Loneliness Is Normal, But If Unchecked Can Damage Your Health

Dr. Julianne Holt-Lunstad, in an exclusive video, discusses how feeling lonely can be a good thing, how it impacts our health, and how to cope with loneliness.
Screenshot Of A Video Interview With Dr. Holt-Lunstad And Saprina Panday For Women's Health Interactive Discussing The Topic Of Loneliness

I’m not supposed to be lonely.

I have everything I ever wanted — very close friends and family, many career options — and to top it off, I’ve found the love of my life. Whenever I feel down I know there are people I can reach out to.

Yet, like many of you, I still feel…lonely.

And perhaps the reality of modern life is that, in some form or other, we ALL do.

In 2017, former U.S. Surgeon General Vivek Murthy called loneliness an epidemic.

The following year, the UK appointed its first Minister for Loneliness.

As harmful to our health as smoking 15 cigarettes a day, loneliness affects millions of people across socio-economic groups and cultures, from millennials to the elderly.

So what does this tell us about the world we inhabit — about ourselves and each other? And what can, or should, we do about it?

All of these questions are explored in our new series: “On Loneliness: A Video Series About Coping With Feeling Lonely” created by The Roots Of Loneliness Project.

Loneliness Is Normal And Not A Sign Of Failure

Dr. Holt-Lunstad Intro: So, first of all, there’s a lot of shame and stigma around loneliness, and it’s unfortunate because, as I said, loneliness is something that is an adaptive response.

We all feel lonely from time to time, there’s no shame in that. I mean that would be like feeling ashamed for feeling thirsty or hungry, right?

But there’s the sense of being a social failure or that there’s something perhaps fundamentally wrong with someone [if you feel lonely].

Saprina Intro: Dr. Julianne Holt-Lunstad is a professor of psychology and neuroscience at Brigham Young University. Her research on health and social connection has been key in recognizing that social isolation and loneliness risk leading to an early death.

Loneliness And Social Isolation Aren’t The Same

Saprina: Welcome, Dr. Holt-Lunstad, and thank you for being here and being willing to talk to us about this very sensitive topic of loneliness.

I would love to first hear from you what loneliness is according to you, what causes it?

Dr. Holt-Lunstad: So, first of all, we use the term loneliness a lot and it’s important to define it, particularly to distinguish it from social isolation because people use the terms interchangeably but they actually refer to a slightly different phenomenon.

Loneliness is really the subjective feeling of being alone. It’s often described as a distressing feeling, but quite often, it’s defined as the discrepancy between one’s actual level of social connection and one’s desired level of social connection.

This is very subjective and differs from social isolation which is thought to be more objective.

Social isolation is more quantifiable in terms of having a few social contacts, or infrequent social contact, or living alone.

Someone can be socially-isolated but not lonely, and someone can be lonely but not socially-isolated, and it’s important to distinguish these.

For instance, some people may be isolated but not feel lonely, so they may enjoy their solitude.

They don’t feel distressed by that because there is no discrepancy between their actual and desired level of social connection.

On the other hand, you could be lonely but not socially-isolated.

People who may be surrounded by others, live in a big city, or are at a party and can still feel profoundly lonely.

Sometimes people will describe this as, “feeling alone in a crowd.” So, I think this helps distinguish between them, but of course, they also can go hand-in-hand — people can be isolated and lonely as well.

Social Connection Is A Biological Need

Saprina: Interesting. And so, what, in your view, causes this loneliness that you’re speaking about? So, not the social isolation but the state?

Dr. Holt-Lunstad: Being socially-connected is thought of as a fundamental biological need, and so it’s argued that loneliness is really this subjective state or a biological motive — much like hunger or thirst motivates us to seek out food or water — that loneliness motivates us to reconnect socially.

Loneliness can be thought of as an adaptive biological mechanism that helps us to reconnect. And really it only becomes maladaptive when experienced more long-term.

Of course, a variety of factors can trigger that and that may be different across different individuals, but that signal itself is actually a normal and healthy signal but it’s when it’s experienced more chronically that it can lead to some detrimental effects.

How Loneliness Affects Your Risk For Mortality

Saprina: And so, you’ve done research on how loneliness affects our risk for mortality. Could you talk a bit about that, please?

Dr. Holt-Lunstad: My colleagues and I, we were interested in how loneliness and social isolation and living alone impact our risk for mortality.

We collected and gathered all of the available evidence that had been published worldwide on this and conducted a meta-analysis.

We were able to combine the data across these studies to get an overall estimate of the effect and what we found was that each of these — social isolation, loneliness, and living alone — significantly predicted increased risk for premature mortality.

What was somewhat surprising is that they equivalently predicted risk for premature mortality. So, these more subjective and objective indicators are both important in terms of predicting our risk for premature mortality.

