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If you feel lonely sometimes, or even often, you’re far from alone. Loneliness affects people of all ages, in what some health experts describe as a growing epidemic. Somewhere between one third and one half of Americans feel lonely sometimes or always, with younger adults and mothers with children among the most affected.
While living alone or being isolated is just one of many factors that contribute to feelings of loneliness, when it comes down to it, it’s how you feel that matters, not the number of close friends or loved ones in your life. And because lonely people are at a higher risk for many physical and mental health issues, including depression, understanding what can cause loneliness and how to deal with it is crucial.
Below, you’ll learn about loneliness, its causes, its physical and mental health symptoms, the actions you can take to curb it, and the actions a healthcare provider can take to curb chronic loneliness.
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What is loneliness, and how is it defined?
Loneliness is not the same as being alone.
It is emotional stress caused by the difference between what a person wants or expects in relationships and social connections and what they feel they actually get (Kotwal, 2021).
Feelings of loneliness are related to whether our interactions meet our social needs, plus the fear that we might become socially isolated (Mushtaq, 2014). People who live alone are more likely to feel lonely. But people who “feel lonely” are much more likely to suffer from poor health outcomes than people who live alone and don’t feel lonely (Christensen, 2020).
The subjective nature of loneliness—your perception of it—is a key to understanding it. Though some research suggests it is caused by social isolation, depression, and poor social skills, other research indicates it is a unique condition more related to perceptions, in which a person feels socially isolated even when around other people (Cacioppo, 2018).
Causes of depression: genetics, environment, and others
Signs and symptoms of loneliness
Loneliness is not always easy to identify in oneself or to spot in others. Studies typically refer to causes, effects, and risk factors rather than specific symptoms.
Americans who say they are unhappy with their families, social relationships, jobs, or financial situations are more likely to also say they feel lonely (Pew Research Center, 2018). Other risk factors and potential causes of feeling lonely include (Holt-Lunstad, 2018):
- Being unmarried (single, divorced, widowed)
- Not participating in social networks
- Having strained relationships or fewer friends
The effects of loneliness on physical and mental health
When people experience loneliness, they are at increased risk for several poor health outcomes, including high blood pressure, anxiety, depression, and memory problems (National Institute on Aging, 2019). It also raises the risk of alcohol abuse, sleep problems, and cancer and it can both cause and be a symptom of physical and mental health conditions. For example, anxiety, depression, pain, and insomnia are all known to contribute to loneliness, but it can also increase them (Mushtaq, 2014).
In a study of more than 6,000 older adults over the age of 65, researchers found that when older people are lonely, they’re twice as likely to use opioids and 2.5 times more likely to take sedatives and anti-anxiety medications. Unfortunately, such medications may not treat the underlying causes of loneliness (Kotwal, 2021).
Anxiety triggers: how to spot and overcome them
The links between loneliness and poor health go well beyond the studies cited above. Here are a few more mental and physical health risks of loneliness:
- People over 60 who see themselves as lonely are apt to have a shorter life expectancy, and they’re more likely to suffer poor health in old age (Malhotra, 2021).
- In mid-life (ages 45-64), persistent loneliness is linked to a higher risk of dementia and Alzheimer’s Disease later in life (Akhter-Khan, 2021).
- Research links feeling lonely to a higher risk of the common cold (LeRoy, 2017).
- Feeling lonely is as deadly as smoking, according to a review of 148 studies that found better social connections reduce the risk of early death by 50% (Holt-Lunstad, 2010).
- Research links feeling lonely in young adults to poor sleep quality (Matthews, 2017).
- Chronically lonely adolescents are up to three times more likely to develop depression later in life (Loades, 2020).
The loneliness epidemic
A surprising number of Americans are lonely, and it affects all age groups. For years, some researchers and public health officials have called loneliness an epidemic. In a survey of 20,096 U.S. adults done before the COVID-19 pandemic, 46% said they sometimes or always feel alone, with people ages 18-22 being the most lonely (48%) and people 72 and older the least lonely at 39% (Ipsos/Cigna, 2018).
Though different polling methods yield different results, the problem worsens, particularly among some groups.
In a separate poll from February 2021, 36% of all Americans said they feel lonely frequently, almost all of the time, or all of the time, with the figure soaring to 61% among young adults and 51% among mothers who have young children. Many young people said that no one had taken more than a few minutes to show they cared in the past few weeks. Researchers concluded that the pandemic has made America’s loneliness epidemic worse (Harvard, 2021).
Experts say one broad societal shift plays a role: the percentage of Americans living alone has risen from less than 15% in 1960 to more than 25% today (U.S. Census Bureau, n.d.).
How to deal with loneliness
Any interventions or therapies aiming to address loneliness in lonely individuals need to be individualized, and experts say more research is required to determine what strategies might work best (Fakoya, 2020).
But if you feel lonely, there are several remedies to consider:
Curb social media use. A study of young adults, ages 18-22, found that limiting social media time to 30 minutes per day reduced symptoms of both depression and loneliness (Hunt, 2018).
Cognitive-behavioral therapy (CBT): what is it and what does it work for?
Volunteer. Social interaction via a social activity like volunteering is great for combating loneliness. A UK study found that two-thirds of people who volunteer felt their volunteering made them feel less isolated. The figure was highest (77%) among people ages 18-24 and 25-34 (76%) (McGarvey, 2019). A U.S. study found widows who volunteer a lot suffer less loneliness (Carr, 2018).
Find a cause. Engaging with a social cause or like-minded people in social groups can help you gain a stronger sense of community (National Institute on Aging, 2019).
Seek professional help. Interventions that help a person deal with negative thoughts and their underlying loneliness work better than trying to improve social skills or enhance social support (Masi, 2010). Helpful approaches include therapist-directed cognitive behavioral therapy (Käll, 2021).
