loneliness in modern world essay

Loneliness and Social Connections

Family and friends are important for our well-being. In this article, we explore data on loneliness and social connections and review available evidence on the link between social connections and well-being.

By: Esteban Ortiz-Ospina

This article was first published in February 2020 and last updated in March 2024.

Research shows that social connections are important for our well-being. Having support from family and friends is important for our happiness and health and is also instrumental to our ability to share information, learn from others, and seize economic opportunities.

In this article, we explore data on loneliness and social connections across countries and over time and review the available evidence on how and why social connections and loneliness affect our health and emotional welfare, as well as our material well-being.

Despite the fact that there is a clear link between social connections and well-being, more research is needed to understand causal mechanisms, effect sizes, and changes over time.

As we show here, oversimplified narratives that compare loneliness with smoking or that claim we are living in a 'loneliness epidemic' are wrong and unhelpful.

See all interactive charts on loneliness and social connections ↓

Related topics

Happiness and Life Satisfaction

Self-reported life satisfaction differs widely between people and between countries. What explains these differences?

Trust is an essential part of social connections. Trust is crucial for community well-being and effective cooperation.

For many, the internet is now essential for work, finding information, and connecting with others.

Other research and writing on polio on Our World in Data:

• Are Facebook and other social media platforms bad for our well-being?
• Are people more likely to be lonely in so-called 'individualistic' societies?
• Is there a loneliness epidemic?
• The importance of social networks for innovation and productivity
• The importance of personal relations for economic outcomes
• Who do we spend time with across our lifetime?

Social connections

How important are social connections for our health.

Dr. Vivek Murthy, former Surgeon General of the United States, recently wrote : “Loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day”.

This ‘15 cigarettes a day’ figure has been reproduced and reported in the news many times, under headlines such as “Loneliness is as lethal as smoking 15 cigarettes per day”. 1

It is indeed quite a shocking comparison since millions of deaths globally are attributed to smoking every year, and back-of-the-envelope calculations published in medical journals say one cigarette reduces your lifespan by 11 minutes .

Here, we dig deeper to try to understand what the data and research tell us about the link between social relations and health. In a nutshell, the evidence is as follows:

• There is a huge amount of evidence showing individuals who report feelings of loneliness are more likely to have health problems later in their life.
• There is a credible theory and explanation of biological mechanisms whereby isolation can set off unconscious surveillance for social threats, producing cognitive biases, reducing sleep, and affecting hormones.
• It's very likely there is a causal link. Still, there is no credible experimental evidence that would allow us to have a precise estimate of the magnitude of the causal effect that loneliness has on key metrics of health, such as life expectancy.
• The fact that we struggle to pin down the magnitude of the effect of loneliness on health doesn't mean we should dismiss the available evidence. However, it does show that more research is needed.

Observational studies: A first look at the data

Measuring loneliness.

Psychologists and social neuroscientists often refer to loneliness as painful isolation . The emphasis on pain is there to make a clear distinction between solitude – the state of being alone – and subjective loneliness, which is the distressing feeling that comes from unmet expectations of the types of interpersonal relationships we wish to have.

Researchers use several kinds of data to measure solitude and loneliness. The most common source of data are surveys where people are asked about different aspects of their lives, including whether they live alone, how much time they spend with other people in a given window of time (e.g., ‘last week’), or specific context (e.g., ‘at social events, clubs or places of worship’); and whether they experience feelings of loneliness (e.g., ‘I have no-one with whom I can discuss important matters with’). Researchers sometimes study these survey responses separately, but often, they also aggregate them in a composite index. 2

Surveys confirm that people respond differently to questions about subjective loneliness and physical social isolation, which suggests people do understand these as two distinct issues.

In the chart here I've put together estimates on self-reported feelings of loneliness from various sources. The fact that we see such high levels of loneliness, with substantial divergence across countries, explains why this is an important and active research area. Indeed, there are literally hundreds of papers that have used survey data to explore the link between loneliness, solitude, and health. Below is an overview of what these studies find.

The link between loneliness and physical health

Most papers studying the link between loneliness and health find that both objective solitude (e.g., living alone) and subjective loneliness (e.g., frequent self-reported feelings of loneliness) are correlated with higher morbidity (i.e. illness) and higher mortality (i.e. likelihood of death).

The relationship between health and loneliness can, of course, go both ways: lonely people may see their health deteriorate with time, but it may also be the case that people who suffer from poor health end up feeling more lonely later down the line.

Because of this two-way relationship, it’s important to go beyond cross-sectional correlations and focus on longitudinal studies – these are studies where researchers track the same individuals over time to see if loneliness predicts illness or mortality in the future after controlling for baseline behaviors and health status.

The evidence from longitudinal studies shows that people who experience loneliness during a period of their lives tend to be more likely to have worse health later down the line. In the Netherlands, for example, researchers found that self-reported loneliness among adults aged 55-85 predicted mortality several months later, and this was true after controlling for age, sex, chronic diseases, alcohol use, smoking, self-assessed health condition, and functional limitations. 3

Most studies focus either on subjective loneliness or on objective isolation. However, some studies try to compare both. In a recent meta-analysis covering 70 longitudinal studies, the authors write : “We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region.” In the concluding section, they highlight that, in their interpretation of the evidence, “the risk associated with social isolation and loneliness is comparable with well-established risk factors for mortality” ; which include smoking and obesity. 4

The link between mental health and subjective well-being

In another much-cited review of the evidence, Louise Hawkley and John Cacioppo, two leading experts on this topic, concluded that “perhaps the most striking finding in this literature is the breadth of emotional and cognitive processes and outcomes that seem susceptible to the influence of loneliness”. 5

Researchers have found that loneliness correlates with subsequent increases in symptoms related to dementia , depression , and many other issues related to mental health , and this holds after controlling for demographic variables, objective social isolation, stress, and baseline levels of cognitive function.

There is also research that suggests a link between loneliness and lower happiness , and we discuss this in more detail here .

Experiments with social animals, like rats, show that induced isolation can lead to a higher risk of death from cancer. Humans and rats are, of course, very different, but experts such as Hawkley and Cacioppo argue that these experiments are important because they tell us something meaningful about a shared biological mechanism.

In a review of the evidence, Susan Pinker writes: “If our big brains evolved to interact, loneliness would be an early warning system—a built-in alarm that sent a biological signal to members who had somehow become separated from the group”. 6

Indeed, there’s evidence of social regulation of gene expression in humans: studies suggest perceived loneliness can switch on/off genes that regulate our immune systems, and it is this that then affects the health of humans, or other animals that evolved with similar defense mechanisms. 7

Causality and implications

The bulk of evidence from observational studies and biological mechanisms described above implies that loneliness most likely matters for our health and well being. But do we really know how much it matters relative to other important risk factors?

The key point here is that estimates are likely biased to some extent.

The findings from longitudinal studies that track individuals over time are insightful. Still, they cannot rule out that the relationship might be partly driven by other factors we cannot observe. Even the studies linking loneliness and genetics can be subject to omitted-variable bias because a genetic predisposition to loneliness may drive both loneliness and health outcomes. 8

I could not find credible experimental evidence that would allow us to have a precise estimate of the magnitude of the causal effect. 9 But the fact that we struggle to pin down the magnitude of the effect doesn't mean we should dismiss the available evidence. On the contrary – it would be great if we had evidence from randomized control trials that test positive interventions to reduce loneliness to understand better if the ‘15 cigarettes per day’ comparison from the Surgeon General of the US is roughly correct, at least for the average person.

Having a better understanding of the magnitude of the effect is important, not only because loneliness is common but also because it’s complex and unequally experienced by people around the world.

As the chart above shows, there are large differences in self-reported loneliness across countries. We should understand how important these differences are for the distribution of health and well-being.

Are we happier when we spend more time with others?

In 1938, a group of Harvard researchers decided to start a research program to track the lives of a group of young men in what eventually became one of the longest and most famous longitudinal studies of its kind. The idea was to track the development of a group of teenage boys through periodic interviews and medical checkups, with the aim of understanding how their health and well-being evolved as they grew up. 10

Today, more than 80 years later, it is one of the longest running research programs in social science. It is called the Harvard Study of Adult Development , and it is still running. The program started with 724 boys, and researchers continue to monitor today the health and well-being of those initial participants who are still alive, most in their late 90s. 11

This is a unique scientific exercise – most longitudinal studies do not last this long because too many participants drop out, researchers move on to other projects (or even die), or the funding dries up.

So, what have we learned from this unique study?

Robert Waldinger, the current director of the study, summarized – in what is now one of the most viewed TED Talks to date – the findings from decades of research. The main result, he concluded, is that social connections are one of the most important factors for people’s happiness and health . He said: “Those who kept warm relationships got to live longer and happier, and the loners often died earlier.”

Here, we will take a closer look at the evidence and show more research that finds a consistent link between social connections and happiness. But before we get to the details, let me explain why this link is important.

As most people can attest from personal experience, striving for happiness is not easy. In fact, the search for happiness can become a source of unhappiness – there are studies that show actively pursuing happiness can end up decreasing it .

The data shows that income and happiness are clearly related , but we also know from surveys that people often overestimate the impact of income on happiness . Social relations might be the missing link: In rich countries, where minimum material living conditions are often satisfied , people may struggle to become happier because they target material rather than social goals.

The cross-sectional correlation between happiness and friends

The World Values Survey (WVS) is a large cross-country research project that collects data from a series of representative national surveys. In the fourth wave (1999-2004), the WVS asked respondents hundreds of questions about their lives, including whether they were part of social or religious groups, how often they spent time with friends, and whether they felt happy with their lives.

By comparing self-reported happiness among those with and without frequent social interactions, we can get an idea of whether there is indeed a raw correlation between happiness and social relations across different societies.

The next chart shows the comparison: The green points correspond to happiness among those who interact with friends at least once per month, while the blue dots correspond to happiness among those who interact with friends less often. 12

This chart shows that in almost all countries, people who often spend time with their friends report being happier than those who spend less time with friends. 13

The link between social relations and happiness over time

The chart above gives a cross-sectional perspective – it’s just a snapshot that compares different people at a given point in time. What happens if we look at changes in social relations and happiness over time?

There is a large academic literature in medicine and psychology that shows individuals who report feelings of loneliness are more likely to have health problems later in life (you can read more about this in this article on social relations and health ); similarly, there are also many studies that show that changes in social relations predict changes in happiness and life satisfaction.

One of the research papers that draws on data from the famous Harvard Study of Adult Development, for example, looked at the experiences of 82 married participants and their spouses and found that greater self-reported couple attachment predicted lower levels of depression and greater life satisfaction 2.5 years later. 14

Other studies with larger population samples have also found a similar cross-temporal link: perceived social isolation predicts subsequent changes in depressive symptoms but not vice versa, and this holds after controlling for demographic variables and stress. 15

Searching for happiness is typically an intentional and active pursuit. Is it the case that people tend to become happier when they purposely decide to improve their social relations?

This is a tough empirical question to test; but a recent study found evidence pointing in this direction.

Using a large representative survey in Germany, researchers asked participants to report, in text format, ideas for how they could improve their life satisfaction. Based on these answers, the researchers then investigated which types of ideas predicted changes in life satisfaction one year later.

The researchers found that those who reported socially engaged strategies (e.g., “I plan to spend more time with friends and family”) often reported improvements in life satisfaction one year later. In contrast, those who described other non-social active pursuits (e.g., “I plan to find a better job”) did not report increased life satisfaction. 16

From decades of research, we know that social relations predict mental well-being over time; and from a recent study, we also know that people who actively decide to improve their social relations often report becoming happier. So yes, people are happier when they spend more time with friends.

Does this mean that if we have an exogenous shock to our social relations this will have a permanent negative effect on our happiness?

We can’t really answer this with the available evidence. More research is needed to really understand the causal mechanisms that drive the link between happiness and social relations. 17

Despite this, however, I think that we should take the available observational evidence seriously. In a way, the causal impact of a random shock is less interesting than the evidence from active strategies that people might take to improve their happiness. People who get divorced, for example, often report a short-term drop in life satisfaction. Still, over time, they tend to recover and eventually end up being more satisfied with their life than shortly before they divorced (you can read more about this in our entry on happiness and life satisfaction ).

It makes sense to consider the possibility that healthy social relationships are a key missing piece for human well-being. Among other things, this would help explain the paradoxical result from studies where actively pursuing happiness apparently decreases it .

Loneliness, solitude, and social isolation

Living alone is becoming increasingly common around the world.

In the US, the share of adults who live alone nearly doubled over the last 50 years . This is not only happening in the US: single-person households have become increasingly common in many countries across the world, from Angola to Japan .

Historical records show that this ‘rise of living alone’ started in early-industrialized countries over a century ago, accelerating around 1950. In countries such as Norway and Sweden, single-person households were rare a century ago, but today, they account for nearly half of all households. In some cities, they are already the majority.

Surveys and census data from recent decades show that people are more likely to live alone in rich countries, and the prevalence of single-person households is unprecedented historically.

Social connections – including contact with friends and family – are important for our health and emotional well-being. Hence, as single-person households become more common, there will be new challenges to connect and support those living alone, particularly in poorer countries where welfare states are weaker.

But it’s important to keep things in perspective. It’s unhelpful to compare the rise of living alone with a ‘loneliness epidemic’, which is what newspaper articles often write in alarming headlines .

Loneliness and solitude are not the same , and the evidence suggests that self-reported loneliness has not been growing in recent decades.

Historical perspective on people living alone: Evidence from rich countries

Historical records of inhabitants across villages and cities in today’s rich countries give us insights into how uncommon it was for people to live alone in the past.

The chart here, adapted from a paper by the historian Keith Snell, shows estimates of the share of single-person households across different places and times, using a selection of the available historical records and more recent census data. Each dot corresponds to an estimate for one settlement in Europe, North America, Japan, or Britain. 18

The share of one-person households remained fairly steady between the early modern period and through the 19th century – typically below 10%. Then, growth started in the twentieth century, accelerating in the 1960s.

The current prevalence of one-person households is unprecedented historically. The highest point recorded in this chart corresponds to Stockholm in 2012, where 60% of households consist of one person.

The rise of one-person households across the world

For recent decades, census data can be combined with data from large cross-country surveys to provide a global perspective on the proportion of households with only one member (i.e., the proportion of single-person households). This gives us a proxy for the prevalence of solitary living arrangements. 19

We produced this chart combining individual reports from statistical country offices, cross-country surveys such as the Demographic and Health Surveys , and estimates published in the EU’s Eurostat , the UN’s Demographic Year Books , and the Deutschland in Daten dataset.

The chart shows that the trend of rising single-person households extends across all world regions. There are large differences between countries – f rom more than 40% in northern European countries to 1% in low-income Asian countries .

(NB. For the US and Canada there are long-run time series from census data that let us directly track the share of people who live alone. This is shown in this other chart , where you can see the same trend.)

Living arrangements and prosperity

National income per capita and the share of one-person households are strongly correlated: As the chart here shows, people are more likely to live alone in rich countries.

In the next interactive chart, you can move the slider to see changes over time. This reveals that the rise of single-person households tends to be larger in countries where GDP per capita has grown more. (NB. You can also see the correlation over time in this other scatter plot comparing average growth in GDP vs average growth in one-person households).

These correlations are partly due to the fact that people who can afford to, often choose to live alone. Indeed, rising incomes in many countries are likely part of the reason why people are more likely to live alone today than in the past.

But there must be more to it since even at the same level of income, there are clear differences between regions. In particular, Asian countries have systematically fewer one-person households than African countries with comparable GDP levels. Ghana and Pakistan, for example, have similar GDP per capita, but in Pakistan, one-person households are extremely rare, while in Ghana, they are common (about 1 in 4) . This suggests cultural and country-specific factors also play an important role.

Additionally, other non-cultural country-specific factors are likely to play a role. In particular, rich countries often have more extensive social support networks, so people in these countries find it easier to take risks. Living alone is more risky in poorer countries because there’s often less supply of services and infrastructure to support more solitary living arrangements.

And finally, it’s also likely that some of the causality runs in the opposite direction. It’s not only that incomes, culture, or welfare states enable people to live alone, but also that for many workers, attaining higher incomes in today’s economy often demands changes in living arrangements. Migration from rural to urban areas is the prime example.

Is the rise of one-person households a problem?

Social connections – including contact with friends and family – are important for our health and emotional well-being. Hence, as the ‘rise of living alone’ continues, there will be new challenges to connect people and support those living alone, particularly in poorer countries where communication technologies are less developed and welfare states are weaker .

But it’s also important to remember that 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.

Incomes and freedom of choice are not the only drivers of the ‘rise of living alone’; but it would be remiss to ignore they do contribute to this trend.

Higher incomes , economic transitions that enable migration from agriculture in rural areas into manufacturing and services in cities, and rising female participation in labor markets all play a role. People are more likely to live alone today than in the past partly because they can increasingly do so.

Interactive charts on loneliness and social connections

There are dozens of articles reporting the ‘15 cigarettes a day’ figure. See, for example this in The Daily Mail . All the articles that cite this figure trace back to Dr. Vivek Murthy and a meta-analysis by Holt-Lunstad et al. (2015), which we discuss in more detail below. When reviewing this meta-analysis, we found the claim that loneliness is a risk factor comparable to smoking, but we could not find the calculations that lead to the 15 cigarettes benchmark. It’s still unclear to me what the unit of loneliness is and what this translates into in terms of years of lives lost. However, given that 15 cigarettes per day are about the average consumption among smokers , the benchmark may come from comparing excess mortality of smoking for the average smoker vs. excess mortality of loneliness for average levels of loneliness.

The most popular composite index is the UCLA Loneliness Scale , which was first proposed in 1978 and is based on a 20-item scale designed to measure subjective feelings of loneliness. You can read more about it here .

Penninx, B. W., Van Tilburg, T., Kriegsman, D. M., Deeg, D. J., Boeke, A. J. P., & van Eijk, J. T. M. (1997). Effects of social support and personal coping resources on mortality in older age: The Longitudinal Aging Study Amsterdam. American journal of epidemiology, 146(6), 510-519.

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on psychological science, 10(2), 227-237.

Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine, 40(2), 218-227.

Pinker, S. (2015). The village effect: How face-to-face contact can make us healthier and happier. Vintage Canada.

Cole, S. W., Hawkley, L. C., Arevalo, J. M., & Cacioppo, J. T. (2011). Transcript origin analysis identifies antigen-presenting cells as primary targets of socially regulated gene expression in leukocytes. Proceedings of the National Academy of Sciences, 108(7), 3080-3085.

Two concrete papers that show this is a real concern are:

- Abdellaoui, A., Sanchez-Roige, S., Sealock, J., Treur, J. L., Dennis, J., Fontanillas, P., … & Baselmans, B. (2018). Phenome-wide investigation of health outcomes associated with genetic predisposition to loneliness. bioRxiv, 468835.

-Abdellaoui, A., Chen, H. Y., Willemsen, G., Ehli, E. A., Davies, G. E., Verweij, K. J., … & Cacioppo, J. T. (2019). Associations between loneliness and personality are mostly driven by a genetic association with neuroticism. Journal of personality, 87(2), 386-397.

If you know of relevant studies that do provide such estimates, please let me know at [email protected].

For historical context: The Harvard Graduate School of Education – the first to admit women – opened admissions to women in 1920, and the Harvard Medical School accepted its first female enrollees in 1945, even though the first woman applied in 1847. You can read more about the hard-earned gains for women at Harvard here: https://news.harvard.edu/gazette/story/2012/04/hard-earned-gains-for-women-at-harvard/

The original participants for this study came from two groups: a cohort of 268 men, 19 years of age, from the Harvard classes of 1939-1944; and a group of 456 caucasian men, ages 11-16, from underprivileged neighborhoods of Boston. Over the years, the project evolved, enrolling more participants, and many of the children of the original participants are included in the study today.

The question on frequency of interaction with friends was asked in the context of time spent at work, clubs or places of worship. The options included ‘weekly’, ‘once or twice a month’, ‘only a few times a month’, and ‘not at all’. The options for happiness, on the other hand, included ‘very happy’, ‘quite happy’, ‘not very happy’, and ‘not at all happy’. In the chart, we took this data and split the sample in two: we classified respondents as ‘often meeting with friends’ if they said they met with friends once a month or more frequently, and we classified them as ‘rarely meeting with friends’ if they said they met with friends ‘once a year’ or ‘not at all’. Then, for each of these two groups, we plotted the share who reported being ‘very happy’ or 'quite happy’.

The estimates have, of course, a margin of error that varies with the survey size. The difference between the green and blue dots is statistically significant for about half of the countries (i.e., for about half of the countries in this chart, the 95% confidence intervals around the blue and green dots would not overlap).

Waldinger, R. J., Cohen, S., Schulz, M. S., & Crowell, J. A. (2015). Security of attachment to spouses in late life: Concurrent and prospective links with cognitive and emotional well-being. Clinical Psychological Science, 3(4), 516-529.

See for example:- Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study . Psychology and aging, 25(2), 453.- Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and aging, 21(1), 140.

The researchers used an open question: “What could you do to ensure that you will be more satisfied in the future?”. There are, of course, many types of answers that people can provide to such an open-ended question, so the authors decided to classify each individual answer into one of two categories, depending on whether or not the respondents described a ‘socially engaged strategy’. This process of classifying answers could naturally raise questions: the authors could manipulate the subjective classification of answers to fit their favorite hypothesis. In order to insure themselves against this criticism, the researchers relied on three independent coders, and they stipulated the classification method and the expected results in a pre-analysis plan . You find more details in the paper: Rohrer, J. M., Richter, D., Brümmer, M., Wagner, G. G., & Schmukle, S. C. (2018). Successfully striving for happiness: Socially engaged pursuits predict increases in life satisfaction. Psychological science, 29(8), 1291-1298.

The key point to remember is that we are not talking about experimental evidence. People who frequently interact with friends or people who say they want to engage more in ‘social strategies to improve their lives’ are likely different. Although the researchers do try to control for this, it is very hard to measure all the relevant characteristics that might help drive life satisfaction. Similarly, asking people about strategies to improve their lives is difficult. Although the qualitative strategy from the paper above is interesting, it’s still hard to draw accurate comparisons: it’s possible that ‘non-social’ strategies, for example, are more difficult or stressful to pursue; so part of the lower apparent impact that these strategies have on happiness might come from the fact that some people are trying but failing to find a better job.

Snell, K. D. M. (2017). The rise of living alone and loneliness in history . Social History, 42(1), 2-28.

The percentage of single-person households is a proxy for ‘solitary living’. However, it’s important to emphasize that these two things are not really the same. Single-person households include those where a person lives alone in an individual housing unit, but they also include people who live independently as lodgers in a separate room within a larger housing unit with other occupants. So technically, there are some people who live in a ‘single-person household’, but they don’t really live alone.

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The History of Loneliness

The female chimpanzee at the Philadelphia Zoological Garden died of complications from a cold early in the morning of December 27, 1878. “Miss Chimpanzee,” according to news reports, died “while receiving the attentions of her companion.” Both she and that companion, a four-year-old male, had been born near the Gabon River, in West Africa; they had arrived in Philadelphia in April, together. “These Apes can be captured only when young,” the zoo superintendent, Arthur E. Brown, explained, and they are generally taken only one or two at a time. In the wild, “they live together in small bands of half a dozen and build platforms among the branches, out of boughs and leaves, on which they sleep.” But in Philadelphia, in the monkey house, where it was just the two of them, they had become “accustomed to sleep at night in each other’s arms on a blanket on the floor,” clutching each other, desperately, achingly, through the long, cold night.

The Philadelphia Zoological Garden was the first zoo in the United States. It opened in 1874, two years after Charles Darwin published “The Expression of the Emotions in Man and Animals,” in which he related what he had learned about the social attachments of primates from Abraham Bartlett, the superintendent of the Zoological Society of London:

Many kinds of monkeys, as I am assured by the keepers in the Zoological Gardens, delight in fondling and being fondled by each other, and by persons to whom they are attached. Mr. Bartlett has described to me the behavior of two chimpanzees, rather older animals than those generally imported into this country, when they were first brought together. They sat opposite, touching each other with their much protruded lips; and the one put his hand on the shoulder of the other. They then mutually folded each other in their arms. Afterwards they stood up, each with one arm on the shoulder of the other, lifted up their heads, opened their mouths, and yelled with delight.

Mr. and Miss Chimpanzee, in Philadelphia, were two of only four chimpanzees in America, and when she died human observers mourned her loss, but, above all, they remarked on the behavior of her companion. For a long time, they reported, he tried in vain to rouse her. Then he “went into a frenzy of grief.” This paroxysm accorded entirely with what Darwin had described in humans: “Persons suffering from excessive grief often seek relief by violent and almost frantic movements.” The bereaved chimpanzee began to pull out the hair from his head. He wailed, making a sound the zookeeper had never heard before: Hah-ah-ah-ah-ah . “His cries were heard over the entire garden. He dashed himself against the bars of the cage and butted his head upon the hard-wood bottom, and when this burst of grief was ended he poked his head under the straw in one corner and moaned as if his heart would break.”

Nothing quite like this had ever been recorded. Superintendent Brown prepared a scholarly article, “Grief in the Chimpanzee.” Even long after the death of the female, Brown reported, the male “invariably slept on a cross-beam at the top of the cage, returning to inherited habit, and showing, probably, that the apprehension of unseen dangers has been heightened by his sense of loneliness.”

