Concerns about loneliness have been mounting for some time, with media reports detailing a ‘loneliness epidemic’ on the rise in wealthy countries. Studies from the past few years have highlighted myriad health risks associated with loneliness, even before COVID-19 turned the world upside down—and consequently, due to global lockdowns, loneliness has become a topical issue. So, how bad are things going to get? And, more importantly, what can we do to prevent it?
Social isolation and/or being alone are often conflated with loneliness, but the differences are important in understanding how and why we feel lonely. Julie Barnett, professor of health psychology at the University of Bath, UK, explains: “Social isolation means having few—or even no people around you. Sometimes social isolation can be positive.” It can, however, contribute to loneliness, which Barnett describes as “a subjective and negative evaluation related to the lack or loss of the presence and companionship of other people. So it is possible to be with lots of other people, and be lonely.” Ultimately, no one is immune to loneliness.
Often seen as a condition that mostly impacts the elderly, studies in various wealthy countries (which make up much of the research on loneliness) including England, Japan, New Zealand, and the US, highlight that it’s in fact young adults, generally between the ages of 16 to 24, who report feeling lonely the most.
“So it is possible to be with lots of other people, and be lonely”
Barnett suggests: “One possible explanation is that young people have higher expectations of social connection and might value it more. Also the social networks of younger people can be less stable—[youth] is a time of physical change as well as a time of transitions around school, employment, moving away from home. It can also be a time when it is difficult to find a balance between being an independent individual and having a need to belong.”
The long-term risks of loneliness
Takahiro A Kato, an associate professor in the department of neuropsychiatry at Kyushu University Hospital in Fukuoka, Japan, studies hikikomori—a phenomenon observed largely in Japan, although it has been documented in other east Asian countries, as well as Spain and Oman, in which adolescents and young adults withdraw from society and become recluses in their parents’ homes over a period of at least six months, unable to work, go to school or social events.
Kato believes that modern society has created an environment “in which people tend to withdraw easily.” While the cause of withdrawal isn’t always clear, Kato hypothesises it stems from psychological factors including shame (for example, from a public situation), OCD, social anxiety, PTSD and depression, which can all lead to social avoidance, physical isolation, loneliness, and ultimately suicide.
According to studies, loneliness has been found to be a predictor of suicide risk in young adults. The long-term risks of loneliness are equally concerning. A 2015 study from Brigham Young University, London, warned of a possible loneliness epidemic by 2030. It found both social isolation and loneliness were associated with unhealthy habits such as smoking, poor sleep and physical inactivity, as well as poorer immune function, and concluded it carried a comparable risk to things such as obesity and substance abuse. Meanwhile, substantial evidence indicated those who lacked social connections were at risk of premature mortality. Loneliness as a significant risk factor for depressive symptoms was confirmed in a separate 2006 study.
Amid pandemic lockdowns and experts’ fears of a ‘social recession’, the press has been eager to highlight the topic. But where exactly do we stand with loneliness in the time of COVID-19? “We have known for a while that loneliness can lead to both physical and mental health problems. And we also know that for many, social isolation has led to loneliness—so in this way, we can expect that there will be long-term health impacts of these increased levels of loneliness,” says Barnett. However, the long-term physical and psychological effects of isolation during lockdown are still not fully known.
Lessons from the lockdown
Madeleine, 32, is a writer from New Zealand who found her experience of loneliness during lockdown at odds with what the media projected. She explains: “I’m actually used to being more alone in regular times compared to lockdown because I work from home.” She then found herself at home 24/7 with her housemate and remembers “feeling a little bit overstimulated and distracted during lockdown with [my housemate] Tess here, compared to usual.” Unsure if she felt truly lonely or simply missed those closest to her, including her sisters, nephews, and niece, she discovered that she was actually more social with certain friends than before, thanks to video calling.
It’s an observation that both Kato and Barnett acknowledge was true for some hikikomori (which describes both the phenomenon and the people who experience it) and chronically lonely people—that their symptoms eased during lockdown. Barnett considers if it was due to increased contact with aid workers, while Kato posits that hikikomori felt less guilt during lockdown, since instead of being sole recluses, everybody else was encouraged to self-isolate as well.
However, for others, the downsides of lockdown were as predicted. Caroline, 34, an Australian working as a communications consultant in London, describes how living in a different country means her support network locally wasn’t big to start with. “I relied heavily on interaction with work friends and colleagues as one of my main forms of socialising. So when lockdown hit, I definitely had periods where I felt quite lonely. One of the positives is that it has strengthened existing friendships, but it has also made me realise how far away from home I am,” she said. As a result, she’s switched to FaceTiming her family instead of having voice calls, and has spoken a lot more with her two grandmothers in Australia, since experiencing loneliness herself has made her aware that they must be feeling quite lonely, too.
Heightened awareness brings hope
Despite bringing the world to a standstill, there are some silver linings to the pandemic. Notably, the heightened attention that loneliness is receiving has brought awareness and is helping to normalise its presence in society; it’s even possible that we’ll look back on the pandemic as a boon to the potential loneliness epidemic.
Likewise, the power of digital technology, particularly social apps, in fostering connections has been made abundantly clear. Barnett noted “how help, support, and compassion has been facilitated through digital connection” during the pandemic, specifying numerous mutual-aid groups on Facebook and WhatsApp as evidence. Although she does bring up the issue of digital exclusion—people described as ‘internet non-users’, who have never used the internet or not in the past three months. For this reason, she points out the necessity of considering other technologies that aren’t digital, including landline telephones, TV and radio.
“Building meaningful connections between people, reducing the stigma around loneliness, and tailoring approaches to the particular needs of individuals or groups—it is not one size fits all”
The emphasis now is on prevention and treatment. At the onset of the pandemic, the World Health Organization issued a guideline on mental health considerations. Another global initiative with outposts in various countries is Mental Health First Aid, which aims to educate the public on how to help someone developing or experiencing mental illness. Further campaigns targeting loneliness specifically exist nationally, including the UK’s Campaign to End Loneliness, and Ending Loneliness Together in Australia.
In terms of practical solutions, Kato suggests adopting a regular sleep rhythm, for example going to bed and rising at the same time each day, and taking up stress-relieving methods other than the internet, including walking, exercise or yoga. He believes that early intervention is a crucial step in ensuring loneliness does not escalate into other mental health conditions, including hikikomori, and that consulting a social worker or psychologist is advisable if one’s condition worsens.
Alongside using technology to stay connected through periods of isolation, Barnett suggests: “Building meaningful connections between people, reducing the stigma around loneliness, and tailoring approaches to the particular needs of individuals or groups—it is not one size fits all.”
You are not alone. For mental health support in Singapore, visit the Singapore Association for Mental Health. For mental health support in Malaysia, visit the Malaysian Mental Health Association.