Saprina: Well, that’s really interesting. Is there something that you see that has happened in the last couple of years that’s changing? Are there some trends or patterns that have emerged?

  • Demographic Changes Are Increasing Social Disconnection

Dr. Holt-Lunstad: That is something that I think is really interesting is whether or not this is changing over time.

If we look at loneliness specifically, loneliness hasn’t been systematically measured population-wide, so it’s really difficult to determine whether or not it’s increased over time or whether we’re just recognizing it more than ever.

But we do have other kinds of indicators that would indicate greater senses of social disconnection.

So it may not be specifically loneliness but, for instance, through census, we are able to see changes in demographics that suggest that people are less connected socially, in a variety of ways.

For instance, there are more people who are living alone now, in the U.S., and Europe, and many countries.

Of course, just because you live alone doesn’t mean you are lonely, but actually living alone does significantly increase your risk for loneliness and is an independent risk factor for mortality in and of itself.

We also have evidence that marriage rates are declining, childlessness is increasing, fewer people are affiliated with some kind of religious organization, fewer people are volunteering.

What these demographic trends suggest, particularly when you combine that with an increasingly aging population, is that, as people age, we have fewer familial resources to draw upon, particularly in older age.

And so, while it’s unclear whether loneliness specifically has increased, we do have evidence that people may be less socially-connected in other kinds of ways.

Is Loneliness Different Across Cultures?

Saprina: And is there something that you see that’s different in different communities, for example, Latino communities versus African-American communities? Is there any research that has been done on that?

Dr. Holt-Lunstad: You know, when we looked at our data, as I mentioned, we tried to gather all evidence worldwide.

Keep in mind that most of the evidence is from more industrialized countries, so less evidence from developing countries. But, across North America, Europe, Asia, South Pacific, across these countries we found no significant difference across country of origin.

Which suggests that this goes along with the idea that being socially-connected is a fundamental human need.

And so, while there might be some cultural differences in terms of norms of social expectations — remember that the definition for loneliness is the discrepancy between one’s actual level of social connection and one’s desired — so there may be higher or lower expectations based on culture.

So, how we see it expressed may differ, but in terms of the effect that it has on our health, it’s consistent across countries.

What Are Some Misconceptions About Loneliness

Saprina: Could you perhaps give some indication of what are some of the perceptions or misconceptions people have about loneliness?

Dr. Holt-Lunstad: So, first of all, there’s a lot of shame and stigma around loneliness, and it’s unfortunate because, as I said, loneliness is something that is an adaptive response.

We all feel lonely from time to time, there’s no shame in that.

I mean that would be like feeling ashamed for feeling thirsty or hungry, right?

But there’s the sense of being a social failure or that there’s something perhaps fundamentally wrong with someone [if you feel lonely].

As I mentioned, this is an adaptive response but really it only becomes problematic when experienced more chronically. And so, one of the things I think that is important to recognize is that every one of us can benefit from our social connections.

The other misconception is that it’s some kind of dichotomy that you’re either lonely or you’re not.

In reality, we’re all somewhere on a continuum. This is something that affects everyone and everyone can benefit from being socially-connected.

  • Relationships Are A Key To Alleviating Loneliness

Saprina: Going off of that, are there some tips you can provide on what people can do if they’re feeling lonely, if they’re feeling chronically lonely?

Are there some things they can do that will really change [their loneliness] because sometimes people will be like, “Oh, if I just go out with my friends, I’ll be fine,” but that’s not necessarily always the case.

Dr. Holt-Lunstad: First of all, I think to be absolutely clear that because there are so many different circumstances that may have led to someone becoming lonely, whatever is causing that loneliness may be different across people.

So, having a one-size-fits-all, piece of advice is not going to work for everybody.

But generally speaking, there are a couple of things that I could recommend and that is that, first of all, we have really good evidence that being socially-connected is protective for our health.

If we think about this like we do other kinds of behaviors and lifestyle factors that we take very seriously for our health, like physical activity, for example, we have to make time in our busy schedule to be physically active often, right?

And people need to start taking their relationships just as seriously for their health. So they may need to make time in their busy schedules to nurture and maintain their existing close relationships. But that may not always be an option for everyone.

It may be that you’ve lost a significant relationship or that you’ve just relocated to another area of the country or world and you’ve lost your social network, or maybe it’s a transition into a different phase of life, and have had loss of relationships.

So then the hard part is now creating new relationships.

And so, one thing to keep in mind is that relationships take time to develop. And so, we shouldn’t feel badly or frustrated if the first time we go out, the person isn’t our instant best friend.

It takes time to go from being a stranger to an acquaintance; it takes even more time to go from being an acquaintance to a friend; and even more time to go from being a friend to a close friend.

So I think having patience and being willing to consider different kinds of settings where you can be open to the kinds of relationships that may be out there.