Loneliness is grief, distended. People are primates, and even more sociable than chimpanzees. We hunger for intimacy. We wither without it. And yet, long before the present pandemic, with its forced isolation and social distancing, humans had begun building their own monkey houses. Before modern times, very few human beings lived alone. Slowly, beginning not much more than a century ago, that changed. In the United States, more than one in four people now lives alone; in some parts of the country, especially big cities, that percentage is much higher. You can live alone without being lonely, and you can be lonely without living alone, but the two are closely tied together, which makes lockdowns, sheltering in place, that much harder to bear. Loneliness, it seems unnecessary to say, is terrible for your health. In 2017 and 2018, the former U.S. Surgeon General Vivek H. Murthy declared an “epidemic of loneliness,” and the U.K. appointed a Minister of Loneliness. To diagnose this condition, doctors at U.C.L.A. devised a Loneliness Scale. Do you often, sometimes, rarely, or never feel these ways?

I am unhappy doing so many things alone. I have nobody to talk to. I cannot tolerate being so alone. I feel as if nobody really understands me. I am no longer close to anyone. There is no one I can turn to. I feel isolated from others.

In the age of quarantine, does one disease produce another?

“Loneliness” is a vogue term, and like all vogue terms it’s a cover for all sorts of things most people would rather not name and have no idea how to fix. Plenty of people like to be alone. I myself love to be alone. But solitude and seclusion, which are the things I love, are different from loneliness, which is a thing I hate. Loneliness is a state of profound distress. Neuroscientists identify loneliness as a state of hypervigilance whose origins lie among our primate ancestors and in our own hunter-gatherer past. Much of the research in this field was led by John Cacioppo, at the Center for Cognitive and Social Neuroscience, at the University of Chicago. Cacioppo, who died in 2018, was known as Dr. Loneliness. In the new book “ Together: The Healing Power of Human Connection in a Sometimes Lonely World ” (Harper Wave), Murthy explains how Cacioppo’s evolutionary theory of loneliness has been tested by anthropologists at the University of Oxford, who have traced its origins back fifty-two million years, to the very first primates. Primates need to belong to an intimate social group, a family or a band, in order to survive; this is especially true for humans (humans you don’t know might very well kill you, which is a problem not shared by most other primates). Separated from the group—either finding yourself alone or finding yourself among a group of people who do not know and understand you—triggers a fight-or-flight response. Cacioppo argued that your body understands being alone, or being with strangers, as an emergency. “Over millennia, this hypervigilance in response to isolation became embedded in our nervous system to produce the anxiety we associate with loneliness,” Murthy writes. We breathe fast, our heart races, our blood pressure rises, we don’t sleep. We act fearful, defensive, and self-involved, all of which drive away people who might actually want to help, and tend to stop lonely people from doing what would benefit them most: reaching out to others.

The loneliness epidemic, in this sense, is rather like the obesity epidemic. Evolutionarily speaking, panicking while being alone, like finding high-calorie foods irresistible, is highly adaptive, but, more recently, in a world where laws (mostly) prevent us from killing one another, we need to work with strangers every day, and the problem is more likely to be too much high-calorie food rather than too little. These drives backfire.

Loneliness, Murthy argues, lies behind a host of problems—anxiety, violence, trauma, crime, suicide, depression, political apathy, and even political polarization. Murthy writes with compassion, but his everything-can-be-reduced-to-loneliness argument is hard to swallow, not least because much of what he has to say about loneliness was said about homelessness in the nineteen-eighties, when “homelessness” was the vogue term—a word somehow easier to say than “poverty”—and saying it didn’t help. (Since then, the number of homeless Americans has increased.) Curiously, Murthy often conflates the two, explaining loneliness as feeling homeless. To belong is to feel at home. “To be at home is to be known,” he writes. Home can be anywhere. Human societies are so intricate that people have meaningful, intimate ties of all kinds, with all sorts of groups of other people, even across distances. You can feel at home with friends, or at work, or in a college dining hall, or at church, or in Yankee Stadium, or at your neighborhood bar. Loneliness is the feeling that no place is home. “In community after community,” Murthy writes, “I met lonely people who felt homeless even though they had a roof over their heads.” Maybe what people experiencing loneliness and people experiencing homelessness both need are homes with other humans who love them and need them, and to know they are needed by them in societies that care about them. That’s not a policy agenda. That’s an indictment of modern life.

In “ A Biography of Loneliness: The History of an Emotion ” (Oxford), the British historian Fay Bound Alberti defines loneliness as “a conscious, cognitive feeling of estrangement or social separation from meaningful others,” and she objects to the idea that it’s universal, transhistorical, and the source of all that ails us. She argues that the condition really didn’t exist before the nineteenth century, at least not in a chronic form. It’s not that people—widows and widowers, in particular, and the very poor, the sick, and the outcast—weren’t lonely; it’s that, since it wasn’t possible to survive without living among other people, and without being bonded to other people, by ties of affection and loyalty and obligation, loneliness was a passing experience. Monarchs probably were lonely, chronically. (Hey, it’s lonely at the top!) But, for most ordinary people, daily living involved such intricate webs of dependence and exchange—and shared shelter—that to be chronically or desperately lonely was to be dying. The word “loneliness” very seldom appears in English before about 1800. Robinson Crusoe was alone, but never lonely. One exception is “Hamlet”: Ophelia suffers from “loneliness”; then she drowns herself.

Modern loneliness, in Alberti’s view, is the child of capitalism and secularism. “Many of the divisions and hierarchies that have developed since the eighteenth century—between self and world, individual and community, public and private—have been naturalized through the politics and philosophy of individualism,” she writes. “Is it any coincidence that a language of loneliness emerged at the same time?” It is not a coincidence. The rise of privacy, itself a product of market capitalism—privacy being something that you buy—is a driver of loneliness. So is individualism, which you also have to pay for.

Alberti’s book is a cultural history (she offers an anodyne reading of “Wuthering Heights,” for instance, and another of the letters of Sylvia Plath ). But the social history is more interesting, and there the scholarship demonstrates that whatever epidemic of loneliness can be said to exist is very closely associated with living alone. Whether living alone makes people lonely or whether people live alone because they’re lonely might seem to be harder to say, but the preponderance of the evidence supports the former: it is the force of history, not the exertion of choice, that leads people to live alone. This is a problem for people trying to fight an epidemic of loneliness, because the force of history is relentless.

Before the twentieth century, according to the best longitudinal demographic studies, about five per cent of all households (or about one per cent of the world population) consisted of just one person. That figure began rising around 1910, driven by urbanization, the decline of live-in servants, a declining birth rate, and the replacement of the traditional, multigenerational family with the nuclear family. By the time David Riesman published “ The Lonely Crowd ,” in 1950, nine per cent of all households consisted of a single person. In 1959, psychiatry discovered loneliness, in a subtle essay by the German analyst Frieda Fromm-Reichmann. “Loneliness seems to be such a painful, frightening experience that people will do practically everything to avoid it,” she wrote. She, too, shrank in horror from its contemplation. “The longing for interpersonal intimacy stays with every human being from infancy through life,” she wrote, “and there is no human being who is not threatened by its loss.” People who are not lonely are so terrified of loneliness that they shun the lonely, afraid that the condition might be contagious. And people who are lonely are themselves so horrified by what they are experiencing that they become secretive and self-obsessed—“it produces the sad conviction that nobody else has experienced or ever will sense what they are experiencing or have experienced,” Fromm-Reichmann wrote. One tragedy of loneliness is that lonely people can’t see that lots of people feel the same way they do.

“During the past half century, our species has embarked on a remarkable social experiment,” the sociologist Eric Klinenberg wrote in “ Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone ,” from 2012. “For the first time in human history, great numbers of people—at all ages, in all places, of every political persuasion—have begun settling down as singletons.” Klinenberg considers this to be, in large part, a triumph; more plausibly, it is a disaster. Beginning in the nineteen-sixties, the percentage of single-person households grew at a much steeper rate, driven by a high divorce rate, a still-falling birth rate, and longer lifespans over all. (After the rise of the nuclear family, the old began to reside alone, with women typically outliving their husbands.) A medical literature on loneliness began to emerge in the nineteen-eighties, at the same time that policymakers became concerned with, and named, “homelessness,” which is a far more dire condition than being a single-person household: to be homeless is to be a household that does not hold a house. Cacioppo began his research in the nineteen-nineties, even as humans were building a network of computers, to connect us all. Klinenberg, who graduated from college in 1993, is particularly interested in people who chose to live alone right about then.

I suppose I was one of them. I tried living alone when I was twenty-five, because it seemed important to me, the way owning a piece of furniture that I did not find on the street seemed important to me, as a sign that I had come of age, could pay rent without subletting a sublet. I could afford to buy privacy, I might say now, but then I’m sure I would have said that I had become “my own person.” I lasted only two months. I didn’t like watching television alone, and also I didn’t have a television, and this, if not the golden age of television, was the golden age of “The Simpsons,” so I started watching television with the person who lived in the apartment next door. I moved in with him, and then I married him.

This experience might not fit so well into the story Klinenberg tells; he argues that networked technologies of communication, beginning with the telephone’s widespread adoption, in the nineteen-fifties, helped make living alone possible. Radio, television, Internet, social media: we can feel at home online. Or not. Robert Putnam’s influential book about the decline of American community ties, “Bowling Alone,” came out in 2000, four years before the launch of Facebook, which monetized loneliness. Some people say that the success of social media was a product of an epidemic of loneliness; some people say it was a contributor to it; some people say it’s the only remedy for it. Connect! Disconnect! The Economist declared loneliness to be “the leprosy of the 21st century.” The epidemic only grew.

This is not a peculiarly American phenomenon. Living alone, while common in the United States, is more common in many other parts of the world, including Scandinavia, Japan, Germany, France, the U.K., Australia, and Canada, and it’s on the rise in China, India, and Brazil. Living alone works best in nations with strong social supports. It works worst in places like the United States. It is best to have not only an Internet but a social safety net.

Then the great, global confinement began: enforced isolation, social distancing, shutdowns, lockdowns, a human but inhuman zoological garden. Zoom is better than nothing. But for how long? And what about the moment your connection crashes: the panic, the last tie severed? It is a terrible, frightful experiment, a test of the human capacity to bear loneliness. Do you pull out your hair? Do you dash yourself against the walls of your cage? Do you, locked inside, thrash and cry and moan? Sometimes, rarely, or never? More today than yesterday? ♦

A Guide to the Coronavirus

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The Loneliness Pandemic

The psychology and social costs of isolation in everyday life.

January-February 2021

Illustration by Francescoch/iStock

Bradley Riew ’18 had a calendar reliably packed from 9 a.m. to midnight. To him, that didn’t seem so bad. “You know,” he says, “you have nine hours to sleep.”

On top of his schoolwork and various extracurriculars, he spent about 20 hours a week volunteering at local homeless shelters. He acknowledges now how well he fit the “overworked Harvard student” stereotype, but during sophomore year the commitments didn’t strike him as unusual. “I was just doing what everyone else was doing,” he says. “I was just absorbed in that culture of go, go, go, go, go.”

But the packed days strung together, the work piled on, and Riew felt more and more drained. Classwork encroached later into the night, and he went to bed with a level of exhaustion that rest couldn’t fix. “I didn’t really have time to do my schoolwork,” he recalls, “and I didn’t have time to just relax or spend time talking to somebody.”

Riew had no problem connecting with others, but keeping in touch and forming strong friendships was harder. He’d think about reaching out to someone, only to realize that they hadn’t spoken for months and decide the effort wasn’t worth it. Potential friends were now just friendly acquaintances. “And all my relationships were like that,” he says.

His productivity outpaced his social life, until it didn’t. His grades began to slip, and he started feeling depressed. “I got to the point where I didn’t care about anything I was doing,” he admits. “I was doing it because I had been doing it before.” He decided to take a leave of absence after that year, staying home in St. Louis. Only when the noise of undergraduate life began to fade did he finally begin to see the root of his problems: though he was far from alone, he was lonely.

Loneliness is a subjective experience—part of what makes it so hard to identify. “If you’re on Mars and you have the most powerful telescope, that can look through walls, you can find all the isolated people on planet Earth,” says Jeremy Nobel, a lecturer at the Harvard T.H. Chan School of Public Health (HSPH) who teaches a course on loneliness. “But you couldn’t find the lonely people.”

The opposite is true as well, says Robert Waldinger, professor of psychiatry and a psychiatrist at Massachusetts General Hospital (MGH). “You’ve probably known people who seem to have a lot of friends, but when they talk about it, they’ll say, ‘I don’t really feel like anybody knows me,’ or ‘I don’t really feel close to many people.’”

Social psychologists define loneliness as the gap between the social connections you would like to have and those you feel you experience. According to a 2018 report by the Henry J. Kaiser Family Foundation, 22 percent of adults in the United States say they often or always feel lonely or socially isolated. A national 2019 survey led by health insurer Cigna found that 61 percent of Americans report feeling lonely. Books like Bowling Alone (2000) , by Malkin professor of public policy emeritus Robert D. Putnam, have highlighted the decline of social capital in the United States, but more recently, loneliness has become a serious issue of public health. In 2017, former U.S. Surgeon General Vivek Murthy ’97 called loneliness a public-health “epidemic.” The United Kingdom appointed a “minister for loneliness” a year later.

The health implications of loneliness have become clearer over time. According to the research of Julianne Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University, and colleagues, the heightened risk of mortality from loneliness equals that of smoking 15 cigarettes a day or being an alcoholic, and exceeds the health risks associated with obesity. Researchers are now actively studying the mechanisms by which loneliness affects health, including its relationship with inflammation and harmful changes in DNA expression. “If you’re stressed chronically, your body may be in a low-level fight-or-flight response all the time,” Waldinger explains. “So what we are looking at is whether some people are in a chronic state of mild inflammation.”

COVID-19 has pushed loneliness further into the public conversation as people across the country have stayed home, fearful of contracting a deadly virus and aiding its spread. Terms like “social distancing,” “self-isolation,” and “shelter in place” accentuate the idea that COVID-19 could have profound social implications. “A major adverse consequence of the COVID-19 pandemic is likely to be increased social isolation and loneliness,” argued several professors in The Lancet Psychiatry in April. “Tracking loneliness and intervening early are important priorities.” “We’re all lonely now,” novelist Olivia Laing wrote in a New York Times column days after lockdowns began. “Social distancing is vital, but that doesn’t make it easy.”

Karestan Koenen, professor of psychiatric epidemiology at HSPH, always keeps an eye out for disasters. It’s part of her job; much of her work deals with trauma and post-traumatic stress disorder. But Koenen started thinking much more about COVID-19 when she began to see the virus’s potential implications for public health.

It began when one of her master’s students returned to the United States from Shanghai before the 2020 spring semester. As he quarantined—the first person she knew who had to do so—he described the situation he’d observed back in China. When they finally met in person, he began to sob uncontrollably.

“He just started crying and saying how awful he felt being in the U.S. when everyone was suffering in China,” Koenen recalls. “His colleagues were having PTSD, having dealt with SARS.” In Wuhan, he’d heard, doctors saw entire families dying, without full knowledge of what was going on. He’d also witnessed discrimination against people from Hubei province. He and Koenen started thinking through potential Chinese government public-health responses to the pandemic—and it struck her that the United States might have to prepare for similar trauma soon.

In March, a week before Harvard began sending students home, Koenen and some of her students and colleagues decided to meet to discuss various mental-health threats involving COVID-19. She added that everyone was free to invite those who might be interested. The group’s meetings usually drew only a handful of people, but when the Zoom call began—during the same afternoon when the World Health Organization declared the novel coronavirus a pandemic—more than 100 people were there. Instead of a group discussion, she and her colleagues presented what they knew about the mental-health repercussions of past pandemics. “A lot of people were thinking about this, and no one had any place to go,” Koenen says. “Clearly there was this huge need.”

Soon their group was hosting weekly forums, discussing the mental-health issue they felt most relevant. At first, the topics reflected the general concerns of past disasters: explaining the pandemic’s impacts on children, handling death and bereavement, and offering guidance on remaining resilient when the future is opaque. “We don’t know how long this thing will last,” she said in the first meeting. “This is a marathon, not a sprint….Really taking care of yourself and keeping routines is really important for kids, and adults too.”

Still Koenen remembers a frantic energy of connectedness. People were putting up signs for essential workers, organizing nightly Zoom dinners, spearheading Zoom book clubs. But as it became clear the pandemic wasn’t going away soon, people had to adjust and move forward in a far different way than they’d imagined. “I don’t think the immediate impact of COVID was people being lonely,” Jeremy Nobel says. “I think what it did do is raise the consciousness of people around isolation…. So I think as people started anticipating future reductions in social contact, it increased anxiety and also, as people started removing themselves from others, it increased the risk for loneliness.”

Loneliness is not monolithic. When most people think of the feeling, they think of what Nobel calls psychological or interpersonal loneliness. “Like, ‘Do I have a friend? Do I have someone I can tell my troubles to?’” he says. But there’s also existential loneliness: “Do I fit into the universe? Does my life have any meaning, purpose, weight, valence, mission?” He finds such questions particularly troublesome for 18- to 24-year-olds, who are, studies have shown, the loneliest group in the country. The third type of loneliness is societal: “If I enter a room, is my arrival both anticipated and welcomed?” Prejudice can augment this type of loneliness, Nobel says, most notably through racism. “But it goes beyond race, class, and gender preference,” he adds. “It affects anyone subject to exclusion, including people who don’t meet our beauty standards, people with disabilities, even many older adults….Society systematically excludes people, often.”

As president of the Foundation for Art & Healing, Jeremy Nobel launched “The UnLonely Project” to increase public awareness of loneliness and lessen its burden. Photograph by Brian Smith

Loneliness was rising even before the pandemic. “Modern progress has brought unprecedented advances that make it easier for us technically to connect,” writes Vivek Murthy in Together: The Healing Power of Human Connection in a Sometimes Lonely World , “but often these advances create unforeseen challenges that make us feel more alone and disconnected.” Social media, for instance, can bring people together with mutual interests or make it easier for friends to make plans, but it also amplifies disagreement and siphons people into increasingly divisive echo chambers . “Because of these divisions, many people are just hunkering down, I think,” Robert Waldinger says. And, he adds, they’re not necessarily happy, huddling in their tribes. “Many people are disturbed by all this, so you see levels of depression and anxiety going up in the population.”

“If you’re lonely, almost the last thing you want to do is reach out,” Karestan Koenen says. “But you have to make yourself.”

And loneliness begets loneliness. “If you’re lonely, almost the last thing you want to do is reach out,” Koenen says. “But you have to make yourself.” She saw the risks for her mother, who has a history of depression and lives alone in Atlanta. Koenen wanted to visit, but it never seemed wise as the pandemic raged in Massachusetts and then took hold in Georgia. To keep her mother engaged socially and focusing on topics other than politics, Koenen and her brother decided to call her each day and have her tell them what she was doing to get out of her apartment or connect with someone else online or by phone. “We’re often better when we’re accountable to other people,” she says. “That’s why you do it in therapy. If you can have someone call you and ask, ‘What did you do today?’ it might be a little motivating.” Her mother might go out just to have something to tell the kids, but that could make her feel better nonetheless.

Meanwhile, Koenen felt her own communication with others had become strained. “We’re in this together, but feeling so alone,” she says. “Although we have these shared experiences, because we’re deprived of so many [other] ways we would connect with people around us, it feels isolating.” She woke up one Saturday to a text from her sister saying that her father-in-law had passed away. A few days later, his wife did, too. “In life pre-COVID, I would be in Saratoga, helping with and taking comfort in the logistics and rituals of death,” she wrote in May. “As an older sister, professor…and clinical psychologist at the Massachusetts General Hospital, I am usually the person in the family everyone relies on to know what to do in a crisis. But instead, I remain in Boston, physically distant and emotionally helpless.”

The gradual reopening of society didn’t always make social connection easier. At times, new decisions about how to interact with others created tension among friends and family. “The people who are alone alone are really lonely,” Koenen says, “but people are feeling isolated even with the people they live with, because there’s a lot of stress and conflict.” Some couples have struggled over how strictly they should avoid other people and families—arguing about whether it’s appropriate to go to an outdoor restaurant or invite friends onto a front patio. Such discrepancies in comfort level have also occurred among families in the same neighborhood. While some children bike outside in groups or play soccer wearing masks, others aren’t allowed to get within 20 feet of their friends, even outdoors.

“What the pandemic did was it froze our lives, right?” Waldinger says. “It froze us in these weird positions where we’re closer than we want to be to some people, and we’re too distanced from others.” He mentions the evaporation of “weak ties” as another possible contributor to feelings of loneliness: “your relationship with the guy you always get your coffee from at Starbucks, or the mail carrier, or the person who checks you out at the grocery store, who you chat with”—or relationships with co-workers or acquaintances. A body of research suggests that these ties are meaningful and predominantly positive. Waldinger himself normally went to MGH every day for work, but by fall, he hadn’t been there in months. Seeing colleagues via Zoom is not the same, he says—and there are people he frequently interacted with in the coffee room whom he would never see in a Zoom call.

To improve mental health in times of stress, Karestan Koenen recommends “the boring stuff”: going to bed and waking up at consistent times, exercising, and scheduling enjoyable activities. Photograph by Brian Smith

And when people feel bad themselves, building relationships with others becomes more difficult. Although Koenen noticed people being quite proactive in connecting or reconnecting with friends when lockdowns began, she thinks some have increasingly decided to deal with their own issues privately. She sees friends on Zoom and says, “Why didn’t you ever tell me that?” and they say, “Well, I know things suck for you, so why would I?”

When the pandemic took hold in the United States, Jeremy Nobel and his staff began to act. He had established The Foundation for Art & Healing in 2004, an independent nonprofit to help people heal emotionally through art-focused activities. Faced with this new threat, the organization launched the “Stuck at Home Together Initiative.” On their website, they encouraged anyone interested to participate in a variety of creative activities—and share the results with others in the group. The idea was spurred by Nobel’s research into how creative processes can enhance well-being and help alleviate loneliness. “It was just a way to bridge the gap,” he says, “offering a chance to be socially connected authentically, even at a time of distancing.” Some people joined virtual creative social circles; others “attended” the UnLonely Film Festival, an online screening of short films about loneliness and isolation, and discussed each film in groups.

Those reactions helped Nobel notice something. “People are typically embarrassed or ashamed about loneliness because they think it ties to some kind of inadequacy or deficiency on their part,” he says. But COVID-19 presents obvious reasons for people to feel lonely—involuntary isolation, quarantining—“So what’s different about this loneliness is it actually has the potential to be unifying.”

This potential for increased connection was observed in research, too. In June, Tyler Vanderweele, professor of epidemiology and director of Harvard’s Human Flourishing Program, found some information that surprised him. An unrelated collaboration with the American Bible Society had caused his group to collect well-being data from thousands of participants in January and then in June. The results offered some unexpected COVID-19 insight, he says: he’d expected participants to experience major declines in their “close social relationships,” but in fact, those statistics declined only modestly.The research had evaluated well-being across six domains: happiness and life satisfaction, mental and physical health, meaning and purpose, character and virtue, close social relationships, and financial and material stability. Vanderweele observed that well-being overall was down, notably, with the largest decline in “financial and material stability.” But scores for “meaning and purpose,” “character and virtue,” and “close social relationships” declined much less significantly—each about a tenth of a standard deviation ( Correction 12/23:  "a tenth" originally written as "a third.") “I think people are reevaluating their lives,” he says, “and trying to find meaning in the midst of what is a very difficult set of circumstances.”

Though opportunities to meet new people and attend events have diminished, Vanderweele suspects that many people—especially those who report their close social relationships improving during this time—have put extra energy into connections they had pre-pandemic. “I tend to think what this time has required for either successful social engagement or successful community engagement is really drawing upon the resources of the past,” he explains. “What relationships do you already have in place? And can you make use of them and invest in them?” In addition to strengthening relationships with family members and close friends, he believes some people are taking the opportunity to revisit past friendships that were lost over an argument or a dispute: salvaging past connections even when forming new ones is difficult.

Tyler Vanderweele hopes the pandemic may spark “renewed interest not just in reestablishing social relationships, but also in participating in deeper, richer forms of community life.” Photograph by Brian Smith

Vanderweele sees some of these trends in his own life. Though he feels the loss of interactions with work colleagues and members of his church community acutely, he has gone from seeing his extended family every couple of months to chatting with them every week on Zoom. “That really has enriched those relationships,” he says.

But while overall declines in social relationships are modest, variance among these self-reports has increased. Some saw their relationships improve, but others saw a sharp decline. Vanderweele thinks that those living alone or lacking much community support fared especially poorly during widespread societal restrictions.

When people ask Robert Waldinger how to improve social relationships, he emphasizes the need to be active. “It’s being the one to reach out,” he says, even when that’s hard to do. “If you’re feeling worse about yourself or about your life, it can be hard to say, ‘I’m going to call up that friend I haven’t seen in a while.’”

“The virus doesn’t know tribes, it doesn’t know boundaries, it just doesn’t know,” says Robert Waldinger. “And that, in some ways, is a dramatic reminder of how connected we are.”

“Mostly, we think our relationships just are what they are, and they take care of themselves,” he adds. The pandemic has played a part in disabusing people of that notion, forcing people to think harder about the social interactions they are and aren’t having, and how they can maintain them. “The one thing that the pandemic does is it really emphasizes our interconnectedness, right?” he says. “The virus doesn’t know tribes, it doesn’t know boundaries, it just doesn’t know….And that, in some ways, is a dramatic reminder of how connected we are.”

“I think the stigma of loneliness can change radically right now,” Nobel says. “We’re lonely now not because someone might not like us, or we might get rejected….We’re lonely because we’re forced to take very specific actions in response to a common enemy.” And when the reasons for loneliness are clear, the answers may come more easily, too.

It took some time for Bradley Riew to realize that his problem, above all else, had been loneliness. But that awareness, and knowing that it wasn’t his fault, enabled him to do something about it.

