Learn About Loneliness

Almost everyone experiences transient feelings of loneliness at some point in their lives. However, for 15-30% of the general population, loneliness becomes a chronic condition (Hawkley & Cacioppo, 2010)¹, meaning that chronic loneliness affects millions of people worldwide. With increasing attention on the matter in recent years, loneliness is viewed by many as one of the major public health challenges we face today, and even global institutions like the WHO have started convening commissions to address the issue (WHO, 2023)². 

Loneliness is not the same as being alone. You can be in a relationship and have friends and still feel lonely, and you can live a relatively solitary life and yet not feel lonely. It depends on how much social connection you desire and how large a discrepancy you feel between what you need and what you currently have (e.g., Peplau & Perlman, 1982)³. Do you feel you have as many and as high-quality social connections as you wish? Then you probably won’t feel lonely. 

Loneliness is not just an unpleasant feeling. A continuously growing body of research has pointed out the negative associations between loneliness and both mental and physical health.

Loneliness is associated with increased morbidity and mortality 1 (Hawkley & Cacioppo, 2010), including an increased risk of dying an early death by around 14% (Wang et al., 2023)⁴ and an overall heightened mortality risk of 27% (Henriksen et al., 2017)⁵. Its accumulating effects seem to accelerate aging in general (Hawkley & Cacioppo, 2007)⁶. Loneliness has been linked to cardiovascular health risks, like elevated systolic blood pressure in middle-aged adults (Hawkley et al., 2006)⁷ and incidents of coronary heart disease in women (Thurston et al., 2009)⁸. It is associated with disruptions in our hormonal stress systems, immune dysfunction, inflammatory diseases, metabolic disorders, poor vascular function, obesity, and more (see Knezevic et al., 2023⁹; Hawkley & Cacioppo, 2010). The WHO describes the effects of loneliness on mortality as comparable to other well-established risk factors, like physical inactivity, smoking, and obesity (WHO, 2023). 

Loneliness is also associated with cognitive problems and cognitive decline over time (Gow et al., 2007)¹⁰, an increased risk of Alzheimer’s Disease (Wilson et al., 2007)¹¹, personality disorders (Richman & Sokolove, 1992)¹², schizophrenia (DeNiro, 1995)¹³, suicide (Goldsmith et al., 2002)¹⁴, diminished executive control (Cacioppo et al., 2000)¹⁵, diminished sleep quality (Kurina et al., 2011)¹⁶, increases in perceived stress, fear of negative evaluation, anxiety, anger, diminished optimism, and diminished self-esteem (Cacioppo et al., 2006)¹⁷.

So, what can we do about it?

Addressing maladaptive cognitions. An overview study by Masi et al. (2011)¹⁸ investigated which interventions most effectively treat loneliness. The researchers examined standard approaches, such as enhancing social skills, providing social support, increasing opportunities for social interaction, and addressing maladaptive social cognition (including cognitive distortions). They found that addressing maladaptive social cognition was the most effective strategy to help people.

One reason for this may be that many cases of loneliness are not due to a lack of opportunities to interact with people but rather to how these interactions unfold and how they are interpreted afterward. Overwhelming evidence depicts humans as social creatures—so much so that bonding with others usually happens automatically when we meet regularly—without much conscious effort and regardless of how different we think we are. When there is no logistical barrier to social contact—such as being bedridden by illness or living in a remote area—loneliness often springs from self-sabotaging behavior, standing in one’s own way, so to speak. Once you discover and free yourself from your maladaptive cognitions and cognitive distortions, you might find it much harder to stay lonely than to make friends. Accordingly, simply participating in more social situations, like joining a football club, while having no self-esteem and thinking everyone hates you, for example, might not do the job since the real reason underlying the loneliness—the cognitive distortions—wasn’t addressed. For this reason, dealing with maladaptive cognitions and cognitive distortions is a key step on the road out of loneliness.

Fostering social skills. Additionally, improving one’s social skills can also help. Some people have been lonely for so long and feel so alienated that they no longer know what is expected of them in social situations. Sometimes, they struggle to calibrate their words and emotions, being too timid or too grandiose, too passive or too aggressive, too self-centered or too focused on others. They often lack self-esteem and show a tendency to avoid social contact altogether (Spithoven et al., 2017)¹⁹. Here, the concept of The SOCIAL 5 comes in, representing five character traits that, when strengthened, can significantly enhance one’s social life.

Dealing with barriers to social contact. Before focusing on cognitive distortions and social skills, it is important to ensure there are not simply structural or logistical barriers to social contact in the first place. For example, individuals who are physically disabled, elderly, ill, held in captivity, trapped in an unhappy arranged marriage, or living in a remote location might not struggle with cognitive distortions or social skills at all but rather face the constraints of their circumstances. However, when life victimizes us, it doesn’t mean we have to play the powerless victim. Sometimes, simple, practical steps can help us to change our situation or approach it differently, increasing our sense of social connection regardless of the cards we’ve been dealt.

The interventions on the road out of loneliness are relatively straightforward, and the more you practice them, the easier they will become. Yet they do require some commitment and effort, especially at the beginning.

Getting immediate relief. Sometimes, however, people feel too depressed or powerless to be proactive about their situation. Sometimes the crippling pain of loneliness becomes overwhelming. What can we do right now when we feel this way and experience the intense pain of loneliness? Fortunately, there are methods that can help manage acute negative emotions, and they form the first step on the road out of loneliness.

