Isolation & Loneliness: Which One Is More Damaging to Our Long-term Health?

Just the other day I was having a debate with a client about isolation versus loneliness.

He believed that the amount of social contact we have with others was a more significant predictor of well-being, whereas I thought that how close we felt was more important for long-term health and happiness.

In other words, he thought that the number of interactions with others was more important than the quality of the relationships. I was solidly on team quality over quantity when it came to the type of relations that we want in our lives.

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Because I wasn’t sure whose position was more supported by research, I decided to subsequently explore the issue further.

My aim in writing this post is to first clearly define the difference between isolation and loneliness, and then highlight what the scientific evidence suggests.

 

Isolation

The Merriam-Webster dictionary for English language learners defines isolation as:

“The state of being in a place or situation that is separate from others: the condition of being isolated”

Notice with this definition that there is no emotion connected to it. It merely indicates being isolated or separate from others.

Someone could choose to live a solitary life in isolation, and they may be happy with their choice. For Alexandra de Steiguer, a shy individual who spent a lot of time alone when she was a child, she chooses to isolate herself each winter as the sole ‘caretaker’ of the Oceanic Hotel on an Island in New Hampshire. For the past 19 winters, she has spent months on the island without any guests.

de Steiguer states:

“it’s the thing I look forward to every year… When I come out here it’s like a homecoming. All those details of mainland life just fall away.”

She later says:

“Being alone (has) it’s advantages. It’s peaceful, and I can use my imagination…It makes me feel connected to life (and the natural world) in a way that I don’t normally feel.”

If you’d like to check out the 14-minute documentary ‘Winter’s Watch’ in full to get a true sense of the solitude that she encounters, please see below:

https://player.vimeo.com/api/player.js%5D

I don’t think I could do what she does, especially after watching ‘The Shining’, but each to their own.

Henry David Thoreau also glorified isolation and solitude in his famous book ‘Walden; or Life in the Woods’, stating:

“I find it wholesome to be alone the greater part of the time. To be in company, even with the best, is soon wearisome and dissipating. I love to be alone. I never found the companion that was so companionable as solitude.”

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To write the book, Thoreau built a cabin on the shore of a pond in 1845 and decided to live there for the next two years.

He also highly valued simplifying life and reconnecting with nature:

“I went to the woods because I wished to live deliberately, to front only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover that I had not lived.”

Before you think about selling up everything Emile Hirsch ‘Into the Wild’ style and moving to the wilderness by yourself, it is important to highlight two things first:

  1. Thoreau walked into the nearby town of Concord, Massachusetts almost daily and received visitors regularly.
  2. Hirsch’s character in ‘Into the Wild’ Christopher McCandless (**spoiler alert**) dies after eating a poisonous plant and concludes “Happiness only real when shared.”

When solitude doesn’t involve nature and is forced upon someone, it is often considered a devastating form of punishment. For this reason, solitary confinement is used by various prisons all over the world. The way it is used is typically in violation of human rights, or the UN’s Mandela Rules, which states that humans must not be “without meaningful human contact for more than 15 consecutive days” (Martin, 2016).

The fact that people would rather be out in the prison yard where they could be stabbed or beaten up instead of in isolation makes me realise that humans really are social creatures. Too much time in isolation can lead to active psychosis or acute suicidality in approximately one-third of the prisoners exposed to solitary confinement (Rodriguez, 2016). It can also lead to crippling social anxiety for prisoners once they are released back into society (Breslow, 2014).

Consequently, I can’t help but feel that except for a few individual cases or for people who are very introverted, too much isolation does more harm than good.

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Loneliness

The Merriam-Webster dictionary defines loneliness as:

“Sad feelings that come from being apart from other people”

Notice with this definition, the focus is on the feelings of sadness. Unlike isolation, loneliness suggests a deficit and a longing for companionship and genuine connection that is not there.

As JD in ‘Scrubs’ suggests, it is also possible to feel lonely in a crowded space, even though you could not be considered isolated:Image result for JD scrubs lonely quote

So what is more damaging – being separate from others, or feeling apart from others?

 

The Village Effect

Our brains light up when they are exposed to human interactions, especially direct face-to-face contact. Online communications and passively watching videos don’t have the same effect.

In her 2017 TED talk, Susan Pinker looks at different reasons why people live longer, including the role that relationships play:

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As you can see in the graph above, minimising both isolation and loneliness were more critical for staying alive than someone’s BMI, their level of activity, their smoking and drinking behaviours, or even their heart health and blood pressure. While these factors are still relevant, having constant and close relationships is almost essential for our long-term health and longevity. Quantity, or level of integration, is seen as slightly more important than the closeness of relationships, or quality. One point for my client.

Either way, in her book ‘The Village Effect’, Pinker suggests that we would all benefit from the type of interconnectedness that a small village lifestyle provides. village effect

Pinker also believes that we would benefit more by increasing our in-person face-to-face contact and cutting back our use of technology as a way to try to better connect with others.

 

Alone Together

Another fascinating book that I read in 2017 was ‘Alone Together’ by Sherry Turkle.

Image result for alone together sherry turkle

Turkle’s 2011 book also highlights the difference between how often we interact with other people and how sad, disconnected or alone we feel.

Her 2012 TED talk nicely summarises the negative aspects of technology and how it is leading to a greater sense of loneliness, even though it is easier than ever to remain in contact in some way or another:

As Turkle says:

“we use conversation with each other to learn how to have conversation with ourselves. A flight from conversation can really matter, because it can compromise our capacity for self reflection. For kids growing up, that skill is a bedrock for development.”