When he returned for his junior year in 2016, he reduced his volunteering from 20 hours to four hours a week. He hung out with his roommates a lot and sought out students who valued “being there for friends” as much as he did—something that wasn’t always easy in the fast-paced Harvard environment. Slowly, he felt his network growing; he felt less alone and saw there were people around whom he trusted and who trusted him. “I realized that it doesn’t really matter how much work I do and how much stuff I put out,” he says. “What really matters is who do I hang out with on Friday? And do I show up for them when they need me to be there?”

Seeing how investing in connections improved his life, he began working with Jeremy Nobel at the Foundation for Art & Healing. He focused much of his work on the organization’s “UnLonely Project,” where he helped spread awareness about loneliness and how to cope. When lockdowns began, he helped transition the “Aging UnLonely” support group, for adults over 65, to a Zoom environment.

The social implications of COVID-19 might have thrown Riew for a loop years ago, but now they strike him more as a personal challenge—“Like, ‘Okay, well, we’re going to level up and throw you something harder.’”

It’s still tough. He lives in New York City, now working at the mental-health nonprofit BrainFutures, but his friends are all across the country. His co-workers are friendly, but not really his friends, and he no longer sees them in person. But he doesn’t feel any reason to suffer quietly with loneliness. He might not always have the energy to reach out, but he knows doing so will keep him grounded and sane, even if it means going for long walks in Central Park with friends while keeping six feet apart and wearing masks.

“I think there’s a lot of people out there who are suffering quietly and don’t really know why. For a subset of those people—the reason why is loneliness. That’s the thing,” he says. “It’s like turning the light on. Once you see it, then you know, and then you can act.” 

Associate editor Jacob Sweet most recently covered student and faculty experiences with distanced learning in “School Goes Remote” (November-December 2020).

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A psychologist explains how modern life is making us lonely, but it doesn’t have to

Young or old, rich or poor, many of us will experience a longing for social contact at some point in our lives. But the unbearable loneliness of being doesn't have to be inevitable.

Dean Burnett

It may seem an obvious outcome of a pandemic where social contact is discouraged, even made illegal, but concerns about rising levels of loneliness were common before the pandemic, and will likely continue for the foreseeable.

Humans are an incredibly social species. That’s one of the reasons we have such powerful brains and advanced intelligence ; to better keep track of and maintain numerous relationships. Our social interactions are a huge factor in how we think, act, and see ourselves, because much of our brains is dedicated to social cognition. Completely depriving someone of any human contact is a recognised form of torture.

Basically, human wellbeing depends on interpersonal interactions and relationships. It’s no wonder that prolonged loneliness is associated with many serious health consequences such as an increased risk of depression, anxiety, dementia, stroke and heart disease, so an epidemic of it should be taken very seriously.

Is it inevitable, though? Are humans destined to experience loneliness, no matter what we do? That may seem to be the case when you look at it from a certain angle. While we’re undeniably social, humans also evolved in a tribal setting, where a few dozen individuals stuck together their whole (short) lives.

This has undoubtedly shaped how we work and what we’ve become . In the grand scheme of things, until relatively recently, in the developed world at least, your average human lived an existence which didn’t much deviate from this. We typically lived, worked, and raised families as part of tight communities, where everyone knew everyone and there was always someone around.

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• Regular yoga practice may reduce symptoms of depression
• Hitting the wall: Can you change your mindset to endure lockdown more successfully?

This is less and less common in the modern world. Blame capitalism, neoliberalism, individualism, globalisation, technology, or anything else which undoubtedly had a part to play in bringing about such changes. The fact is, spending your whole life in the same community and region is not the default now. Many of us go off to university, or relocate across the country, even across continents, chasing the available jobs and opportunities (just ask any academic).

While this may be the best approach on an individual basis, it means we often lack the ability, or opportunity, to ‘put down roots’, and thus build up a network of friends and relations that could be relied upon to counteract eventual loneliness. So, thanks to the world we’ve created for ourselves, is loneliness inevitable?

Not quite. Because the mechanisms of loneliness aren’t quite as straightforward as we might think. The traditional image tied to the loneliness epidemic is that of an older person, past retirement age, living alone, because the modern world and the march of time has deprived them of the ability to interact with close friends and family. And while there are undoubtedly many examples of such people out there, recent evidence suggests that the actual picture is more complex.

For instance a 2018 survey of 20,000 Americans found fewer elderly people experienced loneliness than younger generations , even though the older generations were less likely to be able to do anything about their loneliness. Especially, according to a recent study at Harvard, older teens and young adults, who seem to be hit hardest by it overall, particularly during the pandemic .

This actually makes a certain amount of sense; elderly people have lived much longer and have thus had more time to cultivate lasting relationships, while younger people haven’t.

Also, feelings of loneliness are logically more likely in younger generations, given that their brain is extra-sensitive to peer approval and relationships. Plus, the younger generation increasingly find themselves in a demanding and uncertain world where the traditional means of fostering relationships are ever more difficult. The main issue here is that younger people still have ample time and capacity to make friends and forge meaningful connections, while lonely elderly people seldom do.

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• Early risers and night owls: A neuroscientist explains who is happiest
• COVID lockdowns have made us forgetful. A psychologist explains why (and what you can do about it)

Also, a recent study by National Institute on Aging found that loneliness and social isolation seem to be different things . This means you can actually be cut off from much human contact, and not necessarily feel lonely. On the flip side, you may have a lot of human contact, and still feel lonely. This is likely because loneliness comes from a lack of emotionally rewarding, meaningful connections. As long as you have a few of those, you may still avoid feelings of loneliness.

It’s not so much that loneliness is inevitable, so much as the world around us keeps changing, and long-established means of maintaining relationships or a communal existence often no longer apply. People experiencing loneliness is a likely outcome of this. But while the world around is changing, so are the people in it.

Recent studies show that lonely elderly people taught to use social media experience little to no change in their loneliness , while younger people, born and raised in an online world, readily form meaningful relationships online (for better or worse). Unless something drastic happens in the interim, it suggests that when the younger generations become the older generations, they’ll not struggle with alleviating their loneliness via the internet.

All in all, it could be argued that increasing loneliness is one admittedly common consequence of a world and society constantly undergoing significant change. But increasing acceptance of things like remote technological connections, and movement away from habits like suppressing or denying emotions (particularly in men ), could well counteract it.

It may be that loneliness is something experienced by many people for many years to come. But it need not be permanent, and it need not be inevitable.

• Visit the BBC’s Reality Check website at bit.ly/reality_check_ or follow them on Twitter @BBCRealityCheck

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Loneliness: Causes and Health Consequences

Loneliness vs. solitude.

• Health Risks

While common definitions of loneliness describe it as a state of solitude or being alone, loneliness is actually a state of mind. Loneliness causes people to feel empty, alone, and unwanted. People who are lonely often crave human contact, but their state of mind makes it more difficult to form connections with others.

Growing concerns around the dangers of loneliness have prompted a call to action by US Surgeon General Vivek Murthy, who recently issued an 82-page advisory on the issue. The advisory cites data from several studies, including research that found that nearly half of adults in the US experience feelings of loneliness daily.

Murthy's report also cites a meta-analysis that found that the risk of premature death due to loneliness increased by 26% and 29% due to social isolation. Furthermore, the lack of social connection can increase the risk of anxiety, depression, stroke, heart disease, and dementia.

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Defining Loneliness

Loneliness is a universal human emotion that is both complex and unique to each individual. Because it has no single common cause, preventing and treating this potentially damaging state of mind can vary dramatically.

For example, a lonely child who struggles to make friends at school has different needs than a lonely older adult whose spouse has recently died.

Researchers suggest that loneliness is associated with social isolation, poor social skills, introversion, and depression.

Loneliness, according to many experts, is not necessarily about being alone. Instead, if you feel alone and isolated, then that is how loneliness plays into your state of mind.

For example, a college freshman might feel lonely despite being surrounded by roommates and other peers. A soldier beginning their military career might feel lonely after being deployed to a foreign country, despite being constantly surrounded by other troop members.

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Are You Feeling Lonely? Take the Test

This fast and free loneliness test can help you analyze your current emotions and determine whether or not you may be feeling lonely at the moment:

While research clearly shows that loneliness and isolation are bad for both mental and physical health, being alone is not the same as being lonely. In fact, solitude actually has a number of important mental health benefits, including allowing people to better focus and recharge.

• Loneliness is marked by feelings of isolation despite wanting social connections. It is often perceived as an involuntary separation, rejection, or abandonment by other people.
• Solitude , on the other hand, is voluntary. People who enjoy spending time by themselves continue to maintain positive social relationships that they can return to when they crave connection. They still spend time with others, but these interactions are balanced with periods of time alone.

Loneliness is a state of mind linked to wanting human contact but feeling alone. People can be alone and not feel lonely, or they can have contact with people and still experience feelings of isolation.

Causes of Loneliness

Contributing factors to loneliness include situational variables, such as physical isolation, moving to a new location, and divorce. The death of someone significant in a person's life can also lead to feelings of loneliness.

Additionally, it can be a symptom of a psychological disorder such as depression. Depression often causes people to withdrawal socially, which can lead to isolation. Research also suggests that loneliness can be a factor that contributes to symptoms of depression.

Loneliness can also be attributed to internal factors such as low self-esteem . People who lack confidence in themselves often believe that they are unworthy of the attention or regard of other people, which can lead to isolation and chronic loneliness .

Personality factors may also play a role. Introverts , for example, might be less likely to cultivate and seek social connections, which can contribute to feelings of isolation and loneliness.

Health Risks Associated With Loneliness

Loneliness has a wide range of negative effects on both physical and mental health , including:

• Alcohol and drug misuse
• Altered brain function
• Alzheimer's disease progression
• Antisocial behavior
• Cardiovascular disease and stroke
• Decreased memory and learning
• Depression and suicide
• Increased stress levels
• Poor decision-making

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. 

For more mental health resources, see our National Helpline Database .

These are not the only areas in which loneliness takes its toll. For example, lonely adults get less exercise than those who are not lonely. Their diet is higher in fat, their sleep is less efficient, and they report more daytime fatigue. Loneliness also disrupts the regulation of cellular processes deep within the body, predisposing lonely people to premature aging.

What Research Suggests About Loneliness

People who feel less lonely are more likely to be married, have higher incomes, and have higher educational status. High levels of loneliness are associated with physical health symptoms, living alone, small social networks, and low-quality social relationships.

Close Friends Help Combat Loneliness

Statistics suggest that loneliness is becoming increasingly prevalent, particularly in younger generations. According to one 2019 survey, 25% of adults between the ages of 18 and 27 reported having no close friends, while 22% reported having no friends at all.

The rise of the internet and ironically, social media, are partially to blame.

Experts believe that it is not the quantity of social interaction that combats loneliness, but the quality .

Having a few close friends is enough to ward off loneliness and reduce the negative health consequences associated with this state of mind. Research suggests that the experience of actual face-to-face contact with friends helps boost people's sense of well-being.

Loneliness Can Be Contagious

One study suggests that loneliness may actually be contagious. Research has found that non-lonely people who spend time with lonely people are more likely to develop feelings of loneliness.

Tips to Prevent and Overcome Loneliness

Loneliness can be overcome. It does require a conscious effort to make a change. In the long run, making a change can make you happier, healthier, and enable you to impact others around you in a positive way.

Here are some ways to prevent loneliness:

• Consider community service or another activity that you enjoy . These situations present great opportunities to meet people and cultivate new friendships and social interactions.
• Expect the best . Lonely people often expect rejection, so instead, try focusing on positive thoughts and attitudes in your social relationships.
• Focus on developing quality relationships . Seek people who share similar attitudes, interests, and values with you.
• Recognize that loneliness is a sign that something needs to change. Don't expect things to change overnight, but you can start taking steps that will help relieve your feelings of loneliness and build connections that support your well-being.
• Understand the effects of loneliness on your life . There are physical and mental repercussions to loneliness. If you recognize some of these symptoms affecting how you feel, make a conscious effort to combat them.
• Join a group or start your own . For example, you might try creating a Meetup group where people from your area with similar interests can get together. You might also consider taking a class at a community college, joining a book club, or taking an exercise class.
• Strengthen a current relationship . Building new connections is important, but improving your existing relationships can also be a great way to combat loneliness. Try calling a friend or family member you have spoken to in a while.
• Talk to someone you can trust . Reaching out to someone in your life to talk about what you are feeling is important. This can be someone you know such as a family member, but you might also consider talking to your doctor or a therapist. Online therapy can be a great option because it allows you to contact a therapist whenever it is convenient for you.

Loneliness can leave people feeling isolated and disconnected from others. It is a complex state of mind that can be caused by life changes, mental health conditions, poor self-esteem, and personality traits. Loneliness can also have serious health consequences including decreased mental wellness and physical problems.

Loneliness can have a serious effect on your health, so it is important to be able to recognize signs that you are feeling lonely. It is also important to remember that being alone isn't the same as being lonely. 

If loneliness is affecting your well-being, there are things that you can do that can help you form new connections and find the social support that you need. Work on forming new connections and spend some time talking to people in your life. If you're still struggling, consider therapy. Whatever you choose to do, just remember that there are people who can help.

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Hämmig O. Health risks associated with social isolation in general and in young, middle and old age [published correction appears in PLoS One. 2019 Aug 29;14(8):e0222124].  PLoS One . 2019;14(7):e0219663. doi:10.1371/journal.pone.0219663

Xia N, Li H. Loneliness, social isolation, and cardiovascular health . Antioxid Redox Signal . 2018 Mar 20;28(9):837-851. doi:10.1089/ars.2017.7312

Schrempft S, Jackowska M, Hamer M, Steptoe A. Associations between social isolation, loneliness, and objective physical activity in older men and women .  BMC Public Health . 2019;19(1):74. doi:10.1186/s12889-019-6424-y

Shovestul B, Han J, Germine L, Dodell-Feder D. Risk factors for loneliness: The high relative importance of age versus other factors .  PLoS One . 2020;15(2):e0229087. doi:10.1371/journal.pone.0229087

Ballard J. Millennials are the loneliest generation . YouGov.

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By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

The rise of modern loneliness: 4 essential reads

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Editor’s note: As we come to the end of the year, Conversation editors take a look back at the stories that – for them – exemplified 2018.

In early December, The Wall Street Journal published a feature titled “The Loneliest Generation.”

“Baby boomers,” the article notes , “are aging alone more than any generation in U.S. history, and the resulting loneliness is a looming public health threat.”

The irony is that – in the midst of this loneliness crisis – we’re closer and more connected than ever before. Americans are moving to cities in record numbers , while internet use and smartphone ownership continue to grow.

What’s going on? Shouldn’t trends that ostensibly connect people and bring them closer together mitigate, not exacerbate, loneliness?

The way the meaning of loneliness has shifted – from physical solitude, to psychological isolation – could offer some clues.

1. To stray ‘far from neighbours’

When researching the Romantic poets, Amherst College English professor Amelia Worsley discovered that the concept of loneliness didn’t emerge until the late-16th century . It was first used to describe the dangers of straying too far from society – to surrender the protections of town and city and enter the unknown.

To be lonely, according to one 17th-century glossary, was to be “far from neighbours.”

2. New World loneliness

As the first European explorers left their neighbors and ventured across the Atlantic, they didn’t know what they’d find. What awaited them in the New World, University of Southern California historian Peter Mancall writes, was left to the imagination : creatures with heads in their chests, brutes with a single, massive leg and cyclops.

The Pilgrims didn’t encounter any of these monsters. But according to William Bradford , the first governor of Plymouth Colony, they nonetheless needed to contend with “a hideous and desolate wilderness, full of wild beasts and wild men.”

While they had God and they had each other, there wasn’t much else. A Native American raid could wipe out the entire settlement; a single strain of disease could kill off the whole group.

They were – in the earliest sense of the word – unbearably lonely.

3. The wilderness of the web

The Pilgrims, due to a combination of luck and skill , survived. Others soon joined them. Land was cleared, streets were laid and a country was built.

Over the centuries, as people grew closer and more connected, the old definition of loneliness slipped away.

“Modern loneliness,” Worsley writes, “isn’t just about being physically removed from other people. Instead, it’s an emotional state of feeling apart from others – without necessarily being so.”

Much of this new form of loneliness seems connected to another world – cyberspace – that opened up at the end of the 20th century.

Like the vast, untouched forests of the New World, the wilderness of the web can be imposing, unsparing and lawless. While there might not be literal monsters, trolls pounce, hackers lurk, governments spy and corporations glean data from your messages, searches and purchases.

What – and who – can be trusted ?

4. A sea of information

Yes, all of human knowledge is at our fingertips. But this has created another problem unique to the internet age: information overload.

University of Nevada, Las Vegas sociologist Simon Gottschalk spent a decade studying the social and psychological effects of new information and communication technologies.

“Our devices constantly expose us to a barrage of colliding and clamoring messages,” he writes . The unending stream of alerts and pings “deteriorates how we approach our everyday activities, deforms how we relate to each other and erodes a stable sense of self. It leads to burnout at one end of the continuum and to depression at the other.”

The overwhelming sea of information creates a sense of being unmoored – tugged in one direction by tweets and advertisements, spun in another by breaking news alerts and email notifications.

At the mercy of these forces, exposed to exploitation, unsure of whom to trust, it’s difficult not to feel small, to feel helpless – to feel alone.

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Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms

Louise c. hawkley.

Center for Cognitive and Social Neuroscience, University of Chicago, Chicago, IL, USA. Department of Psychology, University of Chicago, 940 E. 57th St, Chicago, IL 60637, USA

John T. Cacioppo

Center for Cognitive and Social Neuroscience, University of Chicago, Chicago, IL, USA

As a social species, humans rely on a safe, secure social surround to survive and thrive. Perceptions of social isolation, or loneliness, increase vigilance for threat and heighten feelings of vulnerability while also raising the desire to reconnect. Implicit hypervigilance for social threat alters psychological processes that influence physiological functioning, diminish sleep quality, and increase morbidity and mortality. The purpose of this paper is to review the features and consequences of loneliness within a comprehensive theoretical framework that informs interventions to reduce loneliness. We review physical and mental health consequences of loneliness, mechanisms for its effects, and effectiveness of extant interventions. Features of a loneliness regulatory loop are employed to explain cognitive, behavioral, and physiological consequences of loneliness and to discuss interventions to reduce loneliness. Loneliness is not simply being alone. Interventions to reduce loneliness and its health consequences may need to take into account its attentional, confirmatory, and memorial biases as well as its social and behavioral effects.

Introduction

Loneliness is a common experience; as many as 80% of those under 18 years of age and 40% of adults over 65 years of age report being lonely at least sometimes [ 1 – 3 ], with levels of loneliness gradually diminishing through the middle adult years, and then increasing in old age (i.e., ≥70 years) [ 2 ]. Loneliness is synonymous with perceived social isolation, not with objective social isolation. People can live relatively solitary lives and not feel lonely, and conversely, they can live an ostensibly rich social life and feel lonely nevertheless. Loneliness is defined as a distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships [ 2 , 4 – 6 ]. Loneliness is typically measured by asking individuals to respond to items such as those on the frequently used UCLA Loneliness Scale [ 7 ]: “I feel isolated,” “There are people I can talk to,” and “I feel part of a group of friends.” The result is a continuum of scores that range from highly socially connected to highly lonely.

Each of us is capable of feeling lonely, and loneliness is an equal opportunity tenant for good reason. We have posited that loneliness is the social equivalent of physical pain, hunger, and thirst; the pain of social disconnection and the hunger and thirst for social connection motivate the maintenance and formation of social connections necessary for the survival of our genes [ 8 , 9 ]. Feelings of loneliness generally succeed in motivating connection or reconnection with others following geographic relocation or bereavement, for instance, thereby diminishing or abolishing feelings of social isolation. For as many as 15–30% of the general population, however, loneliness is a chronic state [ 10 , 11 ]. Left untended, loneliness has serious consequences for cognition, emotion, behavior, and health. Here, we review physical and mental health consequences of perceived social isolation and then introduce mechanisms for these outcomes in the context of a model that takes into consideration the cognitive, emotional, and behavioral characteristics of loneliness.

Loneliness Matters for Physical Health and Mortality

A growing body of longitudinal research indicates that loneliness predicts increased morbidity and mortality [ 12 – 19 ]. The effects of loneliness seem to accrue over time to accelerate physiological aging [ 20 ]. For instance, loneliness has been shown to exhibit a dose–response relationship with cardiovascular health risk in young adulthood [ 12 ]. The greater the number of measurement occasions at which participants were lonely (i.e., childhood, adolescence, and at 26 years of age), the greater their number of cardiovascular health risks (i.e., BMI, systolic blood pressure (SBP), total, and HDL cholesterol levels, glycated hemoglobin concentration, maximum oxygen consumption). Similarly, loneliness was associated with increased systolic blood pressure in a population-based sample of middle-aged adults [ 21 ], and a follow-up study of these same individuals showed that a persistent trait-like aspect of loneliness accelerated the rate of blood pressure increase over a 4-year follow-up period [ 22 ]. Loneliness accrual effects are also evident in a study of mortality in the Health and Retirement Study; all-cause mortality over a 4-year follow-up was predicted by loneliness, and the effect was greater in chronically than situationally lonely adults [ 17 ]. Penninx et al. [ 15 ] showed that loneliness predicted all-cause mortality during a 29-month follow-up after controlling for age, sex, chronic diseases, alcohol use, smoking, self-rated health, and functional limitations. Sugisawa et al. [ 18 ] also found a significant effect of loneliness on mortality over a 3-year period, and this effect was explained by chronic diseases, functional status, and self-rated health. Among women in the National Health and Nutrition Survey, chronic high frequency loneliness (>3 days/week at each of two measurement occasions about 8 years apart) was prospectively associated with incident coronary heart disease (CHD) over a 19-year follow-up in analyses that adjusted for age, race, socioeconomic status, marital status, and cardiovascular risk factors [ 19 ]. Depressive symptoms have been associated with loneliness and with adverse health outcomes, but loneliness continued to predict CHD in these women after also controlling for depressive symptoms. Finally, loneliness has also been shown to increase risk for cardiovascular mortality; individuals who reported often being lonely exhibited significantly greater risk than those who reported never being lonely [ 14 ]. In sum, feelings of loneliness mark increased risk for morbidity and mortality, a phenomenon that arguably reflects the social essence of our species.

Loneliness Matters for Mental Health and Cognitive Functioning

The impact of loneliness on cognition was assessed in a recent review of the literature [ 9 ]. Perhaps, the most striking finding in this literature is the breadth of emotional and cognitive processes and outcomes that seem susceptible to the influence of loneliness. Loneliness has been associated with personality disorders and psychoses [ 23 – 25 ], suicide [ 26 ], impaired cognitive performance and cognitive decline over time [ 27 – 29 ], increased risk of Alzheimer’s Disease [ 29 ], diminished executive control [ 30 , 31 ], and increases in depressive symptoms [ 32 – 35 ]. The causal nature of the association between loneliness and depressive symptoms appears to be reciprocal [ 32 ], but more recent analyses of five consecutive annual assessments of loneliness and depressive symptoms have shown that loneliness predicts increases in depressive symptoms over 1-year intervals, but depressive symptoms do not predict increases in loneliness over those same intervals [ 36 ]. In addition, experimental evidence, in which feelings of loneliness (and social connectedness) were hypnotically induced, indicates that loneliness not only increases depressive symptoms but also increases perceived stress, fear of negative evaluation, anxiety, and anger, and diminishes optimism and self-esteem [ 8 ]. These data suggest that a perceived sense of social connectedness serves as a scaffold for the self—damage the scaffold and the rest of the self begins to crumble.

A particularly devastating consequence of feeling socially isolated is cognitive decline and dementia. Feelings of loneliness at age 79 predicted “lifetime cognitive change” as indicated by lower IQ at age 79 adjusting for IQ at age 11, living arrangements at age 11 and at age 79, sex, marital status, and ideal level of social support [ 27 ]. This finding does not rule out a reverse causal direction; cognitive impairments may hamper social interactions, prompt social withdrawal, and thus lead to loneliness. Other studies, however, have indicated that loneliness is a precursor of cognitive decline. For instance, the cognitive functioning of 75–85-year-olds (as assessed by the Mini-Mental State Examination) did not differ as a function of loneliness at baseline but diminished to a greater extent among those high than low in loneliness over a 10-year follow-up [ 28 ]. In a prospective study by Wilson et al. [ 29 ], loneliness was inversely associated with performance on a battery of cognitive measures in a sample of 823 initially dementia-free older adults. Moreover, loneliness at baseline was associated with a faster decline in cognitive performance on most of these measures over a 4-year follow-up. This was not true of the converse: cognitive status at baseline did not predict changes in loneliness. In addition, incidence of Alzheimer’s disease (76 individuals) was predicted by degree of baseline loneliness after adjusting for age, sex, and education; those in the top decile of loneliness scores were 2.1 times as likely to develop Alzheimer’s disease than those in the bottom decile of loneliness scores. Depressive symptoms had a modest effect on Alzheimer’s disease risk, but loneliness continued to exert a significant and much larger influence on Alzheimer’s disease than depressive symptoms when depressive symptoms were included in the model [ 29 ]. Overall, it appears that something about our sense of connectedness with others penetrates the physical organism and compromises the integrity of physical and mental health and well-being. What that “something” might be is the topic to which we next turn.

How Loneliness Matters: Mechanisms

The loneliness model.

