Loneliness and Social Isolation

I attended a workshop on loneliness put on at a yearly NAMI (National Alliance on Mental Illness) state conference. My interest in the topic stems from my own experience of terrible, debilitating isolation with my schizophrenia and the recognition that many with mental illnesses are also extremely isolated. That is not to say, that others are not similarly affected, but that the isolation of the mentally ill is often extreme. I believe we can all be involved in the project of making our world more connected, kind and responsive to our oh-so-human needs.

My hope in summarizing this presentation is that it will validate the feeling of many of us that we are lonely or disconnected and will offer some insight into the causes and cures of this social malady

The presenter was Valerie McNicholl of Move Forward Counseling. Ms. McNicholl, LCSW, based her talk on the Surgeon General’s 2023 report: Our Epidemic of Loneliness and Isolation. She characterized loneliness as a subjective feeling and isolation as an objective fact, meaning not being connected to networks, etc. The bottom line is that human beings are wired for connection, which is necessary for survival. Isolation means having to manage all life tasks on one’s own, a heavy burden, if not an impossible one.

The experience of loneliness triggers a pain response in the brain, just as does a broken arm. Our brains light up differently when we see people or animals, but not things. We have social capital, just like financial capital, which consists of social support (i.e., the number of networks we belong to) and social cohesion (i.e., a feeling of connection). Ms. McNicholl pointed out that there is no one word for “not lonely.” I suggested “connected,” but this did not seem to fill the bill.

Three ways to think about social connection are its structure, function and quality. (Sorry to get academic here.) Structure might be characterized as the type of relationship and the frequency of interaction, while its function might be the degree to which the relationship serves various needs. Its quality can be conceptualized as the positive and negative aspects of the relationships and interactions. Concrete examples would be household size, size of friendship network and partnership status. These relate to such things as the availability of emotional support, mentorship, and support in a crisis. The quality of the relationships can be understood in terms of relationship satisfaction, relationship strain, and social inclusion and exclusion. (I would add here in speaking of negative quality, that all relationships are not equal. Some are dysfunctional. An example might be an abusive relationship or one that isolates one of its members.)

The benefits of connectiveness are many: economic, educational, the health of the population, preparedness for natural disasters and resilience to them, community safety and civic engagement.

Chronic loneliness and isolation impact health. Where social isolation is high, there is an increased risk of early death; social connectiveness reportedly increases odds of survival by 50%.

Ms. McNicholl reported that the lack of social connection has a greater effect on mortality than smoking 15 cigarettes a day or drinking 6 alcoholic drinks (I’m not sure of the time frame here), lack of physical activity, obesity or air pollution.

It was estimated that the cost of social isolation and loneliness exceeds $406 billion for the whole economy and reaches $6.7 billion for Medicare. (This is no small potatoes!)

Some risk factors for isolation are low income, age, living alone, chronic disease and disability, marginalization or discrimination (against such things as mental illness, race, and LGBTQ status) and life transitions (such things as becoming a parent, leaving home, becoming homeless, and suffering a divorce).

Those most lonely in general are 15-25-year-olds and older people. In 2022, 50% of adults reported experiencing loneliness, which is manifested in relatively large declines spent in engagement with household and family, with companions, in numbers of social engagements with friends, etc. Changes in the organization of work contribute to this syndrome as do declines in marriage rates, in family size, in faith-involved groups, changes in parenting strategies, in the ascendency of technology over play, decreased involvement in community organizations, and perceived safety. I would add the disruption caused by the pandemic to this list.

So, what possible strategies for combatting this epidemic were presented by Ms. McNicholl?

Macro Solutions: 1) strengthening social infrastructure in local communities (safe parks, pools); 2) enacting pro-community public policies; 3) mobilizing the health sector); 4) reforming digital environments; 5) deepening our awareness and knowledge; and 6) cultivating a culture of connection.

Micro Solutions (things we personally can do): 1) participating in community events and groups; 2) using community gathering spaces; 3) checking on others; 4) prioritizing social interaction over use of technology; and 5) modeling social engagement.

I hope my project can contribute to the breaking of the silence around. and hence, the isolation of, mental illness and contribute to opening up society to more authentic and engaged communication and connection for all its members.

The Surgeon General’s full report is available from the U.S. Department of Health and Human Services. It is Googleable!