Why loneliness can be as unhealthy as smoking 15 cigarettes a day

Marci O'Connor, a mother of two teenagers, struggles with her confident, independent self and recurring loneliness — feelings that psychologists say are increasingly posing public health challenges.

O'Connor, 46, of Mont-Saint-Hilaire, 30 kilometres east of Montreal, said loneliness snuck up on her after she moved away from her family to a predominantly French-speaking area. She now works from home.

O'Connor lost the camaraderie of her community of stay-at-home moms as her children, now 15 and 17, grew and families' circumstances changed.

"I found that I constantly check in with myself and my motives for doing things," O'Connor said. "If I go hiking alone, is it to avoid other people or is that the day I really want to be on my own?"

Taken too far, a sense of independence and self-sufficiency can be a detriment. Psychologists say it's important to recognize loneliness and prioritize the meaningful relationships we all need.

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Demographics are another challenge. Earlier this month, Statistics Canada released new information from the 2016 census suggesting a record number of households, 28.2 per cent, have only one person living in them.  

Grave toll of loneliness

In an upcoming issue of American Psychologist, Julianne Holt-Lunstad, a professor of psychology at Brigham Young University in Provo, Utah, says social connection should be a public health priority. Holt-Lunstad says social connection is associated with a 50 per cent reduced risk of early death, and loneliness exacts a grave toll.

"It's comparable to the risk of smoking up to 15 cigarettes a day," Holt-Lunstad said in an interview. "It exceeds the risk of alcohol consumption, it exceeds the risk of physical inactivity, obesity, and it exceeds the risk of air pollution."

Holt-Lunstad thinks part of the reason loneliness and social isolation haven't been in the spotlight is because it's a nebulous term. Social scientists measure it in three ways that all significantly predict mortality risk:

• Structural — presence or absence of others.
• Functional — what relationships do.
• Quality — the positive or negative aspects of relationships.

While social isolation has to do with objectively lacking relationships, loneliness is about how you you perceive your level of social support, psychologists say.

As the population ages, loneliness and social isolation are on the rise, said Dr. Nasreen Khatri, a clinical psychologist and gerontologist at the Rotman Institute at Baycrest Health Sciences in Toronto.

Physically, being around others alters our cortisol or stress hormone levels, Khatri said. Social connections are protective, helping us to maintain healthy eating routines, exercise and enjoy shared, pleasant activities to boost both physical and mental health while curbing negative behaviours like watching too much TV.

"If I could wave a wand, the one part of this problem I would make disappear is the idea that people who experience loneliness feel that they're alone in that experience," Khatri said. "They're not."

Khatri suggests that people:

• Recognize and name loneliness in their lives.
• Be aware of how our changing social structures enable it.
• Make socializing a priority.
• Plan socially for life changes, such as a move to a new city.
• Nurture real-life relationships.

One strategy O'Connor used was a bartering Facebook group. She helped a woman with a chronic illness to clean her home. The woman, who wasn't physically able to scrub, cooked O'Connor home-cooked meals and offered one-on-one companionship.

O'Connor said that while going into someone's house to help clean helped to get her out of her own head, talking about loneliness itself is still a challenge.

"I just think people don't know how to talk about it," O'Connor said. "Maybe if it was cooler. Maybe we need a celebrity endorsement for loneliness."

For their part, researchers such as Holt-Lunstad recommend that physicians assess patients' loneliness risk and make it part of their care plan.