Our model of loneliness [ 8 , 9 ] posits that perceived social isolation is tantamount to feeling unsafe, and this sets off implicit hypervigilance for (additional) social threat in the environment. Unconscious surveillance for social threat produces cognitive biases: relative to nonlonely people, lonely individuals see the social world as a more threatening place, expect more negative social interactions, and remember more negative social information. Negative social expectations tend to elicit behaviors from others that confirm the lonely persons’ expectations, thereby setting in motion a self-fulfilling prophecy in which lonely people actively distance themselves from would-be social partners even as they believe that the cause of the social distance is attributable to others and is beyond their own control [ 37 ]. This self-reinforcing loneliness loop is accompanied by feelings of hostility, stress, pessimism, anxiety, and low self-esteem [ 8 ] and represents a dispositional tendency that activates neurobiological and behavioral mechanisms that contribute to adverse health outcomes.

Health behaviors

One of the consequences of loneliness and implicit vigilance for social threat is a diminished capacity for self-regulation. The ability to regulate one’s thoughts, feelings, and behavior is critical to accomplish personal goals or to comply with social norms. Feeling socially isolated impairs the capacity to self-regulate, and these effects are so automatic as to seem outside of awareness. In a dichotic listening task, for instance, right-handed individuals quickly and automatically attend preferentially to the pre-potent right ear. Latency to respond to stimuli presented to the non-dominant ear can be enhanced, however, by instructing participants to attend to their left ear. Among young adults who were administered this task, the lonely and nonlonely groups did not differ in performance when directed to attend to their pre-potent right ear, but the lonely group performed significantly worse than the nonlonely group when directed to shift attention to their non-prepotent left ear [ 30 ]. In other words, automatic attentional processes may be unimpaired, but effortful attentional processes are compromised in lonely relative to socially connected individuals.

Of relevance for health is the capacity for self-regulation in the arena of lifestyle behaviors. Regulation of emotion can enhance the ability to regulate other self-control behaviors [ 38 ], as is evident from research showing that positive affect predicts increased physical activity [ 39 ]. In middle-aged and older adults, greater loneliness was associated with less effort applied to the maintenance and optimization of positive emotions [ 31 ]. Compromised regulation of emotion in lonely individuals explained their diminished likelihood of performing any physical activity, and loneliness also predicted a decrease in physical activity over time [ 31 ]. Physical activity is a well-known protective factor for physical health, mental health, and cognitive functioning [ 40 ], suggesting that poorer self-regulation may contribute to the greater health risk associated with loneliness via diminished likelihood of engaging in health-promoting behaviors. A related literature shows that loneliness is also a risk factor for obesity [ 41 ] and health-compromising behavior, including a greater propensity to abuse alcohol [ 42 ]. To the extent that self-regulation accounts for poorer health behaviors in lonely people, better health behaviors may be more easily accomplished in the actual or perceived company of others. Interestingly, animal research has shown that social isolation dampens the beneficial effects of exercise on neurogenesis [ 43 ], implying that health behaviors may better serve their purpose or have greater effect among those who feel socially connected than those who feel lonely. This hypothesis remains to be tested, but research on the restorative effects of sleep is consistent with this notion.

Countering the physiological effects of the challenge of daily emotional, cognitive, and behavioral experiences, sleep offers physiological restoration. Experimental sleep deprivation has adverse effects on cardiovascular functioning, inflammatory status, and metabolic risk factors [ 44 ]. In addition, short sleep duration has been associated with risk for hypertension [ 45 ], incident coronary artery calcification [ 46 ], and mortality [ 47 ].

What is less appreciated is that sleep quality may also be important in accomplishing sleep’s restorative effects. Nonrestorative sleep (i.e., sleep that is non-refreshing despite normal sleep duration) results in daytime impairments such as physical and intellectual fatigue, role impairments, and cognitive and memory problems [ 48 ]. We have noted that loneliness heightens feelings of vulnerability and unconscious vigilance for social threat, implicit cognitions that are antithetical to relaxation and sound sleep. Indeed, loneliness and poor quality social relationships have been associated with self-reported poor sleep quality and daytime dysfunction (i.e., low energy, fatigue), but not with sleep duration [ 49 – 52 ]. In young adults, greater daytime dysfunction, a marker of poor sleep quality, was accompanied by more nightly micro-awakenings, an objective index of sleep continuity obtained from Sleep-Caps worn by participants during one night in the hospital and seven nights in their own beds at home [ 53 ]. The conjunction of daytime dysfunction and micro-awakenings is consistent with polysomnography studies showing a conjunction, essentially an equivalence, between subjective sleep quality and sleep continuity [ 54 ], and substantiates the hypothesis that loneliness impairs sleep quality.

In an extension of these findings, loneliness was associated with greater daytime dysfunction in a 3-day diary study of middle-age adults, an association that was independent of age, gender, race/ethnicity, household income, health behaviors, BMI, chronic health conditions, daily illness symptom severity, and related feelings of stress, hostility, poor social support, and depressive symptoms. Cross-lagged panel analyses of the three consecutive days indicated potentially reciprocal causal roles for loneliness and daytime dysfunction: lonely feelings predicted daytime dysfunction the following day, and daytime dysfunction exerted a small but significant effect on lonely feelings the following day [ 55 ], effects that were independent of sleep duration. In other words, the same amount of sleep is less salubrious in individuals who feel more socially isolated and, ironically, less salubrious sleep feeds forward to further exacerbate feelings of social isolation. This recursive loop operates outside of consciousness and speaks to the relative impenetrability of loneliness to intervention.

Physiological functioning

The association between loneliness and cardiovascular disease and mortality [ 13 , 14 , 19 ] may have its roots in physiological changes that begin early in life. As noted earlier, chronic social isolation, rejection, and/or feelings of loneliness in early childhood, adolescence, and young adulthood cumulated in a dose–response fashion to predict cardiovascular health risk factors in young adulthood (26 years old), including elevated blood pressure [ 12 ]. In our study of young adults, loneliness was associated with elevated levels of total peripheral resistance (TPR [ 49 , 56 ]). TPR is the primary determinant of SBP until at least 50 years of age [ 57 ], which suggests that loneliness-related elevations in TPR in early to middle-adulthood may lead to higher blood pressure in middle and older age. Consistent with this hypothesis, loneliness was associated with elevated SBP in an elderly convenience sample [ 49 ], and in a population-based sample of 50–68-year-old adults in the Chicago Health, Aging, and Social Relations Study [ 21 ]. The association between loneliness and elevated SBP was exaggerated in older relative to younger lonely adults in this sample [ 21 ], suggesting an accelerated physiological decline in lonely relative to nonlonely individuals. Our recent study of loneliness and SBP in these same individuals over five annual assessments supported this hypothesis. Short-term (i.e., 1 year) fluctuations in loneliness were not significant predictors of SBP changes over 1-year intervals, but a trait-like component of loneliness present at study onset contributed to greater increases in SBP over 2-, 3-, and 4-year intervals [ 22 ]. These increases were cumulative such that higher initial levels of loneliness were associated with greater increases in SBP over a 4-year period. The prospective effect of loneliness on SBP was independent of age, gender, race/ethnicity, cardiovascular risk factors, medications, health conditions, and the effects of depressive symptoms, social support, perceived stress, and hostility [ 22 ]. Elevated SBP is a well-known risk factor for chronic cardiovascular disease, and these data suggest that the effects of loneliness accrue to accelerate movement along a trajectory toward serious health consequences [ 20 ].

The physiological determinants responsible for the cumulative effect of loneliness on blood pressure have yet to be elucidated. TPR plays a critical role in determining SBP in early to mid-adulthood, but other mechanisms come into play with increasing age. Candidate mechanisms include age-related changes in vascular physiology, including increased arterial stiffness [ 58 ], diminished endothelial cell release of nitric oxide, enhanced vascular responsivity to endothelial constriction factors, increases in circulating catecholamines, and attenuated vasodilator responses to circulating epinephrine due to decreased beta-adrenergic sensitivity in vascular smooth muscle [ 59 – 61 ]. In turn, many of these mechanisms are influenced by lifestyle factors such as diet, physical inactivity, and obesity—factors that alter blood lipids and inflammatory processes that have known consequences for vascular health and functioning [ 62 , 63 ].

Neuroendocrine Effects

Changes in TPR levels are themselves influenced by a variety of physiological processes, including activity of the autonomic nervous system and the hypothalamic-pituitary adrenocortical (HPA) axis. The sympathetic branch of the autonomic nervous system plays a major role in maintaining basal vascular tone and TPR [ 64 , 65 ] and elevated sympathetic tone is responsible for the development and maintenance of many forms of hypertension [ 66 ]. To date, loneliness has not been shown to correlate with SNS activity at the myocardium (i.e., pre-ejection period [ 21 , 56 ]) but was associated with a greater concentration of epinephrine in overnight urine samples in a middle-aged and older adult sample [ 21 ]. At high concentrations, circulating epinephrine binds α-1 receptors on vascular smooth muscle cells to elicit vasoconstriction and could thereby serve as a mechanism for increased SBP in lonely individuals.

Activation of the HPA axis involves a cascade of signals that results in release of ACTH from the pituitary and cortisol from the adrenal cortex. Vascular integrity and functioning are beholden, in part, to well-regulated activity of the HPA axis. Dysregulation of the HPA axis contributes to inflammatory processes that play a role in hypertension, atherosclerosis, and coronary heart disease [ 67 – 69 ]. Loneliness has been associated with urinary excretion of significantly higher concentrations of cortisol [ 70 ], and, in more recent studies, with higher levels of salivary or plasma cortisol [ 71 , 72 ]. Pressman et al. [ 72 ] found that loneliness was associated with higher early morning and late night levels of circulating cortisol in young adult university students, and Steptoe et al. [ 71 ] found that chronically high levels of trait loneliness in middle-aged adults (M=52.4 years) predicted greater increases in salivary cortisol during the first 30 min after awakening (i.e., cortisol awakening response) such that the cortisol awakening response in individuals in the highest loneliness tertile was 21% greater than that in the lowest tertile. In our study of middle-aged and older adults, day-today fluctuations in feelings of loneliness were associated with individual differences in the cortisol awakening response. For this study, diary reports of daily psychosocial, emotional, and physical states were completed at bedtime on each of three consecutive days, and salivary cortisol levels were measured at wakeup, 30 min after awakening, and at bedtime each day. Parallel multilevel causal models revealed that prior-day feelings of loneliness and related feelings of sadness, threat, and lack of control were associated with a higher cortisol awakening response the next day, but morning cortisol awakening response did not predict experiences of these psychosocial states later the same day [ 73 ]. Social evaluative threat is known to be a potent elicitor of cortisol [ 74 ], and our theory that loneliness is characterized by chronic threat of and hypervigilance for negative social evaluation [ 9 ] is consistent with the finding that loneliness predicts increased cortisol awakening response. The relevance of the association between loneliness and HPA regulation is particularly noteworthy given recent evidence that loneliness-related alterations in HPA activity may occur at the level of the gene, a topic to which we turn next.

Gene Effects

Cortisol regulates a wide variety of physiological processes via nuclear hormone receptor-mediated control of gene transcription. Cortisol activation of the glucocorticoid receptor, for instance, exerts broad anti-inflammatory effects by inhibiting pro-inflammatory signaling pathways. Given that loneliness is associated with elevated cortisol levels, loneliness might be expected to reduce risk for inflammatory diseases. However, as we have noted above, feelings of loneliness and social isolation are associated with increased risk for inflammatory disease. This finding may be attributable to impaired glucocorticoid receptor-mediated signal transduction; failure of the cellular genome to “hear” the anti-inflammatory signal sent by circulating glucocorticoids permits inflammatory processes to continue relatively unchecked. We found evidence consistent with glucocorticoid insensitivity in our examination of gene expression rates in chronically lonely versus socially connected older adults [ 75 ]. Genome-wide microarray analyses revealed that 209 transcripts, representing 144 distinct genes, were differentially expressed in these two groups. Markers of immune activation and inflammation (e.g., pro-inflammatory cytokines and inflammatory mediators) were over-expressed in genes of the lonely relative to the socially connected group (37% of the 209 differentially expressed transcripts). Markers of cell cycle inhibitors and an inhibitor of the potent pro-inflammatory NF–κB transcript were under-expressed in genes of the lonely relative to the socially connected group (63% of the differentially expressed transcripts). The net functional implication of the differential gene transcription favored increased cell cycling and inflammation in the lonely group [ 75 ].

Subsequent bioinformatic analyses indicated that loneliness-associated differences in gene expression could be attributable to increased activity of the NF–κB transcription factor. NF–κB is known to up-regulate inflammation-related genes, and its activity is antagonized by the glucocorticoid receptor. Bioinformatic analyses also indicated a possible decrease in glucocorticoid receptor-mediated transcription in the lonely group, despite the fact that there were no group differences in circulating glucocorticoid levels. These results are consistent with the hypothesis that adverse social conditions result in functional desensitization of the glucocorticoid receptor, which permits increased NF–κB activity and thereby induces a pro-inflammatory bias in gene expression. Group differences in NF–κB/glucocorticoid receptor-mediated transcription activity were not attributable to objective indices of social isolation, nor were they explained by demographic, psychosocial (i.e., perceived stress, depression, hostility), or medical risk factors [ 75 ]. These results suggest that feelings of loneliness may exert a unique transcriptional influence that has potential relevance for health.

In an extension of this work, a recent study showed that feelings of social isolation were associated with a proxy measure of functional glucocorticoid insensitivity [ 76 ]. The composition of the leukocyte population in circulation is subject to the regulatory influence of glucocorticoids; high cortisol levels increase circulating concentrations of neutrophils and simultaneously decrease concentrations of lymphocytes and monocytes. In a study of older Taiwanese adults, this relationship was reflected in a positive correlation between cortisol levels and the ratio of neutrophil percentages relative to lymphocyte or monocyte percentages. However, in lonely individuals, this correlation was attenuated and nonsignificant, consistent with a diminished effect of cortisol at the level of leukocytes.

The precise molecular site of glucocorticoid insensitivity in the pro-inflammatory transcription cascade has yet to be identified, and additional longitudinal and experimental research are needed to determine the degree to which chronic feelings of social isolation play a causal role in differential gene expression. However, the association between subjective social isolation and gene expression corresponds well to gene expression differences in animal models of social isolation (e.g., [ 77 – 79 ]), suggesting that a subjective sense of social connectedness is important for genomic expression and normal immunoregulation in humans. Impaired transcription of glucocorticoid response genes and increased activity of pro-inflammatory transcription control pathways provide a functional genomic explanation for elevated risk of inflammatory disease in individuals who experience chronically high levels of loneliness.

Immune Functioning

Loneliness differences in immunoregulation extend beyond inflammation processes. Loneliness has been associated with impaired cellular immunity as reflected in lower natural killer (NK) cell activity and higher antibody titers to the Epstein Barr Virus and human herpes viruses [ 70 , 80 – 82 ]. In addition, loneliness among middle-age adults has been associated with a smaller increase in NK cell numbers in response to the acute stress of a Stroop task and a mirror tracing task [ 71 ]. In young adults, loneliness was associated with poorer antibody response to a component of the flu vaccine [ 72 ], suggesting that the humoral immune response may also be impaired in lonely individuals. Among HIV-positive men without AIDS, loneliness was associated with a lower count of CD4 T-lymphocytes in one study [ 83 ] but was not associated with the CD4 count in another study [ 84 ]. However, in the latter study, loneliness predicted a slower rate of decline in levels of CD4 T-lymphocytes over a 3-year period [ 84 ]. These data suggest that loneliness protects against disease progression, but no association was observed between loneliness and time to AIDS diagnosis or AIDS-related mortality [ 84 ]. Additional research is needed to examine the role of loneliness chronicity, age, life stress context, genetic predispositions, and interactions among these factors to determine when and how loneliness operates to impair immune functioning.

Future Loneliness Matters

Interventions for loneliness.

Six qualitative reviews of the loneliness intervention literature have been published since 1984 [ 85 – 90 ], and all explicitly or implicitly addressed four main types of interventions: (1) enhancing social skills, (2) providing social support, (3) increasing opportunities for social interaction, and (4) addressing maladaptive social cognition. All but one of these reviews concluded that loneliness interventions have met with success, particularly interventions which targeted opportunities for social interaction. Findlay [ 87 ] was more cautious in his review, noting that only six of the 17 intervention studies in his review employed a randomized group comparison design, with the remaining 11 studies subject to the shortcomings and flaws of pre-post and nonrandomized group comparison designs.

We recently completed a meta-analysis of loneliness intervention studies published between 1970 and September 2009 to test the magnitude of the intervention effects within each type of study design and to determine whether the intervention target moderated effect sizes (Masi et al., unpublished). Of the 50 studies eligible for inclusion in the meta-analysis, 12 were pre-post studies, 18 were non-randomized group comparison studies, and 20 were randomized group comparison studies. Effect sizes were significantly different from zero within each study design group, but randomized group comparison studies produced the smallest effect overall (pre-post=−0.37, 95% CI −.55, −.18; non-randomized control=−0.46, 95% CI −0.72, −0.20; randomized control=−0.20, 95% CI −0.32, −0.08).

Our model of loneliness holds that implicit hypervigilance for social threat exerts a powerful influence on perceptions, cognitions, and behaviors, and that loneliness may be diminished by reducing automatic perceptual and cognitive biases that favor over-attention to negative social information in the environment. Accordingly, we posited that interventions that targeted maladaptive social cognition (e.g., cognitive behavioral therapy that involved training to identify automatic negative thoughts and look for disconfirming evidence, to decrease biased cognitions, and/or to reframe perceptions of loneliness and personal control) would be more effective than interventions that targeted social support, social skills, or social access. Moderational analyses of the randomized group comparison studies supported our hypothesis: the effect size for social cognition interventions (−0.60, 95% CI −0.96, −0.23, N = 4) was significantly larger than the effect size for social support (−0.16, 95% CI −0.27, −0.06, N =12), social skills (0.02, 95% CI −0.24, 0.28, N =2), and social access (−0.06, 95% CI −0.35, 0.22, N =2); the latter three types of interventions did not differ significantly from each other. The results for social cognitive therapy are promising, but this intervention type appears not to have been widely employed to date relative to other types of loneliness therapy. Moreover, existing social cognitive therapies have had a small effect overall (0.20) relative to the meta-analytic mean effect of over 300 other interventions in the social and behavioral domains (0.50) [ 91 ]. A social cognitive approach to loneliness reduction outlined in a recent book [ 92 ] may encourage therapists to develop a treatment that focuses on the specific affective, cognitive, and behavioral propensities that afflict lonely individuals.

Implications for Health

Reducing feelings of loneliness and enhancing a sense of connectedness and social adhesion are laudable goals in their own right, but a critical question is whether modifying perceptions of social isolation or connectedness have any impact on health. VanderWeele et al. (unpublished) recently examined the reduction in depressive symptoms that could be expected if loneliness were successfully reduced and found there would be significant benefits that would accrue for as long as two years following the intervention. Would a successful intervention to lower loneliness produce corresponding benefits in physiological mechanisms and physical health outcomes? The only extant data to address this question comes from a recent study in which 235 lonely home-dwelling older adults (>74 years) were randomly assigned to an intervention or control group. In the treatment arm of the study, closed small groups of seven to eight individuals met with two professional facilitators once a week for 3 months to participate in group activities in art, exercise, or therapeutic writing. The control group continued to receive usual community care. Relative to the control group, individuals in the treatment group became more socially active, found new friends, and experienced an increase in feeling needed [ 93 ]. This was accompanied by a significant improvement in self-rated health, fewer health care services and lower costs, and greater survival at 2-year follow-up [ 94 ]. Feelings of loneliness did not differ between the groups, however [ 93 ], indicating that changes in loneliness were not responsible for improvements in health. According to our theory of loneliness, the interventions targeted by the treatment study would not be expected to influence loneliness dramatically because they fail to address the hypervigilance to social threat and the related cognitive biases that characterize lonely individuals. That is, group activities such as those introduced in this intervention provide new social opportunities but do not alter how individuals approach and think about their social relationships more generally. An intervention study of loneliness and health has yet to be designed that addresses the maladaptive social cognitions that make loneliness the health risk factor it increasingly appears to be. Beyond that, additional research is needed to determine the mechanisms through which successful loneliness interventions enhance health and survival, and to examine whether the type of loneliness intervention moderates its health benefits.

Conclusions

Human beings are thoroughly social creatures. Indeed, human survival in difficult physical environments seems to have selected for social group living [ 95 ]. Consider that the reproductive success of the human species hinges on offspring surviving to reproductive age. Social connections with a mate, a family, and a tribe foster social affiliative behaviors (e.g., altruism, cooperation) that enhance the likelihood that utterly dependent offspring reach reproductive age, and connections with others at the individual and collective levels improve our chances of survival in difficult or hostile environments. These behaviors co-evolved with supporting genetic, neural, and hormonal mechanisms to ensure that humans survived, reproduced, and cared for offspring sufficiently long that they, too, could reproduce [ 96 – 98 ]. Human sociality is prominent even in contemporary individualistic societies. Almost 80% of our waking hours are spent with others, and on average, time spent with friends, relatives, spouse, children, and coworkers is rated more inherently rewarding than time spent alone [ 99 , 100 ]. Humans are such meaning-making creatures that we perceive social relationships where no objectifiable relationship exists (e.g., between author and reader, between an individual and God) or where no reciprocity is possible (e.g., in parasocial relationships with television characters). Conversely, we perceive social isolation when social opportunities and relationships do exist but we lack the capacity to harness the power of social connectedness in everyday life. Chronic perceived isolation (i.e., loneliness) is characterized by impairments in attention, cognition, affect, and behavior that take a toll on morbidity and mortality through their impact on genetic, neural, and hormonal mechanisms that evolved as part and parcel of what it means to be human. Future interventions to alleviate the health burden of loneliness will do well to take into account our evolutionary design as a social species.

Acknowledgments

This research was supported by Grant R01-AG036433-01 and R01-AG034052 from the National Institute on Aging and by the John Templeton Foundation.

Contributor Information

Louise C. Hawkley, Center for Cognitive and Social Neuroscience, University of Chicago, Chicago, IL, USA. Department of Psychology, University of Chicago, 940 E. 57th St, Chicago, IL 60637, USA.

John T. Cacioppo, Center for Cognitive and Social Neuroscience, University of Chicago, Chicago, IL, USA.

Loneliness: contemporary insights into causes, correlates, and consequences

• Published: 11 June 2020
• Volume 55 , pages 789–791, ( 2020 )

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• M. H. Lim 1 , 2 ,
• J. Holt-Lunstad 1 , 3 &
• J. C. Badcock 4  

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Loneliness is not a new phenomenon but in recent years, there has been a growing interest in understanding how feelings of ‘perceived social isolation’ can influence our health and wellbeing. Objective indicators of social isolation—such as living alone and number of social connections—have well-demonstrated links with poorer health outcomes [ 1 ]. However, the latest evidence indicates that feeling lonely is also associated with a multitude of poorer health outcomes, ranging from an increased risk of depression and dementia [ 2 ], increased risk of heart disease and stroke [ 3 ] and higher levels of inflammatory responses [ 4 ] to name a few. Indeed, those who are socially isolated (odds ratio = 1.29; 95% CI 1.06, 1.56), living alone (odds ratio = 1.32; 95% CI 1.14, 1.53), or those who are lonely (odds ratio = 1.26, 95% CI 1.04, 1.53) are at increased risk of earlier mortality [ 5 ].

Current “hotspots” in loneliness research include studies examining how perceived social isolation influences mental health symptoms [ 6 ] and disorders [ 7 , 8 , 9 ], older [ 10 ] and younger adults [ 11 ], workplace productivity [ 12 , 13 ], and social media use [ 14 ]. The contributions to this special issue illustrate some of the progress, possibilities, and problems in contemporary research on loneliness, including two systematic reviews [ 15 , 16 ], one conceptual review [ 17 ], two pilot studies evaluating a novel approach to reduce loneliness in young people with psychosis [ 18 , 19 ], and two studies exploring personalized approaches to reduce loneliness [ 20 , 21 ].

First, Ma et al. (2019) provide a review of the effectiveness of interventions targeting subjective and objective social isolation in people with different mental health problems [ 15 ]. The authors examined: (1) interventions that alter maladaptive cognitions about others (e.g., cognitive-behavioural therapy); (2) social skills training and psychoeducation programmes (e.g., family psychoeducation therapy); (3) supported socialisation (e.g., peer support groups); and (4) community approaches (e.g., social prescribing). When considering only those studies specifically targeting interventions for loneliness, Ma et al. [ 15 ] found that the most promising results emerged for cognition modification interventions.

The study by Mihalopoulos et al. [ 16 ] highlights the importance of understanding the economic burden of loneliness and/or social isolation and is one of the first to evaluate the cost-effectiveness of interventions targeting loneliness and/or social isolation. The authors reported that all but one of the published cost-of-illness studies indicated greater healthcare costs for individuals experiencing loneliness and/or social isolation. However, Mihalopoulos et al. [ 16 ] noted that these costs “are likely to be underestimated” due to the limited evidence available, particularly for younger populations. Of the interventions included in this systematic review, the authors highlight “promising” cost-effective interventions that involved increasing social and peer-contact.

In the conceptual review by Lim, Eres, and Vasan [ 17 ], the authors outline emerging and established correlates and risk factors associated with loneliness. Importantly, the review identified two newer variables of interest in loneliness research, namely workplaces and the use of digital communication. Lim and colleagues also highlight the complexity of loneliness and introduce a new conceptual model that describes how multiple risk factors/correlates can affect loneliness severity. The authors stress that there is no ‘one-size-fits-all’ solution for loneliness; rather, how loneliness is resolved is dependent on an individual’s circumstances and available resources.

