, and even adult children…potentially their declining eye sight and hearing, limited financial resources, and fear of crime may result in an extremely limited interaction with the social world.

“My friends are all dead,” my husband’s uncle used to tell us as he reached the late nineties. “All the guys I would play cards with and have a meal with, they are all gone.”

Residence in an assisted-living facility may surround an elderly individual with people, but social interactions and friendships do not necessarily follow. A sad scene familiar to those of us who have visited relatives in facilities is a row of residents, lined up in wheelchairs, who are not talking to each other, and indeed seem to be totally isolated despite the other people around.

But one does not have to live into old age to feel this social loneliness. People of all ages who are suffering from mental illness can experience it at any age. In a recent report put out by an Australian mental health support organization, about 66% of people with mental illness report feeling socially isolated compared with about 10% of the general population. The reasons for this vary from lack of money and/or transportation, misunderstanding among others as to the nature of the illness, and even fear of others prevent forming a close relationship. Those with mental illness often claim that they are stigmatized, or at the very least, treated differently.

“Maybe people believe we are going to behave in unpredictable, embarrassing, or violent ways,” said a friend who has suffered from bipolar disease for years. “There is reluctance for a casual interaction to go much further.”

Inability to become involved in activities that may decrease loneliness is sometimes generated by mental illness itself. Social phobia, fears about public spaces (although these days, this may just be commonsense), inability to leave the house, hold a job or even communicate without difficulty; all reduce the possibility of interacting with others. A weight-loss client of mine was very specific about the days she could come to my office, as they were dependent on her cycles of mania and depression. Another client who was depressed would stay up very late at night and sleep most of the day, thereby avoiding the necessity to interact with anyone.

Regardless of the causes of social isolation and the groups who are affected by it, being alone is not good for one’s mental and physical health. Being alone most of the time is associated with increased weight, poorer diet, decreased exercise, alcohol abuse, greater risk of sickness, and even a shorter life span. Cognitive functions decline, possibly as a result of few verbal interactions. Added to this is the emotional pain of being lonely. People whose circumstances prevent them from interacting with others for short periods of time report feeling depressed and out of touch with what is going on around them. Imagine the effect if social isolation is a way of life.

Fortunately, there are social spaces where people with mental illness can go and feel comfortable and accepted, as well as receive advice, support, and/or information about relevant services, are available in many communities. Volunteers in organizations like the National Alliance usually run these drop-in centers or peer support groups on mental illness. They provide a critical service, especially for those patients and their families who are seeking to interact with others experiencing the same problems.

Going to meetings is one way of decreasing time spent alone, and it is possible that a network of acquaintances with whom to spend time can develop from this. Several years ago, I led a weight-loss group made up of mentally ill individuals who had gained weight on their psychotropic medications. After a few meetings, the participants organized Sunday walks or, if the weather was bad, a meal and a movie.

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Unfortunately, making available accessible and socially safe places for people with mental illness to meet is dependent on volunteer resources, and these may be limited to family and friends of the mentally ill. The sad fact is that many potential volunteers would probably prefer giving their time (and maybe money) to an animal adoption center than spend time socializing with mentally ill individuals. An acquaintance in a mid-size southern city found that despite city resources to fund a drop-in center associated with a neighborhood health clinic, there were no volunteers available to staff the facility.

According to the previously mentioned SANE report, almost all people with mental illness consider social relationships important in helping them manage their symptoms and improve the quality of their life. They said that simply having someone to talk to about how they feel is critical to their feeling better. It doesn’t take many people to diminish the loneliness of an individual.

Just one will do.

We all should try to be that one.