Loneliness Can Kill, Literally

The paper synthesized the findings from 70 scientific publications that all together included more than 3 million participants. The authors found that loneliness, social isolation, and living alone were factors in explaining early death.
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Lately, I've been plagued by a disturbing sense of anomie, a crosshatch of yearning, isolation and lack. The psychologist in me has been trying to identify precisely what this feeling is. Grief? Boredom? Emptiness? A combination of all three?

As it turns out, it's loneliness. This sensation is deeply unpleasant, and it can be deadly. A review study published this month in Perspectives in Psychological Science found that loneliness was predictive of death, particularly for people under the age of 65. The paper synthesized the findings from 70 scientific publications that all together included more than 3 million participants. The authors found that loneliness, social isolation, and living alone were factors in explaining early death.

Three remarkable things stand out about this study.

First is the scope. A review study looks at all available research in a field and produces reliable conclusions from a large body of knowledge. While it's difficult to explain the relationship between loneliness and death, it's important to empirically document this association. Researchers can now turn their attention to examine whether loneliness causes illness that leads to death, or whether lonely people die because of lack of social support to help them cope with illness.

Second, the authors took into account whether people were objectively isolated, or whether they subjectively felt lonely and found that there was no difference when it came to mortality risk. The quality and type of relationships we have matter. It's not about how many people we socialize with, it's whether we feel connected to them that determines our health and well-being.

Third, and perhaps counterintutively, the study found that the mortality risk was greater for younger people. We often hear about lonely elders, but we very rarely hear about younger people suffering from social isolation. To make matters worse, admitting to loneliness among young adults is shameful. It means you have failed in the playground of life and that is hard to admit to. Lonely people may become even lonelier because of the stigma.

So, what is going on? Why are so many people lonely? The most common explanations for this phenomenon include technology and urbanization.

Technology is especially puzzling given our hyper connected world where it seems that social contact is readily available at our fingertips. Technology, in fact, may be both a cause and a solution to loneliness. Turkle, an MIT professor claims that technology has fundamentally changed the way we relate to one another. In Turkle's view, we are engaged in a Faustian deal that exchanges meaningless virtual connection for the real deal -- intimacy. For immobile elders, on the other hand, or for those living far away from their families and friends, technology may be the only source of social connection that keeps loneliness at bay.

Others blame loneliness on urbanism and modern life. The individualist ethos, the pursuit of wealth, and the trend of living alone, particularly in big cities have all been documented as causes of loneliness. This doesn't take into account, however that urbanization may decrease loneliness for people who don't fit into the places where they happened to be born. Sometimes urbanization can be the only cure for loneliness.

In my own case, loneliness stems from a mixed bag of causes. Immigration, singlehood, grief over too many losses. These are plausible explanations, but none capture the social trend of loneliness that the psychological research consistently documents.

The answer may lie less in what we are doing, than on what we aren't. We know that the people who live the longest and are the happiest are also the most social. Dan Buettner, a scientist who studies longevity around the world consistently documents the relationship between quality and length of life and number and quality of daily social interactions. The people of Ikaria, for example, where centenarians are common, don't plan dinner dates months in advance, or spend inordinate time in front of a screen, or texting each other -- they speak and engage with members of their community multiple times daily. It's woven into the fabric of life rather than another thing to accomplish on the "to do" list.

As a society, we fail miserably in providing social structures that promote opportunities for intimacy. As Anna Fels, a psychiatrist, noted in the Times this week, aside from the therapists office, "There are precious few times and spaces left in our society in which people quietly speak to one another in a sustained, intimate conversation." As wonderful as therapy can be, it should not be a substitute, or a cure for loneliness.

To be sure, the causes of loneliness are complicated and varied. But there is a large gap between what we know from the loneliness research conducted on millions of people and what we are doing about it. Blaming technology and urbanization is not enough. Teaching people social skills, or cognitive strategies to deal with their negative thoughts will also not suffice.

The indisputable relationship between loneliness and early death means that loneliness is a public health issue. Only a solution of public health proportions will stand a fighting chance at curing this modern malaise.

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