By JUDD MATSUNAGA, Esq.
We all know what loneliness is. Loneliness is a perception of not being connected to others to the degree that we would like to be. It’s a subjective feeling of not being seen by others and of being left out and not part of a social group.
Feeling lonely can lead you to believe that there is something wrong with you. You may feel embarrassed, worthless, lacking in social skills, and even unlikeable or unlovable.
Many people believe that they are the only ones going through this. That’s a negative thought that should be silenced! The truth is that close to 50% of the population report feeling lonely in the United States. (Source: Special Health Report, Harvard Medical School, “Combating Loneliness”). To make matters worse, loneliness is stigmatized. We are embarrassed to admit that we are lonely.
Loneliness can affect people of all ages and social strata. Experts say Americans are in the midst of an epidemic of loneliness. This epidemic is a public health crisis.
Loneliness damages our emotional health, and leads to higher rates of anxiety, depression, and suicide. It also affects physical health, and is associated with increased risks of cardiovascular disease, stroke, cognitive decline, and early death.
Have you ever felt lonely? We are all at risk, but research does suggest that certain groups of people are more prone to loneliness. Older adults may be particularly inclined to feel lonely, not because of their age per se, but because of circumstances such as poor health, the loss of a spouse or other close friends, or the demands of serving as a caregiver for someone else. All of these factors increase the risk of social isolation and loneliness.
Single vs. married people: Married people tend to be healthier and happier than single people in general — but only if they are in a good relationship. Partners in unhappy marriages can feel very lonely despite having other people around.
Research has found that happy marriages confer greater immune function, less depression, and better lifestyle habits. A British study found that individuals who are married tend to survive heart attacks 14% more often than those who are single.
Men vs. women: Most research shows that men and women have similar rates of loneliness across their lifetimes. Men, however, may feel more shame than women about feeling lonely and may be more likely to shame others who are lonely.
With aging, though, women tend to have higher levels of loneliness resulting from outside factors, like losing a spouse, i.e., women typically outlive men by an average of six years.
Caregivers: People who care for family members or friends on an informal (unpaid) basis — i.e., the majority of caregivers — are at risk for social isolation and loneliness due to the demands of their roles. Often they are elderly and infirm themselves.
A recent survey revealed that the COVID pandemic greatly increased the burden, loneliness, and isolation of these caregivers.
At every stage of life, from birth until death, humans need social connections and support. “That need is hardwired into us” says Julianne Holt-Lunstad, director of the Social Connection and Health Lab at Brigham Young University in Utah. Holt-Lunstad and her colleagues found that being lonely and socially isolated confers as great a health risk as smoking up to 15 cigarettes a day.
The connections between mind and body have never been as clear as they are today. For instance, research shows that both objective and perceived isolation can lead to the release of stress hormones. While these hormones serve vital roles in the body, they should not remain at high levels on a regular basis. Over time, they can contribute to chronic illnesses such as cardiovascular disease.
Here are some findings on loneliness and various aspects of health:
Heart disease and stroke: A review and analysis of 16 studies published in the medical journal Heart found a 29% increased risk of heart disease and a 32% increased risk of stroke among people with social isolation, poor social support, and loneliness.
A Minnesota study found a 68% greater risk of being hospitalized, a 57% greater risk of emergency department visits, and a 26% greater risk of visits to doctors’ offices compared with heart failure patients who reported low levels of loneliness.
High blood pressure (hypertension): The risk of high blood pressure is also thought to be lower among people with good social support. In a study of Black Americans, who are at greater risk for high blood pressure than other groups, people who had a strong social network had a lower risk of developing the problem over seven years of follow-up compared with those who had weak social networks.
There is also good data to indicate that belonging to social groups and community organizations is associated with better blood pressure control and adherence to medications among people who have this common disease.
Diabetes: Likewise, research shows connections between social isolation and loneliness and the development and adequate control of Type 2 diabetes, as well as premature death from the disease. A review and analysis of 22 studies of people with Type 2 diabetes found individuals were more likely to regularly monitor their blood sugar and engage in other self-care behaviors if their family and friends encouraged them to do so.
