Over the course of the past century, the Western culture has faced numerous health epidemics, from obesity to opioids. Today we are facing an epidemic of a different nature. The epidemic of loneliness.

We're more connected than ever, but are we feeling more alone? In the last 50 years, rates of loneliness have doubled in the United States. In a survey of over 20,000 American adults, it was found that almost half of respondents reported feeling alone, left out, and isolated. Further, one in four Americans shared that they rarely feel understood, and one in five people believe they rarely or never feel not close to people. Loneliness is on the rise for Americans regardless of geographic location, gender, race, or ethnicity.

Human beings did not evolve to be alone. Sociality plays a fundamental part in the wellbeing of Homo sapiens. Conversely, social isolation and loneliness are known risk factors for premature death, more so than being obese (Holt-Lunstad et al., 2015). Individuals who feel socially isolated and alone also have higher rates of cardiovascular disease, alcoholism and suicidality, physical diseases related to stress and compromised immune function, and in later life, greater risk of degenerative dementia. Even worse, researchers have observed that geriatric individuals who are considered lonely have a 45% increased risk of mortality (Leland, 2012; Perissinotto, Stijacic Cenzer and Covinsky, 2012). 

Moreover, lonely individuals experience reductions in reasoning and creativity. In addition to these reduced abilities, loneliness affects workplace productivity, as lonely individuals report less job satisfaction and are more likely to face unemployment. Not surprisingly, loneliness is commonly correlated with mental health concerns such as anxiety and depression. Similarly, loneliness is often associated with poor coping mechanisms, such as compulsive technology use, smoking, and self-harm. In other words, loneliness has both physical and psychological implications, many of which could be long term.

Before determining yourself as lonely, there is a difference between being alone and feeling lonely. Being alone and feeling lonely are not mutually dependent. Loneliness is a subjective experience, a feeling of sadness stemming from isolation or abandonment. But, a person can be alone without feeling lonely, since alone describes a state of being and lonely describes an emotional response to one's circumstance. For example, most people don't feel sad when they go to the restroom by themselves. A person can be alone in the sense that no other people are present, or alone in the sense that they are unaccompanied, even in a crowd.

When assessing loneliness, introverted and extroverted personalities should be taken into account, because some people enjoy the presence of being alone with themselves, whereas others are dependent on others to cope with not being by themselves. Being at either end of the spectrum, whether it is total isolation or complete dependence, is not considered a healthy behavioral pattern.

The predictors of loneliness is the basis for the identification of factors that cause and contribute to loneliness. The are three broad categories that influence the feeling of loneliness:

• problems with relationships;
• traumatic experiences;
• and, personal and developmental variables.

  
These categories may be subdivided into multiple factors that increase loneliness:

1. Personality: There are several personality factors that contribute to loneliness, including but not limited to, anxiety, an inability to assert oneself, and hyper-sensitivity. A victim mentality, a poor self concept, an external locus of control and shyness are other aspects of the personality that contribute to loneliness.
   
2. Affect: Loneliness is linked to negative affect and is typified in conditions such as depression, boredom, hopelessness, aggression, stress, anger, restlessness and tension.
3. Depression: A complicated vicious circle makes diagnosis tricky: people with poor social skills are more inclined to become depressed and yet depressed people are inclined to be lonely. There is a difference between depression and loneliness.
4. Problems in relationships: A lack of feelings of belonging, support and intimacy caused by poor communication promote loneliness. Social estrangement and separation and rejection also contribute to loneliness.
5. Marital status: Married people usually feel less lonely - but this is not the case when marriages are unfulfilling. Loneliness in marriage is linked to a lack of intimacy. Major changes that promote social isolation consist of events such as leaving home, a new career, separation from loved ones, breaking off a major relationship and moving house.
6. Illness or physical disability may lead to limited contact with other people.
7. Religious faith: Religions with strict behavioral prescriptions are likely to isolate individuals from free social interaction, potentially resulting in loneliness.
8. Academic achievement: Researchers have observed that students whose academic performance is poor are more likely to be lonely.
9. Leisure activities that alienate people from each other are watching television and surfing the Internet.

While it is impossible to avoid loneliness completely, it may be alleviated. It is recommended to investigate the contributory factors towards loneliness because knowledge of these may substantially lessen the impact of loneliness on people's mental health status. Such knowledge will contribute to an improved quality of life, productivity and health.

The "loneliness phenotype" can be triggered by sleep deprivation. Researchers have observed that a lack of sleep induces critical changes within the brain, altering behavior and emotions, while also disturbing essential metabolic processes and influencing the expression of immune-related genes. The end result is that people who are sleep-deprived avoid social interaction. This asocial profile is recognizable by other people, who, in turn, shun the sleep-deprived people in a psychosocial loop that perpetuates in a vicious cycle of loneliness and other mental health disorders.

Ali, S. (2018). What You Need to Know About the Loneliness Epidemic. [online] Psychology Today. Available at: https://www.psychologytoday.com/us/blog/modern-mentality/201807/what-you-need-know-about-the-loneliness-epidemic [Accessed 1 Sep. 2019].

Harris, R. (2015). Are we lonelier than ever?. [online] The Independent. Available at: https://www.independent.co.uk/life-style/health-and-families/features/the-loneliness-epidemic-more-connected-than-ever-but-feeling-more-alone-10143206.html [Accessed 1 Sep. 2019].

Holt-Lunstad, J., Smith, T., Baker, M., Harris, T. and Stephenson, D. (2015). Loneliness and Social Isolation as Risk Factors for Mortality. Perspectives on Psychological Science, 10(2), pp.227-237. https://doi.org/10.1177/1745691614568352

Leland, K. (2012). Loneliness Linked to Serious Health Problems and Death Among Elderly. [online] UC San Francisco. Available at: https://www.ucsf.edu/news/2012/06/98644/loneliness-linked-serious-health-problems-and-death-among-elderly [Accessed 1 Sep. 2019].

Perissinotto, C., Stijacic Cenzer, I. and Covinsky, K. (2012). Loneliness in Older Persons. Archives of Internal Medicine, 172(14). https://doi.org/10.1001/archinternmed.2012.1993

Ben Simon, E. and Walker, M. (2018). Sleep loss causes social withdrawal and loneliness. Nature Communications, 9(1). https://doi.org/10.1038/s41467-018-05377-0

At the same time that Americans’ life expectancy is stalling, the age at which people can claim their full Social Security benefits is gradually moving up, from 65 for those retiring in 2002 to 67 in 2027. Almost one in three Americans age 65 to 69 is still working, along with almost one in five in their early 70s. Meanwhile, Americans in their late 50s already have more serious health problems than people at the same ages did 10 to 15 years ago, (Choi & Schoeni, 2017).

Researchers analyzed survey data to compare middle-age Americans’ health. A key measure is whether people have trouble with an “activity of daily living” (ADL), such as walking, dressing and bathing themselves, eating, or getting in or out of bed. The researchers observed that the number of middle-age Americans with ADL limitations has increased; 12.5% of Americans at the current retirement age of 66 had an ADL limitation in their late 50s, an increase from 8.8% for people with a retirement age of 65.

At the current retirement age of 66, 25% of Americans age 58 to 60 rated themselves in “poor” or “fair” health. That’s up 2.6% from the group who could retire with full benefits at 65, the researchers found.

Cognitive skills have also declined over time, according to the study. For those with a retirement age of 66, 11% already had some kind of dementia or other cognitive decline at age 58 to 60; an increase from 9.5% of Americans with a retirement age between 65 and 66.

While death rates can fluctuate from year to year, this study is being added to a growing body of evidence that suggests the health of Americans deteriorating.