Social Isolation and Loneliness: Effects and Differences
CW: Mention of Suicide
I would like to start off this article with a disclaimer: this is a summary of articles and research from surveys, retrospective studies and one meta-analysis. As is mentioned in the articles and studies referenced, and like any other medical issue, it is never one thing that completely affects the health of an individual or a group. It is usually a host of factors - including and definitely not limited to socioeconomic status, culture, sex, genetic, physical activity, even geography. So please read this article with this in mind. If you read this article and are concerned about showing any of the signs and symptoms of isolation and/or loneliness or a decline in mental health please, please reach out.
I remember when the pandemic first started (I say as if it was 20 years ago, but let’s be honest it absolutely feels like it was 20 years ago) initially the health authorities were encouraging us to practice social distancing. A month or so later they changed the wording to physical distancing as everyone realized that in the midst of a global pandemic and when the world is in absolute uncertainty you should not, in fact, be distancing away from the people you care in a social way - if anything we need to be closer to the people we love now. Definitely not within 6 feet, but as much as possible, even if it means virtually. This actually has a scientific basis behind it as social isolation and loneliness can be quite detrimental to the overall health of the individual.
Even before the pandemic and its physical distancing measures, a survey done in 2018 in the US showed that 50% of the adults that participated in the study reported that they always feel alone and 40% reported that they feel alone even in relationships (1). Distinguishing between those two categories is important: social isolation can be quantified objectively while loneliness is a subjective emotional state (2). While social isolation can lead to feelings of loneliness, some people can feel absolutely content with minimal social contact. Others may feel lonely even when surrounded by a group of people if they do not feel socially connected to them (2). Unfortunately, according to a meta-analysis performed in 2015 researching the effect of loneliness on mortality of an individual, the researchers found that in all cases of loneliness, social isolation, and living alone there was an increased likelihood of death by at least 25% after all the participants were corrected for multiple covariates including physical health (2).
What about differences in the effect of loneliness on people?
Well, as the pandemic hit it became very apparent that the social distancing and lockdown measures affected different groups of people differently. I would like to reiterate that no one factor is going to predict or put you at risk for everything. A study by the Canadian Centre for Addiction and Mental Health found that 24.3% of women who participated in the survey reported experiencing moderate to severe anxiety, far more than the proportion of men (17.9% of survey participants) that reported experiencing the same symptoms (3). Another study found that social isolation increases the risk of hypertension in women - middle aged and older, more so than it did for men (4). Loneliness itself is also associated with suicidal behaviour in the general adult population (5). However, according to a study done in 2014, women might be more vulnerable to the impact of loneliness as their suicidal distress was not taken seriously, even by healthcare professionals (6).
I will be honest, research for this article has been a bit sad to write, especially since I am an introvert and do like my time alone, a lot. But I think what all of these studies and surveys were trying to show was the importance of meaningful social connections. You could hypothetically have only three friends, and as long as those three friends are people you can share and vent your feelings with, they could help through all the weirdness and stressors of life. That being said, mental illness is cruel and will convince you that you are less than what you are and that your loved ones don’t love you. I understand it can be difficult to reach out in the midst of an episode or an attack. The pandemic and physical distancing does not help when you have to make extra efforts to reach out to people that were, before the pandemic, always near you. To all who are suffering from loneliness and have their mental illnesses exacerbated through it, I just want you to know that you are not alone.
You are enough, and you are loved, immensely.
The risks of social isolation - https://www.apa.org/monitor/2019/05/ce-corner-isolation
Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review - DOI: 10.1177/1745691614568352
COVID-19 pandemic adversely affecting mental health of women and people with children - https://www.camh.ca/en/camh-news-and-stories/covid-19-pandemic-adversely-affecting-mental-health-of-women-and-people-with-children?fbclid=IwAR1wR499b9h-1YvcljsZPTdvlYbUMEPfy0zsCu5MUMb1ZXHf31w9JDU47wo
Social isolation increases risk of high blood pressure, hypertension in women - https://in.style.yahoo.com/social-isolation-increases-risk-high-172734051.html?guccounter=1
Loneliness, common mental disorders and suicidal behavior: Findings from a general population survey - https://doi.org/10.1016/j.jad.2016.02.054
Nurses' attitudes towards self‐harm: a literature review - https://doi.org/10.1111/jpm.12171
Crisis Service Canada - https://www.crisisservicescanada.ca/en/looking-for-local-resources-support/