Addressing Loneliness

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Volume 17, Number 5

May 2021

Loneliness is a subjective state, defined as the feeling of being alone or the experience of having fewer social contacts than one desires. Social connection, on the other hand, is an objective assessment of the number of social contacts that an individual has. While there is certainly a relationship between social connection and loneliness, a person may feel lonely in spite of having numerous social contacts, whereas a person who has few social contacts may not experience loneliness.

While the number and intensity of social connections are known to be related to health status, loneliness has an even stronger link to health. Increased risk of hypertension, stroke, cardiovascular disease, dementia, depression, and all causes of mortality have been linked to loneliness. Typically there are approximately 162,000 deaths annually that can be attributed to subjective social isolation in the United States. There have been analyses suggesting that the health risks associated with loneliness are as strong as smoking nearly a pack of cigarettes per day.

Social (or physical) distancing has been one of the primary public health mandates for attenuating the pervasiveness of the COVID-19 pandemic. While evidence for the benefits of social distancing to mitigate the effect of the pandemic are substantial, social distancing can exacerbate vulnerability to loneliness.

At the time of this writing, there is welcome progress in the relaxation of public health restrictions on social interaction due to increases in the percentage of the population having received COVID vaccines, as well as benefits from other public health strategies. But returning to “normal” after the pandemic will not eliminate the experience of loneliness for the one-fourth to one-third of US adults estimated to be affected — prior to the pandemic.

Because of the substantial health risks associated with loneliness, it is important to consider steps that can be taken to minimize the experience of loneliness. Studies conducted both prior to and during the pandemic offer important direction. There are a number of interventions that are feasible with social distancing and for which research has established improvement in loneliness. Examples include befriending others via telephone or other virtual connections, distance-based educational activities, shared activities via the computer (e.g., simultaneous exercise), and interaction with domestic animals/pets.

Two of the strongest predictors of psychological well-being during the pandemic have been a sense of personal agency and low social loneliness. Personal agency refers to confidence that one’s choices and behavior can have an impact, particularly with respect to staying socially connected to others… even when in-person contact may not be possible or safe. Prioritizing and nurturing existing relationships appears to be more effective at reducing loneliness than do efforts to create new friendships or social connections, although expanding social connections does have benefits. Intentionality in social interactions, and being mindful of the value of close relationships and shared activities (even if done at a distance using virtual means) are ways to enhance the sense of personal agency (i.e., “I am doing something important with and for people that matter to me”).

Since loneliness is a subjective phenomenon, one of the ways to exert personal agency in a cognitive manner is by managing one’s perspective. Lamenting the number of months that have passed without in-person contact with particular friends or relatives can fuel the experience of loneliness, while being grateful for the technology that has allowed ongoing and regular contact at a distance is a perspective highlighting what one can do with important others. Perspective-taking is a meaningful form of personal agency.

There are trends in the US population contributing to social isolation that will continue post-pandemic. Therefore, addressing loneliness needs to be considered both a personal and societal priority.          

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