Even before COVID-19 became a household name, 2018 surveys showed that loneliness rates in the U.S. had hit all-time highs. The pandemic then amplified our collective sense of isolation — with “alarming” spikes in loneliness reported across all age groups.
A recent report published in the Journal of Advanced Nursing describes chronic loneliness and social isolation as serious yet underestimated public health risks that have an impact on many Americans, particularly older adults.
“While loneliness can start out as a response to a change in your life — like a move to a new city or a breakup — when it persists and gets worse, it becomes chronic loneliness,” explains Christie Hartman, PhD, a mental health expert on the medical review board of The Roots Of Loneliness Project. “So, the first sign is that it doesn’t go away.”
Other signs include:
• Feeling isolated
• Having no close friends
• Struggling to maintain relationships with others
• Developing self-esteem issues
“[Chronic loneliness] has a ‘downward spiral’ feel that can become self-reinforcing,” Hartman says.
Research consistently shows that social isolation and loneliness are major risk factors for poor physical and mental health outcomes:
• A study from Brigham Young University found that social isolation increased the odds of premature death by 50 percent — a greater threat than smoking, obesity, or inactivity.
• The CDC (U.S. Centers for Disease Control and Prevention) reports that chronic loneliness is associated with a 29 percent increase in heart disease risk.
• Research in Evidence Based Nursing shows that loneliness can be a factor that leads to cognitive decline, a weakened immune system, high blood pressure, and Alzheimer’s disease.
A leading theory that might partly explain these health effects is that early humans developed social skills as a matter of survival. Maintaining a cohesive group meant better protection against predators and increased access to necessities like food and water. Being alone meant a need for greater wariness and increased alertness — which increase stress levels.
When cortisol levels remain high due to unremitting stress, this hormone starts to weaken the immune system and contributes to inflammation, promoting a greater risk for disease.
(Learn more about ways you can alleviate stress in your life.)
Hartman adds that depression and loneliness also often intersect: “The struggle to maintain relationships, the isolation, and the sense of ‘failure’ can impact your view of the world and yourself in a negative way that can trigger depression,” she says. “It can also lead to problems with sleep and stress, and over time puts you at greater risk for heart disease.”
The CEO and founder of Makin Wellness, Sara Makin, MSEd, NCC, says that certain groups of people are at a greater risk for experiencing chronic loneliness:
• People who live alone
• Older adults who reside in nursing home facilities
• People who have just suffered the death of a loved one
• People who belong to the LBGTQ+ community
• Some minority groups
Hartman adds that people who are dealing with depression and anxiety are also at risk, as both conditions tend to lead to social isolation: “Those with chronic health conditions that keep them at home are at risk as well,” she says.
While loneliness and isolation are not new public health threats, the COVID-19 pandemic underscored their prevalence and health impacts alike.
(Learn more about coping with grief in the era of COVID-19.)
If you or someone you love is experiencing a sense of loneliness that just won’t go away, the experts advise:
“If you are dealing with loneliness right now, I would encourage you to get creative with how you connect with people you love,” says Bethany Nickerson, LCSW, a therapist at Cobb Psychotherapy in New York City.
This could include:
• Sending a handwritten card or care package
• Cooking dinner or sharing a meal with a distant friend or loved one over a video call
• Taking a virtual class with a friend
• Starting a book or movie club
• Hosting a virtual game night
If you are struggling with loneliness due to a specific event like a divorce or death in the family, it can also be helpful to find a shared sense of community through a peer support group.
Jamie Steiner, LCSW, a therapist at Cobb Psychotherapy, says it’s important to make sure you’re doing things that make you feel good independently of others.
That means re-engaging with hobbies and activities that you enjoy — but good self-care goes beyond that. Make sure to build routines that work to reduce cortisol levels and boost hormones like endorphins and serotonin — our brain’s “happiness chemicals — such as:
• Getting regular, high-quality sleep
• Maintaining consistent levels of physical activity
• Eating a nutrient-rich diet
If your chronic loneliness feels too overwhelming, working with a professional counselor or psychologist can help equip you with the right tools and strategies to reconnect.
“It can be daunting to start therapy and to find the right therapist, but once you do, they can help you feel more connected to yourself, them, and others during this challenging time,” says Ashley Mead, MHC-LP, a therapist at Cobb Psychotherapy.
If you’re facing health concerns or social distancing requirements, or if you simply don’t have the means to attend in-office appointments, virtual therapy has emerged as an ideal solution to help people of all ages navigate chronic loneliness.
“We learned pretty quickly that therapy can take place effectively through virtual channels,” Mead says. “This helps us provide services to underserved or at-risk communities who may not otherwise have the resources to travel into therapy, whether due to scheduling constraints, lack of childcare, or distance.”
Carbon Health offers virtual mental health appointments to California residents; make an appointment via carbonhealth.com or through the Carbon Health app. (If you or a loved one is experiencing thoughts of self-harm, seek emergency medical care or call the National Suicide Prevention Lifeline at any time, day or night, for free and confidential support, at 1-800-273-8255.)