Loneliness isn’t the same as being alone. This feeling of being disconnected from other people and not having someone to confide in is endemic to loneliness and depression. Researchers find that loneliness is a global issue with varying levels of severity across communities. National surveys in the United States indicate loneliness in nearly 35% of adults above the age of 45; a survey of Californian adults reported that 76% of the representative sample suffered from some level and form of loneliness.
Depression and loneliness are a global problem now: this has worsened in the last few years of the pandemic with increased isolation and dysfunction in our collective lifestyles. Young adults and people with previous chronic conditions have suffered poorer outcomes because of COVID-19 preventive measures. A study of four Northern and Western European countries found that young people and people with mental illness in all four countries were the loneliest of all subgroups. Loneliness, anxiety, and psychological distress can develop into long-term mental illness and pose severe socioeconomic and individual consequences.
How can loneliness and other psychological stresses harm people?
Loneliness has not just psychological impacts but leads to physical problems as well. The reciprocal relationship between loneliness and health is marked by increased morbidity and mortality risks. In a cyclic nature, people dealing with depressive stresses are affected by loneliness and develop these stresses because of loneliness. Research indicates that feeling lonely on a daily basis can cause physical limitations and daytime dysfunctions such as sleepiness, fatigue, and low energy.
The two-way relationship between depression and loneliness and how they are high-risk factors for each other is indicated by multiple studies. People dealing with either or both report symptoms such as stress, hostility, and even higher levels of perceived physical pain. Studies also indicate that loneliness increases the risk of developing issues with substance abuse, mood and anxiety disorders, and Alzheimer’s disease, including other kinds of dementia.
Loneliness, thus, predicts a higher number of visits to the physician, especially in older adults, and leads to a higher cost of healthcare.
Factors contributing to loneliness
Almost everyone feels lonely at some point, but the problem festers the longer social isolation and lack of interactions continue. Globally and in India, the trend of joint families has gone down and most families now function in smaller, nuclear units. This has had an impact on the nature, the amount of familial contact, and the support that older and younger adults draw from each other in times of psychological distress.
COVID-19 and the ensuing preventive isolation measures haven’t helped this situation. People were separated from their friends, co-workers, family, and usual support network, leading to an epidemic of loneliness and depression (61% of working Americans reported loneliness in 2020).
Multiple studies, including the State of the World’s Children 2021 report, indicate the toll of distancing measures on the mental state of children as well as younger adults (between ages 18 and 25). They reported higher instances of feeling depressed, losing interest in daily activities, and suffering mental disruptions, and are at a greater risk of developing anxiety and depression. Incidentally, research also indicates that younger adults are much more susceptible to loneliness than older adults, who seem to be more resilient to the negative effects on mental health.
Social polarisation, the economic downturn, and isolation during the pandemic have worsened the precarious situation of mental health worldwide and there is a global unmet need for mental care. As per World Health Organisation’s (WHO) World Mental Health Report, 2022, the prevalence of depression and anxiety has increased by 25% globally since 2019. Irrespective of all other factors, loneliness is proving to be one of the strongest predictors of anxiety and depression.
Do digital answers to mental health needs really work?
For every upside to the solutions provided by digital solutions, their quality may be held to question. The problem with biases in AI algorithms is well known. Moreover, there are significant risks to privacy: one data breach can reveal the intimate data of a multitude of vulnerable people. Some apps share information with advertisers and the entire health-tech industry may need national privacy and security policy implementations.
How can technological interventions help?
Relatively few qualitative studies exist on the efficacy of social and, particularly, technological interventions to reduce loneliness. Nevertheless, the long-term health consequences of loneliness and other mental stresses must be targeted and digital interventions are poised well to meet the global deficit in mental care.
Mental health-tech has been a growing market even before the pandemic and there are more behavioural and psychological digital interventions available now than ever before: today, more than 10,000 such apps exist across various app stores. Aided by AI and advanced data capabilities, these apps can play an important role in detecting, assessing, and treating mental health conditions.
Most of these digital interventions have only been developed recently and their efficacy in treating loneliness is yet to be backed by more than pilot studies conducted in the past 1-2 years. However, there is some preliminary and anecdotal evidence that tech-based interventions can be useful in reducing loneliness.
Digital solutions offer advantages that can be essential in dealing with the current mental care needs worldwide:
• Online communities on platforms such as Reddit, TikTok, Weibo, and more have provided many young adults with community and a safe place to form essential human connections over the internet. These connections can, and often, lead to intra-city or intra-community connections and result in in-person social interactions that are no longer just digital.
• Digital or tele-interventions tend to be more easily available and scalable than traditional face-to-face therapy. With many health professionals turning to tele-medicine and tele-therapy in light of the COVID-19 pandemic restrictions, mental health-tech is a powerful tool in reducing structural and economic barriers that have traditionally prevented people from seeking mental healthcare.
• Mobile networks currently cover 85% of the world population. This presents a great opportunity to distribute internet-based digital interventions. However, in low-income countries, only 20% of the population has internet access. But even then, this presents an opportunity for governments to provide tele-therapy and tele-medicine cheaply.
• Online interactions and consultations do not require travel, reducing the burden of time and cost. For online mental healthcare, help is available to vulnerable people beyond work hours and fits easily around home and work schedules, especially between 2-3 AM when suicide rates peak.
• Digital interventions for loneliness can be provided without compromising anonymity; the stigma attached to seeking psychiatric help is mitigated.
Heterogeneity in people’s experience with mental health across various age groups and population sub-groups makes the nature of loneliness complex and subjective. While younger adults are more open to discussing and seeking help for mental health, older adults are more likely to see their loneliness as a private and complex matter that they’d rather address privately.
Loneliness appears to have different causes and consequences in adolescents (ages 11-18) and young adults (ages 18-25) than in older adults (ages 40 and above). With younger adults bearing heavier consequences of social isolation, I would recommend targeted intervention strategies for various age subgroups and avoid recommending public health measures that are one-size-fits-all.
Answers to reducing loneliness may be found in online communities, increasing social interactions with friends, family, and acquaintances via digital means, tele-therapy, and other executions of public policy. Increasing screen times and the unhealthy effects of social media usually form our more alarmist notions of the digital world; however, they also provide a deep well of answers to improving social isolation in difficult circumstances.