The next two studies illustrate how a theory-driven approach (i.e., strengths-based positive psychology) was used to develop an intervention targeting loneliness. In a brief report, Lim et al. [ 18 ] evaluate the feasibility and acceptability of a positive psychology intervention group program called Positive Connect for young people experiencing psychosis. This 6-week positive psychology group intervention was designed to help young people identify their strengths and practice interpersonal skills that could be used to build close relationships with others. Preliminary evidence presented suggests that the program is both feasible and acceptable for this patient population. Encouragingly, exploratory analyses also indicate a positive benefit for reducing loneliness over time.

In the second related study, the authors describe the development of the same positive psychology program being translated and delivered via a digital smartphone app called + Connect [ 19 ]. The authors used focus groups to steer the design, functionality, and language of the 6-week program, to facilitate consumer engagement. Using an innovative blend of content, concepts were conveyed via text and videos (featuring young people with lived experience, academics, and actors). The feasibility, acceptability, and usability of + Connect is reported for a pilot sample ( N  = 12) of young people with psychosis, along with tentative evidence of a benefit in reducing loneliness.

The next study by Tymoszuk et al. [ 20 ] looked at the impact of arts engagement on loneliness, specifically, whether the frequency of receptive arts engagement was associated with lower odds of loneliness in older adults. The authors used existing data drawn from the English Longitudinal Study of Ageing (ELSA), analyzing participants (over 50 years old) with complete data on engagement with arts, covariate variables, and loneliness from the second wave ( n  = 6222) for cross-sectional analyses, and loneliness data from the seventh wave ( n  = 3127) for longitudinal analyses. In cross-sectional findings, frequent engagement with arts activities was associated with lowers odds of loneliness. However, longitudinal findings were less supportive, including no evidence that cinema engagement reduced loneliness.

Finally, consistent with the need to develop individualized solutions, Wang et al. [ 21 ] examined variables associated with loneliness for individuals (18–75 years old) leaving a Crisis Resolution Team (CRT). A total of 399 participants, with most reporting depression/anxiety disorders (35.0%), followed by schizophrenia/psychosis (27.0%), bipolar affective/manic (16.3%), and other disorders (8.4%) were included in the analyses. Results showed that loneliness was more severe for individuals who have more mental health contact over the years (2–10 years), compared to those who have less than 3 months, and those who have less than 1 year of mental health service contact. Higher loneliness was also associated with more severe affective, positive or negative symptoms. Those who had depression, anxiety, personality disorders or other disorders compared with those who had psychotic disorders were also lonelier. In those with a mental disorder, lower loneliness was also associated with greater social network size and increased neighbourhood social capital [ 21 ].

Many of the studies in this special issue, draw attention to the importance of the need for rigorous loneliness research so that we can extend our knowledge on how loneliness impacts on health. Accordingly, it is crucial that we measure loneliness as a key variable of interest alongside specific health-related outcomes in future research. In doing so, we are also more likely to measure loneliness in a comprehensive way using psychometrically validated assessment tools, avoiding dichotomous measurement of loneliness to draw accurate comparisons across different samples. Given the significant public health implications, the current studies also call attention to the need for a routine and consistent approach to assessing and documenting loneliness as psychosocial “vital signs” of care [ 7 ].

Many of the reviewed studies also highlight the need to conduct longitudinal research to clarify the relationships between loneliness and poorer health outcomes. Pertinent questions such as ‘are people with pre-existing health problems more predisposed to feeling lonely’, or ‘are people who are lonely more predisposed to developing problematic health conditions?’ have significant, real-world implications for the development of effective treatments.

In addition, it is also clear that greater attention is needed in the development and evaluation of solutions/interventions for loneliness. Designing consumer relevant programs can improve uptake and adherence to programs and Lim et al.’s study shows an example of how consumers are increasingly engaged within research to help tailor evidence-based material to be more engaging to relevant groups [ 19 ]. However, there is currently mixed evidence of what is helpful and unhelpful for loneliness in terms of solutions. Hence, solely relying on consumers’ ideas concerning what they can do to address their own loneliness may be helpful for engagement but may not be necessarily effective. What is more crucial is the rigorous evaluation of theory-driven evidence-based interventions that are intended to reduce loneliness, and researchers need to move swiftly from pilot evaluations to high quality, adequately powered randomised controlled trials (RCTs). Furthermore, economic evaluations of interventions should be more frequently included in RCTs, to further augment the evidence-base. This involves including both resource use, cost and utility information, and ensuring that the economic evaluation examines both the costs and benefits in healthcare.

Clearly, there are many unanswered questions. For example, if loneliness is a common experience, when does loneliness make a significant negative impact on health outcomes? When does loneliness as a transient experience become a chronic issue? Much work is required to understand the negative impact of loneliness on ourselves, our community and the society we live in and we look forward to learning more about loneliness within a dynamic social world.

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Tymoszuk U, Perkins R, Fancourt D, Williamon A (2019) Cross-sectional and longitudinal associations between receptive arts engagement and loneliness among older adults. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-019-01764-0

Wang J, Lloyd-Evans B, Marston L et al (2019) Epidemiology of loneliness in a cohort of UK mental health community crisis service users. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-019-01734-6

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Lim, M.H., Holt-Lunstad, J. & Badcock, J.C. Loneliness: contemporary insights into causes, correlates, and consequences. Soc Psychiatry Psychiatr Epidemiol 55 , 789–791 (2020). https://doi.org/10.1007/s00127-020-01891-z

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Is modern life making us lonely?

• Published 8 April 2013

It can be hard to admit to feelings of loneliness, but one in 10 Britons is lonely. It's not just an issue for the elderly - loneliness is rising among the young. So are we all destined to be lonely?

"No man is an island, entire of itself; every man is a piece of the continent, a part of the main," wrote the poet John Donne in the 17th Century.

Some people seek isolation, but few choose to be lonely.

Loneliness not only makes us unhappy, but it is bad for us. It can lead to a lack of confidence and mental health problems like depression, stress and anxiety.

Studies have consistently shown that one in 10 of us is lonely, but a report by the Mental Health Foundation , external suggests loneliness among young people is increasing.

At the same time, social changes such as the rise of the solo dweller and the surge in social networks, combined with an ageing population, are changing the way people interact with each other.

So is modern life making us lonely?

People feel lonely for different reasons, says Michelle Mitchell, charity director general of Age UK, but it tends to be triggered by a big life event.

Befriending services can transform lives

"It can be poor health, illness, money, children moving away, feeling cut off from family and friends and the community, friends dying, a lack of access to transport, redundancy or career problems or divorce. Often it's when people lose a sense of purpose and contribution.

"Bereavement is also a big issue - losing your husband or wife can have a really detrimental impact on how people feel about the world," she says.

It is a feeling that Pam, whose husband Peter died four years ago, identifies with.

"You meet other men, who are on their own. That's not what I'm looking for. What am I looking for? I'm looking for my husband aren't I, and I'm never going to find him," she says.

But while bereavement and ill health may be inevitable, there's a sense modern society is exacerbating other triggers of loneliness.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, argues although there is no hard historic data to show loneliness - which is arguably subjective - is getting worse, there is some sociological evidence.

"We have data that suggests people's social networks have got smaller and families are not providing the same level of social context they may have done 50 years ago.

"It's not because they are bad or uncaring families, but it's to do with geographical distance, marriage breakdown, multiple caring responsibilities and longer working hours," he says.

The lonely old lady is probably the most obvious stereotype. Fifty years ago, people tended to live closer to their elderly parents, but travel and work opportunities have led more people to move further afield.

Last year, charity WRVS warned more than 360,000 older people felt lonely because their children were too far away and "too busy to see them".

It was a feeling Alice, 94, from Yorkshire, was familiar with until she joined a befriending service. She says her daughter and granddaughter are always "very busy working" and she felt incredibly isolated until Andrew, 44, started taking her out to the shops once a week.

"He makes me feel wanted and I don't just say that. He's worth a fortune, I would be lost without him, and I mean lost," she says.

The impact isn't just emotional. Studies suggest social isolation is associated with a higher rate of death in older people and loneliness is the "hidden killer" of the elderly.

Does social networking help people stay in touch - or just the opposite?

But McCulloch says loneliness transcends "all ages and all classes". It could just as easily affect a young person going from school to college struggling to make friends, isolated single parents or someone not in education or employment.

For Lucy, who is in her 30s and from Birmingham, divorce - which is four times the rate it was 50 years ago - was the catalyst.

"Even though I was surrounded by people, nobody I knew was going through the same experience," she says.

Going to a support group enabled her to rebuild her life, but she says she still feels empty when her daughter's father picks her up at the weekend.

"My life is very busy juggling work and having this lovely five-year-old around me. It's a big shock to the system when I'm suddenly on my own again. I find negative thoughts coming into my head and need to distract myself from becoming anxious and worrying about loneliness," she says.

The rise of the solo dweller is also thought to have had an impact.

The proportion of adults living alone in England and Wales almost doubled between 1973 and 2011, from 9% to 16%, according to the ONS.

Of the 16%, 28% are aged between 35-54 years old, but one study suggests people of working age who live alone increase their risk of depression by up to 80% compared with people living in families.

Social networking websites have also come under fire , external for reducing face-to-face contact and making people more isolated, although Mitchell says they can also help some people stay in touch.

But if modern society is making us more lonely, what can be done to counter it?

Mitchell says there needs to be more investment in social help such as befriending schemes - which relies on volunteers - and community outreach programmes, as being part of a social network such as a walking club or local church can help alleviate loneliness.

But she says we also have a responsibility to "think more openly and creatively about how to deal with one of the greatest social problems of our time".

"In the Isle of Wight a community has set up a time bank which is working really well. People share skills and assets.

"There's a huge market in peer-to-peer marketing, on websites such as eBay, and people are swapping houses for a week as part of their holidays. There has got to be something along those lines we can do," she says.

McCulloch agrees innovation is key. "Instead of living alone, people could club together to buy houses - a friend is doing that in his old age, it's mini commercial enterprise," he says.

But he says there needs to be a cultural shift so that people are more concerned about the welfare of those in their communities.

"There is a philosophical issue that arguably society is too materialistic and individualistic.

"Just a basic level of social behaviour, such as saying hello, or asking if people are OK, can have an impact," he says.

There is also still a stigma around loneliness which needs to be changed, and psychological therapy will help, he adds.

Mitchell believes a tipping point is around the corner.

"I think we'll look back and think 'how did we allow that to happen?' It's like looking back at the issue of children going to work at 12 - there's something so fundamentally wrong with what's happening," she says.

Solos On Loneliness is on BBC Radio 4 on Tuesday 9 April at 11.00BST or listen to for seven days afterwards on the BBC iPlayer .

You can follow the Magazine on Twitter , external and on Facebook , external

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Solitude, Loneliness and Modernity

Prior to the late eighteenth century, places were often ‘lonely’ but people seldom were. Of course people experienced the unhappy feelings that we now associate with loneliness, but the word ‘solitude’ served for both the pleasurable and painful forms of aloneness.

However, by the beginning of the twentieth century, ‘lonely’ people were everywhere in western society: in its cultural products, in popular discourse and in everyday life, as urbanisation, community erosion, family breakdown and the individualistic ethos of capitalist modernity left many people actually and/or psychologically stranded.

These socially disintegrative features of modern western life have been with us for so long that we almost take them for granted – until a crisis reminds us of their terrible price. For years, loneliness has been described as an ‘epidemic’. But instead of making available the community services and care that might have lessened people’s social isolation and mitigated this loneliness, succeeding governments have worsened the situation by demolishing services and institutions that support social connectedness.

The consequences of this are everywhere visible now, as people – especially elderly people, and individuals with physical disabilities or psychological disorders – struggle with the loneliness of social distancing and lockdown during a health crisis which shows no signs of abating.

Further reading

• The Origins of Totalitarianism – book by Hannah Arendt (1951)
• ‘Can loneliness be cured with a pill?’ – article by Abby Carney (2020)
• ‘Humanity is rediscovering existential solitude’ – interview with Julia Kristeva (2020)
• ‘Edward Hopper and American Solitude’ – article by Peter Schjeldahl (2020)
• ‘Coronavirus and the isolation paradox’ – article by Abdullah Shihipar (2020)

Further listening

• Disconnected – documentary short by Alice Aedy (2020)
• ‘The Anatomy of Loneliness’ – radio programme from BBC Radio 4 (2018)
• ‘Loneliness’ – podcast from the Emotions Lab (2020)

Blogs and colloquium papers

Our network of researchers frequently write posts for our blog on solitude, loneliness and modernity. You can read their blog posts here .

Over the course of our project, we met regularly with our research network to discuss the themes of our project. You can read a selection of their colloquium papers on solitude, loneliness and modernity here .

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• The prevalence of...

The prevalence of loneliness across 113 countries: systematic review and meta-analysis

Linked editorial.

We need a public health approach to loneliness

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• Peer review
• 1 Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
• 2 Charles Perkins Centre (D17), The University of Sydney, Camperdown, NSW, 2006, Australia
• 3 Neurodisability and Rehabilitation, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
• 4 Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
• 5 Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
• Correspondence to: D Ding melody.ding{at}sydney.edu.au
• Accepted 15 December 2021

Objectives To identify data availability, gaps, and patterns for population level prevalence of loneliness globally, to summarise prevalence estimates within World Health Organization regions when feasible through meta-analysis, and to examine temporal trends of loneliness in countries where data exist.

Design Systematic review and meta-analysis.

Data sources Embase, Medline, PsycINFO, and Scopus for peer reviewed literature, and Google Scholar and Open Grey for grey literature, supplemented by backward reference searching (to 1 September 2021)

Eligibility criteria for selecting studies Observational studies based on nationally representative samples (n≥292), validated instruments, and prevalence data for 2000-19. Two researchers independently extracted data and assessed the risk of bias using the Joanna Briggs Institute checklist. Random effects meta-analysis was conducted in the subset of studies with relatively homogeneous research methods by measurement instrument, age group, and WHO region.

Results Prevalence data were available for 113 countries or territories, according to official WHO nomenclature for regions, from 57 studies. Data were available for adolescents (12-17 years) in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (≥60 years) in 40 countries. Data for all age groups except adolescents were lacking outside of Europe. Overall, 212 estimates for 106 countries from 24 studies were included in meta-analyses. The pooled prevalence of loneliness for adolescents ranged from 9.2% (95% confidence interval 6.8% to 12.4%) in South-East Asia to 14.4% (12.2% to 17.1%) in the Eastern Mediterranean region. For adults, meta-analysis was conducted for the European region only, and a consistent geographical pattern was shown for all adult age groups. The lowest prevalence of loneliness was consistently observed in northern European countries (2.9%, 1.8% to 4.5% for young adults; 2.7%, 2.4% to 3.0% for middle aged adults; and 5.2%, 4.2% to 6.5% for older adults) and the highest in eastern European countries (7.5%, 5.9% to 9.4% for young adults; 9.6%, 7.7% to 12.0% for middle aged adults; and 21.3%, 18.7% to 24.2% for older adults).

Conclusion Problematic levels of loneliness are experienced by a substantial proportion of the population in many countries. The substantial difference in data coverage between high income countries (particularly Europe) and low and middle income countries raised an important equity issue. Evidence on the temporal trends of loneliness is insufficient. The findings of this meta-analysis are limited by data scarcity and methodological heterogeneity. Loneliness should be incorporated into general health surveillance with broader geographical and age coverage, using standardised and validated measurement tools.

Systematic review registration PROSPERO CRD42019131448.

Introduction

Humans thrive on meaningful social connections. Feelings of loneliness set in when a discrepancy exists between one’s desired and one’s actual level of social relationships. 1 Loneliness is a negative, subjective experience 2 closely linked to the quality of social connections. 3 Loneliness is similar to, but distinct from, social isolation, which is defined as a lack of social contacts, and being alone, characterised as being physically removed from social connections. 4 Transient loneliness is a common experience, 5 but chronic or severe loneliness pose threats to health and wellbeing.

Growing evidence has linked loneliness to various adverse health outcomes. Loneliness is associated with unfavourable cardiovascular health indicators, such as increased activation of the hypothalamic-pituitary-adrenal axis, 6 high blood pressure, increased cholesterol levels, 2 7 and coronary heart disease. 8 Loneliness is associated with sleep disturbance 9 and increased risk of mild cognitive impairment and dementia. 10 Loneliness may also be detrimental to behavioural, mental, and social health throughout the lifespan, 2 influencing outcomes such as substance misuse, suicidal ideation, 11 anxiety, depression, 12 and poor subjective wellbeing. 7 According to a 2015 meta-analysis, people with chronic loneliness had a 26% increased risk of mortality. 13 This increased risk is comparable to established risk factors such as physical inactivity 14 and grade 1 obesity. 15

Culture affects levels of loneliness. 16 Individualism-collectivism has been long considered an important cultural determinant of loneliness. 17 A recent conceptual model 2 postulated that risk factors, such as age, interact with triggering events, such as retirement, resulting in feelings of loneliness. Considering that some well established risk factors of loneliness, such as depression 18 and chronic disease, 19 are increasing, and that triggering events are part of life (eg, the covid-19 pandemic), it is likely that these risk factors would impact the prevalence of loneliness. Accordingly, loneliness is increasingly recognised as an important health and social issue, with some health professionals, including former US surgeon general Vivek Murthy, labelling it as an epidemic. 20 In 2018, the United Kingdom appointed the world’s first minister for loneliness. Worldwide, initiatives have been launched to address “the epidemic of loneliness.” 21 22 23

With loneliness now defined as a public health problem, 24 25 tackling it requires public health approaches, which begin with defining the magnitude and distribution of the problem through surveillance. 26 A recent estimate suggests that one third of the population in industrialised countries experience loneliness, and one in 12 people experiences loneliness at a problematic level 25 ; however, the basis of this estimate is unclear. Understanding the prevalence of loneliness globally can help decision makers gauge the scope and severity of the problem. In light of the covid-19 pandemic, summarising the global prevalence of loneliness before the pandemic would help to identify a prepandemic baseline for subsequent monitoring. Identifying data gaps would also help to inform research endeavours and public health surveillance. In our systematic review and meta-analysis we identified data availability, gaps, and patterns for population level prevalence of loneliness among different age groups globally. We summarised and compared available prevalence estimates within World Health Organization regions when feasible through meta-analysis, and examined temporal trends of loneliness in countries with data.

Protocol and data sources

Our reporting conforms to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. 27 The reporting of meta-analysis conforms to the meta-analyses of observational studies in epidemiology (MOOSE) checklist. 28

We searched for scientific literature published in any language using Embase, Medline, PsycINFO, and Scopus, supplemented by searching the grey literature using Google Scholar and Open Grey up to 1 September 2021. Search terms included “loneliness”, “social isolation”, and “prevalence”, as well as other medical subject headings, truncations, and adjacent operators (supplementary table S1). After duplicates had been removed, additional literature was identified through backwards reference searching.

Eligibility criteria

Studies were included if they were observational, reported prevalence of loneliness, included data from January 2000 to December 2019 (pre-covid-19 pandemic), and had nationally representative study samples. To ensure population representativeness and comparability across estimates, we excluded studies if the sampling frame or process was inappropriate for assessing the general population 29 (eg, university students), the sample size was smaller than 292 (calculated using the formula by Naing et al, 30 with an expected prevalence of 5%), the measurement instrument was not validated, and the prevalence of chronic or severe loneliness could not be obtained (eg, studies asked about transient loneliness, which is a common experience and not at a problematic level).

Study selection and data extraction

References were imported into Endnote (Philadelphia, version X8.2) and duplicates removed. Two reviewers (DS, ML) independently screened articles by title and abstract followed by full text and independently extracted study characteristics, including author, population, country, study design, sample size, measurement instrument of loneliness (type, time frame, and operational definition or cut-off points), prevalence estimate, funding role, and conflicts of interest. Disagreements were discussed with a third reviewer (DD) until consensus was reached. Inter-rater agreement was high (94% for study selection and 93% for data extraction). When information was missing or ambiguous, we searched for related publications or emailed the authors. When estimates were non-comparable between studies, such as different definitions of loneliness (eg, feeling lonely “often” or “very often”), we tried to harmonise measures by manually recalculating prevalence based on available information or asking the authors to recalculate the prevalence. Risk of bias was assessed based on the Joanna Briggs Institute critical appraisal checklist for prevalence studies, 31 which is recommended by the Systematic Review Methodology Group for critical appraisal of studies reporting prevalence data. 32 Two authors (DS and DD) independently assessed risk of bias, with 91% inter-rater agreement. Differences were resolved by discussion.

Measures of loneliness

Scale and single item instruments were used to measure loneliness. Because estimates based on the two types of measures were not directly comparable, we summarised prevalence separately. Loneliness is a common experience, thus we excluded transient experiences of loneliness 5 and focused on problematic loneliness, defined by severity (eg, moderate to severe) or chronicity (eg, feeling lonely all the time, usually, or often).

Scale measures

All selected studies with a scale measure used either the University of California Los Angeles (UCLA) Loneliness Scale 33 or the de Jong Gierveld Loneliness Scale 34 ; both have shown good internal consistency, test-retest reliability, and convergent and discriminant validity. 35 The de Jong Gierveld scale measures both emotional and social loneliness but can also be used as a unidimensional construct. 34 Abbreviated versions have been validated for both scales and correlate strongly with their respective original versions. 34 36 Although certain cut-off points are more commonly used than others, such as ≥6 for the three item UCLA Loneliness Scale, different cut-off points have been selected by authors based on various rationales. We have summarised the cut-off points, documented the differences, and extracted prevalence estimates based on the original cut-off points.

Single item direct measures

Single item direct measures are the most commonly used assessment tools of loneliness. 37 Questions were usually worded as “How often do you feel lonely?,” with non-substantial variations across studies. Different single item instruments have specified different recall periods, such as in the past week or year, although some did not specify a recall period and asked about general experience. Previous studies found that single item direct measures of loneliness had a moderate correlation with the UCLA Loneliness Scale 38 and the de Jong Gierveld Loneliness Scale. 39

Data synthesis

Narrative review.

For all studies we summarised study characteristics, including country, study name, sample size, response rate, sample characteristics (age and sex), and conflict of interest. To demonstrate data availability and gaps, we used MapChart.net to map the availability of classification of country level prevalence of loneliness separately for four age groups (adolescents (12-17 years), young adults (18-29 years), middle aged adults (30-59 years), and older adults (≥60 years); fig 1 ). For studies that applied a scale measure, we tabulated the measurement instrument of loneliness (eg, 20 item UCLA Loneliness Scale, six item de Jong Gierveld Loneliness Scale), country level prevalence of loneliness, and the cut-off points for loneliness at a problematic level. For studies that applied a single item direct measure of loneliness, we summarised the time scale such as past week or year, and the operational definition of loneliness, such as feeling lonely “all the time” or “most of the time.”

International estimates for prevalence of loneliness by age groups

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We summarised data separately for adolescents (12-17 years), young adults (18-29 years), middle aged adults (30-59 years), and older adults (≥60 years). These age categories reflected the sample characteristics of most studies, although the specific age range could differ. When age categorisations were different from our defined categories, we recalculated age specific prevalence to best match our overall categories. For example, if a study reported the prevalence of loneliness for those aged 60-79 and ≥80 years separately, we recalculated the prevalence for all adults aged ≥60 years based on information presented in the study or obtained through contacting the authors. Similarly, if a study reported loneliness prevalence by sex only, we recalculated prevalence for males and females combined using available or additionally obtained information. Because most studies only reported point estimates for prevalence of loneliness nationally, we used a logit transformation 40 to obtain pooled variance estimates to calculate 95% confidence intervals. Finally, we narratively summarised studies that reported multiple measures of loneliness using identical sampling frames, procedures, and instruments over time.

Meta-analysis

Meta-analysis was conducted for relatively similar studies whenever feasible. We pooled prevalence estimates from studies that applied the same or comparable measures, followed similar study protocols (eg, Global School-Based Student Health Survey), and included similar samples (eg, adolescent school students). In cases when multiple studies reported estimates of loneliness prevalence using identical samples, measures, and surveys, we only included the estimate with the largest analytical sample in the meta-analysis, to avoid double counting. Whenever possible we pooled estimates within WHO regions (Africa, the Americas, Eastern Mediterranean, Europe, South-East Asia, Western Pacific) and conducted subgroup analysis based on the World Bank classification of country income group (low, lower middle, upper middle, and high income countries). For Europe, considering the smaller variability in country income level and the established evidence on geographical difference, particularly the divide between east and west, 41 42 we conducted subgroup analysis based on modified geographical region classification by the United Nations standard country or area codes for statistical use (M49; https://unstats.un.org/unsd/methodology/m49/ ), which classified the WHO European region further into northern, southern, eastern, and western Europe, and central and western Asia. For pooled estimates of prevalence and variance, both overall and in subgroups, we used generalised linear mixed effects models with random intercepts by subgroup. 40 This approach has been used in about 94% of recent meta-analyses of prevalence estimates. 43 Binomial-normal models were specified to allow for the calculation of pooled proportion estimates. We conducted additional sensitivity analyses using a double arcsine transformation 44 to pool prevalence estimates, and reported both τ 2 and I 2 statistics to describe heterogeneity. 45 The τ 2 estimates between study variability, whereas I 2 refers to the proportion of the total variance between studies as a result of “true” variance between populations. 46 47 Meta-analysis was performed in R (version 4.0.3).

Patient and public involvement

Patients and members of the public were not involved in the design and execution of the study. However, we plan to engage the public in the dissemination of our findings, including media coverage, social media engagement, newsletters, and public talks and presentations.

The initial database search yielded 7290 records. After the removal of duplicates, the title and abstract of 2853 were screened, resulting in 194 articles for full text screening. Supplementary figure S1 lists the reasons for exclusion, and supplementary table S2 provides further explanations. Two additional articles were identified through reference searching and three through searches of grey literature. Data on prevalence were extracted from 57 studies for 113 countries or territories.

