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Monday, May 17, 2021

Battling the hidden pandemic of loneliness

Combating loneliness through healthy relationships with oneself and others is one of the best ways to preserve humanity.

New Delhi |
Updated: April 12, 2021 5:46:19 pm
Battling the hidden pandemic of lonelinessPeople are likely familiar with the unusually painful experience of loneliness which leads to a complex emotional state of isolation, be it real or virtual. (Illustration/Suvajit Ray)

Written by Debanjan Banerjee

“Loneliness is the most terrible poverty, leading to the feeling of being unloved”
-Mother Teresa

We all love to be around people. We like social gatherings, friends, families, relatives, hanging out or conversing for hours and travelling. In social psychology, there are terms like “self-concept” and “interpersonal attractions” which basically state that the constant need for human interaction is in reality the constant attempt to battle loneliness.

People are likely familiar with the unusually painful experience of loneliness which leads to a complex emotional state of isolation, be it real or virtual. Ironically enough, the apparently enhanced social proximity facilitated by the modern technology does not do enough to battle the “inner loneliness” that human minds feel. Due to certain factors, irrespective of the background noise or number of people, one can still be silent and lonely, often leading to adverse consequences.

Loneliness is a universal emotion, subjective to each individual. It stems from physical, social or emotional isolation of an individual from his/her intimate surroundings (can be other humans, pets or even loved objects). Several factors contribute to it.

A marked change in life caused by an unwanted event or loss, feeling “out of place” or “out of sync” with people around, having no close bonds/partner, having no proximal human contact/pets to share emotions or talk to, introverted personality, having a developmental illness that restricts expression or an illness that causes significant social stigma, not enough of “me” time, multiple failed relationships, excessive dependence on virtual relationships and an unfriendly or bullying environment.

Loneliness can bring about negative thinking patterns of “hopelessness” (feeling that nothing is going to change) and “worthlessness” (feeling one is not worthy enough to live), which in turn can spiral into depression. A lot of anxiety and doubts generate about the future and a lonely person starts considering him/herself to be unwanted, unloved and unproductive.

As mentioned, loneliness is not just about “external isolation”, it is a state of mind. One can feel as lonely in a party, a festival or in a joint family even when surrounded by a group. We commonly see the examples of marriages or relationships in which people stay “isolated” and emotionally “lonely” even after living together for years.

However, loneliness is a reversible state of mind and based on the environment, stress and mental state of the individual, it can either resolve or lead to adverse mental health effects. Worse again, the prevalence of loneliness is on the rise.

Factor analysis of the National Mental Health Survey (NMHS) 2015-16 marks 30 per cent of the population as feeling “lonely” most of the time, whereas 65 per cent of these people have at least one mental disorder or substance abuse. Loneliness is commonly linked to depression, anxiety, poor occupational performance and headaches, and also being the sixth most potent risk for suicide.

Research clearly states that depression (a severe mental illness) and loneliness are intricately linked. It can also lead to generalised anxiety disorder, panic attacks and increased risk of schizophrenia. In children it can lead to learning problems, school refusal, selective mutism (unwillingness to speak in specific situations), and disorders with decreased academic and social performance.

In adolescents, it is a common trigger for violence, aggression and substance abuse. Loneliness has commonly been termed as a “gateway” factor for highly addictive substances like alcohol, cocaine and heroin. It leads to poor sleep quality and quantity with exhaustion by seeking alternate means of socialisation. People can also retire to the digital world leading to internet addiction and mobile overuse.

Most importantly, the World Health Organisation (WHO) considers loneliness as a “red flag” for suicidal risk, especially in adolescents and women. In 2010, the Tata Institute of Social Sciences (TISS) studied a large group of suicide attempters in the age group 15-40 years with or without mental disorders and concluded “loneliness” as one of the most important preventable risk factors.

Research in old-age depression identifies loneliness and social isolation to double the risk of suicide and quadruple the risk of depressive and anxiety disorders.

Feeling emotionally lonely for years together can influence the stress-handling mechanism of the body (adrenal glands) releasing excessive cortisol (hormone that is released in body at times of stress) causing persistent anxiety, hair fall, digestive and heart disorders, gastritis, high cholesterol and uric acid with increased risk of diabetes, obesity and stroke.

Immunity can get affected in the long-term causing increased vulnerability to infections. Loneliness leads to “hyper-awareness” and “hyper-vigilance” states in which the individual is more and more preoccupied about the self with enhanced threat-response and paranoia.

In the elderly age group, dementia (disease of the brain leading to loss of memory and other abilities) risk is associated with physical and emotional loneliness. People feeling lonely tend to be constantly involved with others’ lives in social media and news feeds causing chronic sense of unhappiness and inadequacy, which is more harmful.

There is no single common cause of loneliness and hence there is no common solution. Loneliness is not an illness, but rather a state of mind. Hence it can be prevented or altered, the ways varying widely. Most suggested measures are lifestyle modifications (daily schedule, Yoga and exercise, walking, hobby and activity involvement), indulging in spiritual or humanitarian activities, pet therapy, reminiscence of olden days or memories and music. These factors can promote healthy socialisation and reduce stigma.

Loneliness inevitably overlaps with some degree of depression and hence psychotherapy (a form of face-to-face counselling) that alters negative thoughts and beliefs enabling healthy attitudes and behaviour helps.

It is important to understand the nature of loneliness, the reasons, the circumstances leading to it and the thoughts surrounding it. For example, a lonely school student who is an introvert and bullied repeatedly might have very different thoughts than a divorced IT professional with competitive employees all around. Each situation is unique and hence needs individualised planning.

A vital step in fighting loneliness that arises due to fear of socialising is learning adequate social skills and behaviour. There are separate social and cognitive skill training modules that are scientifically proven to encourage healthy thinking, adaptive patterns of dealing with loneliness and fearless interaction.

Here by socialising we do not mean that every person has to move out and forcibly hang around with friends or strangers. Loneliness is prevented when one voluntarily interacts just enough with the people he likes, getting emotional satisfaction.

Prevention is the best step, but a different approach altogether. It is important to be aware about this neglected evil. It is an unspoken topic and considered to be quite integral to life. Education, community awareness, having hubs and activities of healthy human-interaction, where like-minded people can meet, fight stigma and promote positive mental health can help relationships, thereby reducing loneliness.

Internal loneliness deserves a special mention here. We often fail to utilise adequate opportunities to be with ourselves. We forget to sing our favourite song aloud, sway our body to the tune that we love, laugh at our own humour or even look back at our days and smile at their completion. These small apparently insignificant activities help us find solace in ourselves from the background noise and promotes mental well-being.

However, it is not about being in solitude all the time. Social interaction and self-absorption need to be well-balanced. Tipping off this balance contributes to loneliness. Social media as always has two sides. It helps human-bonds and communication but at the same time leads to multiple pseudo-relations and superficial emotional patterns which break down easily giving rise to loneliness.

A study done in University of Surrey in 2009 shows that excessive “screen-time” (total time devoted to any visual and digital media) reduces self-satisfaction and quality of life. Technology has the risk to create a virtual world of relationships for the lonely person, which are fragile, thus causing more emotional trauma.

In the words of Sigmund Freud, “the time we spend connecting with ourselves, is the wise time”. Combating loneliness through healthy relationships with oneself and others is one of the best ways to preserve humanity.

The writer is a psychiatrist at the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore. Views expressed are personal

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