Loneliness and Social Isolation

Loneliness and social isolation are prevalent issues globally, with significant impacts on mental and physical health. In India, where social connections and community are deeply valued, these issues can be particularly challenging. Understanding the nature of loneliness and social isolation, as well as effective treatment approaches, is crucial for improving overall well-being.

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Loneliness is a natural occurrence, a very subjective experience which impacts anyone regardless of their gender, age, socioeconomic factors. Individuals experiencing loneliness feel dissatisfied with the quality and the quantity of their social life, be it lack of contact with people, unable to engage in social activities, absence of social circle, absence of attachment figure or support system.

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Loneliness and social isolation are not simply feelings of being alone; they reflect a lack of meaningful social connections. Individuals experiencing loneliness may feel disconnected, even when surrounded by others. Social isolation, on the other hand, refers to the objective lack of social interactions or relationships. Both can lead to serious health consequences, including depression, anxiety, and even physical conditions such as heart disease.

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Impact of Loneliness and Social Isolation

Loneliness and social isolation independently are associated with poor health. There is high risk similar to cigarette smoking, alcohol consumption, obesity, cardiovascular diseases, dementia, anxiety, depressive symptoms, cognitive impairment, infectious diseases and many other factors.

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The HPA axis is sensitive to the way the brain interprets threats and stressors. With social isolation, there is an increased HPA activity, increased blood level of catecholamine, increase in cortisol and vascular resistance. This also leads to having symptoms of anxiety, hostility, disturbance in sleep, fatigue, genetic alterations, increase in impulsiveness, and increase in depressive symptoms.

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Loneliness and social isolation impacts the individual’s health considering behaviour, psychosocial and physiological characteristics. Factors like social support, presence of attachment figures influence the physiology, impacting immunity, metabolism, and also interferes with cardiovascular functioning.

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Loneliness is psychological representation of social isolation, which reflects dissatisfaction in closeness, discrepancy between relationships, unmet needs in the relationship, contradiction in their understanding of relationships and their present reality.

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Factors for experiencing loneliness

1. Emptiness feeling

2. Abandonment by closed ones

3. Lack of relationships or intimacy

4. Unpleasant emotions – sadness, frustration, shame, grief

Loneliness is the subjective experience based on the individual’s perception of social relationships, interactions with people, socio-economic factors, and life-events.

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Ways to Reduce Loneliness and Social Isolation

Following are some of the ways tried to reduce social isolation and help one to deal with loneliness-

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(1) Group interventions:

The group interventions target certain groups, offer support and instructional activities, make use of available community resources, and involve facilitator training and support. According to the research, Masi et al. classified the strategies in four categories: social skill building; social support strengthening; increasing opportunities for social engagement; and socio-cognitive training.

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Joining a community support group or socialising can help an individual to create a sense of support for themselves, which will strengthen their social skills and improve their engagements with the outside world. This will help the individual feeling lonely and isolated to experience cohesiveness!

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(2) Friendship Enrichment Program:

It was made just with ladies in mind. The 12-week Friendship Enrichment Programme covered relationship skills, self-worth, and the various stages of friendship creation, use, and maintenance. The classes also emphasised the application of pertinent social skills, such as empowering older women to meet their own friendship goals; assisting participants in defining their needs, desires, and expectations in friendships; examining their current social networks to find genuine and potential friends; creating goals that involve strengthening current friendships or forming new ones; and creating plans to reach those goals.

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With the day and age, considering the work and time and the other commitments, it gets difficult for a few to engage with their social connections. The person who wants to spend time with their loved ones and is not able to, and the person who has no people to spend time with - both get isolated and feel lonely. Hence, joining groups which include similar age and similar interests in social activities can help in forming new horizons of friendships and redefining the expectations and fulfilling and extending the need for social engagements.

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(3) Creative Stimulation and Engagement:

Upstream Healthy Living Centre is a community based programme where volunteers first visit participants once a week and give them regular phone calls. They then involve people in community activities at social centres, like Tai Chi, painting, creative writing, storytelling, memory exercises, computer science, ceramics, music and sound exploration, arts and crafts, fall education, cooking, singing, walking and talking groups and book clubs.

