In this bizarre, uncertain period – full of, perhaps, incessant digital connection (hello, endless ‘Teams’ meetings) and very few IRL hangs, feelings of loneliness are spiking. Here at Women’s Health, we know this first hand. After polling over 2,000 of you – our readers, listeners and followers – we found that 79% of you feel more lonely now than you did before the pandemic. For single people, this number rises to 87%. It’s thanks to this scary data that we are launching a new campaign: ‘The Loneliness Remedy.’
This hinges on a simple concept, rooted in the latest research on the significance of social connection: that much as you prep healthy food, plan your at-home workouts and take time out for self-care, working on your ‘social nutrition’ – cultivating meaningful connections and caring for others, to avoid the problem of loneliness – is key to your health. Our advice? That just as you strive to eat five portions of fruit and vegetables a day, you aim for five socially nutritious interactions every day, too. (You can read up on how to get your other five a day, here.)
The coronavirus pandemic and lockdowns part one and two have made all of our world’s smaller, connections more scarce and have reduced many of our most nourishing relationships to a tinny voice emanating from an iPhone speaker. Unsurprisingly, loneliness has soared as a result. According to a Women’s Health survey carried out on you, our readers, 79% feel more lonely now than you did before the pandemic. For single people, this number rises to 87%.
Not being able to maintain social connections in the usual, face-to-face way has for many people strained those essential ties, while for others loneliness is deeper rooted and has in contrast been a feature of life for a much longer time. According to the Office for National Statistics, from 3 April to 3 May 2020, around 2.6 million people across the UK were ‘chronically lonely’, having reported that they felt lonely ‘often or always’.
During the same period, around 7.4 million people reported that their well-being had been affected through feeling lonely in the past seven days, a group referred to by the ONS as ‘lockdown lonely’.
Working-age adults living alone were more likely to report loneliness both ‘often or always’ and over the past seven days than the average adult; this was also the case for those in ‘bad’ or ‘very bad’ health, in rented accommodation, or who were either single, divorced, separated or widowed.
Again, according to the ONS, women report feeling lonely ‘often or always’, ‘some of the time’ or ‘occasionally’ more often than men, and are less likely to say they ‘never’ felt lonely.
Loneliness is most often seen as a psychological rather than a physical affliction. As consultant psychologist Dr. Elena Touroni explains, those dealing with it: ‘may feel like they can’t connect to their loved ones on a deeper, more intimate level. They may feel like their family only knows them on a surface-level and that they don’t know the real them. Although they might have plenty of acquaintances, they might not feel they have best friends who “get them”.’
But as the Campaign to End Loneliness points out, the sensation is a more complex problem than simply an emotional experience. It’s a physical one, too, with social isolation harmful to our physical as well as our mental health.
Paying attention to the physical impacts as well as the mental impacts – acknowledging that these are not quite as distinct from each other as that – can help ease loneliness. Below we’ve outlined some of loneliness’s physical manifestations to be aware of.
1. Sleeping too much or too little
The low mood that comes with feeling lonely can disrupt one’s normal sleeping patterns and lead to the development of poor health behaviours which then exacerbate low mood. This can then turn into a cycle of poor physical and mental health.
‘I think it’s always a surprise to people that loneliness impacts the quality of sleep so much,’ Professor Pamela Qualter, a leading UK loneliness in children and adolescents at the University of Manchester, explains.
“But given that we need good sleep for physical development and also to engage with work, the implications of loneliness are important to consider. Helping people manage the emotions that accompany loneliness enables people to make better health choices, but providing people with information about loneliness empowers them, and hopefully, enables them to re-connect with others.”
She adds that often people seek to self-medicate, “trying to manage the negative emotions that come with loneliness (sadness, anger) through comfort eating or drinking alcohol”, but warns that doing so only propagates a negative pattern of behaviour that can further isolate an individual.
2. Cardiovascular problems
Researchers have argued that loneliness is linked to cardiovascular disease because of the increased cortisol – a stress hormone – that accompanies loneliness.
This is because, Professor Qualter explains, ‘cortisol causes wear and tear of the cardiovascular system, so if it is experienced for a long time the effects can be very damaging.’ Research by the University of York found that loneliness and social isolation are linked to a 29% increased risk of a heart attack or angina and a 32% heightened risk of having a stroke, with the association comparable to the effects of anxiety and job stress. According to Harvard research, loneliness poses the same risk as smoking for heart disease.
Hypertension – or high blood pressure – can also be a result of loneliness, researchhas found. It found that the effect of loneliness accumulates to produce greater increases in systolic blood pressure (a measure of the pressure in your arteries when your heart beats) over a 4-year period than are observed in less lonely individuals. Greater loneliness means greater pressure on the cardiovascular system which can lead to problems later down the line.
4. Immune system problems
Loneliness can lead to long-term ‘fight-or-flight’ stress signalling, according to a study by the University of California, which negatively affects immune system functioning.