Data availability

Eleven studies (nine using the UCLA Loneliness Scale, two using the de Jong Gierveld Loneliness Scale) provided 30 scale based prevalence estimates for 16 countries, and 46 studies provided 295 estimates for prevalence of loneliness measured by single item instruments for 110 countries or territories (supplementary table S3). Across measures, the prevalence of loneliness was identified for adolescents in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (≥60 years) in 40 countries (supplementary table S4). Of those, 212 estimates for 106 countries from 24 studies were included in meta-analyses (supplementary table S5). Supplementary tables S6 and S7 summarise the characteristics of each study. Overall, data showed disparities in loneliness research and surveillance across regions ( fig 1 ) and age groups; while data on adolescents were available across all WHO regions—primarily through the Global School-Based Student Health Survey, data on adults, particularly younger and middle aged adults, were mainly concentrated in Europe.

Risk of bias assessment

All included studies scored 5-9 out of 9 based on the Joanna Briggs Institute checklist (supplementary table S8). Although all studies met criteria 1 (sampling frame), 3 (sample size), 6 (valid measures), and 7 (standardised measures) as part of this review’s inclusion criteria, only eight studies (14%) met criterion 8 (appropriate statistical analysis), mainly because of missing confidence intervals. Around half of the studies (49%) reported using random probabilistic sampling (criterion 2), whereas the rest did not provide sufficient information on participant recruitment procedures.

Except for one Australian study 48 and two American studies, 49 50 all studies using scale based measures focused on older adults (supplementary table S9). In the meta-analysis of estimates for older adults in 12 countries based on the six item de Jong Gierveld Loneliness Scale, 42 51 prevalence of loneliness showed a clear geographical pattern ( fig 2 ), with much lower estimates in western European countries (pooled estimate 11.1%, 95% confidence interval 9.3% to 13.2%) than eastern European countries (27.7%, 21.2% to 35.3%). Subgroup effect was statistically significant (P<0.01); however, variance between studies was high in western and eastern European countries (τ 2 =0.047 and 0.224, respectively, P<0.01), with this variance mostly related to true differences between populations (I 2 =94% and 99%, respectively). In the meta-analysis of 13 estimates derived from the three item UCLA Loneliness Scale for older adults (including subgroup analysis based on different cut-off points), 52 53 54 55 56 four countries (England, Poland, Spain, and US) had estimates ranging from 9% to 19%. A fifth country, Finland, had a reported prevalence of 5.9% (95% confidence interval 4.7% to 7.2%). No subgroup effect by cut-off point was significant (P=0.91). Variance between studies was high overall and in subgroups with the same cut-off points.

Meta-analysis of loneliness prevalence using scale based measures (de Jong Gierveld Loneliness Scale, six item version, and University of California Los Angeles (UCLA) Loneliness Scale, three item version) in older adults (≥60 years). *Thresholds of five or six were applied. Generalised linear mixed effects models with binomial-normal distribution were used. Norway is included as part of western Europe owing to the lack of data from other northern European countries

Single item measures

Adolescents —Twenty eight studies reported 132 prevalence estimates of loneliness for adolescents in 76 countries (supplementary table S10). Of these, 76 estimates for 68 countries across 17 studies were included in meta-analysis ( fig 3 , fig 4 , fig 5 , fig 6 ), nearly all from the Global School-Based Student Health Survey. Five meta-analyses were conducted, one for each of the following WHO regions: Africa (five studies, 57 58 59 60 61 11 countries), the Americas (five studies, 62 63 64 65 66 26 countries), Eastern Mediterranean (two studies, 58 67 10 countries), South-East Asia (five studies, 58 68 69 70 71 nine countries), and Western Pacific (four studies, 58 71 72 73 12 countries). A meta-analysis was not performed for Europe owing to fewer comparable measures across a small number of countries with prevalence data for this age group. Pooled prevalence estimates ranged from 9.2% (95% confidence interval 6.8% to 12.4%) in South-East Asia to 14.4% (12.2% to 17.1%) in the Eastern Mediterranean. High heterogeneity was observed in all regions, indicated by high τ 2 and I 2 . Subgroup analysis showed no clear patterns by country income level, although a significant subgroup effect by country income group was detected in Africa and the Americas (P<0.05).

Meta-analysis of loneliness prevalence based on single item measures in adolescents (12-17 years) by World Health Organization Africa region. Generalised linear mixed effects models with binomial-normal distribution were used

Meta-analysis of loneliness prevalence based on single item measures in adolescents (12-17 years) by World Health Organization The Americas region. Generalised linear mixed effects models with binomial-normal distribution were used

Meta-analysis of loneliness prevalence based on single item measures in adolescents (12-17 years) by World Health Organization Eastern Mediterrean and South-East Asia regions. Generalised linear mixed effects models with binomial-normal distribution were used

Meta-analysis of loneliness prevalence based on single item measures in adolescents (12-17 years) by World Health Organization Western Pacific region. Generalised linear mixed effects models with binomial-normal distribution were used

Young adults —Five studies reported 34 prevalence estimates for young adults (18-29 years) in 30 countries ( fig 7 ). After removing one duplicate (same estimate reported by two studies 74 75 ), 33 estimates were meta-analysed. All but two estimates 39 76 came from two multicountry studies: the Europe and Health in Times of Transition study 77 and the European Social Survey. 74 The overall pooled prevalence estimate was 5.3% (4.4% to 6.4%), although dispersion was high (τ 2 =0.280, P<0.01). When stratification was by the United Nations regional classification, dispersion reduced, although a large proportion remained owing to true variance between populations (I 2 range 44-85%). A statistically significant subgroup difference was detected (P<0.01), with pooled prevalence being the highest in eastern Europe (7.5%, 5.9% to 9.4%) and the lowest in northern Europe (2.9%, 1.8% to 4.5%).

Meta-analysis of loneliness prevalence based on single item measures in young adults (18-29 years) in Europe. Generalised linear mixed effects models with binomial-normal distribution were used. *Unspecified recall period; past week otherwise. †Includes Israel. ‡Includes Georgia

Middle aged adults —Four studies reported 36 prevalence estimates for middle aged adults (30-59 years) in 32 countries ( fig 8 ). Similar to studies for young adults, all estimates came from European countries, and all but one 39 came from the Europe and Health in Times of Transition study 77 (nine countries) and the European Social Survey 74 (additional 23 countries). After excluding one duplicate estimate, 75 35 estimates for 32 countries were meta-analysed. 39 74 77 The pooled prevalence estimate was 6.9% (5.6% to 8.6%), with high dispersion (τ 2 =0.483, P<0.001). Subgroup difference was significant (P<0.01), where the pooled prevalence was the lowest in northern Europe (2.7%, 2.4% to 3.0%) and highest in eastern Europe (9.6%, 7.7% to 12.0%) and central and western Asia (9.8%, 5.1% to 18.0%).

Meta-analysis of loneliness prevalence based on single item measures in middle aged adults (30-59 years) in Europe. Generalised linear mixed effects models with binomial-normal distribution were used. *Unspecified recall period; past week otherwise

Older adults —Seventeen studies reported 93 prevalence estimates for 38 countries, including 30 European countries and eight non-European countries ( fig 9 ). A total of 43 estimates from 30 European countries were included in meta-analysis. All but two estimates 39 78 came from large multicountry studies: the Europe and Health in Times of Transition study, 77 the European Social Survey, 74 and the Survey of Health, Ageing, and Retirement in Europe. 79 Overall dispersion was high (τ 2 =0.461, P<0.01). Although less variability was shown within geographical subgroup, the proportion of observed variance due to true differences between populations remained high (I 2 range 78-89%). Subgroup difference was significant (P<0.01), where northern European countries had the lowest pooled prevalence (5.2%, 4.2% to 6.5%), followed by western Europe (8.7%, 7.3% to 10.5%), southern Europe (15.7%, 13.2% to 18.7%), and eastern European countries had the highest prevalence of loneliness (21.3%, 18.7% to 24.2%).

Meta-analysis of loneliness prevalence based on single item measures in older adults (≥60 years) in Europe. Generalised linear mixed effects models with binomial-normal distribution were used. *Includes Israel. †Includes Georgia. ‡Unspecified recall period; past week otherwise

Sensitivity analysis

For meta-analysis of loneliness prevalence in younger, middle aged, and older adults in Europe, additional analysis was conducted using the World Bank country income group for subgroups. For young adults, no evidence was found for statistically significant subgroup differences (P=0.35) (supplementary figure S3). For middle aged and older adults (both using the de Jong Gierveld Loneliness Scale and single item measures), high income European countries had a lower pooled prevalence than middle income European countries, and the subgroup difference was statistically significant (supplementary figures S2, S4, S5). Additional sensitivity analysis using the Freeman-Tukey double arcsine transformation approach to meta-analyses resulted in nearly identical findings 80 (supplementary figures S6-10).

Temporal trends in loneliness

Four studies reported multiple comparable prevalence estimates of loneliness based on repeated cross sectional surveys. One study in Danish school children (11-15 years old) found that the prevalence of loneliness increased from 4.4% (95% confidence interval 3.4% to 5.4%) in 1991 to 7.2% (6.4% to 8.0%) in 2014 (P<0.001 for trend). 81 Similarly a significant and steady increase in loneliness was found in Norwegian secondary school children, from 9.0% (95% confidence interval 8.5% to 9.5%) in 2014 to 12.1% (11.7% to 12.5%) in 2018 (P<0.001). 82 Additionally, a study found no change in loneliness prevalence among adolescent school students between 2005 and 2016 in the United Arab Emirates (P>0.05). 67 Finally, a study in adults aged 77 years or older in Sweden found no significant trend in prevalence of loneliness from 1992 to 2014 (P=0.71). 83

Based on data from 113 countries or territories during 2000-19, we found that loneliness at a problematic level is a common experience worldwide. We further identified important data gaps and substantial geographical variation in loneliness. Considering the physical, mental, and social health consequences of loneliness, our study findings reinforce the urgency of approaching loneliness as an important public health issue. 24 25

Although 113 countries or territories reported some data on loneliness prevalence, globally there is still a dearth of data across broader geographical areas. International surveillance systems, such as the Global School-Based Student Health Survey, are important for priority setting, benchmarking progress, and cross country comparisons. The Global School-Based Student Health Survey has provided valuable data for loneliness in children and adolescents in 67 countries or territories, most of which are low and middle income countries. Disparities still exist in data availability across WHO regions and country income levels. While Europe is leading in loneliness research and surveillance with a wealth of data sources, such as the Survey of Health, Ageing, and Retirement in Europe, the European Social Survey, and the Europe and Health in Times of Transition study, other regions and most low and middle income countries have much less data coverage. Importantly, no low income countries and only five of all 47 lower middle income countries have reported any nationally representative data on loneliness in adults. Such data gaps might be a result of limited resources and competing priorities from issues deemed more urgent, such as food security, housing, and basic provision of medical services. 84

Data on loneliness prevalence is also lacking for young and middle aged adults, compared with adolescents and older adults. Such data gaps could be driven by the widely held belief that middle aged adults are the least susceptible to loneliness, and that young and old people are particularly vulnerable because of the changes experienced during these life stages. 85 Although our meta-analysis based on European data suggests that young and middle aged adults have a lower prevalence of loneliness compared with their older adult counterparts, findings from the AARP national loneliness survey 49 and the 2020 Cigna Report 50 from the US suggested otherwise. According to the Australian Loneliness Report, adults aged between 36 and 65 years reported consistently higher loneliness scores than those aged between 26 and 35 years, and those aged 65 and older. 86 Such findings suggest that the age pattern of loneliness might be context specific, although more data are needed among the general adult population to fully understand the susceptibility to loneliness throughout the lifespan. 87

Based on our meta-analysis, the prevalence of loneliness is highly heterogenous across countries, even within the same region. While insufficient data prevented us from identifying geographical patterns of loneliness outside of Europe, within Europe the pattern is clear and consistent. Across different adult age groups, northern European countries consistently reported the lowest prevalence of loneliness, whereas eastern European countries reported the highest. One study attributed country level differences to demographic characteristics, health status, social participation, and social support. 41 Others have cited welfare systems and social security schemes as contributing factors, 42 as welfare generosity has been positively linked to social participation and inversely associated with social exclusion. 88 A previous meta-analysis found an inverse association between socioeconomic status and loneliness. 89 A combination of high socioeconomic status, overall health, welfare generosity, and high social participation could explain the low levels of loneliness in northern European countries. In contrast, eastern European countries tend to have poorer health outcomes, healthcare services, and state welfare. 41 Other demographic characteristics, such as large gaps in life expectancy between men and women (hence a high proportion of widows) and increasing emigration among young people, might have contributed. 42 Changes associated with transition from socialism, such as reductions in pensions paired with rising living expenses, change in care arrangements, and reduced social trust are also potential explanations for high levels of loneliness in eastern Europe. 41 90

Despite media and public dialogue describing loneliness as a worsening social problem, 91 92 we found insufficient evidence to support this claim. We only identified four studies that repeatedly examined loneliness using comparable measures over time, and the findings from these studies were mixed. Even if the problem of loneliness had not worsened during our search period (2000-19), covid-19 might have had a profound impact on loneliness. 93 94 In this context, our review provides an important prepandemic baseline for future surveillence.

Strengths and limitations of this study

To maximise the validity of our findings, we limited our study selection to those based on nationally representative samples, sufficient sample sizes, and validated instruments. We maximised comparability across studies by harmonising results when feasible and summarising findings according to measurement instrument and age groups. However, our findings should be interpreted in light of weaknesses. Comprehensive global comparison and quantitative synthesis is limited by heterogeneity in study design, sampling procedures, and measurement instruments. Despite our attempts to improve comparability through harmonisation and stratification, we still found considerable evidence of heterogeneity, even within smaller subgroups of regions. Such heterogeneity is common in meta-analyses of prevalence, 43 and the pooled estimates should be interpreted as indicative only.

Understanding loneliness as a global health issue requires data from most countries—however, data are lacking for most regions outside of Europe. Meanwhile, the lack of repeated measurements limited our conclusions about temporal trends. Additionally, no studies explicitly reported elements of “co-design” with the intended communities. This might be the case particularly for translated instruments. Even though the instruments reviewed in our study have been translated, validated, and widely used in many countries, cross cultural adaptations of these questions could have limitations. 95 What loneliness means in one cultural and linguistic context might not be the same in another.

Differences in age groups and survey time also introduced additional complications. Although we limited study selection to those with data from 2000 to 2019, estimates in some countries could be more than 10 years older than those from other countries. Despite our attempts to provide prevalence estimates for different age groups, specific age categories differed by study, further limiting comparability across studies. Finally, different interpretation and operationalisation of loneliness (eg, cut-off points, recall time frame) across countries may lead to differential reporting biases. Because no single definition of problematic loneliness exists, what was labelled as “problematic” varied (eg, severity versus chronicity). This poses further challenges in interpreting prevalence across countries.

Strengths and limitations in relation to other studies

Another systematic review on the prevalence of loneliness has been peformed. 96 This review, however, was of a narrower scope than ours, as it only synthesised studies among older adults in high income countries published between 2008 and 2020. This review was subject to methodological limitations, such as not considering population representativeness and not accounting for different measurement instruments or operational definitions of loneliness across studies.

In early 2021, researchers reported the prevalence of loneliness for adults in 237 countries and territories based on the BBC loneliness experiment dataset. 97 As a primary study (in contrast with our systematic review and meta-analysis), it benefited from being able to apply the same measurement instrument to all participants and directly model predictors of loneliness, such as age, sex, and individualism, of the country of residence. Participants were, however, recruited as a convenience sample through BBC programmes (presumably in English only) and thus were not representative of populations—32% of the participants were men and 74% were UK residents. Therefore, prevalence estimates derived from this study are unlikely to be representative of the countries and territories.

Meaning of the study

We advocate among health professionals, decision makers, and the general public for better awareness of widespread loneliness. The data gaps in low and middle income countries raised an important issue of equity. Public health efforts to prevent and reduce loneliness require well coordinated ongoing surveillance across different lifes stages and broad geographical areas. High quality data based on validated and comparable instruments are urgently needed to tackle loneliness. Sizeable differences in prevalence of loneliness across countries and regions call for in-depth investigation to unpack the drivers of loneliness at systemic levels and to develop interventions to deal with them.

Recommendations for future research

Measurement is an ongoing challenge in loneliness research and surveillance. Researchers have previously documented the difficulty in comparing estimates of loneliness prevalence across studies and advocated for maximising comparability across survey instruments. 39 Conflicting evidence resulting from different definitions and measurements of loneliness has been identified as a major challenge. 84 One fundamental difference between measures is that single item questions directly asked about “loneliness,” but scales exclude direct reference to loneliness. Therefore, single item estimates might consistently misclassify loneliness. The UK Office for National Statistics recommends using both direct and indirect scale measures of loneliness when possible, and using direct single item questions when constrained by space. 37 Future studies could benefit from probabilistic sampling, repeated measures, and sufficient reporting of prevalence (eg, including uncertainty in addition to point estimates). Finally, considering the potential impact of covid-19 on social health worldwide, we encourage more studies to track long term trends of loneliness across the lifespan using the estimates we summarised as a prepandemic baseline for comparison.

What is already known on this topic

Increasing evidence suggests that loneliness at a problematic level has serious health consequences

As loneliness is increasingly recognised as an important health and social problem, governments worldwide should aim to tackle this issue through policies and initiatives

It is still unclear how widespread loneliness is on a global scale

What this study adds

Loneliness at a problematic level is prevalent in many countries, and important data gaps exist, particularly in low and middle income countries

A geographical pattern for loneliness prevalence was found, with northern European countries consistently showing low levels

Data are insufficient to make conclusions about temporal trends of loneliness on a global scale

Ethics statements

Ethical approval.

Not required.

Data availability statement

No additional data available.

Contributors: DS, KG, and DD conceived the study. DS, AB, and DD developed the review protocol. DS and DD conducted the literature search. DS and ML independently screened the studies, extracted data, and discussed results with DD. DS, RE, and DD conducted the literature search. JvB conducted the meta-analysis. DS and DD drafted the manuscript. All authors provided critical input during the writing and revision of the paper. DD supervised the study. DS, ML, and DD are the guarantors. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Funding: None received.

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

The lead author (DS) affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Dissemination to participants and related patient and public communities: The authors plan to disseminate the findings of this research to the public communities through media outlets, social media engagement, talks, and presentations.

Publisher’s note: Published maps are provided without any warranty of any kind, either express or implied. BMJ remains neutral with regard to jurisdictional claims in published maps.

Provenance and peer review: Not commissioned; externally peer reviewed.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

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• Review article
• Published: 07 November 2022

Loneliness across time and space

• Maike Luhmann   ORCID: orcid.org/0000-0001-6211-9304 1 ,
• Susanne Buecker   ORCID: orcid.org/0000-0003-3443-5400 1 &
• Marilena Rüsberg   ORCID: orcid.org/0000-0001-8788-8687 1  

Nature Reviews Psychology volume  2 ,  pages 9–23 ( 2023 ) Cite this article

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People feel lonely when their social needs are not met by the quantity and quality of their social relationships. Most research has focused on individual-level predictors of loneliness. However, macro-level factors related to historical time and geographic space might influence loneliness through their effects on individual-level predictors. In this Review, we summarize empirical findings on differences in the prevalence of loneliness across historical time and geographical space and discuss four groups of macro-level factors that might account for these differences: values and norms, family and social lives, technology and digitalization, and living conditions and availability of individual resources. Regarding historical time, media reports convey that loneliness is on the rise, but the empirical evidence is mixed, at least before the COVID-19 pandemic. Regarding geographical space, national differences in loneliness are linked to differences in cultural values (such as individualism) but might also be due to differences in the sociodemographic composition of the population. Research on within-country differences in loneliness is scarce but suggests an influence of neighbourhood characteristics. We conclude that a more nuanced understanding of the effects of macro-level factors on loneliness is necessary because of their relevance for public policy and propose specific directions for future research.

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Introduction.

People experience loneliness when they feel that their social relationships are deficient in terms of quantity or quality and perceive a gap between their actual and desired relationships 1 . Around the world, people describe loneliness as a painful, sometimes agonizing, experience 2 . Loneliness is conceptually distinct from being alone (a momentary state of objective absence of other people), solitude (when being alone is perceived as pleasant and sought out intentionally) 3 and social isolation 1 , 3 , 4 , 5 (the objective lack of social relationships and social contact 1 ).

Through its adverse effects on sleep, immune functioning and health behaviours, loneliness can lead to long-term health issues such as an increased risk for cardiovascular diseases and reduced longevity 1 , 6 , 7 , 8 , 9 . The health-related consequences of loneliness are detrimental for individual well-being and come with substantial economic costs for society 10 , 11 . Loneliness has therefore been recognized as a public health issue that needs to be addressed by public policy 12 , 13 . Indeed, loneliness is on political agendas in the United Kingdom 14 , Germany 15 , Japan 16 and the European Union 17 . Thus, loneliness has important societal implications, and there is a need for evidence-based recommendations for public policy.

Despite these societal implications, loneliness is a deeply subjective experience and almost all empirically established predictors of loneliness refer to characteristics of the person (Table  1 ). Loneliness is more common among individuals with low socioeconomic status 18 , 19 and poor health 19 , 20 , two individual factors that limit people’s opportunities to participate in everyday social activities. Because poor health is particularly common among the elderly, old age is sometimes considered a critical risk factor for loneliness. However, although studies conducted before the COVID-19 pandemic found that average loneliness was highest in the oldest age group (80 years and older) 18 , 21 , 22 , 23 , increased loneliness has also been reported in younger age groups 18 , 24 , and a meta-analysis of longitudinal studies found no significant relationship between age and loneliness 25 . Identifying with a group that is marginalized within a society (for example, ethnic/racial 26 , 27 or sexual orientation/identity 28 , 29 , 30 , 31 minority groups) is associated with higher average levels of loneliness, presumably because these groups are more likely to experience stressors such as discrimination or rejection, which increase the risk of loneliness 29 , 30 , 31 , 32 , 33 . Loneliness is also correlated with personality traits. Individuals high in extraversion and emotional stability are less prone to loneliness than individuals low on these traits 34 . Finally, the characteristics of one’s social relationships are among the most proximal predictors of loneliness. Having a romantic partner, a large social network, frequent social interactions, and high-quality relationships decrease the risk of loneliness 19 , 20 , 35 , 36 .

However, how people think, feel and behave is also shaped by the greater context 37 , including the sociohistorical context 38 , 39 and the geographical and cultural context 40 , 41 . Macro-level factors can influence the distribution of individual-level predictors of loneliness at a given time or in a given location. For example, cultural norms and values, societal welfare and demographic composition explain geographical differences in loneliness through their effects on individual-level predictors such as the quality of living conditions and social integration 42 . Such indirect pathways are also proposed in theories that focus on loneliness-related outcomes. For example, context factors influence people’s social opportunities, their available time and energy, and their capacity and motivations, all of which influence the extent to which people form and maintain friendships in older age 43 . Moreover, health outcomes are partly determined by a causal cascade of macro-level factors (such as culture, socioeconomic factors and social change) that influence social networks and psychosocial factors such as loneliness 44 .

Macro-level factors can also moderate the associations between individual predictors and outcomes. Macro-level factors influence people’s standards for their social relationships (social expectations), which in turn moderate the extent to which other factors such as the level of social integration are related to loneliness 42 . For example, when macro-level factors restrict people’s opportunities for social interactions (such as during pandemic-related lockdowns), the frequency of daily social contact might be less strongly related to loneliness than when macro-level factors do not influence people’s opportunities for social interactions.

In this Review, we summarize the current evidence on whether and why loneliness varies across time and space. Because historical changes and geographical differences in loneliness have largely been investigated separately, we review these topics in separate sections. For each topic, we first examine whether differences in loneliness across time and space exist in the first place. Next, we discuss macro-level factors that might account for these differences. To that end, we draw on the HIstorical changes in DEvelopmental COntexts (HIDECO) framework 39 that organizes macro-level factors into four categories: values and norms, family and social lives, technology and mobility, and individual resources and living conditions. Although this taxonomy was developed to explain historical changes in adult development, the included macro-level factors can, in principle, also vary across geographical regions. HIDECO therefore provides a useful framework to organize our review of macro-level factors related to loneliness. Finally, we discuss policy implications, and provide specific recommendations on directions for future research.

Loneliness across time

Headlines and titles such as “ The Loneliness Epidemic ” or “The Lonely Century” 45 convey that loneliness is more common today than ever before. But, although it is true that variables related to objective social isolation (such as living alone 46 and time spent alone 47 ) have increased in the past half-century 38 , 39 , 48 , it is less clear whether loneliness is on the rise as well.

Long-term trends in loneliness

The ideal way to examine long-term trends in loneliness across historical time would be to track large, representative samples across multiple years or even decades. For example, according to the General Social Survey 21 , average loneliness levels declined from 2014 to 2018, except among young adults, who experienced an increase in loneliness over these 4 years 21 . Unfortunately, existing long-running panel studies started incorporating standardized loneliness measures only within the past 15 years (since 2008 in the Dutch Longitudinal Internet Studies for the Social Sciences panel 49 ; since 2013 in the German Socio-Economic Panel 18 ; and since 2014 in the General Social Survey 21 ). Thus, these data cover only short time periods and cannot be used to track longer-term changes in average loneliness levels. Data on loneliness from representative samples from the past century are almost non-existent.

