Deconstructing the ‘epidemic of loneliness’

Editor’s note: You must be wondering what’s up with us this week—first a Big Story on death and now one on loneliness. Well, it was either this or look at the implications of Kerala’s Supreme Court case for fiscal federalism. Yeah, we picked analysing loneliness over explaining Net Borrowing Ceiling on a Friday morning. Such are the life choices at splainer. That said, loneliness is a fascinating topic—once you get past the hand-wringing. 

PS: We greatly enjoy doing Big Stories on a wide range of subjects—when there isn’t a big headline to explain. It’s even more satisfying when the topic is suggested by you. So send us your requests at talktous@splainer.in

The lead image: is a 1932 painting by Edward Hopper titled ‘A Room in New York’.

Wtf is loneliness?

Before we dive into the research, let’s start with that very basic question: How do any of these studies define or measure an emotion?

The medical definition: As The Lancet acknowledges, the “slippery nature of loneliness” has made it difficult to arrive on one agreed upon definition:

Loneliness is not the same as being alone. It is not a binary state, and feelings of loneliness are heavily shaped by cultural norms. This subjectivity presents a fundamental challenge. How can the measurement of a feeling be standardised?

Roughly, studies measure loneliness in terms of subjective experience and/or objective isolation.  

I feel lonely: This is the stuff that global surveys look at—how we feel, so to speak. This seems like an inherently subjective measure: 

Loneliness, as defined by mental health professionals, is a gap between the level of connectedness that you want and what you have. It is not the same as social isolation, which is codified in the social sciences as a measure of a person’s contacts. Loneliness is a subjective feeling. People can have a lot of contact and still be lonely, or be perfectly content by themselves.

But, but, but: Health experts often compare that subjective feeling to an objective condition—hunger. For example, the US Surgeon General Vivek Murthy who has said: "It's like hunger or thirst. It's a feeling the body sends us when something we need for survival is missing." Here loneliness is a biological instinct: “In small doses, loneliness is like hunger or thirst, a healthy signal that you are missing something and to seek out what you need.” If you feel hungry, you are hungry. Ergo, if you feel lonely…

I am alone: Studies often link rising numbers of people living alone in a society to increasing levels of loneliness: 

“Loneliness is tough to gauge directly, but measures of social isolation—for example, living alone or single marital status—can be a good proxy. When we look at the trend in living alone, we see a sweeping upward curve. Worldwide, up until the 1960s, single-person households were exceedingly rare.”

These tend to conflate feeling alone with living alone—slipping from one to another as this paragraph below:

Nearly half of Britons over 65 consider the television or a pet their main source of company. In Japan, there are more than half a million people under 40 who haven’t left their house or interacted with anyone for at least six months. In Canada, the share of solo households is now 28%. Across the European Union, it’s 34%.

The world makes me lonely: Some measures of loneliness are a mix of the external factors and internal. As a result, loneliness has increasingly become a focus for public policy:

Perhaps what is needed is a recognition of loneliness as a product of how societies and the world around us are constructed: what Xiaoqi Feng and Thomas Astell-Burt term “lonelygenic environments”. Our physical surroundings, dictated by urban planning, can deter social connection if they do not enable interactions and engagement. Remote work has become more common, making it harder to form meaningful connections with colleagues. Social media use, with its promises of bringing people together, has been associated with increased feelings of social disconnection.

And then there’s poverty, racism, and xenophobia—all of which also increase the sense of exclusion. This is why Britain and Japan have ministers of loneliness. 

My generation is lonely: The theory of ‘lonelygenic’ environments also lends itself to generational theories of loneliness. Gen Z in the US are supposedly the “loneliest generation”—with 72% reporting they feel alone either sometimes or always. The reasons mostly centre on technology—they are “overstimulated” by distractions, isolated by social media and more dependent on the internet than humans for information or advice.

Researching loneliness: What we know 

In recent years, there have been a number of global surveys—and any number of experts—ringing the alarm bells. But they’ve also thrown up surprising results.

The Gallup survey: A 2023 Meta-Gallup survey of 142 countries found that at least a quarter (24%) of people aged 15-plus report feeling very or fairly lonely. That’s one in four human beings in the world. The map looks something like this—with lighter greens indicating greater levels of loneliness (more on this later):

A global epidemic: In November, the World Health Organisation declared loneliness to be a dangerous health threat. It is supposedly as lethal as smoking 15 cigarettes a day—and carries a greater risk than obesity and physical inactivity. There is escalating worry about the health risks of loneliness. Studies have linked it with pretty much every serious illness:

The list of health conditions linked to loneliness is long and sobering. Some of these make intuitive sense—people who feel lonely are often depressed, for example, sometimes to the point of being at risk of suicide. Other links are more surprising. Lonely people are at greater risk of high blood pressure and immune-system dysfunction compared with those who do not feel lonely, for example. 

 

There’s also a startling connection between loneliness and dementia, with one study reporting that people who feel lonely are 1.64 times more likely to develop this type of neurodegeneration than are those who do not.  

But, but, but: Scientists have not established a causal relationship between loneliness and these diseases—and they don’t entirely understand how they are linked: 

Do people’s brains start functioning differently when they become lonely, or do some people have differences in their brains that make them prone to loneliness? “We don’t really know which one is true,” [Cognitive neuroscientist Livia Tomova] says.

