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Loneliness affects far more than our mental health. Studies are now showing that loneliness and social isolation also have profound effects on our physical health, and increase the risk of death substantially.

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  • Dr. Richard Schwartz, Associate Professor of Psychiatry, Harvard Medical School and co-author, The Lonely American: Drifting Apart In The 21st Century
  • Dr. Tim Smith, Professor of Psychiatry, Brigham Young University

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The Health Effects of Loneliness

Reed Pence: Humans are innately social creatures. Few of us can truly go it alone. Our survival depends on having relationships with others, so our species has evolved a way to make sure we maintain them: loneliness.

Richard Schwartz: Loneliness actually has a kind of signal to us that we are longing for more contact he is not a problem actually more to a solution when it actually motivates us to get back into contact with others.

Pence: Dr. Richard Schwartz is Associate Professor of Psychiatry at the Harvard Medical School, and co-author of the book The Lonely American: Drifting Apart In The 21st Century.

Schwartz: As human beings, we survive in groups. That loneliness is a feeling that motivates us to get back into the group when we’re out of it, and that has positive survival value, and it’s a good thing if it gets us back into contact with people.

Pence: Schwartz says that solitude is rampant. But loneliness and being alone are not the same. You can be in a room crowded with people and still feel lonely, or be miles away from anyone for days at a time and feel no loneliness at all. Experts say that’s the difference between social isolation and what we perceive as loneliness.

Schwartz: Perceived loneliness, which essentially amounts to saying on a questionnaire I feel lonely, and that has nothing to do with objective measures of your contact with other people. It’s just a feeling that some of us have. It’s a feeling that all of us have at least some of the times, but some people have a lot of. And social isolation has to do with actually counting the amount of contact that you have with other people. How many people did you see over the past week? How much time did you spend with them? Things of that sort.

Pence: But even though a strong evolutionary need pulls us toward other people, Schwartz says social isolation is increasing quickly in the United States.

Schwartz: One of the most dramatic demographic shifts in this country is, (definitely over the century) is there has been a stunning increase in the number of people who are living alone in one-person households. With each census, every ten years, has gotten higher and higher. The people living alone a hundred years ago used to be people out on the frontier, basically, now they tend to be more people in cities, but you would hope that since people are living alone now mainly out of choice, that it would be something that would be a good thing.

Pence: But that’s not the case. New research shows that both loneliness and being alone are very bad for our health.

Tim Smith: We know that when we’re feeling lonely it’s no fun, but what science had not done until recently was made the connection between the mental health, the social life, and physical health. And now the research is there in spades to show us that, yes, it’s absolutely something that major health institutes and government initiatives need to account for.

Pence: That’s Dr. Tim Smith, Professor of counseling Psychology at Brigham Young University, and co-author of a major study that quantifies the looming toll of loneliness.

Smith: The parallels that we use in the manuscript is the obesity epidemic, where about thirty years ago researchers were noticing increased production of massed produced foods with high sugar content, people had more sedentary lifestyles, we weren’t working out around the farm eight hours a day anymore and sitting in front of the TV when we get home. So, they predicted at that point an obesity epidemic, and, sure enough, we’re experiencing that. Well, the data in terms of social isolation are pretty much pointing that we’re on track for a loneliness epidemic, where already we have the highest rates in recorded history of individuals living alone, the highest rates of people reporting loneliness, and those are projected to increase markedly over the next several decades. So, if we’re not addressing that openly, proactively, we will eventually be paying the cost.

Pence: “The cost” will come in lives shortened among people who don’t have very many, or very close friends. The impact is surprisingly high.

Smith: Overall the effect of living alone or being lonely is equivalent in terms of its risk predicting death as to, let’s say, severe obesity. It’s almost as much as the affect of alcoholism, and probably equivalent to about smoking ten cigarettes a day. If you’re feeling lonely, if you’re living in a social isolation setting, and we all know that smoking and alcoholism is bad for us, but we don’t necessarily equate the social psychological side to our physical health.

Pence: Smith’s team found that chronic feelings of loneliness increase a person’s risk of death by 26 percent. Social isolation increases death risk by 29 percent. And simply living alone raises the risk of death by 32 percent. But if someone’s feeling truly, desperately lonely, the risk may be even higher.

Smith: Our study looking at health (and particularly death outcomes) found a gradient. It’s an ongoing linear relationship where the more lonely you are, the more likely you are to have a premature death relative to others. So, the more, the worse. That’s kind of the take-home message there. There’s not a specific tipping point that we were able to identify, anyway.

Pence: However, no one directly dies of loneliness. So what’s going on in the body that makes lonely people sicker? Smith says several pathways have been proposed.

Smith: Some of them are purely social, such as people who are around people more often will have fewer bad habits. They’ll be more likely for example to wear a seatbelt if they know that they’re with people who are reminding them to use a seat belt and care about them using a seatbelt. Less likely to engage in risky behavior. Nutrition is another factor. People who are around people more often will tend to eat more healthy because they have access to, in some instances, just right out there cooking. But also a broader variety of diet when you are engaging in social activities with more people. People engage in better self-care as well.

