Seeking Connection

For people of all ages, social connections are critical to health and wellbeing. Experts say we are inherently social creatures — hardwired to engage and depend on others for support throughout our lives.

Doctors and health researchers have signaled concerns about loneliness for decades, and forced isolation during the COVID-19 pandemic introduced many more people to daily struggles with loneliness. 

How important are social connections? How does loneliness impact a person’s mental and physical health? And are people looking for social connections in the right places?  

MPR News shares “Seeking Connection,” a special broadcast from Call to Mind, American Public Media’s initiative to foster conversations about mental health. The special explores the relationship between loneliness, mental health and the power of social connections.    

Three experts on isolation and social connections join Call to Mind host Kimberly Adams: Dr. Elias Aboujaoude, Dr. Julianne Holt-Lunstad, and professor Carla Perissinotto.

Here are some key moments from the conversation. The broadcast special includes the experts’ complete input on the matter, the latest data on loneliness in the U.S. and reporting from different parts of the country telling the stories of adults who have struggled with loneliness and have found ways to overcome it.

The following transcript has been edited for length and clarity.

What kinds of health conditions can be affected by loneliness?

Dr. Julianne Holt-Lunstad: We have very good evidence loneliness impacts a variety of physical health conditions, including both short-term and long-term health effects. This is independent of age or any kind of lifestyle factor. The feeling of loneliness, or even just being isolated, can be thought of as a state of threat because, throughout human history, humans have needed to rely on others for survival. When this state of activation is heightened for long periods of time, the biological process of inflammation in our bodies can occur. Chronically elevated inflammation has been linked to depression, dementia, cardiovascular disease, cancer and diabetes. Global data indicates that loneliness is associated with a 26 percent increased risk for earlier death, and isolation a 29 percent increased risk for earlier death.

Why is finding quality relationships so important for people dealing with loneliness?

Holt-Lunstad: Relationship quality matters and not all relationships are entirely positive. As we strive to address this issue of isolation and loneliness, it may be tempting to just simply increase social contact, without any kind of attention to the type of contact. If we fail to take into account quality, we may have unintended consequences such as conflict or straining relationships. We all need social connection and we can start to look at various quantifiable aspects that measure the quality of our social connections: the number of relationships in our social network, the interaction frequency and the types of interaction.

How healthy are online relationships and interactions, especially for somebody who is lonely?

Dr. Elias Aboujaoude: They can be very healthy. We prescribe online dating for folks who have social anxiety disorder and who really struggle with initiating contact with people. The challenge is when these relationships stay online and end up not providing the support that the person needs in real life. There is an aspect to online connections of all kinds, an aspect that's really easy come, easy go. During COVID-19, we have come to appreciate what a double-edged sword that the whole virtual realm has become. On the one hand, it made life possible during a pandemic. On the other hand, we have grown much more conscious of how lonely you can be in that world, even when you have 400 friends on Instagram and 600 followers on Twitter. 

What's your advice for people who use the internet or social media to meet people?

Aboujaoude: In order to keep those relationships and connections healthy they should look to transpose the relationship offline rather quickly, or at least incorporate an offline component to the relationship if that's a possibility. They should also look for possible red flags in their social connections, for example, when the bulk of their social relationships are now social media relationships, but they hardly connect with anyone offline. That's a sign to me that maybe the person needs to recalibrate. Maybe the person needs to find more equilibrium in their social lives than they currently have.

Who is at the highest risk of loneliness?

Carla Perissinotto: For the longest time, we saw that older adults have a higher risk. When we get older, our physiologic reserve, which means our ability to bounce back from an illness when something happens to us, is just smaller. We're not as resilient in that sense. But what we're finding now is actually younger generations and children are at very high risk. I would love to blame social media and technology for everything, but I don't think that's the full picture. There are other things that predict risk like coming from a traditionally marginalized group. That's going to increase your risk of loneliness, because of feelings of belonging. 

Is the American health care system set up for older people to age well and stay socially connected?

Perissinotto: Even though we are not prepared, we can be, but it takes making that commitment and changing how we define health. In the last five years, we've seen a turn of the tide, we've seen this turn in social determinants of health, which is everything that we've ignored for decades and healthcare suddenly starts coming into medical encounters. Julianne Holt-Lunstad and I just published an article in the New England Journal of Medicine, talking about a framework to help clinicians assess loneliness and isolation in healthcare settings. We proposed a very simple framework called EAR: the E is for educate, the A is for assess and the R is for respond.

Useful resources

988 Suicide & Crisis Lifeline  
The 988 Suicide & Crisis Lifeline provides 24/7, free and confidential phone & text crisis support. Call or text 988 to get started. 
 
Coalition to End Social Isolation and Loneliness 
An organization working to increase public awareness, amplify research findings, and advocate for policy change that combats the consequences of social isolation and loneliness, with the goal to improve social connectedness for all people and communities in the United States. 
 
Connect2Affect 
An AARP Foundation program working to create solutions, a network or resources and a deeper understanding of loneliness and isolation among older adults. 
 
Foundation for Social Connection 
In partnership with a world-renowned scientific advisory council, the foundation is leading research, convening forums, publishing resources for public use, and advising government agencies and non-government organizations. 
 
Fountain House 
A national mental health nonprofit fighting to improve health, and end social isolation for people with serious mental illnesses. Drawing on more than 200 community-based social rehabilitative programs inspired by Fountain House and known as “clubhouses” – in nearly 40 states and with more than 60,000 members. 
 
Give Us the Floor 
A safe teen-only online community for LGBTQI+ youth to break isolation while providing social contact and anonymity. Trained teen peer counselors facilitate the confidential groups chats.  

Make the Connection 
An online resource designed to connect Veterans, their family members and friends, and other supporters with information, resources, and solutions to issues affecting their lives. 

Mental Health America  
Helping all people live mentally healthier lives through advocacy, public education, and service.

National Council on Aging 
Works with nonprofit organizations, governments, and businesses to provide community programs and services. A resource to find what senior programs are available to assist with healthy aging, financial security, increase social connectedness and healthy eating habits. 

The National Alliance on Mental Illness (NAMI)  
The nation’s largest grassroots mental health organization dedicated to improving the lives of those affected by mental illness. 
 
National Institute on Aging 
The NIA leads research and scientific research about the nature of aging. Shares tips and resources about aging well, in addition to information about loneliness and tips to stay connected. 
 
Volunteer Match 
Serving millions of interested volunteers each month and thousands of nonprofits – an award-winning nonprofit service providing the internet’s largest volunteer recruiting platform.