Your Brain on Loneliness
is like trying to read a small print
prescription bottle label in a pillowcase
with sunglasses on. . .
A shadow of a shadow
A dream right before you wake up
that makes you question if it’s sleep
or a sad excuse of
real or imagined
myth or fact
at best. . .
which begs the wondering
as we swim through this
s l u d g e:
How loneliness could be changing your brain and body
A growing amount of research shows loneliness could be linked to a range of health problems. Erin Carson recently reported some of these effects.
People were already lonely before the coronavirus pandemic hit. Before COVID-19 stranded folks at home and made getting close to others an unnerving experience, researchers were realizing Americans were lonelier than ever.
A 2018 study from health care insurer Cigna found that 54% of 20,000 Americans surveyed reported feeling lonely. In the span of a bit more than a year, the number rose to 61%. Generation Z adults 18-22 years old are supposedly the loneliest generation, outpacing Boomers, Gen X and Millennials, despite being more connected than ever.
Loneliness has hit epidemic proportions, said Doug Nemecek, chief medical officer at Cigna.
More troubling: A growing body of research suggesting that being lonely for a sustained period of time could be bad for people’s physical and mental wellbeing.
That same study from Cigna placed associated health risks on par with smoking and obesity.
An 2018 article in The Lancet described the situation like this: “Imagine a condition that makes a person irritable, depressed and self-centered, and is associated with a 26% increase in the risk of premature mortality.”
But these are strange times. As a result of COVID-19, keeping distance from others is the safest way to stay healthy, despite the fact it could compound feelings of isolation. It’s a new reason to consider how loneliness can impact everything from your brain, to your heart, to your immune system.
Why we get lonely
Loneliness might conjure images of being apart from friends and family, but the feeling runs much deeper than not having plans on a Friday night or than going stag to a wedding. Evolutionarily, being part of a group has meant protection, sharing the workload and increased odds of survival. After all, humans take a long time to mature. We need our tribes.
“It’s very distressing when we are not a part of a group,” said Julianne Holt-Lundstad, professor of psychology and neuroscience at Brigham Young University. “We have to deal with our environment entirely on our own, without the help of others, which puts our brain in a state of alert, but that also signals the rest of our body to be in a state of alert.”
Staying in that state of alert, that high state of stress, means wear and tear on the body. Stress hormones like cortisol and norepinephrine can contribute to sleeplessness, weight gain and anxiety over extended periods of exposure, according to the Mayo Clinic.
The pandemic, Holt-Lundstad pointed out, is possibly the most stressful experience many people have had in their lifetime. Daily life has been upended, unemployment has skyrocketed and more than 6 million people around the world have been infected. Normally, immense challenges like those would have you seeking the reassurance and support of family and friends. But due to the nature of virus, people are at least more physically alone than ever, making it that much harder to cope.
Loneliness is something almost everyone can relate to, but scientists are still working to understand how and why it impacts health. One of the fundamental challenges of the research: Loneliness is a subjective feeling that can’t really be measured. Not even the size of a person’s social network can guarantee how lonely they are.
Holt-Lundstad said it’s a matter of asking people how they feel in surveys, either directly (how often would you say you’re lonely?) or indirectly (do you feel you lack companionship?).
NASA has been studying the effects of isolation and confinement on astronauts for years, coming to some of the same conclusions as myriad other studies: Isolating conditions can lead to cognitive and behavioral issues. Elsewhere, though, researchers are looking at biological aspects of loneliness and how it physically affects the body.
That can mean looking at brains. . .
Researchers at the Rush Alzheimer’s Disease Center in Chicago studied 823 older adults during a four-year period. They used questionnaires to assess loneliness, classifications of dementia and Alzheimer’s disease, as well as tests of the participants’ thinking, learning and memory, and assigned a loneliness score between 1 and 5. They found a person’s risk factor for Alzheimer’s increased 51% for each point on the scale.
Autopsies were performed on those who died during the study. Loneliness wasn’t shown to cause the “hallmark brain changes associated with Alzheimer’s disease, including nerve plaques and tangles, or tissue damaged by lack of blood flow.” However, one researcher involved in the study, Robert S. Wilson, said loneliness could make people more vulnerable to the “deleterious effects of age-related neuropathology.”
“Loneliness [can] be a good predictor of accelerated cognitive decline,” said Turhan Canli, professor of integrative neuroscience at Stony Brook University.
How exactly loneliness links up with health issues isn’t entirely understood. One idea, Canli said, is that if someone is lonely and feeling down on themselves, they might be less likely to take care of themselves. They might not eat right. They might drink too much, worry a lot, sleep too little. Habits like those can have longer-term effects.
Canli also talked about work he’s been involved in with another researcher at the Rush Alzheimer’s Disease Center, David Bennett, that explores how different genes are expressed in people who are or are not lonely.
Some 30 years ago, Bennett started a longitudinal study whose participants agreed not only to annual physical and psychological checkups, but to donate their brains when they died. Researchers looked at two regions of the brain related to cognition and emotion. They found genes associated with cancer, cardiovascular disease and inflammatory diseases expressed in those who were lonelier.
“There’s actually a network of connections between these different genes by which they can affect each other,” Canli said, “that might be an underlying genetic reason why these diseases might show up as a function of loneliness.”
That’s not to say loneliness causes heart disease. There’s more research to do, including the role heritability plays in gene expression. Earlier work by a UCLA researcher named Steve Cole suggested one possibility — that the release of certain hormones while under the stress of sustained loneliness could be activating certain genes linked to health issues.
“The subjective experience has to be translated somehow in the brain into biology, and so that’s that’s we’re looking at now,” Canli said.
