The recent controversy over the still-developing DSM-5 — that compendium of mental disorders the media love to call, inappropriately, “The Bible of Psychiatry” — has gotten me thinking about loneliness.
Now, thankfully, nobody has seriously proposed including loneliness in the DSM-5. Indeed, loneliness is usually thought of as simply an unpleasant part of life — one of the “slings and arrows” that pierce almost all of us from time to time. Loneliness, in some ways, remains enmeshed in a web of literary and cultural clichés, born of such works as Nathaniel West’s darkly comic novel, Miss Lonelyhearts, and the Beatles’ whimsical anthem, “Sgt. Pepper’s Lonely Hearts Club Band.”
But loneliness turns out to be a serious matter. And as psychiatry debates the diagnostic minutiae of DSM-5, all of us may need to remind ourselves that millions in this country struggle against the downward tug of loneliness. Yet even among health care professionals, few seem aware that loneliness is closely linked with numerous emotional and physical ills, particular among the elderly and infirm.
It’s easy to assume that loneliness is simply a matter of mind and mood. Yet recent evidence suggests that loneliness may injure the body in surprising ways. Researchers at the University of Pittsburgh School of Medicine studied the risk of coronary heart disease over a 19-year period, in a community sample of men and women. The study found that among women, high degrees of loneliness were associated with increased risk of heart disease, even after controlling for age, race, marital status, depression and several other confounding variables.
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Let’s remember we live in postmodern times, which encourages us to ignore the context, which can be the cause of our alienation. The entire late stage capitalist system and all of its institutions are conducive to loneliness, a condition not prevalent in hunter/gatherer societies where we once lived in packs of 25 people. Freud speculated on archaic man and his “telepathic” abilities. We must be careful of further victimizing by diagnosing, and instead also diagnose our dehumanizing culture/society.
Dave
Not every negative emotion is an mental illness, it is only so, when it is caused by illogical thinking. But it is always a health problem, because it indicates a movement toward death.
I am gregarious, outgoing and happy….born that way, but after 31 years of “marriage” which was abusive, I am alone. For me, that is right next to death.
I have lots of friends and colleageues, but they don’t come home at night with me.
Talking about the lonliness feels worse. Nothing helps.
We may need to place more focus on what can happen when we are unable to correct a situation in our lives. If nothing is done to correct loneliness, then a person’s mood may become depressed. Depression is already a recognized diagnosis and there are many treatments to help elevate moods.
If we believe that loneliness can be corrected, then it also means that we feel helpless and hopeless. Those are symptoms of depression, rather than an identification or a feeling which should be transitional. When we feel lonely, we can do something about it. If not, people should seek help for the depressed mood which is causing them to feel stuck in a situation.
This is not a discovery. Being depressed causes immune problems, probably because from an evolutionary standpoint, unpopular people were a waste of resources. As for the brilliant deduction that there’s a relationship between depression and loneliness– if you haven’t figured out that people no one cares about, with no friends or family, whose own families wouldn’t notice if they died, you belong in another profession. And if you think it’s as simple as “people should be more friendly” the same. If you’ve spent a lifetime of no one caring, you think you’re capable of anything else or risking more hurt? Here’s a news flash–lonely people KNOW they are alone and that they have no one to turn to. And that no one cares. They don’t need to be reminded or treated like idiots.
Dear Captain Obvious, it sounds to me like you need a very big hug – so I am sending one your way
Thanks to all who have written in so far, and for your sensitivity to the loneliness so many may feel. Simply reaching out to others in this way is one positive step we can all take. –Ron Pies MD
Dear Captain Obvious, You really touched a nerve and struck a chord in me and I hope the cyberhug helped. I believe it was Gandi who said we could judge a society on how it treats its poor or weakest members.
I too have been so incredibly alone it physically hurts. All through my life that pain was lessened somewhat by one person’s actions every so often. A nun at school, a friend’s mother, until finally my husband. But even then that loneliness can creep up on me, and stay uninvited for a long time.
You are very perceptive – unpopular people are a waste of resources – evolutionarily speaking. But I feel humans are not guided by evolution alone. If nothing else matters to you at this very moment – please remember that there is at least one person on this planet thinking of you and feeling for you at this very moment.
Regards Sonia
I am with Captain Obvious on this one. Having been estranged from my family for many years, I rely heavily – too heavily – on friends. I try hard to provide love and support to the people I know, thinking that I will be supported in return. Last Christmas I found out at the last moment that the 4 key friends in my life had all made plans for Christmas that didn’t include me. They knew I would be alone for the day, but that didn’t matter enough for them to put aside even an hour for me. I don’t know how I survived it – indescribable pain. “Reach out to people” – well, who? I am already dreading next Christmas, the worst time of year for the lonely.
