The loneliness disease

These changes have taken a long time. Singing emerged around half a million years ago and language around 100,000 years ago; however, that pace of change is really accelerating. It has only been 150 years since the first telephone enabled easy virtual conversation and 50 years since mobile phones were invented.

Apps like Snapchat, TikTok and WhatsApp have all happened just in the last few years. These changes to the way that we bond and socialize are affecting us. Even though we are in frequent contact with other people, many of us are feeling increasingly isolated from those in the real world. This can lead to feelings that our social connections are not actually meeting our emotional needs and that we are lonely. Estimating rates of isolation and loneliness is hugely complex, but broadly around the world we know that loneliness follows a U-shape. It can be higher among younger adults. It decreases as we start to get into middle age but then increases again as we get older.

Some estimates suggest that as many as one in four people feel lonely. This rate increases year on year. I have increasingly been hearing loneliness and isolation described as an epidemic, although I am not so sure about this term. They are not contagious, but they are nonetheless things that can have a profound effect on us and have a profound effect on our health.

Health is about us being able to manage symptoms we might be experiencing, to cope with them, to have resilience and to be able to lead lives with autonomy, meaning and purpose in them.

This definition of health is broadly recognized and accepted, but the way that our healthcare systems are designed is still predominantly biomedical in focus, not considering that broader, holistic definition of what health actually means.

They are also borne out through experimental studies and through animal studies. Some of the reasons for this are indirect. While we sometimes talk disparagingly about negative peer pressure, according to the social-control hypothesis, social support networks can actually be positive influences. They tend to discourage poor health behaviors and encourage good health behaviors. When we become socially isolated, we lose this beneficial influence, and this can actually mean that we engage in adverse health behaviors. For example, we can be more likely to take substances like alcohol, tobacco or drugs.

We can also have reduced positive leisure behaviors and a poor diet. All of this can lead to increased risk of malnutrition, eating disorders and consumption of ultra-processed foods. We are also less likely to follow health guidelines when we are isolated, such as taking medication, and because we do not have as many people around us to talk to, we can often not have as much support or resources to draw on — meaning that we are less likely, perhaps, to go and see a doctor about our symptoms or know where we could even seek help.

While these responses increase the likelihood of short term survival, if the isolation becomes repeated or chronic, they actually carry long term costs.

Having an overactive stress system, dysregulated cardiovascular response, increased atrophy of the brain — all of these factors happen as a result of isolation and are detrimental to our health. For example, in our research, we have shown that people who are socially isolated have higher levels of inflammatory markers like C-reactive protein and white blood cells. People who are lonely have reduced inhibition of inflammation. We have also found that isolation can lead to increases of specific proteins in the blood that are related to cancers like myeloma, leukemia and lung cancer, as well as increases in other proteins that are receptors for viruses like Zika, Covid and Ebola.

The thing that can feel the most unfair in all of this is that the people who are most likely to be lonely and isolated are also the most likely to be at risk of all of these mental and physical health conditions. There is a very clear social gradient and pattern of social inequality in loneliness and isolation.

We consistently saw that increased isolation during lockdowns had detrimental effects on people's health, and we saw that our modern ways of communication were substantially less effective at reconnecting us than the more traditional methods. People who stayed in touch via messaging had the highest levels of loneliness. Video conferencing was a little bit better in terms of supporting mental health, but there was absolutely no substitute for real in-person contact as a way of reducing loneliness and supporting mental health.

Seeing people face-to-face, even if it was distanced, was the thing that was the most helpful for enhancing people's well-being, reducing depression and reducing anxiety during the pandemic.

This teaches us a lot about how we might deal with future pandemics. It shows that face-to-face meeting, even if it is distanced, is actually ver important for maintaining mental health during really difficult times like this. It also has implications for how we think about societies as a whole and the ways that we connect with each other.

One of the things about social isolation is that it typically starts to occur gradually over time. People start to become more isolated from activities, from people. As they get older, it can be exacerbated by things like bereavement. What was weird within the pandemic was that it happened so suddenly. It was not something where we had that sense of preparation or gradual adjustment. For some people, there was a sudden cliff edge between having had that social world around them and now being completely isolated. It is actually more akin sometimes to more of these unusual experiences, like going into outer space. We wrote a paper in the BMJ where we discussed this opinion — the idea that it was not necessarily ordinary isolation people were experiencing but being plunged into much more of an alien landscape that you have not had the time to prepare for necessarily, something you have not navigated before. This has taught us a lot about the ways we think about isolation and loneliness within society. It has taught us the importance of helping to recognize people as they might gradually be slipping into these states but also particularly identifying those where there might be more of a cliff edge — people who might have had social networks around them but suddenly lose them, perhaps as they move location or as they are bereaved — and how critical it is that those people are given these opportunities. We help to identify them and find ways that they can reconnect with others before this starts to really adversely affect their health.

One point of discussion is whether doctors should start screening people for loneliness and social isolation in the same way that we ask people about their BMI or their smoking habits. This could be a way of identifying people who are lonely or isolated in the community and helping to connect them to things that could help — schemes like social prescribing, for example.

We also have to question how we are thinking about children's education. It is absolutely important to build academic skills like reading and writing, but it is also really important to be building social connections, helping children to learn the skills of how to make and maintain friends, to try and reduce their risk of becoming isolated in the future.

Giving children opportunities for unstructured social play is really important in helping them to learn how to navigate complex social situations. Providing young people with youth clubs, community venues they can go to, where they can engage in activities with others is also important. Of course, we have to be really reconsidering the role that phones and digital devices are playing in the lives of young people.

It is really important that we find groups that we feel comfortable with. What we see very clearly from social psychology is that if we engage in groups that do not feel like we have that meaningful connection to, it can actually make us feel more out-group. This is something that can then be worse for our mental health. It is critical that we identify opportunities where we feel that sense of belonging, that sense of in-group membership, people that we feel we have affinities with. That is the thing that is most likely to support lower loneliness and a higher sense of social connection with others.

Communities and society all have a really important role to play here as well, making sure that we have the assets to engage in this, whether that is arts venues, cafes, community spaces, leisure centers — places where we can form those in-person human connections.

Social clubs are opportunities for us to form connections and help to bridge divides, helping to address some of the differences that we can feel potentially even insurmountable when they are approached via online forums.

It is a failing of our modern societies, the emphasis that we are placing on digital technology, the blindness to the importance of preserving community spaces, that we are actually facing these high levels now of loneliness and isolation.

My advice to policymakers is that the heart of societies is our communities. They are utterly dependent on those simple day-to-day points of human contact. If we want to have healthy, happy, cohesive societies, we have to be investing in the assets and the opportunities that enable these simple interactions.

Editor’s note: This article has been faithfully transcribed from the original interview filmed with the author, and carefully edited and proofread. Edit date: 2025