Loneliness Can Occur at Every Life Stage

By Rajesh K. Mehta, MD, FAPA, Narpinder Malhi, MD, FAPA, Dhanalakshmi Ramasamy, MD, and the Committee on Family at the Group for the Advancement of Psychiatry

A February 2024 poll by the American Psychiatric Association found that 30 percent of adults felt lonely at least once a week in the past year, and 10 percent felt lonely every day. The World Health Organization calls loneliness a global health threat and estimates that one in four adults and one in 15 adolescents experience loneliness.

Loneliness can be defined as a complex feeling of being alone or lacking companionship, even when surrounded by people. Most recently, the COVID-19 pandemic significantly heightened feelings of loneliness due to prolonged social isolation and reduced in-person interaction.

Social isolation and having few social connections can lead to loneliness. However, not all individuals with few social connections are lonely, and, perhaps paradoxically, even those who are socially connected can still experience loneliness.

According to a report by the National Academies of Sciences, Engineering, and Medicine, over one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are socially isolated. Older adults are at higher risk because they are more likely to live alone, lose family or friends, and suffer from chronic illnesses.

Further, it is important to distinguish loneliness from solitude. Solitude is a voluntary choice to be alone, to meditate, and for reflection or relaxation, often leading to rejuvenation and personal growth. Loneliness, on the other hand, is often involuntary and linked to serious mental health issues.

How to Combat Loneliness

The rising costs of loneliness as a societal problem have led to interventions tailored to different age groups. These interventions require personalized approaches that consider social determinants and their needs. Mindfulness, social cognitive training, and social support can help the elderly.

Mark is a teenager whose family is geographically dislocated due to political instability in their home country. Mark and his older sister struggled in their new school, while his parents had to adjust to a new environment and culture. Mark refused to go to school, fought with his sister, and was verbally aggressive towards his mother. He isolated himself in his room, chronically overslept, and expressed a strong desire to return to his home country to be with his extended family and friends. He was brought to a clinic to help manage his angry outbursts.

Strategies for adolescents to combat loneliness

• Social skills training: Learning to initiate and maintain friendships, how to resolve conflicts, and how to put one’s thoughts and feelings into words.
• Peer support programs: Peer mentoring in school with other students and engaging in extracurricular activities such as arts and sports.
• Encouraging families to spend quality time together.

The mental health clinic offered a family intervention to help Mark. This included acknowledging cultural humility, using interpreter services during their clinical care, and collaborating with schools and community services. Mark and his family gradually adapted to their new community. This holistic approach helped them overcome feelings of isolation and to build new social connections.

Jessica is a 27-year-old woman diagnosed with anxiety, depression, and attention deficit disorder. She has been receiving psychiatric care since middle school. She has been stable and without symptoms since graduating college five years ago. However, she now finds her depression and anxiety returning as a result of COVID isolation, living away from family, and starting a new job.

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Strategies for Adults to Combat Loneliness

• Networking events: Participating in hobbies, workshops, and social events to foster connections. Joining book clubs to form social connections.
• Community Activities: Engaging in volunteering activities to build a sense of belonging and community.
• Workplace Activities: Participation in team-building events, and wellness programs to foster camaraderie and reduce isolation.
• Technology: Facilitating connections through various digital platforms and tools.
• Mental Health Resources: Utilizing peer support, and counseling to navigate life challenges and cope with loneliness.

Jessica tried engaging in new activities. She took up mountain climbing with her new work peers, adopted a cat, and participated in a blog for pet lovers. She also became active in a nearby church. These actions provided her with a community of belonging and her symptoms have subsided.

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Paul is a military veteran in his late 60s who is diagnosed with Parkinson’s disease and has limited mobility. Having always been independent most of his life; he became lonely and started isolating after his wife’s death during the pandemic.

Strategies for Older Adults to Combat Loneliness

• Social Activities: Engaging in recreational activities, social events, and support groups at residential centers to reduce social isolation.
• Intergenerational Connections: Fostering relationships between younger and older generations to create meaningful connections.
• Technology Training: With the support of technology, older adults can stay connected with their families and friends

With support from his children, Paul decided to move to a retirement community where he started feeling reconnected with society. Regular face time and virtual meetings with his grandkids also gave him new connections.

Interventions such as cognitive behavioral therapy can help individuals develop healthy social habits; social skills training can improve interpersonal competence, and group therapy can provide supportive environments for sharing experiences and building social skills. Mindfulness-based stress reduction can help individuals cultivate present-moment awareness and self-compassion.

Conclusion

Addressing loneliness requires a multifaceted approach that includes individual, interpersonal, family, and environmental factors. These interventions must be implemented with empathy, cultural humility, and a deep understanding of social contexts and needs, combining clinical expertise, community resources, and ongoing evaluation for effectiveness and sustainability.