Loneliness and Your Health

What is the unspoken epidemic of our time? And the greatest predictor of overall health, happiness, job satisfaction, and resiliency? Loneliness.

As a clinical cardiologist I am committed to the health and well-being of my patients.

As a recovering burned out physician who suffered in silence for years while hiding this so well from others, I am committed to finding solutions to help my partners suffering so often in silence.

As a husband, father, and friend I am committed to creating larger and larger cultures of connection that support us all to live our best lives and help the greater good.

1. SOCIAL ISOLATION IS A GROWING EPIDEMIC

According to a Cigna survey of 20,000 US adults in 2018:

• half of us routinely feel alone
• half of us do not have one meaningful daily social interaction
• one in four feel no one understands us
• one in five feels there is no one we can talk to

Loneliness in our society has steadily increased over the last 50 years. And for a multitude of reasons, Generation Z (ages 18-22) is the loneliest generation. We haven’t begun to see the real societal consequences of this fact. 

2. THE CAUSES ARE INTERNAL AND EXTERNAL

The sources of social isolation are countless, and include personal habits of mind and fear-based thinking, decreased participation in community groups and organized religion, political polarization, a widespread breakdown social trust, and a loss of emphasis as a culture on the virtue of civility — in our workplaces, public places, and homes. 

Loneliness among healthcare providers is on the rise as we are separated from our calling. We are allowed less and less time with our patients, and more time performing clerical tasks.

We escape from our individual loneliness by soothing the pain of disconnection in so many ways: our devices, our self-perpetuated emotions (fear, anger, rage, frustration, resentment), and our addictions. And these just add to the shame...

3. SHAME MAKES THE PROBLEM WORSE

The word shame derives from the Proto-Indo-European root “skem”, meaning “to cover” as in “to hide one’s feelings or actions from the view of others."

Unlike other sources of suffering, psychological and social suffering carries with it an inherent stigma. We are afraid of being judged for being “broken” or “weak”. So we keep silent. And we suffer in silence. And the cycle continues...

The most effective remedy for the toxic effects of shame is the practice of self-compassion and the practice of replacing negative self-talk with the habit of being kind to ourselves. Kristen Neff, PhD and Christopher K. Germer, PhD have done the seminal work in the field of self-compassion and founded the Center for Mindful Self-Compassion in 2012.

4. SOCIAL ISOLATION HAS A NEGATIVE IMPACT ON KEY HEALTH-RELATED BEHAVIORS

Social isolation has far-reaching consequences on the mind, body, and behavior. A 2015 meta-analysis found isolation to be a stronger predictor of cardiovascular risk than smoking or obesity.

As providers and leaders of healthcare, we must become atuned to the fact the loneliness among our patients and our colleagues profoundly impacts health-related behaviors: inactivity, quality and duration of sleep, dietary choices, tobacco use, sexual health behaviors, and adherence to treatment.

And we are all aware of how feelings of isolation, wedded to a feelings of helplessness are core elements in the epidemic of burnout affecting roughly one half of all U.S. healthcare providers.

5. LONELINESS HAS A NEGATIVE IMPACT ON HEALTH OUTCOMES

Compelling data on the crisis of social isolation and loneliness is reported in a 2017 overview of 40 systematic reviews on the public health consequences of social isolation and loneliness.

Bottom line: loneliness impacts our overall health, well-being, longevity, cardiovascular disease outcomes, early death, depression, anxiety, cancer outcomes, risk of suicide and dementia.

6. MANY SOLUTIONS EXIST

If we wish to live up to our mission as the vanguard of care we as a healthcare system — from the C-suite to every last employee — must commit to screening and support for all of our patients AND all of our providers and team members. 

We can start by ensuring that we ask every patient about their social support network, who they can call on as an advocate, and which family members are available if needed. How can we check in with our teams to see if they are feeling alone? For me, the best way to know how each member of my team is doing is simply to ask them, in a way that communicates that I want the real answer. This requires openness, a foundation of trust, and an ability to simply be with someone else’s pain so that they feel felt and understood. We can offer our patients a variety of evidence-based resources to support their mental health and well-being. Many resources and solutions are available online.

A real culture of connection leaves no one behind. A real culture of connection respects and celebrates the diversity of each of its members. A real culture of connection works to operationalize empathy which, with the right intention and tools, can be done.

For providers who feel alone because of burnout, healthcare organizations must commit time and resources for meaningful process change: more autonomy for providers, more flexibility in scheduling, less clerical work, less mandatory screen time and more time face to face with our patients, improved office efficiency, and more emphasis on creating a supportive social network for providers. Additional emotional and psychological supports are required to help those already on the downward spiral of disengagement and burnout. By normalizing conversations about our own unmet needs and our mental health, we can begin to heal the wounds resulting from disconnection from our calling. A 312 page roadmap to help end the isolation and suffering relating to burnout was published in October 2019 by the National Academy of Medicine.

7. ISOLATION ENDS AND CONNECTION BEGINS WITH EMPATHY AND COMPASSION

We must shine a light on the epidemic of disconnection affecting us all in some way, and work together to find lasting solutions to create a feeling of inclusion for all inside and outside our healthcare system’s walls. Every solution begins with empathy and compassion, the ability to understand and feel what others are going through, combined with the desire to alleviate the suffering of our fellow human beings.

As humans we are wired for connection.

We cannot survive and thrive without it. 

Once we begin to seek and share our own best practices and solutions to the crisis of social isolation and loneliness, we are no longer alone.

What’s your best solution to the problem of widespread social isolation among our patients and our peers? What will you do differently this week to bring more connection into your life? At work? At home?