An alternative way to identify long-term trends in loneliness is to examine how average loneliness levels reported in empirical studies change over time. Cross-temporal meta-analyses statistically aggregate mean scale scores of a construct from single studies using samples that are approximately the same age 50 , 51 . By examining the correlation between the mean scale scores and the year of data collection, this method enables changes in a construct to be estimated over historical time. Existent cross-temporal meta-analyses on loneliness have been restricted to specific age groups, countries, measurement instruments and/or time periods (Table  2 ). For young adults (aged <30 years), a meta-analysis focusing on the USA reported decreases in average loneliness 52 , a meta-analysis focusing on China reported increases in average loneliness 53 , and a meta-analysis including samples from all over the world found a weak increase in average loneliness that was more pronounced in North American samples and not significantly different from zero in non-North American samples 54 . A fourth cross-temporal meta-analysis found increasing loneliness levels among older adults (aged >60 years) in China 55 . Notably, both meta-analyses that focused on Chinese samples found increases in loneliness over time 53 , 55 ; however, this trend was not replicated in the worldwide meta-analysis examining young adults 54 , so these findings do not allow any inferences about potential systematic national differences in loneliness trends.

Cross-temporal meta-analyses are often the only way to examine changes in a construct over several decades, but they have several limitations. First, existing meta-analyses focus on specific populations and measurement instruments, so it is unclear whether the findings generalize to other age groups and measurement instruments. Second, most of the original studies relied on convenience samples (for example, college students who participated for course credit). Convenience samples are generated using non-probability sampling techniques and are usually not representative of the population of interest (for example, all college students or young adults in general). Specific subgroups might be overrepresented or underrepresented owing to sampling biases. Survey research indicates that response rates have generally been declining over the past five decades 56 , raising additional concerns that the nature of these sampling biases might change over time. If sampling bias is systematically related to loneliness, estimates of changes in loneliness over time might be biased as well. Thus, cross-temporal meta-analyses allow conclusions to be drawn only about how loneliness changed among people who participated in these kinds of study.

Third, cross-temporal meta-analyses cannot establish the extent to which the observed mean-level trends might be influenced by historical changes in how people respond to questions about loneliness (that is, lack of measurement invariance across time). For example, people might be more likely to admit to feeling lonely frequently in times when loneliness is socially accepted rather than stigmatized 54 , 57 . Empirical tests of longitudinal measurement invariance of loneliness scales are rare and typically cover only short time lags 58 , 59 , 60 and therefore do not allow inferences about historical changes in response styles. Nevertheless, the impact of longitudinal measurement invariance on the mean-level trends observed in cross-temporal meta-analyses is generally assumed to be small 54 .

Finally, cross-temporal meta-analyses do not allow conclusions about whether the observed changes are due to the specific historical context (period effects) or due to generational differences (cohort effects). To disentangle period and cohort effects, it is necessary to track loneliness in multiple generations across long periods of time. Even then, possible causes of these effects often remain unclear. Only a few studies have systematically examined generational differences in loneliness, with — again — inconsistent findings (Table  3 ). Studies from Germany 61 and the Netherlands 62 reported lower levels of loneliness in later-born cohorts of adults aged 55 years and older. However, most other studies focusing on older European adults did not find any cohort-linked differences in loneliness levels 63 , 64 , 65 , 66 . The findings are similarly diverse in studies of non-European or younger populations. In general, observable differences in loneliness across time can be due to different effects (for example, period effects, cohort effects, or cohort × age interactions), which can only be inferred in specific research designs (for example, in cohort × age designs that enable investigation of cohort differences in age-related changes across multiple historical periods) 67 , 68 . Thus, when studies report cohort or period effects, it must be critically examined whether the research design was appropriate to examine these kinds of effect.

Despite these limitations, cross-temporal meta-analyses currently represent the best available estimates of changes in loneliness over historical time. However, their findings are inconsistent and therefore do not support sweeping claims of a global loneliness epidemic. More methodologically robust research on historical changes in loneliness in diverse populations is needed.

Relevant macro-level factors

One reason the popular narrative that loneliness is on the rise persists despite a lack of clear empirical evidence might be that many societies have been experiencing major changes in macro-level factors (described below) that influence how people form and maintain social relationships 48 . It is plausible that these changes inform people’s intuitions about whether loneliness is becoming more common.

Values and norms

Cultural values are constantly changing 39 . For example, individualism (viewing individuals as self-directed, autonomous and separate from others 69 ) is on the rise across the world 69 , and is associated with an increased focus on self-development and a devaluation of traditional family ties 70 . On the surface, the devaluation of family relationships might pose a risk for increased loneliness because the quantity and quality of family relationships might suffer when people are less invested in them. However, individualism does not devalue social relationships in general but rather is defined by a shift in the importance of different types of relationship 69 . For example, relationships with friends are gaining importance relative to relationships with biological family members 69 , and the concept of ‘family’ is becoming more inclusive and less bound to biological relationships 71 . Thus, it is not clear that rising individualism increases the risk for loneliness in a population.

Another cultural value with potential implications for loneliness is materialism. Materialism refers to the importance people place on money and materialistic possessions and acquisitions 72 . Materialism is correlated with negative outcomes such as poor well-being 73 and increased loneliness 72 . A population-wide increase in materialistic values might therefore lead to an increase in loneliness. Such an increase has been found in the USA 74 , 75 , but a study using representative data from the Netherlands found the opposite pattern 72 . Thus, increasing materialism might contribute to rising loneliness levels in some countries.

Historical periods are also characterized by the political values and attitudes that are dominant at the time. One way in which the contemporary political climate might contribute to loneliness on a societal level is through its implications for marginalized groups who might be less likely to experience personal and institutional discrimination (both risk factors for loneliness 30 , 32 , 33 ) in more progressive periods than in more conservative political periods 76 , 77 .

Family and social lives

Many societies have experienced shifts in social norms related to family relationships and household structures: people get married less frequently and at an older average age, and are more likely to get divorced and to live alone or in non-traditional family constellations 39 , 71 . Living with others and being married is generally associated with a lower risk of loneliness 20 , 35 , so an increase in the number of people who live alone or are unmarried might increase loneliness in a population. However, this effect might be counteracted by the changing social norms themselves, such that living alone or being unmarried might matter less in generations or historical periods in which marital norms are less strict. Supporting this view, a study conducted among German adults (aged 40–85 years) found that partnership status was less strongly associated with loneliness among younger birth cohorts (in which social norms for partnerships were more liberal) than among older birth cohorts (in which social norms for partnerships were more conservative) 78 . Similarly, a study among Dutch adults found that loneliness levels among divorcées decreased from 1992 to 2012, presumably because divorces became more common and therefore more accepted over this timeframe 79 .

Technology and mobility

The wide distribution of smartphones and the rise of social media have substantially changed how people interact in daily life 80 . The impact of digitalization on loneliness and other indicators of well-being is a highly active research area and the results are complex 81 , 82 , 83 , 84 . Overall, the link between the digitalization of social interactions and loneliness seems weak (average r  = 0.04 in a meta-analysis 85 of 139 effect sizes) 81 , 86 . Moreover, the causal direction of the association is unclear: whereas some studies suggest that using smartphones and social media lead to higher levels of loneliness, others suggest that loneliness leads to more frequent smartphone use 81 .

Many countries have also experienced increased residential mobility, both within countries (for example, work-related residential mobility) 87 and between countries (for example, voluntary or forced migration) 88 . Climate change is an additional cause of global residential mobility that will become more important in the coming decades 89 . Residential mobility has disruptive effects on people’s social networks 90 , 91 . In the face of a residential transition, people often anticipate 92 and experience loneliness 93 , 94 , 95 , but they might also be motivated to expand their social networks 96 . The extent to which residential mobility contributes to loneliness and social isolation therefore depends on how successful people are at forming new and maintaining old social networks 97 .

Individual resources and living conditions

Macroeconomic indicators such as poverty rates or unemployment rates reflect the distribution of low income and unemployment in a population, two factors that increase the risk for loneliness 18 , 19 . Hence, changes in these kinds of macro-level factor might be correlated with changes in loneliness levels in a population because the macro-level factors mirror the prevalence of individual-level risk factors.

The authors of the HIDECO framework assume that individual resources are generally more widely available today than in the past 39 . However, this does not imply that loneliness is less prevalent today than in the past. For example, medical advances have improved disease prevention and treatment, leading to an increase in life expectancy in most countries 98 , 99 . However, in the USA the prevalence of diseases has also increased, indicating that medical advances have not led to a healthier population in the USA overall 98 . On the individual level, this means that, all else being equal, an individual person suffering from a serious disease in the USA today is more likely to survive, to experience a higher quality of life (including an active social life), and hence less likely to be lonely than in the past. But this positive effect on the individual level does not necessarily translate to a reduction in loneliness prevalence on the population level because the relative proportion of people with health issues in the total population has increased.

This complex association between changes in macro-level factors and loneliness can also be found for the link between historical changes in the demographic composition of a population and loneliness. In most countries, the combined effects of higher longevity and lower fertility rates increase the proportion of older adults in the total population 100 . Many studies have identified older adults as a central risk group for loneliness, presumably because of a higher prevalence of risk factors such as widowhood and functional limitations in this age group 18 , 21 , 101 . A growing proportion of older adults in a population can therefore be associated with increased average loneliness levels, but this effect could be counteracted by older adults having more opportunities for social interactions with peers 42 , 101 .

In sum, there are a number of macro-level factors for which links to loneliness are theoretically plausible. However, these links are complex and mediated through multiple pathways. Thus, they are not always evident when examining simple correlations between changes in macro-level factors and changes in loneliness across time. In addition, correlations among time trends are often spurious 102 , making it methodologically challenging to establish true causal links between historical changes.

Loneliness across space

The potential relevance of macro-level factors for loneliness can also be gauged by examining how and why loneliness varies across geographical space, both between and within countries.

Cross-national differences

Similar to studies on long-term historical trends, studies examining cross-national differences in loneliness should be based on large, nationally representative samples from multiple countries that all use the same loneliness measure. Most comparative studies that fulfill these criteria focus on European countries (Table  4 ). These studies consistently find that loneliness levels are lowest in northern and western European countries and substantially higher in southern and eastern European and other former Soviet countries 103 , 104 , 105 , 106 , 107 , although there is also substantial variation within these regions 108 . For example, in one study examining a representative sample of adults aged 65 years and older in 11 western European countries, the proportion of respondents who reported feeling lonely ‘most of the time’ was more than four times as high in Italy and Greece (>25%) than in Denmark and Switzerland (≤6%) 104 . Similar patterns were found in a meta-analysis that examined loneliness across 113 countries 107 .

Overall, these studies indicate that loneliness can and does vary across countries. It is possible that these cross-national differences are at least partly driven by methodological factors. For example, survey response rates vary across countries 109 . Differences in response rates are particularly problematic if survey nonresponse is associated with loneliness. Such a nonresponse bias would directly bias national prevalence estimates. Furthermore, the observed cross-national differences might stem from a different understanding of the concept of loneliness itself. Most cross-national studies use single items such as ‘How often do you feel lonely?’ If the term ‘lonely’ is interpreted differently across nations or languages, the data collected with this measure are not comparable. Indeed, some research suggests that there are cultural differences regarding the meaning of loneliness 110 , for example, in the extent to which loneliness is about romantic experiences versus broader social approval 111 . However, qualitative studies examining the meaning of loneliness in different cultures and languages 2 and quantitative studies examining the structure and measurement invariance of loneliness measures across cultures 112 , 113 , 114 , 115 indicate that loneliness is a universal experience that can be measured reliably and validly across cultures.

Beyond these methodological issues, cross-national differences in loneliness can also be due to national differences in macro-level factors. Most research has focused on cultural values, particularly individualism/collectivism, as a macro-level factor that might account for cross-national differences in loneliness. Individualistic cultures value autonomy and self-reliance, whereas collectivistic cultures value being part of and contributing to the ingroup 70 , 116 . Hence, individualism/collectivism reflects the value of social relationships and might therefore be particularly relevant for loneliness, but in complex ways 111 , 117 , 118 . On the one hand, loneliness might be more prevalent in individualistic cultures because social ties are looser and people might invest less in their social relationships than in collectivistic cultures. On the other hand, loneliness might be more prevalent in collectivistic cultures because social ties are more important and social relationships might be more likely to be perceived as insufficient. Moreover, people in collectivistic cultures are more likely to perceive the social stigma of loneliness than people in individualistic countries 119 . The social stigma of loneliness is characterized by the belief that disclosure of being lonely will engender negative responses from others 120 , 121 . Because the perceived risk associated with disclosing loneliness is stronger in collectivistic than in individualistic cultures, people in collectivistic countries might be less likely to disclose their feelings of loneliness in surveys or interviews. In addition, tight social relationships are not necessarily indicative of good social relationships, but can be characterized by ingroup vigilance (being aware that others in the ingroup might have bad intentions 122 ) and within-group competition, which are more common in collectivistic than in individualistic cultures 122 . Cross-national studies suggest that the latter effects trump the former: at least in Europe, loneliness levels are higher in more collectivistic than in more individualistic nations 117 , 123 . Cultural values might also moderate the effect of individual-level predictors on loneliness by influencing people’s social expectations, such that people in collectivistic countries might be more likely to take having close friends and living with others for granted than people in individualistic countries 42 , 124 . Consistent with this perspective, the protective effect of having a confidant was stronger in individualistic than in collectivistic countries 117 , whereas the harmful effect of living alone was weaker in individualistic than in collectivistic countries 125 .

It must be noted that the individualism/collectivism distinction has been criticized as being vaguely defined and lacking explanatory power for many cross-cultural differences 126 . It is therefore important to consider more precisely defined cultural values as well 126 . For example, cultural norms related to family and social relationships might contribute to population levels of loneliness via their effects on family and social lives. According to the culture–loneliness framework 127 , people in cultures with more restrictive norms about social relationships might experience more loneliness because, despite being less physically isolated, they are more likely to experience a discrepancy between their actual and desired social relationships. This notion is consistent with the work on individualism/collectivism discussed above, and with research showing that stronger filial norms (the extent to which adult children are expected to care for their elderly parents) in eastern compared to western European countries might contribute to the higher loneliness levels among older adults in eastern European countries compared to those in western Europe 42 , 123 .

Beyond cultural values, national differences in loneliness can also partly be explained by macro-level factors reflecting the sociodemographic composition of a population. For family and social network structures, studies comparing older adults across multiple European countries have found that loneliness levels are higher in countries with higher proportions of older adults living alone and never-married older adults 103 , 123 . With respect to individual resources and living conditions, two studies found that loneliness levels were lower in countries with higher average wealth and better average health 103 , 123 . Differences in technology and mobility have not yet been systematically examined as correlates of national differences in loneliness, but it has been proposed that higher rates of mobility and migration might be linked to higher national loneliness levels 103 , 107 , and there is some evidence that the effect of social media use on psychological outcomes might differ across cultures 128 .

Overall, these studies show that loneliness varies across nations and that macro-level factors such as values or sociodemographic characteristics account in part for this variability. However, most studies focused on European countries, and only a few macro-level factors have been examined systematically.

Within-country differences

Geographical variation in loneliness can also be found within countries 129 , 130 , 131 , 132 , 133 , 134 . In a study using a representative German sample, there was a difference greater than two standard deviations between the regions with the highest and lowest loneliness levels 131 . In another study examining a representative sample of young people (aged 16–24 years) in the UK, geographical region accounted for 5–8% of the total variance in loneliness 132 . Explanations for within-country differences in loneliness include sociodemographic, physical and perceived neighbourhood characteristics. Under the HIDECO taxonomy, physical and demographic characteristics can best be categorized as individual resource and living conditions factors, whereas perceived neighbourhood characteristics describe the cultural and social aspects of neighborhoods.

Similar to cross-national research, regional differences in loneliness are often explained by differences in the sociodemographic composition of the population. Empirical studies directly examining this link on a within-country level provide mixed results. Some studies find that loneliness levels are elevated in areas with a greater percentage of older low-income adults 134 and in socioeconomically deprived areas 135 , but these associations do not hold up in other studies 131 , 136 , suggesting that the effect of the sociodemographic composition of the population on loneliness might depend on other factors to be identified in future research.

A group of macro-level factors unique to within-country studies comprises physical characteristics of places, such as the distinction between urban and rural areas. Multiple studies find no significant differences in average loneliness levels between urban and rural areas after controlling for covariates such as income or age 129 , 130 , 131 , 134 , 135 , 136 . Furthermore, related characteristics such as population density are also not associated with loneliness 131 , 136 . However, one study found that loneliness levels were higher in areas that were more remote from local centres 131 . Physical characteristics also encompass neighbourhood characteristics such as general walkability 137 and walkable distance to public parks 131 , which are associated with lower loneliness. Overall, concrete and tangible physical characteristics of places appear to be more relevant to explain differences in loneliness than broad categorizations such as urban versus rural.

Perceived neighbourhood characteristics such as perceived neighbourhood quality (for example, feeling safe at night or perceived attractiveness of buildings) or neighbourhood social capital (for example, perceived reciprocity, trust and civic participation in a neighbourhood) tend to be negatively correlated with loneliness 129 , 132 , 133 , 138 . However, this effect seems to be limited to self-reports (rather than more objective informant reports) of neighbourhood characteristics 136 and does not replicate in all studies 139 .

In sum, regional and neighbourhood characteristics potentially account for some of the within-country variation in loneliness, but these findings do not always replicate across studies. There are several possible reasons for the lack of replicability. First, the studies have been conducted in different countries (including Australia 130 , Canada 134 , Germany 131 , Hong Kong 137 and the UK 132 , 136 , 138 ), and it is possible that neighbourhood characteristics vary in their importance across different countries. Second, some studies focused on specific age groups (for example, adolescents and young adults 132 , 136 or older adults 130 , 133 , 134 ), whereas others included the entire adult age range 131 . It is possible that some neighbourhood characteristics are more important for certain age groups than for others. More generally, it is unclear to what extent the association between individual-level predictors of loneliness is moderated by macro-level factors describing regional differences.

Linking macro-level factors to loneliness

Overall, there are many plausible reasons why macro-level factors such as values, family and social network structures, technology, and living conditions might affect population levels of loneliness across time and space. However, for both historical changes and geographical differences, it is often hard to find robust associations between macro-level factors and loneliness.

There are multiple possible explanations for this observation. First, most macro-level factors influence social relationships (and, by extension, loneliness) through multiple indirect pathways, some positive and some negative. These positive and negative pathways might counteract each other such that the net effect of specific macro-level factors on loneliness is close to zero (Fig.  1a ). For example, social media can lead to more frequent social contact and decrease people’s sense of social isolation (potentially decreasing loneliness), but also displace offline interactions and increase online mobbing and cyber bullying (potentially increasing loneliness). Thus, when combined, the population-level effect of social media on loneliness might be weak 81 , 86 .

a , Macro-level factors might influence loneliness through multiple indirect pathways, some leading to an increase (+) and some leading to a decrease (–) in factors that in turn either increase (+) or decrease (–) loneliness. The direction of the total effect of an indirect pathway is defined by the product of the two direct effects. For example, the indirect pathway involving offline interactions involves two negative effects (social media use reduces offline interactions and engaging in offline interactions reduces loneliness) that together result in a total positive effect (social media use increases loneliness). If positive (blue) and negative (red) pathways are approximately counter-balanced, the overall (net) effect of a macro-level factor is close to zero, even though specific causal effects might exist. b , Macro-level factors might have differential effects on different subgroups within a population. These differential effects might differ in strength and direction such that they lead to increased levels in loneliness in some subgroups (red) and to decreased levels of loneliness in other subgroups (blue). c , Most sociocultural changes occur gradually over time, but sudden changes are possible, for example in the context of historical events. Changes in loneliness might be similarly slow, and they might be delayed such that loneliness changes lag behind changes in macro-level factors. Whether these changes can be linked empirically depends on the time window examined. For example, the yellow time window would reveal no association between changes in the macro-level factor and changes in loneliness levels. By contrast, the purple time window would reveal a strong association between changes in the macro-level factor and changes in loneliness levels.

Second, the strength and even the direction of the effect of a macro-level factor on loneliness might differ among different subgroups (Fig.  1b ). In population-level studies, these subgroups are collapsed, so strong effects that exist in only some subgroups might be overlooked. For example, social media use appears to be more beneficial for older adults than for adolescents and young adults 81 , but this differential association would not be detected if these groups were analysed together.

Third, the effects of most macro-level factors might unfold over long timescales 39 , so effects on loneliness might be weak, slow and delayed (that is, only detectable after a certain time lag; Fig.  1c ). The exact temporal course of these effects is unclear, but it is possible that many macro-level factors require decades to affect population levels of loneliness in an observable way because their effects are weak initially but accumulate over time 140 .

Implications for policy

A better understanding of how macro-level factors influence loneliness across historical time and geographic space is necessary to develop evidence-based recommendations for public policy measures against loneliness. For researchers, this is an invitation to study these factors more systematically in future research. But loneliness has also become a public policy issue in the past 5 years, and policymakers cannot wait for science to reach some consensus. For those who require guidance now, we offer some tentative policy implications.

First, the impact of macro-level factors should not be overestimated: even on the individual level, the causes of loneliness are complex and idiosyncratic. This is probably even more true for the effects of macro-level factors on population levels of loneliness. Attempts to pin some perceived uptick in loneliness to highly specific macro-level factors such as the introduction of smartphones 141 are likely to overestimate the relevance of a single factor, at the peril of drawing attention away from other factors that are at least as important. Instead, public policy is probably most effective if it targets individual risk factors such as poverty and unemployment and provides funding for the development and dissemination of individual-level evidence-based interventions against loneliness. Several reviews provide overviews of effective interventions for different target populations 142 , 143 , 144 .

At the same time, the importance of macro-level factors should not be underestimated. Shifts in macro-level factors such as demographic changes or changes in norms and values can influence the risk of loneliness in a population, albeit through complex and still poorly understood pathways. Geographical differences in the distribution of these macro-level factors can help to identify regions that might be particularly at risk and could serve as model regions for testing specific policies. Macro-level trends can therefore provide some tentative information on whether loneliness might become a greater (or lesser) concern in the future.

Finally, macro-level factors might moderate the effects of individual-level predictors on loneliness 42 . For example, the protective effect of being married might depend on the social norms related to marriage at a particular time period or in a particular geographical region 78 . Thus, the efficacy of policies aiming at reducing loneliness by strengthening marriages will vary across historical time and geographical space. This also means that both individual-level and macro-level measures against loneliness have to fit into the greater context. Policies that are applied in different historical or geographical contexts are not necessarily as effective as in the original setting and therefore need to be re-evaluated and, if necessary, adapted.

Summary and future directions

Systematic effects of macro-level factors on loneliness are theoretically plausible but difficult to detect. Macro-level factors tend to have weak effects on individual-level psychological phenomena, particularly if their effects are directly contrasted against individual-level predictors 140 . However, this does not mean that macro-level factors should be dismissed: the effects of macro-level factors often accumulate over time 140 , influence individual-level constructs through multiple indirect (sometimes contradicting) pathways, and might have divergent effects on different subgroups.

To achieve a more nuanced and complete picture of the association between macro-level factors and loneliness, it is necessary to broaden the available database. Representative samples are key to drawing valid conclusions about differences in population levels of loneliness across time or space. Representativeness can be restricted unintentionally through methodological factors (such as nonresponse bias 56 , 109 ) and intentionally (such as by excluding certain subgroups from the population of interest). For example, many panel studies deliberately exclude residents of care homes, yet this group faces substantial risk for loneliness 145 . Future research must include individuals from groups, regions and countries that have been underrepresented or completely excluded from previous studies.

To study macro-level factors systematically, researchers must routinely collect multilevel data on the social network, neighbourhood and region in which their participants are embedded. Many individual-level predictors can be aggregated at higher levels. For example, the availability of individual resources can be studied at the individual level (for example, how is individual income related to loneliness) as well as at the local, regional and national level (for example, how are local, regional or national poverty rates related to loneliness levels). In addition, future theoretical and empirical work needs to consider genuine macro-level factors, that is, factors that can only be conceptualized and measured at the macro level (for example, the extent to which mental health is prioritized in a health-care system).

Collecting data repeatedly at regular intervals (for example, annually) over multiple years or even decades would allow systematic investigations into the causal dynamics through which macro-level factors are linked to loneliness. Although most theories and empirical studies treat macro-level factors as predictors of loneliness, the association between macro-level factors and individual-level loneliness is most probably bidirectional (Fig.  2a ). The effects of loneliness on individual economic, physical and psychological well-being can translate into population-wide outcomes such as reduced life expectancy 6 , increased health-care costs 10 , 11 , or reduced political participation 146 . Moreover, trends in macro-level factors might be more relevant than their absolute levels. For example, changes in the demographic composition of a population due to high residential mobility might be more predictive of population loneliness than the demographic composition itself 131 , owing to a cascade of indirect effects across multiple levels (Fig.  2b ). Such a cross-level process takes time to unfold and can only be detected with longitudinal data in which factors at all levels are measured repeatedly over long periods of time.

a , A multilevel perspective on loneliness according to which individuals are embedded in a greater social context (a couple or social network) and greater geographical contexts (local community, such as town or city; broader region, such as county or state; or country). Factors at all higher levels might influence individuals’ loneliness. At the same time, individuals influence higher-level factors directly (for example, through social contagion) and indirectly (for example, by being part of the composition of their respective population). b , Bidirectional associations between macro-level factors and loneliness might be explained by a cascade of cross-level indirect effects that unfold over time. In this example, an increase in residential mobility on the country level is assumed to lead to less contact with friends, which in turn increases individual-level loneliness. This individual-level increase might lead to increased loneliness in their social network (social contagion) and contribute to increased loneliness at the community, regional and country level.