Looping back to hunger: This is where researchers fall back on the evolutionary theory of loneliness:

One theory is that our evolution as a social species has bequeathed a fundamental craving for human company — a hangover akin to our evolved preference for sweet, fatty foods. Left unsated, the craving causes psychological stress, which induces physiological effects such as raised levels of cortisol, the stress hormone. As Wigfield explained, loneliness seems to trigger the “flight or fight” response, which causes inflammation and increased white blood cell production (a response to inflammation).

Research of note: In a 2022 study, researchers deprived people of either food or social connections for ten hours. Then they identified which parts of the brain are activated by images of food—and which by “social interactions, such as friends laughing together”:

Some of the activated regions were unique to images either of food or of people socializing, but a region in the midbrain known as the substantia nigra lit up when hungry people saw pictures of food and when people who felt lonely saw pictures of social interactions. That’s “a key region for motivation — it’s known to be active whenever we want something”, says [Livia] Tomova, who is an author on the study.

Also notable: The other, simpler theory is that lonely people often have unhealthy habits—smoking, drinking, eating junk food—which they use as coping mechanisms. But this too may have a neurological origin:

In mice, loneliness sensitizes certain midbrain neurons to a neurotransmitter called dopamine7, which can also cause people to cave in to cravings, such as for food and drugs. Likewise, isolation might make humans more sensitive to rewards and more eager to seek them out.

As for the naysayers: There are any number of respected experts who don’t buy the rhetoric about an ‘epidemic’. We’ve just become better at recognising what humans have experienced for a long time:

[T]he data suggests that loneliness isn’t any worse than it was before. It hasn’t exploded in a sudden outbreak because our environments have made us more susceptible. Instead, it seems that we have uncovered the depths of a problem that has been with us for some time, and the reason is that we’re paying more attention to mental health and caring more about the risks certain marginalized groups face. A problem we should solve? Yes. An epidemic? No.

They also argue that we are turning a natural, even healthy human condition into a disease. Loneliness may indeed be like hunger—a neurological nudge to remind us to seek what is essential to our well-being—social connection. But that is the sign of health—not sickness.

Loneliness in India: Still a mystery

There has been very little research on loneliness in India. Most datasets tend to be small—or loneliness is studied within a very specific context (for e.g, the pandemic). But here are some of the larger studies:

• A 2004 study conducted by the National Sample Survey Office (NSSO) showed that around 4.91 million people (1.23 million men and 3.68 million women) were living alone—and suffered from loneliness. It isn’t clear if one was equated with another.
• A 2017 Centre for the Study of Developing Societies (CSDS) study of young people aged 15-34 years across 19 States—found that 12% reported feeling depressed often, and about 8% frequently felt lonely.
• The most authoritative data to date was collected by the Longitudinal Ageing Study in India (LASI)—which found 20.5% of those above the age of 45 years were moderately lonely—and 13.3% were severely lonely.

Loneliness & sanskriti: Experts are divided on whether our culture fosters or counteracts loneliness. Rising number of lonely older adults may be due to the erosion of traditional ties. It’s part of the lament for the disappearing extended family—as a Bangalore psychiatrist says: 

This [loneliness] partly stems from the breakdown of traditional family structures. Shifts from joint to nuclear families, increasing divorces, and single-parent households impact both parents and, notably, children. This trend towards individualism is further fuelled by the waning influence of social values.

But others point out that our cultural norms are just as likely to make us feel lonely:

“Talking or even acknowledging loneliness has always been a taboo point in our society. The assumption is that because we are a collectivistic society and more ingrained in the community, loneliness is out of the question. But in fact, it is the opposite,” Dr. Thakore says. “For some of us, the feeling of community can bring its fears of judgement and question, if we express we are feeling lonely.” A 2023 study of mental health literacy in urban, rural and tribal parts of Kerala found people were likely to see poor mental health as a “collective problem” that reflects badly on the family, even impairing one’s marriage eligibility.

A map to note: The Gallup-Meta survey also bucked conventional wisdom on the role of culture. In this map, shaded areas represent countries where three-quarters or more said they felt very or fairly connected. People in many “individualistic” Western nations—like the US or Australia—felt more connected than those in traditional cultures: 

FWIW: 65% of the Indians surveyed said they felt very or fairly connected—compared to 78% in the United States and 50% in Madagascar. (Hover on the map here for the numbers)

Also a point to note: The results above also confirm other research that shows “living alone” is not the same as feeling lonely:

There’s evidence that living alone is, by itself, a poor predictor of loneliness. Self-reported loneliness has not been growing in recent decades. In fact, the countries where people are most likely to say they have support from family and friends are the same countries—in Scandinavia—where a large fraction of the population lives alone.

The bottomline: Sylvia Plath described loneliness as “a disease of the blood.” Even so, it’s often just a fever—uncomfortable yet necessary. Other times, it’s an affliction that cripples both society and soul. The trick lies in knowing the difference. 

Reading list

Nature has a very good review of the research on the neurological roots of loneliness. New York Times offers a broad overview of the ‘epidemic’. The Gallup report on its 2023 survey results is worth a read. For a careful and measured take on the research, read Esteban Ortiz-Ospina in Our World Is Data. For a sceptical view of the ‘epidemic of loneliness’, read Kevin Dickinson in Big Think. The Hindu and India Today report on loneliness in India—the first is especially good. If you want more, read this research paper by Tapan K Pandit.