All the lonely people: Epidemic of loneliness is leading to chronic health problems

A growing epidemic, loneliness affects almost one in 10 people in Ireland. It has also been identified as a key health hazard, writes Helen O’Callaghan

LIKE being thrown in at the deep end with no one to save you, a killer eating away at you over time — how loneliness has been described by people who have felt it.

But loneliness is not just a personal, private pain. It has become pervasive in recent decades in our increasingly disconnected society.

In December, the Jo Cox Commission on Loneliness — named after the feisty British MP who was deeply committed to the issue up until her murder in 2016 — delivered its report. The commission found that isolation has escalated from personal misfortune into a social epidemic. As a result, Theresa May has appointed a Minister for Loneliness to tackle the issue.

Senator and Belmullet-based GP Keith Swanick is delighted May has “supercharged the whole debate” by appointing a minister with responsibility for loneliness. Here, he has set up a taskforce on the issue. He wants to start a dynamic conversation about loneliness, observing it’s “a huge epidemic”. In his Co Mayo surgery, he meets lonely people.

“Absolutely, I meet a lot of people with loneliness. Some are upfront and talk about it. Others are quite embarrassed and won’t disclose it. There’s an overwhelming sense of melancholy, they’re just sad — they say a lot of the time they have very little human interaction,” he says.

It’s estimated about 400,000 people in Ireland suffer from loneliness. And it increases with age. TILDA (The Irish Longitudinal Study on Ageing) found more than 37% of people aged 50 and over reported feeling lonely often or some of the time. The figure stood at 36% of those aged 50-64, rising to 45% of 75-year-olds and older.

“Women are more likely to feel lonely than men — 41% compared to 33%. They tend to live longer so they’re probably living without a partner,” says Cathal McCrory, psychologist and senior research fellow at TCD. Loneliness is set to get worse, he says. “Our population is ageing and at a fast pace.”

Yet loneliness doesn’t discriminate across age groups, according to other studies. German-based research into loneliness across the lifespan found it peaked at around age 30 and again at age 60, while it dipped at 40 and at 75. It climbed up again in the over 80s. The Jo Cox Commission on Loneliness reported 43% of 17 to 25-year-olds using Action for Children — a charity helping vulnerable and neglected young people — reported feeling isolated. And more than 50% of parents researched by the charity had faced problems with loneliness — one in five reported feeling lonely in the previous week.

Harry Barry, GP and author of Flagging Stress: Toxic Stress and How to Avoid It, thinks an Irish Minister for Loneliness is a nice idea but realistically a non-runner — however, he thinks the issue warrants a junior ministry.

“Loneliness could easily be given to a Junior Minister for Health as part of the community health brief.” Barry describes loneliness as feeling irrelevant. “The person rates themselves as of lesser worth. Their loneliness comes from feeling of no relevance — that family, friends or community don’t feel they’re important enough to relate to.”

Yet, desire for connection is wired deep in our DNA — from birth, a strong emotional and physical attachment to at least one primary caregiver is vital for personal development. “Some people are introverts and quite happy to be alone, pottering in the garden or listening to music, but [mostly] human beings are gregarious creatures and are usually happiest in communities,” says Barry.

When Samaritans Irish regional director Cindy O’Shea began working with the organisation, she expected most calls to be about suicide. “In fact, we deal much more with people with mental health issues and loneliness. Loneliness is a huge problem, a really hidden problem.”

’Shea finds people don’t anticipate it happening to them: “They’re generally confused as to how they find themselves in this situation. Younger people especially get a massive shock if they feel lonely — they expected to feel busy and have friends and family.”

And yet it happens to this cohort, perhaps a young person moving to a new area for work or college. “They don’t have friends or a family network. They’re missing home — they don’t know who to turn to. They sit in their flat for the evening, maybe watching TV.”

At the other end of the age spectrum, O’Shea gets calls from older people living alone who haven’t seen or spoken to anyone for a week. “Perhaps they’ve lost their spouse or have retired from work and had no network outside work. They have nobody to bounce something off. They ring us just to hear a human voice. They might want to talk about their day, about something they’re planning.”

Being alone isn’t in itself a prescription for loneliness. Philosopher Paul Tillich said language created the word ‘loneliness’ to express pain of being alone — and it created the word ‘solitude’ to express glory of being alone. But it’s still true that anything that causes people to be alone creates a risk of loneliness in a percentage of the population. The catalyst could be job loss; being single when you’d hoped to be in a relationship but weren’t fortunate enough to meet a life partner; or bereavement. “The bereaved are often extremely lonely, particularly if they had a good relationship. They can feel massively, desperately lonely, feeling they can’t replace the essential wonderful relationship they had,” says Barry.

And people in relationships can be deeply lonely too. At Accord, most couples looking for counselling cite communication as their most problematic area. It could be lack of understanding, verbal conflict, silence or criticism, explains specialist in counselling Mary Johnston: “When it becomes difficult to understand a partner and there are lots of arguments, when a partner withdraws or is critical, it can be a very lonely place.”