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The program's goal is to offer individualised activities to elderly individuals who are socially isolated, emphasising creative stimulation and engaged, active social interaction. Through artistic, physical, and cultural activities that prioritise social connection, they aim to ignite their enthusiasm and curiosity in life.

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‍(4) Self-compassion:

Self-compassion is not the same as self-indulgence or self-pity. Three key components make up self-compassion: mindfulness, common humanity, and self-kindness. When going through a difficult time in life, people tend to be very critical of them; during that time, they are either in the past, criticising themselves or the events that happened that they cannot go back and change, or they are in the future, worrying about whether or not what they believe will happen. As a result, the person withdraws from society and believes that they are the only ones to blame for whatever is going wrong and that their suffering is worthwhile. Cultivating self-compassion teaches people to be nice to themselves, to ruminate less, to connect socially, to compare less with others, and to do many other good things.

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A group in a UK hospital was subjected to a technique known as Compassionate Mind Training (CMT) by Gilbert and Procter (2006). Various self-compassion exercises and tasks, such as letter writing, imagery, and chair practice, were part of the sessions. Depression, anxiety, humiliation, self-blame, inferiority complex, and submissiveness all decreased for the subjects. They learned how to be self-compassionate and self-soothing!

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(5) Other mostly used Interventions:

Programmes aimed at lessening loneliness typically result in improvements to psychological health, depressive symptoms, and the perception of loneliness. Numerous intervention approaches have been used in institutional settings. Some, like cognitive therapies, concentrate more on the individual's subjective experience of loneliness, while others, like recollection therapy programmes, focus more on life history. Others, like humour therapy, were intended to increase enjoyment and lessen the depressed symptomatology that is frequently connected to loneliness.

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Conclusion

People are inherently sociable animals. Indeed, social group living appears to have evolved as a means of human survival in harsh physical circumstances. Because humans are meaning-making beings, we are able to sense social ties in situations where there is neither an objectifiable link nor a possibility for reciprocity. Even when social opportunities and interactions are present, we are unable to fully utilise the potential of social connectivity in our daily lives, which leads us to sense social isolation. Persistent feelings of isolation, also known as loneliness, are marked by deficits in attention, cognition, mood, and behaviour. These deficits have a detrimental effect on morbidity and mortality by altering genetic, neurological, and hormonal systems that are intrinsic to the human experience.

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Treating loneliness and social isolation requires a multifaceted approach. Building social connections is key, whether through joining community groups, volunteering, or reconnecting with old friends. Cultivating meaningful relationships takes time, so patience is essential. Engaging in activities that bring joy and fulfilment can also combat loneliness. Additionally, seeking professional help, such as therapy or counselling, can provide valuable support and guidance.

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Online therapy can be particularly beneficial for individuals experiencing loneliness and social isolation in India. Rocket Health India provides online mental health services, connecting individuals with licensed therapists who can provide personalised support and guidance. 

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If you or someone you know is struggling with loneliness or social isolation, don't hesitate to seek help. Contact Rocket Health India today to connect and start your journey towards a healthier, more connected life.

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References

Aylor, H.O., Cudjoe, T.K., Bu, F. et al. The state of loneliness and social isolation research: current knowledge and future directions. BMC Public Health 23, 1049 (2023). https://doi.org/10.1186/s12889-023-15967-3

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Gilbert P., Procter S. (2006). Compassionate Mind Training for People with High Shame and Self-Criticism: Overview and Pilot Study of a Group Therapy Approach. Wiley InterScience: USA. https://self-compassion.org/wp-content/uploads/publications/Gilbert.Procter.pdf 

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Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010 Oct;40(2):218-27. doi: 10.1007/s12160-010-9210-8. PMID: 20652462; PMCID: PMC3874845. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874845/

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Yanguas J, Pinazo-Henandis S, Tarazona-Santabalbina FJ. The complexity of loneliness. Acta Biomed. 2018 Jun 7;89(2):302-314. doi: 10.23750/abm.v89i2.7404. PMID: 29957768; PMCID: PMC6179015. https://pubmed.ncbi.nlm.nih.gov/29957768/