As a psychiatrist and therapist, talking about social and relationship relationships is essential to mental health because they can play a role in many aspects of care. From social withdrawal being a symptom of multiple mental illnesses to loneliness often exacerbating mental distress, whether it is a diagnosis or treatment for a mental illness, social connection certainly affects health and well-being.
When I started my practice, I felt the topic was crucial to talking to patients because of my first-hand experience of how harmful loneliness can be. As a medical intern, I’ve spent countless weekends alone in a stark, windowless white room. As a psychiatrist on call, I had to stay there alone, waiting for a need, while friends and family gathered without me to celebrate anniversaries, birthdays, and holidays.
Looking back, I realize I was angrier during that time than I had been at any other time in my life. Also, I always seemed to catch or recover from a cold.
Loneliness is not just something that can make a person feel down. It is not just something that can make an individual physically or mentally ill. It is an issue with wide public health implications.
All of this was detailed earlier this month in a health advisory issued by US Surgeon General Vivek Murthy, MD. According to the U.S. Department of Health and Human Services, the American Surgeon Health Advisory is “dedicated to significant public health challenges that require the immediate attention of the American people.”
It’s not the first time that health experts have considered loneliness a problem.
The COVID-19 pandemic has brought with it social distancing and isolation for many and a transformation in how we interact with others (thanks to many daily activities, such as work, fitness classes, and therapy appointments moving to virtual spaces).
And multiple groups noted the impact loneliness had on us. In February 2021, the Harvard Graduate School of Education released a report on 950 Americans discussing different types, causes, and costs of loneliness.
Also in 2021, Dr. Murthy published a book on the subject, Together: The Healing Power of Human Connection in a Sometimes Lonely World. Explore the prevalence of loneliness, the health consequences of loneliness, and the way loneliness affects how children and adults experience school and work, respectively.
In August 2022, researchers at Columbia University’s Mailman School of Public Health published an article outlining the need for and suggesting evidence-based solutions to combat loneliness.
So, the new advice from the Surgeon General felt partly like a summary of what we already know: Loneliness is becoming more prevalent and has dire consequences for our health. What is new, however, is the intention and urgency to address the problem as well as the recognition of the need for institutions, organizations and government agencies – rather than our own individual efforts – to get involved in helping fix this.
What we knew: Loneliness has major health consequences
Loneliness and loneliness are not quite the same thing. While being alone is an objective state of having limited social connections, loneliness describes an unpleasant subjective state in which we feel a lack of social connection.
We may feel lonely because we are actually alone or because we have many social connections but they are not satisfying or of good quality.
Although it is not new information that loneliness has major health consequences, the way Murthy’s report succinctly laid out these consequences may be more appealing to some.
For example, one of the most quoted parts of the counseling text is the fact that loneliness poses a greater health risk than smoking 15 cigarettes a day, a key finding of research published in 2017.
The consultant went on to enumerate the many compelling statements that exist on the body’s many systems. For example:
- Poor social relationships can increase the risk of heart disease by 29 percent and the risk of stroke by 32 percent.
- Having a smaller social network is associated with more complications in people with type 1 and type 2 diabetes, including increased risk of heart attack, retinopathy, decreased sensation in the feet, and signs of kidney disease (after controlling for blood sugar, quality of life, and other factors). other cardiovascular risk).
- People with six or more different types of social ties (such as a parent, spouse, friends, family, co-worker, or group membership) have a four-fold lower risk of catching a cold when compared to people with connections to fewer (one to three) roles. social.
- Chronic loneliness and social isolation can increase the risk of dementia by 50% in older adults.
- A review of 63 different studies found that loneliness in teens increases the risk of both anxiety and depression.
- In a study of more than 500,000 middle-aged adults, men who lived alone were twice as likely to die by suicide.
What’s new: The 4 Ways report actually goes into how to fix the problem
While seeing all of the individual health consequences of loneliness gathered in one place made an impression, what really felt new and noteworthy about the new health advisory was that there was an effort to understand the complex and multifaceted causes of loneliness, as well as to emphasize the steps and action elements that They may actually help address the problem on both small and large scales. Here are four ways to do this:
1. It reminds us that loneliness was an issue before COVID
Although COVID-19 has accelerated the path towards loneliness, it has shifted the realization away from the fact that loneliness was an issue before “social distancing” was a thing. Much of the literature on loneliness since the pandemic has focused on changes in society during the pandemic. What this warning made clear, however, was that the “old normal” wasn’t much better than the “new normal” of the pandemic days at promoting social contact.
In fact, his counseling showed that loneliness was an issue long before the pandemic, and it remains an issue even as the federal COVID-19 public health emergency ends this month. The Counseling presented data showing increased time spent alone as well as decreased social engagement with family, friends and the wider community for decades prior to 2020. Specifically, Murthy describes long-term trends in community planning and programmes, cultural norms, policies and technology that promote separation.
Special attention has been given to technology, particularly the concern that the increase in technology use has resulted in fewer, lower quality, and more sporadic face-to-face interactions. One cited study found that people who reported using social media for more than two hours per day were twice as likely to report feeling socially isolated compared to those who used social media for less than 30 minutes per day.
2. There is recognition that loneliness affects more than our personal health
Many of the people I work with report feeling generally anxious about the state of the world. In recent years, among the reasons cited have been mass shootings, natural disasters, the economy, and a general lack of confidence in government institutions or fellow Americans in general.
Counseling indicates the unit’s role in all of this.
Previously, the conversation about the health effects of loneliness focused on an individual’s physical and mental health. Moorthy points out here that loneliness affects the health of society as well.
One example from the report: Research shows that communities that are better connected through service organizations, religious groups, or community organizations are more likely to prepare for, respond to, and recover from natural disasters more quickly than communities with less social connection.
Additional examples showed how well-knit communities can be safer from violence. One such study showed that just a small increase in social connectedness—as measured by people from the same city of birth migrating to the same new city versus people moving to new cities and towns where they had no social ties—was associated with significantly fewer murders and robberies. cars.
The advisory also describes how social connectedness can enhance economic prosperity and civic engagement.
3. Loneliness is recognized as a systemic problem, not an individual one
Another thing that jumped out to me was the recognition that social connectivity is a systemic problem, not necessarily just something an individual can influence on their own. Similar to how the workplace can create an environment that promotes well-being and flexibility, so too can a community and a country foster social connection.
Some of the ways systems can affect loneliness, according to this advisory, include: the availability of community organizations, public policies, transportation availability, technology standards, and housing choices.
Importantly, when pointing out the many ways society influences social networks, these guidelines call for more than just individuals to make change happen. It requires change on a broader societal and governmental scale.
4. There is a plan to address the problem
This advisory calls on individuals, professionals, and organizations, as well as local and federal government groups within the United States to make change happen. As part of this advocacy, the consultation defined a national strategy to promote social contact as a basis. This foundation of change consists of six pillars, including a call for city planners and policymakers to create infrastructure that enhances connectivity, a call for healthcare systems to recognize and address loneliness, and a call for digital environments to minimize technology-related harms.
The instructional text ends with specific action items for different groups of people—government agents, educators, media professionals, philanthropists, parents, and many others. These elements are ways we can collectively work together to address loneliness and enhance social connection.
If you are looking to enhance your social connection as well as within your community, these pages are a great place to start.