In an increasingly compartmentalised society (“we tend to stick to our own lives, becoming more distant from others,” says O’Shea), social media isn’t necessarily part of the solution — but could be part of the problem. While Facebook provides us with contacts, what we crave is human connection at a profound level. In fact, Pittsburgh University researchers claimed they found a link between social media use and feeling disconnected from society. Surveying almost 1,800 young adults about their use of 11 popular social media sites, they found those who clicked into their social media profiles more than 58 times a week were three times more likely to feel socially isolated than those who checked in less than nine times weekly.

We need to take loneliness seriously because it’s a health hazard — more harmful than physical inactivity and obesity, as bad for you as smoking 15 cigarettes a day, warn experts. John Cacioppo, director of Centre for Cognitive and Social Neuroscience at University of Chicago and author of Loneliness: Human Nature and the Need for Social Connection, says the mortality rate for air pollution is 5%; for loneliness, it’s 25%.

Steve Cole, professor of medicine, psychiatry and bio-behavioural sciences, as well as director of UCLA Social Genomics Core Laboratory, explains why loneliness is so toxic. Studying the biology of how loneliness turns into disease, Cole concludes that our bodies see loneliness as a mortal threat — and this threat-sensitivity makes our bodies work differently. Working with Cacioppo, Cole found a key anti-viral response deeply suppressed in lonely people compared to the non-lonely. And to make matters worse, another block of genes to do with inflammation was greatly activated.

“Inflammation fuels disease processes in a host of devastating illnesses, including atherosclerosis, Alzheimer’s and cancer,” Cole explained.

A study in journal Cancer reported socially-isolated women had 40% increased chance of recurrent breast cancer and 60% higher risk of dying from it. A review of 70 studies examining lives of 3.4 million people found the lonely were 30% more likely to die in the next seven years. And a 2012 Dutch study found people who reported feeling lonely have 64% greater risk of developing dementia in old age than those who didn’t feel lonely.

McCrory says mental health isn’t just absence of depression or anxiety. It encapsulates high quality of life — and loneliness is definitely detrimental to this. “It’s almost cathartic to say ‘I feel lonely’, to admit it to self and others,” he says.

But it’s not always easy, as author Olivia Laing points out in The Lonely City: “Loneliness is hallmarked by an intense desire to bring the experience to a close; something which cannot be achieved by sheer willpower or by simply getting out more, but only by developing intimate connections. Once [loneliness] becomes impacted, it is by no means easy to dislodge.”

O’Shea believes loneliness as a concept isn’t well developed in people’s language. “It’s hard to start a sentence with ‘I’m lonely’. People don’t start conversations like that, whereas they might say ‘I’m depressed’. We might ask someone ‘are you lonely’ and they’ll say ‘yes, I’m so lonely’.”

Barry points to a sense of shame around admitting to loneliness — ‘what will people think that I’m not resilient enough to mind myself?’

TURNING AWAY: Dr Harry Barry says people often experience shame about their loneliness. Picture: Gareth Chaney Collins

Loneliness is a subjective realisation that quality and/or quantity of one’s social networks isn’t sufficient to meet one’s needs, explains McCrory, who says these needs vary between people.

Loneliness occurs periodically for most of us, he says, but it’s an issue when it becomes persistent.

SO what’s to be done? China’s Elderly Rights Law orders grown-up children to visit ageing parents and ‘never neglect or snub’ the elderly. France passed a similar decree in 2004, requiring citizens to keep in touch with elderly parents. But usually loneliness-combating initiatives are on a more ad-hoc basis. Like ‘Writing Back’, a volunteer project in which Leeds University students become pen-pals with older Yorkshire residents.

Or Homeshare, first established in America over 40 years ago and now in 16 countries. It matches two unrelated people to live together for mutual benefit. The householder, often older, gets low-level practical help and/or companionship (usually 10 hours weekly). And the home-sharer — perhaps a renter forced out of the marketplace — gets an affordable place to live.

Lucie Cunningham set up THE HomeShare (Together Helping Each other) in Dublin eight months ago. “We’ve had phenomenal uptake. We’ve had more than 230 individuals apply to be home-sharers and more than 100 householders. Householders are mainly referred by medical social workers, through public health nurses, as well as by GPs and word of mouth. We have 15 successful matches and are in the process of finalising another 10.”

When Cunningham meets an older person thinking about home-sharing, she does a loneliness questionnaire — and redoes it three months after their home-sharer moves in. “Evidence is: loneliness levels drop by over 80%. One householder told us before his sharer moved in: ‘even knowing someone’s going to move in with me in a week or two is a huge relief. There’s light at the end of the tunnel’.”

But with medical evidence identifying loneliness as a key health hazard, a targeted national approach to the problem is needed. Organisations like Alone have called for a health policy on it, dedicated resources and a public information campaign. Senator Swanick’s Loneliness Taskforce will produce a report on what’s needed to tackle the issue on an all-Ireland basis. Suggestions/proposals from the public can be made on lonelinesstaskforce.com.

While the Jo Cox loneliness campaign catchphrase was ‘happy to chat’, Swanick’s mantra is ‘we can all beat loneliness, one conversation at a time’.

Contact Samaritans on Freephone 116 123; text 087 260 9090 or email jo@samaritans.ie


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