Volume 13, Number 5
Loneliness is as an unpleasant emotional state in which one perceives social isolation from others. In other words, it can be thought of as the discrepancy between a person’s desired and actual quality of social relationships. Loneliness is not the same as being alone, because one can feel lonely even when surrounded by other people. Human beings are social creatures, and the perception of social isolation can be experienced by anyone at any time. While loneliness is distinct from depression, there are some overlapping characteristics.
A study recently published in Health Psychology found that among persons exposed to a rhinovirus (common cold virus), the presence of loneliness was a strong predictor of which persons actually developed cold symptoms. Importantly, social isolation itself did not predict illness.
This study is just one of a large body of research that has examined the health effects of loneliness, particularly chronic loneliness. Not surprisingly, chronic loneliness is associated with higher rates of depression, anxiety, and substance abuse. It has been established that loneliness is a risk factor for progression of cognitive decline among persons with Alzheimer’s disease or who have had a stroke. Furthermore, numerous other health problems are related to loneliness, including obesity, poorer sleep quality, cardiovascular and cerebrovascular disease, diminished immune function, and earlier death. For the purpose of comparison, while obesity raises the odds of premature death by 20%, loneliness has been found to increase the odds of premature death on the order of 25-45%. Those who study loneliness have also found that it is increasing in prevalence, from rates in the 20% range in the 1980’s to around 40% today. One of the barriers to broader recognition of how severe the health consequences of loneliness can be is that the stigma of loneliness impedes self-reporting of this emotional state.
Dr. John Cacioppo, a social psychologist at the University of Chicago, is perhaps the scientist best known for his research of loneliness. He describes how loneliness progresses. When feeling like one is on the social perimeter (on the “outside”), there is a tendency to go into a self-preservation mode. This leads to some cognitive biases that include increased attention to social threats, and therefore heightened awareness of potential social dangers or pitfalls. A person typically does not realize that these cognitive changes are occurring. Cacioppo and colleagues have found brain imaging evidence that corroborates such social hyper-alertness. These cognitive changes lead to more defensiveness or withdrawal, such that the person is less pleasant to be around, further decreasing the likelihood of positive social interactions. This cycle continues. The stress of such subjective experience has physiologic components, including higher levels of cortisol, a stress-related hormone. Loneliness is associated with poorer sleep quality, and lonely individuals are found to have higher levels of cortisol even when they wake up in the morning, as if the body is prepared for danger. Not surprisingly, less physical activity, poorer diets, and higher rates of smoking have been found in persons who are lonely.
Because of the robust relationship between chronic loneliness and poorer health, Dr. Cacioppo argues that an initial experience of loneliness should be viewed as a type of warning sign and the need for taking action, much like the experience of thirst prompts an individual to drink water. Because chronic loneliness can become debilitating, early intervention is very important. It appears that a key component of effective “action” to take when lonely is to dispute the negative and faulty thoughts that tend to be present with loneliness. For example, rather than allowing the thought that “no one cares about me” to lead to further social withdrawal, one might approach others with an emphasis on active listening as a way to engage with others. Notice the emphasis is more on what oneself can do, rather than on what others need to do differently.
Much has been published on the topic of loneliness in the field of social neuroscience, so this brief summary is just of glimpse of both the negative effects of loneliness and interventions to address loneliness. One take-home point is that having several high-quality relationships appears to be more important than having a large quantity of friends. Nurturing several close relationships is an important means to help prevent chronic loneliness and its health consequences.
Paul J. Hershberger, Ph. D.
… is a clinical health psychologist. He is Professor and Director of the Division of Behavioral Health, Department of Family Medicine, Wright State University Boonshoft School of Medicine.
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