Following the mentioned points, we can outline a roadmap for treating loneliness that is discussed in the next section. Click on “Next” for an overview.

Next: The Road Out of Loneliness

Sources

1. Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 40(2), 218– 227. https://doi.org/10.1007/s12160-010-9210-8 ↩︎
2. Social Isolation and Loneliness. (2023). who.int. https://www.who.int/teams/social-determinants-of-health/demographicchange-and-healthy-ageing/social-isolation-and-loneliness ↩︎
3. Peplau, L. A., & Perlman, D. (1982). Perspectives on loneliness. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 1-18). Wiley. ↩︎
4. Wang, F., Gao, Y., Han, Z. et al. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav 7, 1307–1319 (2023). https://doi.org/10.1038/s41562-023-01617-6 ↩︎
5. Henriksen, J., Larsen, E. R., Mattisson, C., & Andersson, N. W. (2019). Loneliness, health and mortality. Epidemiology and Psychiatric Sciences, 28(2), 234–239. https://doi.org/10.1017/S2045796017000580 ↩︎
6. Hawkley, L. C., & Cacioppo, J. T. (2007). Aging and Loneliness: Downhill Quickly? Current Directions in Psychological Science, 16(4), 187-191. https://doi.org/10.1111/j.1467-8721.2007.00501.x ↩︎
7. Hawkley, L. C., Masi, C. M., Berry, J. D., & Cacioppo, J. T. (2006). Loneliness is a unique predictor of age-related differences in systolic blood pressure. Psychology and Aging, 21(1), 152–164. https://doi.org/10.1037/08827974.21.1.152 ↩︎
8. Thurston, R. C., & Kubzansky, L. D. (2009). Women, loneliness, and incident coronary heart disease. Psychosomatic Medicine, 71(8), 836–842. https://doi.org/10.1097/PSY.0b013e3181b40efc ↩︎
9. Knezevic, E., Nenic, K., Milanovic, V., & Knezevic, N. N. (2023). The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders. Cells, 12(23), 2726. https://doi.org/10.3390/cells12232726 ↩︎
10. Gow, A. J., Pattie, A., Whiteman, M. C., Whalley, L. J., & Deary, I. J. (2007). Social support and successful aging: Investigating the relationships between lifetime cognitive change and life satisfaction. Journal of Individual Differences, 28(3), 103–115. https://doi.org/10.1027/1614-0001.28.3.103 ↩︎
11. Wilson, R. S., Krueger, K. R., Arnold, S. E., Schneider, J. A., Kelly, J. F., Barnes, L. L., Tang, Y., & Bennett, D. A. (2007). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry, 64(2), 234–240. https://doi.org/10.1001/archpsyc.64.2.234 ↩︎
12. Richman, N. E., & Sokolove, R. L. (1992). The experience of aloneness, object representation, and evocative memory in borderline and neurotic patients. Psychoanalytic Psychology, 9(1), 77–91. https://doi.org/10.1037/h0079323 ↩︎
13. DeNiro D. A. (1995). Perceived alienation in individuals with residual-type schizophrenia. Issues in Mental Health Nursing, 16(3), 185–200. https://doi.org/10.3109/01612849509006934 ↩︎
14. Institute of Medicine (US) Committee on Pathophysiology and Prevention of Adolescent and Adult Suicide, Goldsmith, S. K., Pellmar, T. C., Kleinman, A. M., & Bunney, W. E. (Eds.). (2002). Reducing Suicide: A National Imperative. National Academies Press (US). https://pubmed.ncbi.nlm.nih.gov/25057611/ ↩︎
15. Cacioppo, J. T., Ernst, J. M., Burleson, M. H., McClintock, M. K., Malarkey, W. B., Hawkley, L. C., Kowalewski, R. B., Paulsen, A., Hobson, J. A., Hugdahl, K., Spiegel, D., & Berntson, G. G. (2000). Lonely traits and concomitant physiological processes: the MacArthur social neuroscience studies. International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 35(2-3), 143–154. https://doi.org/10.1016/s0167-8760(99)00049-5 ↩︎
16. Kurina, L. M., Knutson, K. L., Hawkley, L. C., Cacioppo, J. T., Lauderdale, D. S., & Ober, C. (2011). Loneliness is associated with sleep fragmentation in a communal society. Sleep, 34(11), 1519–1526. https://doi.org/10.5665/sleep.1390 ↩︎
17. Cacioppo, J. T., Hawkley, L. C.,  Ernst, J. M., Burleson, M., Berntson, G. G., Nouriani, B., & Spiegel, D. (2006). Loneliness within a nomological net: An evolutionary perspective. Journal of Research in Personality, 40, 10541085. https://doi.org/10.1016/j.jrp.2005.11.007 ↩︎
18. Masi, C. M., Chen, H. Y., Hawkley, L. C., & Cacioppo, J. T. (2011). A meta-analysis of interventions to reduce loneliness. Personality and social psychology review : an official journal of the Society for Personality and Social Psychology, Inc, 15(3), 219–266. https://doi.org/10.1177/1088868310377394 ↩︎
19. Spithoven, A. W. M., Bijttebier, P., & Goossens, L. (2017). It is all in their mind: A review on information processing bias in lonely individuals. Clinical Psychology Review, 58, 97-114. https://doi.org/10.1016/j.cpr.2017.10.003 ↩︎