If you picture a lonely person, you probably imagine the elderly. But recent research paints a very different picture of loneliness in New Zealand and the western world.
Far from being an issue confined to people in their later years, modern-day loneliness is affecting younger generations, too.
In fact, New Zealand's General Social Survey shows that it is young people aged 15 to 24 who report feeling the most isolated. Feelings of loneliness then decrease over the next few decades, but then increase again in our 70s, with those over 80 especially vulnerable.
Studies in other areas of the world show similar statistics. A study in the US identified the late 20s, mid-50s and late 80s as peak times for people to feel lonely. In 2018 the Australian Loneliness Report also found that it is younger people feeling most isolated, with those over the age of 65 being the least likely to feel lonely.
According to The Selwyn Institute, a lonely person is significantly more likely to suffer an early death than a non-lonely individual.
Some studies also liken the health effect of loneliness to the equivalent of smoking 15 cigarettes a day.
"The statistics paint a pretty grim picture," says Nick Tebbey, National Executive Officer of Relationships Australia. "We know that loneliness can have a significant impact on someone's mental and physical health and wellbeing. It's a very real issue."
Thankfully, growing recognition of the loneliness epidemic is prompting health authorities, governments and support organisations to research what can be done to help people feel more connected.
In the UK, the government recently appointed the first ever ministerial lead for loneliness and is developing a strategy that brings together government, local government, public services, the voluntary and community sector, and businesses to tackle loneliness. Researchers in other areas of the world are also developing programmes and initiatives to turn the tide of loneliness.
"Loneliness is a feeling of social isolation," says Dr Michelle Lim, a clinical psychologist at Swinburne University in Melbourne.
"You can feel lonely at work or in a marriage depending on how connected you feel with the people who surround you. Loneliness is like hunger – if you have meaningful relationships and friendships, you're more likely to be satisfied. The quality and nutritional value of your relationships is important."
US research found the late 20s are when people make choices that affect the rest of their lives, such as deciding on a career, partner and where they will settle. Those decisions can create pressure and a sense of isolation, particularly if people feel they made the wrong choice. Dr Lim says, for a younger generation, partnering later and the isolation that can come with high-rise living may contribute to loneliness.
"More people live alone rather than living with housemates as they used to. People are also living alone for longer because they are marrying later," she says.
"Apartment living is also different from living in a community of houses. We still don't know enough about how this all contributes to loneliness, but these things may change how people interact with each other."
Loneliness in the mid-50s can be due to a mid-life crisis and questioning what you've achieved and what comes next. We are confronted by a sense of time running out. Helplessness due to physical and mental illness and the death of family and friends can lead to loneliness in our 80s.
Julianne Holt-Lunstad from Brigham Young University in the US extensively researched the health implications of loneliness and concluded that a person's likelihood of death increases by a significant 26 percent if they report being lonely.
Loneliness has been described as having worse effects on heath than obesity and increases the likelihood of dementia, heart disease and depression, according to research by Professor John Cacioppo at the University of Chicago.
The Australian Loneliness Report also found people with higher levels of loneliness are more likely to experience sleeping difficulties, headaches, stomach complaints, nausea, colds and infections.
"I think people understand the emotional impact of loneliness, but they don't always understand that physiologically we are more stressed out when we feel lonely," says Dr Lim.
"This means we have higher cortisol levels and our brain functions in a more stressed state. We are hypervigilant, trying to work out if people are safe to relate to. It's exhausting. And people who are lonely have shown a poorer ability to regulate blood pressure, they have poorer cardiovascular health and they are more likely to have persistent inflammatory disorders."
One initiative already being rolled out in the UK to combat loneliness is the Pocket Parks program that transforms unused spaces into green areas where people can join voluntary groups and interact with neighbours.
But inroads can be made into loneliness even before we try and establish new social networks, says Dr Lim.
"If you don't know where to start when it comes to making new friends, focus on the relationships you already have. Quality is more important than quantity. Strengthening existing relationships and building intimacy is important," she says.
Dr Lim says the stigma of loneliness also needs to be lifted so people feel comfortable to reach out to friends, family, colleagues or to support organisations.
She says we need to be more comfortable with telling trusted people that we feel lonely, rather than trying to hide the issue under the carpet.
"A lot of people are reluctant to say they are lonely, and we need to build awareness that it is normal," adds Dr Lim.
"We also need to better understand the fluctuating dynamics of relationships. Some relationships must be let go and others can be built."
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