Pence Scientists don’t know if those social factors create what’s evident in the body’s physiology, but it’s clear that people who are well-connected benefit from a variety of markers for good health.

Smith: Research has shown that people who have higher social networks have lower blood pressure on average, they have higher pleasure endorphins and neuroendocrine activity that is indicating that the brain is being more positively stimulated. They also have greater meaning, purpose, desire in life. I just came across a study a month ago where they tracked people’s purpose in life, and those folks who had great purpose in life were actually less likely to have a stroke. Meaning in existence turns out to be important. Then some other research that shows that our immune system functions better when were socially connected.

Schwartz: Simply feeling lonely altered the level of expression the amount of activity of more than two hundred genes on the human life cell, which were deemed mainly involved in the immune system. So, these lonely feelings actually manage to affect us at some of the deepest levels of our biology.

Pence But what determines whether a person feels lonely on not? Simply being alone doesn’t necessarily make a person lonely. But Schwartz says one thing willaffect almost anyone–feeling left out

Schwartz: You can be alone without feeling left out, but if you actually feel left out when other people are off doing things and having a good time without you, that’s actually a very bad feeling. We all know it from grade school and high school but we have it as adults as well. Sometimes when we want a little solitude we want to step back from people see them a little less, you know, we make that choice ourselves, even though we’re choosing a little more loneliness, when we start to notice that people seem to be going on without us, we start to feel left out. And that’s really a kind of awful feeling, and there’s been a interesting body of research done on feeling excluded, not just alone, but excluded, and when people feel that other people are leaving them out it really has immense affects on how they feel and behave after that.

Pence: Scientists have even been able to test this in the laboratory by having someone cut out from a group they’ve just met.

Schwartz: If you feel that you’ve been excluded by others, then you get more aggressive that you are more likely to do things that getting your own way, eat in unhealthy ways read movie magazines rather then study for a test. Your IQ scores actually drop a little. You’re more likely to give up on a task that’s difficult and that’s one of those vicious cycles where you get excluded by people and this leads you to behave in ways that make it less likely that your gonna be included again.

Pence In fact, if anyone wants to break out of ongoing loneliness, Schwartz says it’s likely they’ll have to fight off a vicious cycle.

Schwartz: When their lonely they often feel that they are not quite good enough, not quite worthy of being in contact with other people, that nobody likes them very much, that they’re kind of losers, and those sort of feelings get in the way of reconnecting with people and lead to a persistent state of loneliness.

Pence but what about people who say, “Sure, I may not have much contact with anyone in person, but i text people, and I have Facebook friends.” Can technology make up for personal contact? Or is it part of the problem?

Smith: Technology can be part of the problem, but it also can be part of the solution. If we’re able to text people across the country that we normally wouldn’t have any social contact with, and that’s a positive. There are many uplifting stories of people in nursing homes for example who otherwise would be socially isolated but for Facebook or other methods that they gain access to, to contact their grandkids or relatives or friends. Social media, texting can be a big positive, or it can lead to increased superficiality in relationships, and that of course would be the negative side of that. The Internet and modern technology is a tool, and it can be used for positive or in a ways that aren’t as positive as we would like to believe.

Pence: Smith says people can be satisfied with the contact they get on social media, and so they score low on loneliness itself. But if those people are living in social isolation, even the ones who are happy with just Internet contact have an added risk of death approaching 30 percent. So, is it the quantity of friendships we have? Or is it the quality that’s important?

Schwartz: It’s probably both. Certainly feeling generally close to and know by other people and loved by them matters. But there’s also some evidence that the more casual friendly contacts we have–someone we chat with at the store or the gas station or just bump into a couple of times in the course of a wee–those actually have a pretty powerful affect on our well-being and how we feel as well.

Pence: Having friends is important. But finding them in a new city, for example, can be difficult. It can take effort, and some courage, to get involved in activities with other people, even if it’s something that interests you.

Schwartz: The old advice, if you’re lonely join a church choir is actually wonderful advice. The importance of not just going out to something one night but getting involved in something that you’re interested in that brings you into regular contact with some of the same people and that’s what friendships grow out of.

Smith: Many people in hearing about these findings instantly assume, well, I need to increase my friendships then. And friendships are an important part of social networks, but since infancy it turns out the most important social network that we have, that we come with, usually are those who gave birth to us the family the caretakers that raised us. So, many people have overlooked the implication of the results on family life. And that if family relationships can be strengthened that actually would be a number one way to decrease loneliness and increase social connectivity.

Pence: So having friends is important to how long we live as well as how well we live. You can find out more about Schwartz’s book online at thelonelyamerican.com. You can find out more about Tim Smith at education.byu.edu, or through links on our website, radiohealthjournal.net, where you can also find archives of our shows. You can also find our shows on iTunes and Stitcher. I’m Reed Pence.

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