Feeling lonely? Well, you’re not alone. Nearly three in five Americans feel lonely, and only 39% of us feel very connected to other people, according to data in the 2023 US Surgeon General’s advisory “Our Epidemic of Loneliness and Isolation.”

Good news: There are ways to deal with loneliness and isolation, says ­Julianne Holt-Lunstad, PhD, an expert on social connections at Brigham Young University and lead scientific editor for the Surgeon General’s Advisory. Bottom Line Personal recently spoke with Dr. Holt-Lunstad to learn more…

What exactly is loneliness? Loneliness is the distressing feeling that stems from the difference between our desired level of social connection and our actual level of connection. It’s related to but different from social isolation, in which an individual has few relationships or infrequent social contact. Social isolation can make you feel lonely, of course. But it is also possible to be isolated and not feel lonely…and it is possible to be surrounded by people and still feel lonely.

What health problems are associated with loneliness? Most of us recognize that loneliness and social isolation are linked to mental health problems, including depression and anxiety. But there is a wealth of data demonstrating strong links to physical health as well.

Loneliness increases risk for heart disease and stroke, type 2 diabetes, cancer, viral infections and premature mortality from all causes, according to several reviews of the evidence highlighted in the Surgeon General’s Advisory. Furthermore, a 2023 review of published studies found loneliness and lack of social interaction raise risk for cognitive decline and Alzheimer’s disease as well. Other studies find loneliness is associated with chronic inflammation, which may help explain its broad health effects.

My own research shows that lacking social connection can be as bad for your health as being obese or physically inactive or being exposed to air pollution or smoking 15 cigarettes a day.

Is it ever normal to feel lonely? In the short term, loneliness can encourage us to seek out social connections we need to thrive. Loneliness affects men and women of all ages, but it is especially common among younger people…people with poor health…those who live alone…and those who struggle financially. While younger people are more likely to feel lonely, older people tend to be more socially isolated than younger people. One recent study by Oslo Metropolitan University showed that television provides the only source of companionship for many seniors in the UK. Isolated older people, however, are not necessarily more likely than isolated young people to feel lonely even though our social networks do tend to shrink as we get older as friends and family members move away or die.

How can people overcome feelings of loneliness? There are steps we can take to reduce loneliness…

Strengthen existing relationships and cultivate new ones. Don’t wait for others to make the first move—extend an invitation or offer a helping hand.

Get out of the house. Take a class…volunteer…join a club, book group or some other kind of group—ideally one whose members get together in person. Relatively passive activities such as attending lectures can help, but the best activities are those that involve significant interpersonal interactions.

Try to appear approachable when you are out. Just smiling and saying hello to strangers can help you feel less isolated. Even simple things like wearing a sports team cap or carrying your favorite book can spark conversations. And research has shown that expressing gratitude to others can go a long way toward assuaging feelings of loneliness, as can performing small acts of kindness. Sharing your talents or skills with others, such as teaching how to cook your favorite recipes or tend a garden, can help you feel more connected.

There’s also evidence that spending time in nature or practicing mindfulness meditation can help reduce loneliness.

Can getting a pet help? Caring for a pet is no substitute for interactions with people. But some evidence—including a 2022 review by researchers at University Medical Center Hamburg-Eppendorf—links pet ownership to less social isolation. Owning a dog may increase time out of the house for walks and interactions with other people.

How about connecting with others virtually? In-person contact is best, but like phone calls and letters, e-mail, texts and video chats can be instrumental in helping you maintain key relationships, especially when it is difficult to get together in person.

What about seeking help from a health-care provider? That’s a good idea. In addition to monitoring you for the possible health impacts of lacking social connection, a health-care provider can help connect you with resources and support—for example, helping cancer patients connect with a support group.

Patients with health concerns who are given psychosocial support as well as standard medical care are 20% more likely to survive than similar patients given only medical care, according to a 2021 meta-analysis of 106 randomized controlled trials published in PLoS Medicine.

How many friends should a person have? While the research often doesn’t break it down in this way, some studies, including one published in 2016 in ­Proceedings of the National Academy of Sciences, suggests that having at least four to six people in your life is about right. Fewer than that makes you vulnerable. Some studies suggest having more than six friends may provide additional benefits, while others show a plateau.

Losing a loved one is hard. How can people minimize feelings of loneliness under such circumstances? The key is to have close connections with several people so that our social needs can be buffered by the loss. People get different things from different relationships. Relationships with coworkers can help us feel competent, for example, while those with friends and romantic partners help meet our need for intimacy.

Neighbors can be vitally important sources of support. If you don’t know them already, introduce yourself. Check in on them regularly,. Knowing your neighbors can not only reduce your loneliness and increase your sense of community but also can increase your likelihood of survival in a crisis.

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