A better understanding of the causal relationships between macro-level factors and loneliness is also necessary to identify causal factors that can be targeted by public policy measures to reduce loneliness 147 . Examples of research designs that would allow such causal inferences include randomized control trials on community-level or regional-level interventions. In addition, and contrary to conventional wisdom among psychologists, nonexperimental studies can, under specific circumstances and with specific assumptions, be used for causal inference 148 , 149 , for example, natural experiments and prospective studies conducted in the context of major historical events 147 , including wars 150 , natural disasters 151 , pandemics 151 , 152 or economic crises 153 . Indeed, since 2020, researchers have used the COVID-19 pandemic to study the impact of sudden changes in macro-level factors on loneliness 152 , 154 , 155 , 156 .

Finally, a broad database fulfilling these criteria would enable integrative investigations of loneliness across both time and space. The association between a macro-level factor and loneliness always has to be understood in its specific geographic and historical context simultaneously, and, as geographic space or historical time change, so might the relevance of a macro-level factor for changes in loneliness across space and time. In addition, the relationships and interactions among different macro-level factors might also vary across time and space. For example, on the individual level, social class is correlated with the size and function of social networks such that individuals of higher socioeconomic classes tend to view themselves as more independent (rather than interdependent), allowing them to form more diverse and loose social networks 157 . It is possible that similar relationships can be found on the macro level. For example, economic growth could lead to changes in cultural values related to social relationships.

Although there is some overlap between macro-level factors explaining long-term trends in loneliness across historical time and macro-level factors explaining geographical variation in loneliness, few attempts have been made to conceptually or empirically integrate these different perspectives. A recent exception is a spatiotemporal meta-analysis in which historical changes in loneliness among young adults were related to different regional-level characteristics 54 . In general, spatiotemporal meta-analyses expand classic meta-analytic techniques by using spatial and temporal information (that is, considering not only when but also where an included single study was conducted) to explain heterogeneity in effect sizes 158 . Although no significant spatiotemporal associations were found in that particular meta-analysis 54 , this methodological approach might serve as a template for future research examining macro-level factors across time and space simultaneously.

In sum, longitudinal multilevel data from representative samples from multiple countries are necessary to gain a deeper understanding for why loneliness varies across time and space. Collecting such comprehensive data is not feasible for any single laboratory, but with shared resources it is not an impossible goal. In fact, large-scale studies that cover multiple countries across multiple years already exist (for example, the World Happiness Report 159 ), but loneliness is not yet routinely measured in these studies. We therefore call on researchers and funders of large-scale, cross-national panel studies to include standardized measures of loneliness. In addition, we call on researchers around the world to routinely measure loneliness in their studies and thereby contribute to growing the collective database of loneliness across time and space.

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Solitude and Loneliness

Why do some people fear solitude while others embrace it.

Posted August 15, 2024 | Reviewed by Michelle Quirk

• Understanding Loneliness
• Take our Social Anxiety Test
• Find a therapist near me
• Loneliness is when we feel our separateness as human beings and feel uneasy in our mental space.
• Some people experience less separation and so feel more comfortable with solitude.
• Healthy psychological development involves developing a positive relationship to solitude.

Some people are reluctant to spend time alone. Solitude makes them anxious and restless, and so they try to ensure that they’re always in the company of others. But other people have a completely different attitude toward solitude. Even if they enjoy the time they spend with others, they savor their moments of solitude. They find solitude therapeutic and essential to their well-being, a time to rest and reconnect themselves.

Solitude doesn’t necessarily mean loneliness . Loneliness is when we feel our separateness as human beings. We feel trapped inside our mental space, in separation from other human beings, and from a world that appears to be “out there.” (I refer to this as “ego-isolation.”) As the psychiatrist Frieda Fromm-Reichmann wrote in her seminal 1958 paper "Loneliness," there is a threat to “self-orientation” too, since we derive our sense of self from “overt relationships with others." 1 We need contact with others to maintain our sense of identity . In loneliness, our sense of identity weakens.

At the same time, loneliness involves experiencing the habitual restlessness of our minds, leaping from one association to the next, and often gravitating to negative thoughts. For people who suffer from more intense psychological discord, perhaps due to depressive tendencies or past trauma , loneliness is an even more negative experience.

Embracing Solitude

But why are some people much less affected by these negative aspects? Why do they feel comfortable with solitude, while others don’t?

Ego isolation is not a constant, or even a given. It exists on a continuum. In my book DisConnected , I describe the “hyper-disconnected” personality who experiences extreme separation and, therefore, has an intense fear of solitude and inactivity. 2 Hyper-disconnected people are unable to form any emotional connection to others or to feel empathy. Their intense separation typically generates an intense desire to accumulate success, power, and wealth, together with a deep unconscious frustration, which may express itself in violent and destructive behavior.

Hyper-disconnected people typically feel a compulsive need for activity and company to avoid experiencing the discomfort of their extreme separation. One example is the British business tycoon Robert Maxwell—father of Ghislaine Maxwell—whose hyper-disconnection was probably linked to early life experiences of trauma and emotional and material deprivation. In the words of one of Maxwell’s confidantes, “What drove him more than anything [was]…the desire to generate activity, no matter how pointless it was. Above all, he dreaded being on his own with nothing to do.” 3

However, some people experience less ego isolation than others. A small proportion of people may experience very little separation at all and are therefore less prone to loneliness. Rather than seeking to avoid solitude, they may embrace it. Abraham Maslow identified a greater-than-normal need for peace and solitude as one of the characteristics of self-actualized individuals. 4

In my own research—described in my book The Leap —I have found that a positive attitude to solitude is one of the characteristics of “wakefulness,” a state of expansive awareness with a strong sense of connection to other human and living beings, to nature, and to the world in general. Wakefulness can be cultivated gradually or arise suddenly and dramatically in the aftermath of intense psychological turmoil. In this state, people relish quietness and inactivity. Many people reported that they never felt lonely, even if they were alone for long periods. One participant reported, “I really love my quietude. It gives me the chance to read and delight and meditate in a different way that allows for reflection and for an ever-deepening.” Another person reported, “I can be on my own for long periods of time and doing nothing and that is okay with me.” 5

In other words, our attitude to solitude and our vulnerability to loneliness depends on our degree of separation or connection, together with our degree of psychological discord.

The more ego isolation and psychological discord we experience, the more vulnerable we are to loneliness. But when we experience little or no ego separation, we relish solitude—and also inactivity. The compulsion to keep our minds occupied fades away.

Healthy psychological development therefore involves developing a positive relationship to solitude and inactivity. Of course, this doesn’t mean that we should isolate ourselves from others—we should aim for a healthy balance of society and solitude. At the very least, we should learn not to fear the inevitable moments when we are obliged to be alone. On the contrary, we should view these periods as an opportunity to enter and explore our own inner being and to reattune to our essential selves.

In his poem "The Uprooted," D.H. Lawrence vividly portrays the connection between ego isolation and loneliness. As he writes, "People who complain of loneliness must have lost something,/Lost some living connection with the cosmos, out of themselves… like a plant whose roots are cut." For Lawrence himself, who lived in an intense state of connection, "To be alone is one of life’s greatest delights…feeling oneself uninterrupted in the rooted connection with the centre of all things.” 6

1. Fromm-Reichmann, F. (1990). Loneliness. Contemporary Psychoanalysis 26, 305–329.

2. Taylor, S. (2023a). DisConnected: The Roots of Human Cruelty and How Connection Can Heal the World . Iff Books.

3. Preston, J. (2021). Fall: The Mystery of Robert Maxwell . Penguin.

4. Maslow, A. H. (1954). Motivation and Personality . Harper and Row.

5. Taylor, S. (2017). The Leap: The Psychology of Spiritual Awakening. New World Library

6. Lawrence, D.H. (1994). The Complete Poems . Penguin

Steve Taylor, Ph.D., is senior lecturer in psychology at Leeds Beckett University. He is the author of several best-selling books, including The Leap and Spiritual Science.

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Theme of Loneliness, Isolation, & Alienation in Literature with Examples

Humans are social creatures. Most of us enjoy communication and try to build relationships with others. It’s no wonder that the inability to be a part of society often leads to emotional turmoil.

World literature has numerous examples of characters who are disconnected from their loved ones or don’t fit into the social norms. Stories featuring themes of isolation and loneliness often describe a quest for happiness or explore the reasons behind these feelings.

In this article by Custom-Writing.org , we will:

• discuss isolation and loneliness in literary works;
• cite many excellent examples;
• provide relevant quotations.

🏝️ Isolation Theme in Literature

• 🏠 Theme of Loneliness
• 👽 Theme of Alienation
• Frankenstein
• The Metamorphosis
• Of Mice and Men
• ✍️ Essay Topics

🔍 References

Isolation is a state of being detached from other people, either physically or emotionally. It may have positive and negative connotations:

• In a positive sense, isolation can be a powerful source of creativity and independence.
• In negative terms , it can cause mental suffering and difficulties with interpersonal relationships.

Theme of Isolation and Loneliness: Difference

As you can see, isolation can be enjoyable in certain situations. That’s how it differs from loneliness : a negative state in which a person feels uncomfortable and emotionally down because of a lack of social interactions . In other words, isolated people are not necessarily lonely.

Isolation Theme Characteristics with Examples

Now, let’s examine isolation as a literary theme. It often appears in stories of different genres and has various shades of meaning. We’ll explain the different uses of this theme and provide examples from literature.

Forced vs. Voluntary Isolation in Literature

Isolation can be voluntary or happen for external reasons beyond the person’s control. The main difference lies in the agent who imposes isolation on the person:

• If someone decides to be alone and enjoys this state of solitude, it’s voluntary isolation . The poetry of Emily Dickinson is a prominent example.
• Forced isolation often acts as punishment and leads to detrimental emotional consequences. This form of isolation doesn’t depend on the character’s will, such as in Hawthorne’s The Scarlet Letter .

Physical vs. Emotional Isolation in Literature

Aside from forced and voluntary, isolation can be physical or emotional:

• Isolation at the physical level makes the character unable to reach out to other people, such as Robinson Crusoe being stranded on an island.
• Emotional isolation is an inner state of separation from other people. It also involves unwillingness or inability to build quality relationships. A great example is Holden Caulfield from The Catcher in the Rye .

These two forms are often interlinked, like in A Rose for Emily . The story’s titular character is isolated from the others both physically and emotionally .

Symbols of Isolation in Literature

In literary works dedicated to emotional isolation, authors often use physical artifacts as symbols. For example, the moors in Wuthering Heights or the room in The Yellow Wallpaper are means of the characters’ physical isolation. They also symbolize a much deeper divide between the protagonists and the people around them.

🏠 Theme of Loneliness in Literature

Loneliness is often used as a theme in stories of people unable to build relationships with others. Their state of mind always comes with sadness and a low self-esteem. Naturally, it causes profound emotional suffering.

We will examine how the theme of loneliness functions in literature. But first, let’s see how it differs from its positive counterpart: solitude.

Solitude vs. Loneliness: The Difference

Loneliness Theme: History & Examples

The modern concept of loneliness is relatively new. It first emerged in the 16 th century and has undergone many transformations since then.

• The first formal mention of loneliness appeared in George Milton’s Paradise Lost in the 17 th century. There are also many references to loneliness in Shakespeare’s works.
• Later on, after the Industrial Revolution , the theme got more popular. During that time, people started moving to large cities. As a result, they were losing bonds with their families and hometowns. Illustrative examples of that period are Gothic novels and the works of Charles Dickens .
• According to The New Yorker , the 20 th century witnessed a broad spread of loneliness due to the rise of Capitalism. Philosophers Jean-Paul Sartre and Albert Camus explored existential loneliness, influencing numerous authors. The absurdist writings of Kafka and Beckett also played an essential role in reflecting the isolation felt by people in Capitalist societies. Sylvia Plath has masterfully explored mental health struggles related to this condition in The Bell Jar (you can learn more about it in our The Bell Jar analysis .)

👽 Theme of Alienation in Literature

Another facet of being alone that is often explored in literature is alienation . Let’s see how this concept differs from those we discussed previously.

Alienation vs. Loneliness: Difference

While loneliness is more about being on your own and lacking connection, alienation means involuntary estrangement and a lack of sympathy from society. In other words, alienated people don’t fit their community, thus lacking a sense of belonging.

Isolation vs. Alienation: The Difference

Theme of Alienation vs. Identity in Literature

There is a prominent connection between alienation and a loss of identity. It often results from a character’s self-search in a hostile society with alien ideas and values. These characters often differ from the dominant majority, so the community treats them negatively. Such is the case with Mrs. Dalloway from Woolf’s eponymous novel.

Writers with unique, non-conforming identity are often alienated during their lifetime. Their distinct mindset sets them apart from their social circle. Naturally, it creates discomfort and relationship problems. These experiences are often reflected in their works, such as in James Joyce’s semi-autobiographical A Portrait of the Artist as a Young Man .

Alienation in Modernism

Alienation as a theme is mainly associated with Modernism . It’s not surprising, considering that the 20 th century witnessed fundamental changes in people’s lifestyle. Capitalism and the Industrial Revolution couldn’t help eroding the quality of human bonding and the depth of relationships.

It’s also vital to mention that the two World Wars introduced even greater changes in human relationships. People got more locked up emotionally in order to withstand the war trauma and avoid further turmoil. Consequently, the theme of alienation and comradeship found reflection in the works of Ernest Hemingway , Erich Maria Remarque , Norman Mailer, and Rebecca West, among others.

📚 Books about Loneliness and Isolation: Quotes & Examples

Loneliness and isolation themes are featured prominently in many of the world’s greatest literary works. Here we’ll analyze several well-known examples: Frankenstein, Of Mice and Men, and The Metamorphosis.

Theme of Isolation & Alienation in Frankenstein

Mary Shelley’s novel Frankenstein is among the earliest depictions of loneliness in modern literature. It shows the depth of emotional suffering that alienation can impose.

Victor Frankenstein , a talented scientist, creates a monster from the human body parts. The monster becomes the loneliest creature in the world. Seeing that his master hates him and wouldn’t become his friend, he ruined everything Victor held dear. He was driven by revenge, trying to drive him into the same despair.

The novel contains many references to emotional and physical alienation. It also explores the distinction between voluntary and involuntary isolation:

• The monster is involuntarily driven into an emotionally devastating state of alienation.
• Victor imposes voluntary isolation on himself after witnessing the crimes of his creature.

To learn more about the representation of loneliness and isolation in the novel, check out our article on themes in Frankenstein .

Frankenstein Quotes about Isolation

Here are a couple of quotes from Frankenstein directly related to the theme of isolation and loneliness:

How slowly the time passes here, encompassed as I am by frost and snow…I have one want which I have never yet been able to satisfy and the absence of the object of which I now feel as a most severe evil. I have no friend. Frankenstein , Letter 2

In this quote, Walton expresses his loneliness and desire for company. He uses frost and snow as symbols to refer to his isolation. Perhaps a heart-warming relationship could melt the ice surrounding him.

I believed myself totally unfitted for the company of strangers. Frankenstein , Chapter 3

This quote is related to Victor’s inability to make friends and function as a regular member of society. He also misses his friends and relatives in Ingolstadt, which causes him further discomfort.

I, who had ever been surrounded by amiable companions, continually engaged in endeavouring to bestow mutual pleasure—I was now alone. Frankenstein , Chapter 3

In this quote, Victor shares his fear of loneliness. As a person who used to spend most of his time in social activity among people, Victor feared the solitude that awaited him in Ingolstadt.

Isolation & Alienation in The Metamorphosis

The Metamorphosis is an enigmatic masterpiece by Franz Kafka, telling a story of a young man Gregor. He is alienated at work and home by his demanding, disrespectful family. He lacks deep, rewarding relationships in his life. As a result, he feels profound loneliness.

Gregor’s family isolates him both as a human and an insect, refusing to recognize his personhood. Gregor’s stay in confinement is also a reflection of his broader alienation from society, resulting from his self-perception as a parasite.  To learn more about it, feel free to read our article on themes in The Metamorphosis .

The Metamorphosis: Isolation Quotes

Let’s analyze several quotes from The Metamorphosis to see how Kafka approached the theme of isolation.

The upset of doing business is much worse than the actual business in the home office, and, besides, I’ve got the torture of traveling, worrying about changing trains, eating miserable food at all hours, constantly seeing new faces, no relationships that last or get more intimate. The Metamorphosis , Part 1

In this fragment, Gregor’s lifestyle is described with a couple of strokes. It shows that he lived an empty, superficial life without meaningful relationships.

Well, leaving out the fact that the doors were locked, should he really call for help? In spite of all his miseries, he could not repress a smile at this thought. The Metamorphosis , Part 1

This quote shows how Gregor feels isolated even before anyone else can see him as an insect. He knows that being different will inevitably affect his life and his relationships with his family. So, he prefers to confine himself to voluntary isolation instead of seeking help.

He thought back on his family with deep emotion and love. His conviction that he would have to disappear was, if possible, even firmer than his sister’s. The Metamorphosis , Part 3

This final paragraph of Kafka’s story reveals the human nature of Gregor. It also shows the depth of his suffering in isolation after turning into a vermin. He reconciles with his metamorphosis and agrees to disappear from this world. Eventually, he vanishes from his family’s troubled memories.

Theme of Loneliness in Of Mice and Men

Of Mice and Men is a touching novella by John Steinbeck examining the intricacies of laborers’ relationships on a ranch. It’s a snapshot of class and race relations that delves into the depths of human loneliness. Steinbeck shows how this feeling makes people mean, reckless, and cold.

Many characters in this story suffer from being alienated from the community:

• Crooks is ostracized because of his race, living in a separate shabby house as a misfit.
• George also suffers from forced alienation because he takes care of the mentally disabled Lennie.
• Curley’s wife is another character suffering from loneliness. This feeling drives her to despair. She seeks the warmth of human relationships in the hands of Lennie, which causes her accidental death.

Isolation Quotes: Of Mice and Men

Now, let’s analyze a couple of quotes from Of Mice and Men to see how the author approached the theme of loneliness.

Guys like us who work on ranches are the loneliest guys in the world, they ain’t got no family, they don’t belong no place. Of Mice and Men , Section 1

In this quote, Steinbeck describes several dimensions of isolation suffered by his characters:

• They are physically isolated , working on large farms where they may not meet a single person for weeks.
• They have no chances for social communication and relationship building, thus remaining emotionally isolated without a life partner.
• They can’t develop a sense of belonging to the place where they work; it’s another person’s property.

Candy looked for help from face to face. Of Mice and Men , Section 3

Candy’s loneliness on the ranch becomes highly pronounced during his conflict with Carlson. The reason is that he is an old man afraid of being “disposed of.” The episode is an in-depth look into a society that doesn’t cherish human relationships, focusing only on a person’s practical utility. 

I never get to talk to nobody. I get awful lonely. Of Mice and Men , Chapter 5

This quote expresses the depth of Curley’s wife’s loneliness. She doesn’t have anyone with whom she would be able to talk, aside from her husband. Curley is also not an appropriate companion, as he treats his wife rudely and carelessly. As a result of her loneliness, she falls into deeper frustration.

✍️ Essay on Loneliness and Isolation: Topics & Ideas

If you’ve got a task to write an essay about loneliness and isolation, it’s vital to pick the right topic. You can explore how these feelings are covered in literature or focus on their real-life manifestations. Here are some excellent topic suggestions for your inspiration:

• Cross-national comparisons of people’s experience of loneliness and isolation.
• Social isolation, loneliness, and all-cause mortality among the elderly.
• Public health consequences of extended social isolation .
• Impact of social isolation on young people’s mental health during the COVID-19 pandemic.
• Connections between social isolation and depression.
• Interventions for reducing social isolation and loneliness among older people.
• Loneliness and social isolation among rural area residents.
• The effect of social distancing rules on perceived loneliness.
• How does social isolation affect older people’s functional status?
• Video calls as a measure for reducing social isolation.
• Isolation, loneliness, and otherness in Frankenstein .
• The unique combination of addiction and isolation in Frankenstein .
• Exploration of solitude in Hernan Diaz’ In the Distance .
•  Artificial isolation and voluntary seclusion in Against Nature .
• Different layers of isolation in George Eliot’s Silas Marner .
• Celebration of self-imposed solitude in Emily Dickinson’s works.
• Buddhist aesthetics of solitude in Stephen Batchelor’s The Art of Solitude .
• Loneliness of childhood in Charles Dickens’s works.
• Moby-Dick : Loneliness in the struggle.
• Medieval literature about loneliness and social isolation.

Now you know everything about the themes of isolation, loneliness, and alienation in fiction and can correctly identify and interpret them. What is your favorite literary work focusing on any of these themes? Tell us in the comments!

❓ Themes of Loneliness and Isolation FAQs

Isolation is a popular theme in poetry. The speakers in such poems often reflect on their separation from others or being away from their loved ones. Metaphorically, isolation may mean hiding unshared emotions. The magnitude of the feeling can vary from light blues to depression.

In his masterpiece Of Mice and Men , John Steinbeck presents loneliness in many tragic ways. The most alienated characters in the book are Candy, Crooks, and Curley’s wife. Most of them were eventually destroyed by the negative consequences of their loneliness.

The Catcher in the Rye uses many symbols as manifestations of Holden’s loneliness. One prominent example is an image of his dead brother Allie. He’s the person Holden wants to bond with but can’t because he is gone. Holden also perceives other people as phony or corny, thus separating himself from his peers.

Beloved is a work about the deeply entrenched trauma of slavery that finds its manifestation in later generations. Characters of Beloved prefer self-isolation and alienation from others to avoid emotional pain.

In Aldous Huxley’s Brave New World , all people must conform to society’s rules to be accepted. Those who don’t fit in that established order and feel their individuality are erased from society.

• What Is Solitude?: Psychology Today
• Loneliness in Literature: Springer Link
• What Literature and Language Tell Us about the History of Loneliness: Scroll.in
• On Isolation and Literature: The Millions
• 10 Books About Loneliness: Publishers Weekly
• Alienation: Stanford Encyclopedia of Philosophy
• Isolation and Revenge: Where Victor Frankenstein Went Wrong: University of Nebraska-Lincoln
• On Isolation: Gale
• Top 10 Books About Loneliness: The Guardian
• Emily Dickinson and the Creative “Solitude of Space:” Psyche
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• Older people and COVID-19

High-quality social connections are essential to our mental and physical health and our well-being. Social isolation and loneliness are important, yet neglected, social determinants for people of all ages – including older people.

Social isolation and loneliness are widespread, with an estimated 1 in 4 older people experiencing social isolation and between 5 and 15 per cent of adolescents experiencing loneliness. A large body of research shows that social isolation and loneliness have a serious impact on physical and mental health, quality of life, and longevity. The effect of social isolation and loneliness on mortality is comparable to that of other well-established risk factors such as smoking, obesity, and physical inactivity.

Social isolation and loneliness are increasingly being recognised as a priority public health problem and policy issue across all age groups. During the course of the UN Decade of Healthy Ageing (2021-2030) , the Demographic Change and Healthy Ageing Unit will be addressing social isolation and loneliness as one of the themes that cuts across the four main action areas of the Decade.

WHO Commission on Social Connection

The Demographic Change and Healthy Ageing Unit is also part of the Secretariat for the WHO Commission on Social Connection (2024–2026), separately established to bring together world-class Commissioners towards recognising and resourcing social connection as a global public health priority.

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Social isolation and loneliness are widespread, painful, and harmful for our health

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Commentaries and news

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Seeking shelter from social isolation and loneliness under the tree of friendship

New advocacy brief highlights serious consequences of social isolation and loneliness on the health of older people, calls for greater political priority to the issue

Related links

The Decade of Healthy Ageing knowledge exchange Platform

UN Decade of Healthy Ageing (2021-2030)

UN International Day of Friendship - 30 July

Related topics

Social determinants of health

Urban health

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Opinion Guest Essay

The Senator Warning Democrats of a Crisis Unfolding Beneath Their Noses

Credit... Allison Minto for The New York Times

Supported by

By James Pogue

Mr. Pogue, a writer, started talking to Senator Chris Murphy two years ago.

• Aug. 19, 2024

In December 2022, early into what he now describes as his political journey, Senator Chris Murphy of Connecticut gave a speech warning his fellow Democrats that they were ignoring a crisis staring them in the face.

For over a year, President Biden and his allies had been promoting data showing an economic miracle, as friendly pundits described it — a record-setting stock market, low unemployment and G.D.P. growth outpacing that of almost every other Western nation. But very few voters believed the story those metrics were telling. In poll after poll, they expressed a bleak view of the economy — to the frustration of both Democrats and many economists.

Mr. Murphy thought he knew why. “The challenges America faces aren’t really logistical,” he told the crowd. “They are metaphysical. And the sooner we understand the unspooling of identity and meaning that is happening in America today, the sooner we can come up with practical policies to address this crisis.”

The subject of the speech was what Mr. Murphy called the imminent “fall of American neoliberalism.” This may sound like strange talk from a middle-of-the-road Democratic senator, who up until that point had never seemed to believe that the system that orders our world was on the verge of falling. He campaigned for Hillary Clinton against Bernie Sanders during the 2016 primaries, and his most visible political stance up until then was his work on gun control after the Sandy Hook shooting.

Thoughtful but prone to speaking in talking points, he still comes off more like a polished Connecticut dad than a champion of the disaffected. But Mr. Murphy was then in the full flush of discovering a new way of understanding the state of the nation, and it had set him on a journey that even he has struggled sometimes to describe: to understand how the version of liberalism we’d adopted — defined by its emphasis on free markets, globalization and consumer choice — had begun to feel to many like a dead end and to come up with a new vision for the Democratic Party.

As the Democrats gather for their national convention this week, with Kamala Harris as their candidate for president, the party has a long way to go toward confronting the crisis Mr. Murphy sees.

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