 

Turkle concludes:

“we’re lonely, but we’re afraid of intimacy. (We want) the illusion of companionship, without the demands of friendship.” (As a result, we) expect more from technology, and less from each other. (We imagine, that with technology), we’ll never have to be alone.”

It’s pretty scary stuff when you think about it. However, Turkle’s findings are a clear indicator that loneliness is more damaging than isolation, so one point for me.

 

Other Research

Social isolation is associated with:

  • an increased risk of depression (Hari, 2018),
  • more heart disease (Barth, Schneider, & von Känel, 2010),
  • a more significant risk of infectious illness (Cohen et al., 1997),
  • quicker cognitive decline (Bassuk, Glass & Berman, 1999),
  • elevated blood pressure (Shankar, McMunn, Banks & Steptoe, 2011),
  • greater inflammation and metabolic responses to stress (Uchino, 2006), and
  • increased mortality (Eng, Rimm, Fitzmaurice & Kawachi, 2002)

Loneliness is associated with:

  • a higher risk of major depressive disorder (Hari, 2018),
  • increased blood pressure (Hawkley et al., 2010)
  • heightened cortisol (Cacioppo et al., 2000)
  • elevated inflammation (Steptoe et al., 2004), and
  • increased risk of heart disease, functional decline and early death (Patterson & Veenstra, 2010; Perissinotto, Stijacic Cenzer & Covinsky, 2012).

A 2013 study titled “Social Isolation, Loneliness and All-Cause Mortality in Older Men and Women” looked at 6,500 men and women over the age of 51 from the English Longitudinal Study of Ageing between 2004 and March 2012. After taking demographics and health at baseline into account, social isolation significantly predicted later mortality, but loneliness did not (Steptoe, Shankar, Demakakos & Wardle, 2013).

Both loneliness and social isolation were associated with an increased risk of mortality, but reducing isolation was considered to be more critical in reducing the risk of premature death than loneliness was. Loneliness did not add to the risk of early death for people who were already socially isolated (Steptoe et al., 2013).

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Final Outcome and Recommendations

THE VERDICT: SOCIAL ISOLATION IS MORE DANGEROUS THAN LONELINESS!

This is one time where I really am surprised to be wrong, but I am glad to have a bias pointed out to me whenever it occurs. I personally have never felt socially isolated, but I have definitely felt lonely, so my own experience must have influenced my opinion to some degree.

Social isolation is more hazardous to our long-term health than the subjective feeling of loneliness. However, both of these states are potentially damaging, and steps should be taken if you are experiencing them on a regular basis.

Lifeline recommends the following strategies for overcoming social isolation and loneliness:

  • Connect or reconnect with friends and family – staying in contact with loved ones can prevent loneliness and isolation. If your family don’t live nearby, technology can help you stay in touch
  • Get out and about – regular outings for social functions, exercise, visiting friends, doing shopping, or simply going to public places can help
  • Get involved in your community – Try a new (or old) hobby, join a club, enrol in study, or learn a new skill. Try looking online, at your local TAFE/Community College, library or community centre for things in your area that might be interesting to you
  • Volunteer – helping others is a great way to help yourself feel more connected
  • Consider getting a pet –pets are wonderful companions and can provide comfort and support during times of stress, ill-health or isolation
  • Get support – If loneliness and social isolation are causing you distress, you should discuss your concerns with a GP, counsellor or a trusted person

Engaging in treatment with a clinical psychologist could help if social anxiety or other mental health difficulties are contributing to your isolation or loneliness. If not, the meetup website is an excellent resource for getting out there, trying some new things, and meeting some new people.

As George Valliant says:

“Joy is connection… the more areas in your life you can make connection, the better.”

Dr Damon Ashworth

Clinical Psychologist

11 thoughts on “Isolation & Loneliness: Which One Is More Damaging to Our Long-term Health?

  1. Despite your verdict, I would say both are right. I don’t think it’s possible at this time to compare (social) isolation vs loneliness effects though. One is based on a physical spectrum and the other on a psychological one. It’s much easier to create a metric for the first and use a metric for the second one which actually does not offer a reliable measure. Tricky measures, tricky results, tricky comparisons. For instances, in the ageing study – social isolation proved to have a greater impact maybe because lower social isolation allows elderly people receive help and medical support on time. Loneliness depends on each individual resilience and psychological health…

    Liked by 1 person

  2. I love that you took the time to examine both sides of the argument and admit that you were mistaken. When I was reading this, I couldn’t help but think of Maslow’s hierarchy of needs. My guess is that minimising isolation is probably closer to the bottom of the hierarchy because it seems a bit more basic than minimising loneliness. But I believe you still need both. I couldn’t help but notice how close the bars were for social integration & close relationships were in Susan Pinker’s presentation.

    Liked by 1 person

  3. What an interesting article. For me though it’s comparing 2 very different problems. Loneliness is a feeling, and as such will fluctuate and pass at times. Isolation however is a hard physical fact, which means that for it to pass or change we would have to change physical factors often out with our control. Feelings come from within, so we always have a choice about how we own and take them forwards. Physical realities are external and give us less direct control to change them. I guess the hardest thing is to feel isolated and lonely even in a crowd….as this may mean that those around us just don’t understand what’s going on inside us at that moment….this is a horrible type of isolation, to not be understood.

    Liked by 1 person

  4. Hi Damon, I’ve casually referenced this article on my own blog, probably in an unconventional way. I guess WordPress has shown you. Let me know if that kind of mention is OK, if you hate it for whatever reason I’ll take it off. Greetings, Sasha.

    Liked by 1 person

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