Because loneliness is so common, it’s clear that there’s no easy society-wide fix. But better understanding your own loneliness—or recognizing it in your loved ones—is an important first step to help overcome the negative feelings and physical ailments that can come with social isolation.
- Akhter-Khan, S. C., Tao, Q., Ang, T., Itchapurapu, I. S., Alosco, M. L., Mez, J., et al. (2021). Associations of loneliness with risk of Alzheimer’s disease dementia in the Framingham Heart Study. Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association. doi: 10.1002/alz.12327. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33760348/
- Cacioppo, J. T., & Cacioppo, S. (2018). The growing problem of loneliness. Lancet (London, England), 391(10119), 426. doi: 10.1016/S0140-6736(18)30142-9. Retrieved from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30142-9/fulltext
- Carr, D. C., Kail, B. L., Matz-Costa, C., & Shavit, Y. Z. (2018). Does becoming a volunteer attenuate loneliness among recently widowed older adults? The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 73(3), 501–510. doi: 10.1093/geronb/gbx092. Retrieved from https://academic.oup.com/psychsocgerontology/article/73/3/501/3938841
- Christensen, A. V., Juel, K. (2020). Significantly increased risk of all-cause mortality among cardiac patients feeling lonely. Heart (British Cardiac Society), 106(2), 140–146. Doi: 10.1136/heartjnl-2019-315460. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31685646/
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- Harvard University/Making Caring Common. (2021). Loneliness in america: how the pandemic has deepened an epidemic of loneliness and what we can do about it. Retrieved Aug. 19, 2021 from https://mcc.gse.harvard.edu/reports/loneliness-in-america
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- Ipsos/Cigna. (2018, May). U.S. Loneliness Index. Retrieved Aug. 23, 2021, from https://www.multivu.com/players/English/8294451-cigna-us-loneliness-survey/
- Käll, A., Bäck, M., Welin, C., Åman, H., Bjerkander, R., Wänman, M., et al. (2021). Therapist-guided internet-based treatments for loneliness: A randomized controlled three-arm trial comparing cognitive behavioral therapy and interpersonal psychotherapy. Psychotherapy and Psychosomatics, 90(5), 351–358. doi: 10.1159/000516989. Retrieved from https://www.karger.com/Article/FullText/516989
- Kotwal, A. A., Steinman, M. A., Cenzer, I., & Smith, A. K. (2021). Use of high-risk medications among lonely older adults: Results from a nationally representative sample. JAMA Internal Medicine, e213775. doi: 10.1001/jamainternmed.2021.3775. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2782349
- Lee, S. L., Pearce, E., Ajnakina, O., Johnson, S., Lewis, G., Mann, F., et al. (2021). The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. The Lancet. Psychiatry, 8(1), 48–57. doi: 10.1016/S2215-0366(20)30383-7. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33181096/
- LeRoy, A. S., Murdock, K. W., Jaremka, L. M., Loya, A., & Fagundes, C. P. (2017). Loneliness predicts self-reported cold symptoms after a viral challenge. Health psychology. Official Journal of the Division of Health Psychology, American Psychological Association, 36(5), 512–520. doi: 10.1037/hea0000467. Retrieved from https://www.apa.org/pubs/journals/releases/hea-hea0000467.pdf
- Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., et al. (2020). Rapid systematic review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. Journal of the American Academy of Child and Adolescent Psychiatry, 59(11), 1218–1239. doi: 10.1016/j.jaac.2020.05.009. Retrieved from https://www.jaacap.org/article/S0890-8567(20)30337-3/fulltext
- Malhotra, R., Tareque, M. I., Saito, Y., Ma, S., Chiu, C. T., & Chan, A. (2021). Loneliness and health expectancy among older adults: A longitudinal population-based study. Journal of the American Geriatrics Society. doi: 10.1111/jgs.17343. Retrieved from https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.17343
- 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. Official Journal of the Society for Personality and Social Psychology, Inc, 15(3), 219–266. doi: 10.1177/1088868310377394. Retrieved from https://www.researchgate.net/publication/45694673_A_Meta-Analysis_of_Interventions_to_Reduce_Loneliness
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- Matthews, T., Danese, A., Gregory, A. M., Caspi, A., Moffitt, T. E., & Arseneault, L. (2017). Sleeping with one eye open: loneliness and sleep quality in young adults. Psychological Medicine, 47(12), 2177–2186. doi: 10.1017/S0033291717000629. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28511734/
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- Mushtaq, R., Shoib, S., Shah, T., & Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of Clinical and Diagnostic Research, 8(9), WE01–WE4. doi: 10.7860/JCDR/2014/10077.4828. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225959/
- National Institute on Aging. (2019). Social isolation, loneliness in older people pose health risks. Retrieved Aug. 19, 2021 from https://www.nia.nih.gov/news/social-isolation-loneliness-older-people-pose-health-risks
- Pew Research Center. (2018). Americans unhappy with family, social or financial life are more likely to say they feel lonely. Retrieved Aug. 19, 2021, from https://www.pewresearch.org/fact-tank/2018/12/03/americans-unhappy-with-family-social-or-financial-life-are-more-likely-to-say-they-feel-lonely/
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- University of Chicago Medicine (2019). What is loneliness? Retrieved Aug. 19, 2021 from https://www.uchicagomedicine.org/forefront/health-and-wellness-articles/what-is-loneliness
- U.S. Census Bureau (n.d.) The rise of living alone. Retrieved Aug. 19, 2021, from https://www.census.gov/content/dam/Census/library/visualizations/time-series/demo/families-and-households/hh-4.pdf
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.