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Understanding Loneliness

How older adults can stave off the isolating effects of chronic loneliness

John T. Cacioppo, Ph.D., directs the Center for Cognitive and Social Neuroscience at the University of Chicago. He also co-authored Loneliness: Human Nature and the Need for Social Connection, which explores the evolutionary roots of lonelinesss. We asked him to tell us why social bonds help us lead healthy lives, how loneliness threatens our well-being and what lonely people can do to break the destructive cycle.

See Also: All the Lonely People

What is loneliness? How is it different from solitude?

"Loneliness" expresses the pain of feeling alone, whereas "solitude" expresses the joy of being alone. Loneliness is a debilitating psychological condition. It is characterized by a deep sense of emptiness, worthlessness, lack of control, and personal threat. Physical isolation can contribute to feelings of loneliness, but people can also be lonely in a marriage, in a family, in a crowd. And as the AARP The Magazine survey revealed, millions of people suffer from loneliness every day.

In your book you say that loneliness serves a purpose.

Early in our history as a species, we survived and prospered only by banding together — in couples, in families, in tribes — to provide mutual protection and assistance. Loneliness evolved like any other form of pain; it is what neuroscientists call "an aversive state," meaning it signals us to change our behavior, in much the same way that hunger, thirst or physical pain do. So even though loneliness feels like it has no redeeming features, it motivates us to renew the connections we need to survive.

Are loneliness and depression the same thing?

Simply put, no. Feeling socially isolated — lonely — means you want to be close to others but you're not sure whom you can confide in, depend on or trust. Feeling depressed means you generally feel sad and lethargic; when that's the case, even pleasant nonsocial events in your life, such as a beautiful sunset, seem less pleasant than normal. Loneliness refers to how people feel about their social connections, whereas depression refers to how people feel about their life overall. Because loneliness can lead to depression, a person may be both lonely and depressed. However, you can be depressed for reasons besides loneliness, and loneliness does not always lead to depression. Many students who go away to college experience feelings of loneliness and sadness stemming from the loss of contact with their friends and family, but the loneliness motivates them to make new friends; that way they escape the clutches of loneliness before it leads to depression.

It sounds like it's easy for people to get stuck in chronic loneliness.

We need others to survive and thrive, so loneliness makes us feel not only unhappy but unsafe. And when we feel unsafe, we respond by looking out for ourselves, which can interfere with connecting with others. So when a person becomes lonely, they can get caught in a negative feedback loop.

How would someone know if he or she is chronically lonely?

Most people feel lonely at some point in their lives. But that doesn't mean they are chronically lonely any more than feeling pain at some point in their lives means they are suffering chronic pain. If, however, a person feels lonely over a period of months or years, they could be characterized as chronically lonely.

Does loneliness have health risks?

Loneliness has been linked to poor immune functioning, elevated blood pressure, higher levels of stress hormones, lower sleep quality, obesity, alcoholism and drug abuse, and even dementia in older adults. The evidence has built to the point where loneliness can be considered a serious health risk, joining more established risks such as obesity or smoking. Loneliness also diminishes the brain's executive functioning, making it harder for lonely people to control their impulses, such as indulging in a guilty pleasure rather than exercising or eating well.

How can you confront or overcome loneliness?

I suggest four simple steps, which I've captured in the acronym EASE, to deal with chronic loneliness:

E is for Extend Yourself. The perception of being threatened causes the withdrawal and passivity associated with loneliness. To test other ways of behaving without that feeling of danger, you need a safe place to experiment. So start small: Volunteer at a shelter or a hospice, tutor children, or help out with a kids' sports team. You won't necessarily receive gratitude and praise for your good deeds — that's not what you're after — but you may feel the positive sensations that can reinforce your desire to change, while building your confidence.

A is for Action Plan. Some people view themselves as adrift on a genetic or environmental raft whose course they cannot control. The simple realization that we are not passive victims — that we can change our situation by changing our thoughts, expectations and behaviors toward others — can have a surprisingly empowering effect.

S is for Selection. The solution to loneliness is not the quantity of your relationships, but their quality. Because these human connections are of necessity mutual, they require equal levels of intimacy and intensity on both sides. So try to sense which prospective relationships are promising, and which would be climbing the wrong tree. For people who tend to be quiet, for example, it's a good idea to select someone who is comfortable with silent companionship. How you go about meeting people hinges on what kind of people you want to meet.

E is for Expect the Best. We have more control over our thoughts and behavior patterns than we think. With a little practice, any one of us can "warm up" what we present to the world. This warmth and goodwill on one person's part will likely elicit warmth and goodwill from others — that's the power of reciprocity.

How many resources — programs, websites, hotlines — are available out there for lonely people?

Not many, unfortunately. One helpful organization that I'm aware of is Little Brothers: Friends of the Elderly, which is dedicated to reducing the loneliness of older adults who are living in isolation.

This lack of programs suggests loneliness isn't being taken as seriously as it should be.

Let me put that in perspective. People used to think infants had to have only their physical needs cared for. But then we learned that human contact and affection are essential, too. There's a parallel in today's views toward older adults. Our society pays a great deal of attention to their financial and medical conditions, but little attention to their social environment — whether they feel socially isolated, or whether they have connections to people they trust and care about. Most people still regard loneliness as a personal deficit or a weakness. Because it is stigmatized, those who are afflicted by it tend to deny it, ignore it or attempt to "tough it out." Conversely, those who do not feel lonely regard it as the other person's problem.

As I said earlier, more and more evidence points to loneliness being a serious risk factor for poor health. For more traditional risk factors such as smoking and obesity, there are established methods supported by science to help people decrease their risk of disease. But what's the correct strategy for reducing a person's loneliness? Is it simply a matter of surrounding a lonely person with other people, giving them more opportunities to socialize? Do they need help developing social skills? Or does a lonely person need a sort of "cognitive tune-up" to break the cycle of negative thoughts and perceptions? I think we must take this question seriously — and search for the best possible answers — if we're to enjoy our later years.

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