Thanks to all who have written in. I would like to clarify a couple of points that I might have stated more sensitively. In discussing some ways lonely individuals might break out of, or overcome, their loneliness, I hope I didn’t give the impression that this is easy, or that it’s just a matter of being friendly, “reaching out”, etc. As a number of readers have noted, there is cruelty and insensitivity out there, and sometimes, even with one’s best efforts, you “get shot down”. That is indeed painful, and I don’t want to minimize that.
At the same time, over-dependence on others–for self-esteem, approval, boosting our morale, etc.–can set us up for “crashing” when we are not met with friendliness, praise, or reciprocal affection. And so, for some people who describe intense loneliness, it is often a matter of finding ways of feeling better about oneself, so that being with others is a matter of desire–not of “neediness.” Not surprisingly, when we begin to enhance our own self-esteem and self-worth, others are more likely to find us good companions.
Ron Pies MD
I know this an old post but I have a terrible fright of others dying and am unable to find footing in society for what is now 21 years. I’ve never fought anyone but have made a lot errors in being over bearing in a context not to subtle and I would like to be accepted someday and actually notice it. I do accept blame for my ignorance but that has wasted my time as well so I’m just running circles and making others angry and vanishing from my company. I’m too concerned with why we do anything we do as in an absolutist context and I become obsessively curios. This causes my ego to confuse itself and often inflate or deflate erratically. It becomes overwhelmingly difficult to draw the line between ambition and managing what gets me self motivated. Ultimately I end up lost an fearing my own age.
Hi, Mr. Smith–Thanks very much for writing. From what you describe, your life has not been easy, and I am sure it is no coincidence that you are responding to an article on “loneliness.” What you describe certainly sounds like a lonely and often painful existence. But the fact that you are “reaching out” here and now seems to me a very good sign that you are interested in finding a way out of the situation you have endured for more than 20 years.
I don’t know if you have been involved, or are now involved, in any type of psychotherapy–but I would certainly recommend you give that idea some consideration. A therapist specializing in “IPT” (interpersonal psychotherapy) might be a good start. Your family MD might be able to recommend someone to see you. I would also recommend the book, “A Guide to Rational Living”, by Albert Ellis PhD and Robert Harper PhD, though not as a substitute for therapy. There may also be support groups in your area that could be of help to you. The journey to a “better place” won’t be easy, but I think you have already taken the first step. Best of luck!–R. Pies MD
For those of us with a “paradoxical” fear of getting close to others, that fear generally came from our parents, families, who didn’t provide a sense of closeness,trust & support, which IS a need for humans. I’m not nitpicking with Dr. Pies, but many of us who feel intense loneliness ARE self sufficient (perhaps too self sufficient?), successful in our work lives, have friends and social lives – but lack an intimate connection. And I don’t think that David Vergi, in the 1st comment, is far off either. Our brains still react emotionally as we did when we lived in clan or tribal groups; our technology and social systems may be more complex, but we have lost some basic sense of belonging – which we need for our well being.
Yes, I agree that early (infantile) deprivation of nurturing, “closeness” and trust can have long-term, adverse effects on one’s ability to form intimate relationships with others–and, as a result, may leave the person feeling “alone” or “not belonging”, even though he or she may be a self-sufficient, independent person who has many “friends”.
Alas, there is no easy “cure” for these deep-seated problems, and long-term psychotherapy is sometimes needed. Being “too self-sufficient” (for example, never asking anybody for help) is sometimes an over-compensation for the fear of becoming too dependent on others.
Finally, there are many forces at work in modern-society that militate against closeness and intimacy–and perhaps anonymous and faceless emailing is an example of that! And yet, exchanges such as those on this website may, for some, foster a “sense of belonging”, even if it is incomplete and imperfect.
Best regards, Ron Pies MD
I always think its funny when people don’t acknowledge that many, perhaps most people feel lonely because they are not in a successful romantic relationship. While being around others may help, ultimately friendships and support groups can’t give you romance, and hence the lonliness stays…..
I would agree. However I feel that having good friends & family can help if you don’t have a romantic partner. I’ve gone without a romantic partner for a very long time.
I went for a few years of being friendless along with not having a romantic partner. Also my family is distant from me both in location and emotionally. If you don’t have a good thing going with friends and family, then loneliness abounds.
Being friendless for a while, I was able to get through it, but it was hard. Yes there were occassions of having someone call and having someone to go out with. But nothing solid.
Just recently I started to make new friends. The quantity has increased but there’s not much quality with the new friends. So it does make me feel pretty empty. Quite a few years back, I had only one real good friend. For only a year he lived next door to me. It was great when he lived next door, and to this day, I feel spoiled because it has not been like that since he moved. And when he moved about 20 miles away, we remained friends for a while. But things were not the same. And then we split up because of differences.
Yes, I had very little in quantity with just having one friend. But there was a lot of quality with it. Much more quality I had going for me back then than right now, even though the friendship numbers have increased.