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What the Doctor Ordered: Friendships


We all know that there are several lifestyle and environmental risk factors for early mortality, including obesity, a sedentary lifestyle and smoking. However, we often forget a far less researched and talked about risk factor for mortality: loneliness and social isolation.

Often that loneliness and social isolation are heightened during the holidays, which, ironically, is a time meant to be enjoyed with family and friends. However, for many it is a time that can exacerbate feelings of loneliness and a desire to withdraw.

The holidays, therefore, present an excellent time to discuss the role we can all play in reinforcing connections in a world that, on the surface at least, is more connected than it has ever been due to social media and technology in general. However, the stark reality is that studies have shown we are more lonely now than in any other time in recent history.

People who subjectively feel they are isolated or have few, if any, strong connections to others live shorter lives than those who feel they have strong, dependable and meaningful social bonds.

Consider your own life. When was the last time your physician asked:

  • Do you socialize often with friends?
  • Do you have someone you can confide in?
  • How often do you visit with family?

I’m not talking about Facebook friends or other social media connections that occur in a virtual and voyeuristic forum, but rather real and meaningful connectedness with others.

Chronic loneliness shortens lives

It is true what they say; we are social animals or at least we are meant to be. According to one study (Cacioppoi and Cacioppoi, 2012), a person’s position along the continuum of perceived social isolation/bonding to others is associated with various physical and mental health effects. Loneliness is twice as dangerous as obesity. It has a direct impact on one’s immune system and sleep patterns, with a direct correlation to higher rates of depression. Perhaps most striking, people who subjectively feel they are isolated or have few, if any, strong connections to others live shorter lives than those who feel they have strong, dependable and meaningful social bonds.

A study by the American Association of Retired Persons found that loneliness in the U.S. has doubled since the 1980s, and 40 percent of U.S. adults acknowledge feeling lonely. While most of us feel lonely from time to time, chronic loneliness is a much more serious issue with profound consequences.

The lonely are not likely to self-disclose or reach out

We live in a society that values the expansiveness of one’s social network so acknowledging that one is lonely brings with it a new type of stigma. Individuals can be reluctant to admit to behavioral health professionals that they are lonely.

So what does all this mean in terms of the role of primary care and behavioral health?

  1. Health care providers need to ask the question. We must assess in our intake process whether individuals feel a sense of social connectedness with others. If they do not, it needs to become part of the care plan and goal setting.
  2. We need to address social isolation like the public health issue it is. Raising public awareness around the impact of loneliness is important to reduce stigma and increase help-seeking behaviors. It is also important to enlighten the health care industry, which may think there is nothing they can do to affect an individual’s connectedness with others. Employers and business leaders can also make a difference as well by creating a supportive work environment.
  3. We all need to reach out to others; simple acts of social interaction make a difference to others. Individuals who feel isolated may feel overwhelmed at the idea of reaching out to others in order to try and make a connection. Whether it is calling a relative you have lost contact with or stopping to speak with a coworker or neighbor, you may be making a far bigger difference than you realize through these small gestures.

Despite the interconnectedness of our modern world, we need to be mindful of the power of strong relationships and the impact they have on one’s health and happiness. What can you do this holiday season to connect with others in a more meaningful way?

For a Related Blog, read: “Thinking Out of the Mailbox: A New Model for Health Care Delivery?” In it, Beacon’s Dr. Emma Stanton describes how postal workers on the island of Jersey are checking in on older residents to build social connectedness.

2 Comments. Leave new

This is such an important message, not only for those who may feel isolated at holiday time; but also for those who feel somewhat connected. What better time than the holidays to think about friends (even distant ones) and family who might be alone or unoccupied. Invite them to dinner or a social event, even though it might seem a bit out of the ordinary. For years, my brother has invited “Tom,” an elderly man with no family to all his holiday events simply because he liked him. They weren’t necessarily close friends; but Tom had an open invitation every year.

Sheronda McDonald
December 16, 2015 2:20 pm

This is a great article! It reminds us of how important it is to have true, face to face, in-person connections.


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