But definitely, it’s not going to be a quick fix, so we need to be patient. It’s kind of like you can’t just exercise once and expect to be in phenomenal physical shape. Consistency, right? The same is true for our relationships.

Social Media Can Have Positive And Negative Effects On Loneliness

Saprina: Do you think that social media has any role to play in this, in making us feel lonely? Because everybody’s on their phone, even when we’re together, for example.

Dr. Holt-Lunstad: Of course this was hotly debated and there are potential ways that it can be both negative and positive.

For instance, if we think again to that definition of loneliness as the discrepancy between one’s actual and desired level of social connection, to some extent viewing what others are doing online might heighten those expectations and that could potentially exacerbate some of those discrepancies.

But of course, we need to acknowledge that that doesn’t necessarily always mean that using social media always leads to loneliness, and certainly social media may be an outlet for those who are lonely because it may help to fulfill those needs.

In particular, for some who have some degree of social anxiety, it may be easier to connect online versus in person — it might help to bridge that gap.

But most of the evidence that we have about the health benefits of social relationships are based on research from in-person relationships that predate the widespread use of many of these social media platforms and applications and environments.

And so, we know less about the long-term effects of those.

But I don’t think they’re going anywhere so we really need to think strategically about harnessing the potential of these tools while being very careful and mindful of the potential detrimental effects as well.

  • Investigating The Protective Effects Of Social Support

Saprina: I was just curious as to what took you on this journey to study loneliness?

Dr. Holt-Lunstad: So really, I first started with research around social relationships and health more broadly and really looking at the protective effects of social support, but then also recognizing that the quality of our relationships matter.

And this took me on this journey of recognizing not only the protective effects of having more and better relationships, but conversely, the flip side of that is the dark side of having fewer or poor-quality relationships and, unfortunately, the risk that comes along with that.

Social Relationships And Loneliness: Quality And Quantity Matter

Saprina: So what are some tips that we could have to create more qualitative relationships? Because I think a lot of people feel lonely because the relationships they have, they’re not able to reach the level of intimacy or closeness.

Dr. Holt-Lunstad: Ultimately the research has shown that quantity and quality matter.

Interestingly, it’s not only having people — the presence or absence of others in our lives is important — but the quality of those relationships is important.

This quality can be looked at in a variety of different ways — it can be looked at in terms of the positivity and negativity in a relationship.

Positivity has been associated with more protective effects on health, and negativity — things like relationship strain, conflict, insensitivity, rejection — these kinds of negativity in relationships have been linked to greater risk and poorer health.

And so, of course, it’s important to maintain high-quality relationships.

But then there’s also the extent to which relationships are close and intimate versus those that are much more superficial.

There’s been quite a bit of research in terms of the importance of these close intimate relationships.

Interestingly, there’s also some evidence to suggest that even these more, I hate to use the word “superficial” — sometimes in the research it’s referred to as “weak ties,” more of the acquaintance kinds of relationships — but just the less intimate relationships — talking to the person at the market as you’re checking out, saying hello to someone on the street — that some of these weaker kinds of connections still can have a significant impact on our health.

It’s good to recognize that even some of these small things that we think may not have much of an effect can indeed have an effect.

What’s also really incredible is that there’s some research to suggest that having a diversity of kinds of social relationships and social roles can be associated with stronger health effects as well, really suggesting that getting to know lots of different kinds of people and getting involved in different ways that occupy different roles for us socially can have a real strength and benefit.

  • Different Social Roles Provide Various Resources For Fulfillment

Saprina: Well, that’s really fascinating. So that means that basically, if we’re just used to always being around one peer group, we might actually feel less lonely if we started connecting with other people, people older than us, younger than us, in different places?

Dr. Holt-Lunstad: Right.

And if you think about also interacting in different kinds of roles — so you might have friends that provide a certain kind of role, but then, family members, and even within families, if you likely have a different role with your parents and/or siblings than you would with say a spouse, or romantic partner, or children — those kinds of relationships are very different than your relationships with your friends and they may be very different from your relationship with your co-workers, or someone you go to church with, or that you are involved within some kind of organization.

These different kinds of roles can provide different kinds of resources for us and fulfill different kinds of needs and goals and even different kinds of advice.

So, when dealing with various challenges in your life, when you have more diverse kinds of roles and resources, this can be quite adaptive and help one become much more resilient.

Saprina: Now that was really useful. Thank you so much, Dr. Holt-Lunstad.

Editor’s Note: This article is a transcript from “On Loneliness: A Video Series About Coping With Feeling Lonely.” The interview has been edited for length and clarity.

This video is part of our ongoing series The Roots Of Loneliness Project, the first-of-its-kind resource that comprehensively explores the phenomenon of loneliness and over 100 types that we might experience over the course of our lives.

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