The research found that in lonely people there was an increased expression of genes involved in inflammation and a decreased expression of genes involved in antiviral responses.
Lisa Jaremka, a postdoctoral fellow at the Institute for Behavioural Medicine Research at Ohio State University and lead author of another paper on ‘Loneliness and Immune Dysregulation’ says: ‘One reason this type of research is important is to understand how loneliness and relationships broadly affect health.
‘The more we understand about the process, the more potential there is to counter those negative effects – to perhaps intervene. If we don’t know the physiological processes, what are we going to do to change them?’
She adds that loneliness has been thought of in many ways as a chronic stressor – a socially painful situation that can last for a long time. ‘We saw consistency in the sense that more lonely people in both studies had more inflammation than less lonely people [and] it’s also important to remember the flip side, which is that people who feel very socially connected are experiencing more positive outcomes.’
5. Cognitive decline
Scientific research has found that loneliness can impact cognitive function – and has even been linked to dementia.
One such study by the Instituto de Salud Carlos III in Madrid, Spain concluded that: ‘Both loneliness and social isolation are associated with decreased cognitive function [such as delayed recall and verbal fluency] over a three year follow-up period’ and that ‘the development of interventions that include the enhancement of social participation and the maintenance of emotionally supportive relationships might contribute to cognitive decline prevention and risk reduction.’
So, what can be done?
For Professor Qualter, talking more openly about loneliness will help to remove some of the stigma around it and, hopefully, encourage more people to seek help and support when they are in need.
‘Loneliness is a subjective experience,’ she says. ‘Remember that saying “lonely in a crowd”? Often people are surrounded by others and do not look to be suffering. Sometimes it’s just not possible for others to know when others are lonely. And because of the stigma still associated with loneliness, people do not talk about it.
Taking a moment to stop and evaluate why we’re feeling how we’re feeling can also illuminate a path out of the woods.
‘I think it’s hard for individuals to know why they are feeling sad and angry,’ she explains, ‘and they may not put it down to loneliness. That’s why it is so important that we take time to re-evaluate our social relationships and work out whether the uncomfortable, negative emotions we are feeling come from loneliness: if they do, it is about finding ways to manage that and re-connect.’
How to get your ‘five socially nutritious interactions’ a day
To counter all of this, and to help you to increase the connection in your life, WH wants you to get to know your ‘social biome’ – a concept at the core of The Loneliness Remedy. Jeffrey Hall, Professor of Communication Studies at the University of Kansas, coined the phrase and believes it to be a useful metaphor for how we imagine the medley of social interactions we get throughout a day. Think of it like your gut microbiome: a living, ever-evolving thing that responds to what you feed it and has seismic implications for how you feel.
So, just like you know to keep your gut microbes healthy by aiming to eat 30+ plant foods per week and showing them extra love by adding in fermented foods, your social biome deserves similar TLC. Our suggestion, that Professor Hall supports? That you aim for five socially nutritious interactions a day: the same number as the amount of fruit and veg that the NHS recommends you get in.
Practically, this means taking a more analytical approach to your social life and dedicating time to engaging in the sorts of meaningful interactions that will truly enrich you. To determine how socially nourishing an interaction will be, Professor Hall wants you to think about the following…
‘The interactions that will sustain you the most will be from the people you are closest to,’ he explains. ‘I call this your “first 15”. Take the time to identify who those people are, then actively allocate time to nurture your emotional connection with them.’ This is extra important during a stressful time, when you want to make sure that you’re spending your limited reserves of social energy efficiently; on interactions that you know will truly nourish you.
‘There are four kinds of conversations that are particularly valuable for your social health. They are: meaningful (talking about the big stuff or stuff that matters to you), catching up, joking around and expressing concern or affection,’ Professor Hall explains. Someone with a healthy social biome will have a balance of these sorts of interactions every week.
‘The gold standard is always meeting face to face, followed by a phone call,’ says Professor Hall. Video isn’t actually all that fulfilling. ‘Because you expend more energy in setting it up and keeping it going, it isn’t as easy as calling someone for a chat.’ Next on the list comes texting and instant messaging and then, bottom rung, is going on social media.
Prioritise hearty social meals over junk snacks
‘Even though going on social media allows you to consume lots of information about people it doesn’t provide the depth of connection that people need to feel really socially nourished. And research shows that when we have that motivation to interact decreased, then we’re less likely to turn to the more in-depth conversation because we’ve already used up all our energy scrolling through our social feeds for an hour.’
Plan your social life like your meals and workouts
‘More than ever, we have to build intentional social routines, like you do around work, exercising and what you eat. That includes fostering our closest relationships through routine and generally we don’t do that. Diarise catch ups with your closest relationships so there’s a solid foundation of connection. And then when you feel that pang of loneliness, treat it as what it is: a cue to connect.’
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