All the Lonely People

Crawford is lonely — but he's not alone. A groundbreaking AARP The Magazine survey reveals that millions of older Americans suffer from chronic loneliness, and their ranks are swelling: Of the 3,012 people ages 45 and up who participated in our study, 35 percent are chronically lonely (as rated on the UCLA Loneliness Scale, a standard measurement tool), compared with 20 percent in a similar survey a decade ago. Loneliness was equally prevalent regardless of race, gender, or education levels. Unexpectedly, though, age does make a difference: Those who said they are suffering most are not the oldest among us but rather adults in their 40s and 50s.

Chronic loneliness, experts tell us, is an ever-present, self-perpetuating condition that pushes people away from the relationships that sustain us and make us happy. But the chronically lonely are not merely unhappy — they are in danger. "Loneliness has surprisingly broad and profound health effects," says John T. Cacioppo, Ph.D., director of the Center for Cognitive and Social Neuroscience at the University of Chicago and a leading authority on the topic. There is mounting evidence that loneliness significantly increases the chances of diabetes, sleep disorders, and other potentially life-threatening problems. Research has also shown a greater risk of high blood pressure among lonely people, as well as higher levels of the stress hormone cortisol, weakened immune systems, and Alzheimer's disease.

Over time, the heightened stress that comes with chronic loneliness takes an emotional and physical toll. The lonely find it difficult to control their emotions. They overreact to small things and feel threatened when approached by strangers. They withdraw further, and a downward spiral begins. "Lonely people have more miserable lives," says Cacioppo, "and earlier deaths."

Everyone feels lonely from time to time. It's normal to feel lonely after a loss, for example, such as a divorce or a death in the family. Therapists call this situational loneliness, a painful but temporary condition. It differs from chronic loneliness, a destructive cycle that is difficult to reverse (the " lonely" in this article are chronically lonely). "If a person with a high need for connection suffers a loss or fails to nurture relationships, they are at greater risk of falling into chronic loneliness," says Cacioppo, coauthor of Loneliness: Human Nature and the Need for Social Connection. The destructive cycle begins when a painful rejection or loss makes a person fear more rejection. That fear in turn generates a defensiveness that makes it harder to connect with other people.

According to the Census Bureau, 127 million Americans are over age 45. That means, based on our survey results, that more than 44 million older adults suffer from chronic loneliness. These numbers corroborate a controversial study published four years ago, which found that social networks are shrinking: The percentage of Americans who say they have no one to discuss important matters with rose from 10 percent in 1985 to more than 24 percent in 2004; those with just one or two confidants increased from 31 percent to 38 percent.

This increase was so rapid that some experts insisted it couldn't be real. But it didn't surprise Robert Putnam, Ph.D., the Harvard professor whose 2000 book Bowling Alone charted a long-term decline in Americans' civic engagement. "Boomers have been more socially disengaged than their parents all their adult lives," he says.

The severe recession that started in 2007 has likely contributed to the rise as well. "The general effect of economic hard times in the past has been that people hunker down and withdraw from their communities," says Putnam, who studied trends in group membership, church ­ going, and other social activities throughout the 20th century. Add to that the rapid increase in single-person households, from 20.6 million in 1985 to 31.7 million in 2009. More than 70 percent of these households consist of a person 45 or older. What we end up with is a society primed for loneliness.

Shocking no one, married people are less lonely than those who are divorced, separated, or never married. But that wedding band doesn't have magical powers: 29 percent of married people reported being lonely. "There's nothing worse than being half of a couple that's not getting along," says Ironside, the London Independent advice columnist. "There are lots of difficult things about living alone, but at least no one is actively ignoring you."

Not surprisingly, 62 percent of respondents who said they are depressed also reported being lonely; depression and loneliness often appear together, and are often mistaken for each other, though they are two distinct mental states. Depression is feeling sad, lethargic, apathetic, and listless; loneliness is feeling alienated, threatened, hostile, and desperate. "A person can be depressed but not lonely if a loving friend or family member is there to comfort and support them," says Cacioppo. "You can also be in a reasonably good mood about life in general but still feel socially isolated, if you don't know and trust the people around you."

Consider the case of Emily White. She was a successful lawyer who lived alone and often worked alone; after losing her father to cancer in 2001, she retreated to a solitary routine of home and office that went on for years and deepened into chronic loneliness. "It was maddening," she says. "My friends were becoming parents and partners, and I felt left behind. I tried to socialize, but no matter what I did, I couldn't find a sense of connection. I told myself the feeling would lift, but it didn't. It became a constant, solid presence in my life."