Brain health, cognitive function, and dementia: The American Heart Association states that although more research is needed, there appears to be a connection between brain health and both perceived and objective assessments of social isolation and loneliness. A study looking at more than 8,000 men and women over age 65 found evidence to link social isolation and loneliness with faster cognitive decline (20% faster over 12 years) and greater risk of dementia in older adults.
Another study found an increase of 49% to 60% in dementia risk among isolated older adults during the COVID lock-down.
Anxiety and depression: As is common with chronic illnesses, there is a chicken-or-egg conundrum with anxiety and depression. Feeling lonely and isolated, not surprisingly, leaves people more vulnerable to both conditions. In turn, anxiety and depression typically cause people to withdraw socially, leading to even greater feelings of loneliness and isolation.
Too much time spent on social media, strains in family and marital relationships, or persistent troubles (quarreling, negative attitudes or behaviors) in any important relationship can also create feelings of anxiety, depression, loneliness, and social disconnection.
On the upside, it’s been found that engagement in social and physical activities may help to protect against declining mental health due to loneliness in older adults.
Infections: Although you’re less likely to catch a cold, flu, or other infectious diseases if you’re socially isolated and therefore not in contact with many people, your immune system is likely to be less protective and you’re more likely to catch infections when you are exposed. You’re also more likely to have a severe course of illness.
In one recent study, people with few social connections had a weaker antibody response to COVID vaccination than did people with many social connections.
The GOOD NEWS is that you don’t have to live with loneliness. The Harvard Special Report makes the following suggestions. Perhaps one or more will work for you. Take baby steps, and don’t think you have to do everything, but do resolve to take a risk to foster more and better connections. It is well worth the effort, as it is the key to a healthier and happier life.
(1) Break the ice. Even brief pleasantries exchanged with other people can make you feel happier. Small steps and small successes are often the best way to approach social challenges. You may not meet a new friend at every event, but you may start to build a community of casual acquaintances and develop a sense of belonging. And ultimately, you’ll start to feel better both physically and mentally.
(2) Smile at the first 10 people you encounter today. Try it while walking down the street, shopping at the supermarket, buying a sandwich at the deli or wherever else you run into people. Chances are they’ll smile back. And you’ll probably both feel better and just a little bit more connected.
Studies show that people consider even such tiny acts as evidence of kindness. For starters, the facial expression you produce when you smile is likely to make you feel happier. In other research, genuine smiles produced even greater happiness than facial expressions that merely mimicked smiles. So smile at someone, and see if your mood lifts.
What’s more, the positive feelings you experience when you smile are likely to spread from you to those around you. Scientists now know that the brain contains cells called mirror neurons that make you likely to copy not only other people’s body language expressions (think of yawns), but also their emotions. See someone crying, and you will likely feel sad. See someone smiling, and you will feel happier.
(3) Learn how to engage in small talk. Many people — especially introverts — are averse to small talk, deeming it a waste of time. But, according to Alison Wood Brooks, an associate professor at Harvard Business School who researches the science of conversation, small talk is inevitable, so you might as well acquire the skills to do it and even enjoy it at least a little bit.
“It’s a social ritual that you actually have to engage in, especially with strangers or people that you don’t know that well,” she says.
Try to view the conversation as an opportunity to learn something new or surprising. The key to successful and even interesting small talk is to ask questions that become increasingly personalized with each follow-up. You can start by asking about the other person’s connection to the event you’re at, or what their hobbies or interests are. Just be sure to avoid controversial topics like politics and religion.
(4) Make the first move. Given that people are predisposed to like you, think about asking a friend or acquaintance to your home for a cup of coffee or tea, a beer or cocktail, a meal, or to play a game or watch a movie together. That’s more productive than waiting around for someone to notice you and invite you to meet (which probably won’t happen, especially if you’re prone to sticking to home).
If it seems too overwhelming to invite someone to your home, suggest meeting for lunch, a class, or a walk.
In conclusion, strengthening your social network will make you happier, and it could also save your life. Get involved in the local senior center and join a club. If you don’t know how to start or join a conversation, sign up (i.e., volunteer) to do a specific job at a meeting or event. This will give you a natural and unforced way to interact and meet new people.
Finally, don’t just go to one club meeting, barely talk to anyone, and decide it’s not for you. Try going a few times so you get more comfortable being with a group. Be sure to show up on time, openly express gratitude and affection for your friends, and (most importantly) try to listen as much as you speak.
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Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.