Better understanding these relationships could one day influence therapies designed to treat patients.
The future of loneliness
Even as states are starting to relax lockdown orders and restrictions on restaurants, bars and other public places, the role social distancing could play in society is unknown. In April, Harvard researchers said intermittent social distancing could be necessary through 2022.
NASA astronaut Scott Kelly, who spent 340 days in space, wrote a piece for The New York Times in March, offering advice based on his experience. Kelly recommends keeping a journal, sticking to a schedule and getting a hobby.
Nemeck, from Cigna, noted that now more than ever, it’s more important to check in on others and be open to having honest conversations about feelings of loneliness, while batting down stigma attached to the feeling.
“We need to reach out to some friends and make sure we maintain those connections and have meaningful conversations,” he said. “It’s important for all of us to be comfortable asking other people how they feel.”
Loneliness, that most universal human condition, existed long before we could compare follower counts, of course. “Loneliness is and always has been the central and inevitable experience of every man,” wrote the novelist Thomas Wolfe. But it’s impacting an increasing number of people, according to studies, with some even warning of a loneliness epidemic. At least one scientist is working on a pill to ease its pain.
“Our culture has put upon us these expectations that if we’re going to be successful we need to have a huge network of contacts,” says Susan Matt, a history professor at Weber State University in Ogden, Utah, who specializes in the history of emotions. “That extra set of expectations makes the experience of aloneness even harder. Our grandparents, our great-grandparents, didn’t think they were going to have an average of 338 Facebook friends.”
Matt, along with Luke Fernandez, a computing professor at Weber State University, explore the connection between tech and emotion in their 2019 book Bored, Lonely, Angry, Stupid: Changing Feelings about Technology, from the Telegraph to Twitter. Scouring letters, diaries and memoirs, they found that even though our Facebook-free ancestors felt lonely too, they had more modest expectations about the number of friendships they should have. They also considered loneliness an inescapable part of being human.
Our forebears also weren’t confronted with endless Instagram-perfect vacation photos and posts about kids who seem incapable of anything but cuteness. Numerous studies have found social media can lead to feelings of depression, inadequacy and isolation as people compare their lives with everyone else’s carefully curated versions.
Many of the subjects Matt and Fernandez interviewed for their book talked about this sort of FOMO, or fear of missing out. “It made people’s anxieties more apparent,” Matt says, giving them a “sense that was something going on and they weren’t a part of, that sense of being neglected or abandoned.”
Loneliness, a big business
Technology, as COVID-19 has made more clear than ever, can link people in amazing and unparalleled ways. It crosses geographical borders, broadens communities and opens the world to those with otherwise limited access. But these benefits can come at a cost. “[Technology] can distract us with endless activities that occupy our mental bandwidth and prevent us from recognizing the dearth of relationships that may mark our social lives,” Aboujaoude says.
It can also prevent us from enjoying potential rewards of loneliness, and its close cousin, boredom. Both can, at least in limited doses, lead to self-awareness, creativity and a deeper appreciation for meaningful relationships.
But loneliness can be devastating, even terrifying. A dark veil. A weight on the heart.
“Loneliness and a dangerous world like the one we’re in add up to a challenging combination,” says Aboujaoude, whose books include Virtually You: The Dangerous Powers of the E-Personality. “They produce a sense of vulnerability and can make people feel they lack a safety net or lifeline. If not recognized and addressed, they can also contribute to depression and other negative mood states.”
A 2018 survey from health services company Cigna found that nearly half of Americans report sometimes or always feeling alone or left out, though social media use on its own is not a predictor of loneliness levels. The researchers evaluated 20,000 subjects 18 or older using the well-established UCLA Loneliness Scale, a 20-item questionnaire developed to assess subjective feelings of loneliness and social isolation.
“The eternal quest of the individual human being is to shatter his loneliness,” journalist and author Norman Cousins wrote. We are inherently social creatures, with anthropologists saying our social interactions have played a major role in our evolution as a species.
Given how excruciating loneliness can feel, it comes as no surprise that hardware and software that promise instant connection hold such broad allure. If there is an epidemic of loneliness, it goes hand in hand with the imperatives of capitalism.Luke Fernandez, computing professor and author
“They’re intent on selling us cures for loneliness,” Fernandez says of companies marketing eternal connectivity. “That’s what social media is partly about, a way of commodifying and pathologizing loneliness and offering us a cure. If there is an epidemic of loneliness, it goes hand in hand with the imperatives of capitalism.”
Look no further than the constant parade of Zoom activities that fill our lives during lockdown to see that aloneness is a state many would much prefer to avoid.
“But nothing makes a room feel emptier than wanting someone in it,” poet Calla Quinn wrote.
The Cigna study found that people who engage in frequent meaningful in-person interactions have lower loneliness scores and report better health than those who rarely interact with others face to face. Researchers who study loneliness say technology can help establish and enhance meaningful connections. But it can’t replace them. What we’ve learned from coronavirus is the more we use technology, the more we actually want to be in person connecting to other people.Dan Schawbel, author
Schawbel cites research from Oxford University that found out of 150 Facebook friends, you can truly count on only four, on average, when you need a real friend. The kind who picks you up from the hospital after a procedure, helps you pack on moving day and listens to you dissect your breakup for the 16th time because you need to process it just once more, promise.
“If we know through all these studies that the root of happiness is relationships,” he asks, “why are we letting technology deceive us into thinking we have more than we have?”
Enter Zoom fatigue, the much-discussed condition du jour, which could end up being a harbinger of a renewed reach for connections beyond Facebook birthday messages.
“What we’ve learned from coronavirus is the more we use technology, the more we actually want to be in person connecting to other people,” he says. “It’s pushing us to be more human.”