White, 40, who wrote about her experiences in the memoir Lonely, says she always knew she was lonely and not depressed. "The strange thing about my loneliness was that it didn't darken my view of life as a whole. I always had this sense that if I could just connect with someone, my life would actually be pretty good."

Perhaps the scariest thing about loneliness is its links to serious medical problems. More than half of the respondents who reported being in poor health were lonely, compared with one-quarter who reported being in excellent health. And though there's no way to establish a direct cause and effect from our findings, the percentages of the lonely among those diagnosed with obesity (43 percent), sleep disorders (45 percent), chronic pain (47 percent), and anxiety (56 percent) were considerably higher than the 35 percent who are lonely overall. Could loneliness be contributing to these conditions? "Studies have shown that people sleep more poorly, exercise less, eat more fats and sugars, and are more anxious when they feel lonely than when they are not," says Cacioppo. "In addition, the research has shown that illness and disability can leave people more isolated and lonely."

But amid these disturbing statistics emerged one heartening surprise: Respondents who had been diagnosed with cancer had the lowest rate of loneliness — just 24 percent. A puzzling percentage, until you talk to a cancer survivor such as Bob Riter, 54, acting executive director of the Cancer Resource Center of the Finger Lakes in Ithaca, New York. "Cancer is the great equalizer," he says. "It is a life-or-death situation that throws people together regardless of their backgrounds. You form bonds similar to the bonds soldiers have." Riter, who underwent a mastectomy for breast cancer, has been cancer free for 14 years. But he still attends a weekly breakfast group where college professors, construction workers, and firefighters gather as friends united by the shared experience of fighting cancer. "All those sympathetic ears make it hard to stay lonely," Riter says.

The key takeaway from our survey? Social connections are critical when it comes to warding off loneliness. "We've known for a long time that people who do not feel connected to something outside themselves feel a malaise, as if there's a hole in their lives," says psychiatrist Jacqueline Olds. This may account for the fact that only 27 percent of the people who say they are "very religious or spiritual" are lonely, compared with 43 percent who report they aren't religious at all. At the same time, 44 percent of respondents who never attend religious services reported feeling lonely, compared with 30 percent who attend services once a month or more.

Similarly, only 28 percent of those who had donated their time at a school, hospital, or other nonprofit organization in the past 12 months are lonely, along with 26 percent of folks who belong to a book club, garden group, or other social organization. This compares with 41 percent who had not volunteered and 39 percent who belonged to no social groups. "Any situation where people meet regularly to work together on some common cause is likely to result in deepening relationships," says Olds. "It's good for the soul."

Confidants — those you know and trust, and who offer you support — are likewise vital. We asked our respondents how many people they had in their lives with whom they could discuss matters of personal importance. Almost two-thirds of those who answered "none" — and close to half of those who had one or two such people — were lonely. Loneliness was much less common among those who had three or four confidants (32 percent), and it was lower still for those who had five or more (21 percent). When we asked how many people had been supportive of them in the past year, 76 percent of those who reported having no supportive persons in their lives were lonely, compared with just one-third who had at least one. Cacioppo's prescription for happiness: "People who need social connections should think about being alone in the same way a person with high blood pressure thinks about salt."

But making connections can be daunting for the lonely. Emily White volunteered at several charities while she was lonely, and although she found it satisfying, she did not find someone in whom she could confide. "My family was always urging me to just get out and meet people," she says. "But that advice didn't correspond to the reality of my loneliness. The lonelier I became, the harder it was for me to socialize. I knew that I needed connections, but creating them seemed almost impossibly challenging."

Alas, there are no easy solutions for people like Emily. Unlike treatments for depression, there are no pills or established therapies for loneliness. Social connections and a circle of intimates are obvious antidotes, but establishing them can be a trial.

So, where can the lonely turn for help? Loneliness is only now being recognized as a distinct mental health issue in the United States, and credible anti-loneliness programs have yet to be developed. Dialogue with a therapist is the only recourse at this point — that and a willingness to probe the roots of one's isolation.

Lonely author Emily White has a partner now, and she finds socializing less intimidating. The onset of her recovery, she says, came when she discovered the research on loneliness. "Start with education," she says. "Learning about loneliness can be a powerful tool in responding to it."

What White learned was that chronic loneliness can end only when the person who has it looks in the mirror and sees an entirely different person, someone who draws support and meaning from others instead of just themselves. But a change this profound cannot happen overnight. So when she met the woman who became her partner, White moved into the relationship gradually, with lots of breaks for alone time.

"I know now that I am vulnerable," she admits, "and that loneliness will probably re-emerge in my future. But I have learned that connection is critical. If I have to work to keep loneliness at bay, that's what I'll do."

Brad Edmondson is the former editor of American Demographics magazine. He lives in Ithaca, New York.