Dr. Suzanne B. Phillips

Licensed Psychologist, Psychoanalyst, Diplomate in Group Psychology, Certified Group Therapist, Author, Radio Host and Media Consultant Covering a Wide Range of Psychological Topics

Post: Loneliness and Depression: New Findings and Strategies

I'm lonelyAre you lonely?

Loneliness is defined as a lack of desired social connection and social support. It is often associated with feelings of isolation, worthlessness, and sadness. Loneliness is not necessarily the state of being alone. One can be utterly lonely in a room full of people who don’t seem to notice, in a college dorm with no special friend, in a marriage with no understanding. Loneliness is not the peaceful solitude we cherish. It is the pain of being without meaningful connection, a feeling of emptiness that entraps us in fears, longing and negative perceptions about ourselves and others.

Loneliness is widely prevalent.  In a survey of eighteen countries, the United States was in the top quarter of countries in terms of average levels of loneliness.

Loneliness is a dangerous place both physically and psychologically. Research finds that loneliness is associated with alterations in the functioning of the cardiovascular, endocrineand immune systems. It is implicated as a risk factor in high blood pressure, diminished cognitive abilities, progression of Alzheimer’s disease and sleep difficulties. Psychologically, loneliness has been associated with depression, stress, hostility, lack of confidence and unhappiness.

A new study offers important findings about the connection between loneliness and depression.

While there is often overlap and confusion between depressed and lonely feelings, the researchers demonstrate that loneliness and depression are conceptually and operationally different phenomena.

  • Loneliness, as measured in the study by the UCLA Loneliness Scale -Revised (a 20 item questionnaire) is reflected in questions as “How often do you feel unhappy doing so any things alone?  How often do you feel shut out and excluded by others?
  •  Depression, as measured in this study by CES-D (a 20 item questionnaire) is reflected in questions as “I felt that I could not shake the blues even with help from my family or friends.” “I had crying spells.”

Studying 229 middle age adults, researchers VanderWeele, Hawkley, Thisted & Cacioppo tested the adults for loneliness and depression each year for five years. They found that loneliness persisted across the years and had a major effect on increasing depression symptoms.

The researchers report that by using a marginal structural model analysis that separates out factors and can study loneliness and depression over a number of years, prior loneliness (two years) proves to be a more significant predictor of later depression than self-esteem or even prior depression.

Of crucial importance is the additional finding that if you intervene to reduce loneliness, you can significantly reduce depression symptoms. In fact, the quicker the intervention to reduce loneliness, the better the reduction of depression. Intervention to reduce loneliness 2 years prior to assessment of depression had a greater impact on reducing depression than one year.

Strategies for Reducing Loneliness

As we recognize the suffering from depression in those we love or in ourselves, it is worth considering the impact of loneliness on depression and the proven value of taking steps to intervene.

State of Mind

“The Mind can make a heaven out of Hell or a Hell out of Heaven” (John Milton)

A central component to loneliness is perception of self and others. Feeling alone and without the social connections desired, one can begin to see everything “through a glass darkly.” The world feels rejecting and everyone else seems connected. Loneliness is self-perpetuating as it becomes more and more difficult to believe that anyone cares or that a call or email could make a difference.

Cognitive Re-framing

A Meta-Analysis of Interventions to Reduce Loneliness found that the most effective interventions for reducing loneliness are those that involve changing our negative news of self and others. An example of this is cognitive re-framing. This psychological technique involves re-assessing a situation with a new meaning and as such, altering our perspective, our feelings and eventually our behavior. Even a small step of reconsidering can matter. For example,

  • You consider going down to the faculty lunch room rather than staying in your classroom and assuming everyone else has received an invitation – More likely everyone is barely getting through the morning and won’t know where you are or why you choose to stay away- if you don’t show up.
  • You go to the book club you registered for even though you were too anxious to go to the first meeting. You consider that they probably didn’t become life-long friends in one week.
  •  On a Friday night, you consider that EVERYONE is calling someone to find out what is going on. NO ONE gets calls without making calls.

A Different Way of Being with Self

From Pain to Passion -Another antidote to the emptiness and longing of loneliness is to step out of pain into your own passion. Pursuing what you love is a win-win. When you are doing what you love be it hiking, fishing, reading or golf (yes you can join a three-some), you are back in control of fueling yourself physically and emotionally. In most cases, your mood, manner, smile and posture change.  Sometimes the added bonus is that you come across someone who also likes fishing.

Traveling with a Goal- A newly divorced and lonely young woman once told me that she could never travel again. She disliked “groups” and “Who ever goes to Paris alone?” We worked on the idea that if you are on a mission, if you have a goal, then it changes your feeling about being alone. You are far less worried about who is next to you – and far more determined to see what is in front of you.

She set off for Paris with the goal of taking photos of balconies with flowering pots. She came home with photos and the stories of the paths and people she found along the way.

The Power of Pets

  • Pets are awonderful antidote to loneliness.  It is hard to wonder “Who would want to be with me?” when a big or little creature is waiting at the window eager to see you and ready to go almost anywhere with you. The fact the pets are a magnet for people is a bonus to the feelings of connection and value one gives and gets from pets.
  •  An interesting study of nursing home residents found that the residents were less lonely after spending time alone with a dog then they were when they visited with a dog and other people. Whereas the original hypothesis was that the dog would increase interaction among the residents and reduce loneliness, it became clear that the special one on one feeling with the dogs did much more.

Altruism-Looking Beyond Self

The effort to help another or to give to others has been found to reduce feelings of loneliness. In one sense it disrupts the self-perpetuating negative focus on self because it involves focus on another. It reduces the hesitancy of stepping forward to risk connection and the fear of rejection because the goal is giving – not getting. The privilege to help is a gift in that it increases our sense of worth and provides meaning for being.

Spirituality-The Impact of Belief

There is evidence that spirituality reduces loneliness. In one research study that matched groups of healthy and ill adults, the findings revealed that in both groups the higher the Religious Well Being Scores and the Spiritual Well Being Scores the lower the loneliness scores.

  •  It may well be that a belief system affords a person a sense of not being alone, of having a Higher Being to turn to, or perhaps a reframing of being alone as an opportunity to meditate, pray, appreciate nature – make room for God.
  •  Spirituality may also reduce loneliness because whether as a mental image or actually in a church, temple or mosque full of people, there is acceptance and connection in a community of believers.

You can step away from loneliness in many ways – it is a step worth taking.

Photo by Quinn Dombrowsky, available under a Creative Commons attribution license.