AM I LONELY?

Going it alone: for some, the quickest route to individual empowerment. To others, a sure-fire path to isolation and an emptiness that sits in the pit of your stomach. Thing is, more and more women are struggling to live with feelings of loneliness, many not even realising the cause. WH contributor Amy Abrahams seeks out answers...

As I hovered at the supermarket checkout, watching the friendly looking woman beep a solitary Twix bar through the scanner, I wondered what the odds might be that she’d engage me in chit-chat. She was probably a good 15 years older than me, and who’s to say we’d have anything in common, but we could at least attempt a discussion on whether it was the crunchy biscuit or chewy caramel that gave the bar that special something. I hadn’t spoken to anyone in hours – well, days actually – which is nothing new; I quit my office job three years ago to go freelance and regularly pass entire days without talking. When I lived by myself, weekends loomed with no plans to fill them, and even now I’m married, my husband’s job means we have month-long stretches apart. I’m alone. But am I lonely? Truth is, I’m not sure. And, come to think of it, what does it even mean? For something so difficult to define, loneliness is currently standing front and centre. Headlines report it’s as harmful as smoking and have linked it with depression, cardiovascular disease, Alzheimer’s and anxiety. A new report by Co-op and The British Red Cross revealed that nine million people in the UK consider themselves lonely, and Samaritans says that isolation and loneliness are raised as concerns in one in five calls to its helpline. Meanwhile, three out of four GPS say they see at least one patient seeking help for loneliness every working day, and an LSE study found the problem racks up £6,000 per sufferer in health and societal costs over just 10 years. Given these consequences, perhaps it’s no wonder the parliamentary Jo Cox Loneliness Commission urged the government to act, leading to the appointment of Tracey Crouch as the UK’S first loneliness minister in January (with Crouch set to publish her government strategy this autumn). And recent stand-out novel, the uplifting Eleanor Oliphant Is Completely Fine by Gail Honeyman – which won the Costa First Novel Award – is a story exploring the lonely life of a woman who, as a reader, you can’t help but pity and fangirl in equal measure. But, unlike a bout of the flu – which dictates bed rest via a pile of tissues and a Lemsip dash to Boots – it’s far trickier to determine when loneliness presents itself, what’s causing it and how to counter it.

ALL FOR ONE

‘Loneliness is a subjective emotion, rather than a clinical condition,’ says psychiatrist and dementia specialist Dr Jamie Wilson, founder of live-in care service Hometouch. ‘Like love, envy or contempt, it cannot be diagnosed.’ And just like other emotions, it can have a very real physiological effect on the body. ‘Chronic loneliness – which affects sleep, mood and immunity – causes an excess release of cortisol, the body’s stress

from physical dangers, he dubs loneliness ‘social pain’. ‘It evolved for a similar reason: because it protected the individual from the danger of remaining isolated,’ Professor Cacioppo wrote. Essentially, humans have a #squadgoals mentality, which traditionally meant you’d hunt more efficiently, ward off predators and increase the likelihood of finding a mate. ‘Feeling lonely at any moment simply means that you are human,’ Professor Cacioppo argued. But therein lies the rub. Loneliness isn’t simply social isolation – that is, being alone – but about social satisfaction and maintaining meaningful connections with others. Where isolation is ‘the objective measure of how large your social network is’, loneliness stems from ‘a subjective perception of how one feels’.

GOING IT ALONE

The drive to form tribes may be more about your ancestors, but the idea of being alone in today’s world can seem just as terrifying as being eaten by a hairier, toothier mammal. ‘From baby groups to education to work, the cultural norm is to be a member of a group, to be accepted by like-minded people,’ says psychotherapist William Pullen, author of Run For Your Life: Mindful Running For A Happy Life. ‘Despite the fact that people move on, jobs change and life stages differ, there’s still an expectation that to break connections means to fail.’

‘Loneliness is a subjective emotion, rather than a clinical condition. Like love, it cannot be diagnosed’

hormone, which, when persistently raised, is associated with a range of long-term conditions, such as diabetes, obesity and depression,’ says Dr Wilson. But why this surge in cortisol? Because, as the late social psychologist and neurologist Professor John Cacioppo says in his seminal book Loneliness: Human Nature And The Need For Social Connection, loneliness is a fight-orflight stress response to perceived danger – namely, the threat of what’s out there if you’re left alone. Just like pain protects you And digital connections don’t cut it. A study by San Francisco State University found that increased digital use was linked with heightened feelings of isolation, anxiety, loneliness and depression. Experts believe these ‘symptoms’ are in part a consequence of replacing face-to-face interaction with communication sans body language. ‘We try to satisfy our yearning by speaking briefly on the telephone, or sending an instant message… practices that have been called “social snacking”, but a snack is not a meal,’ wrote Professor Cacioppo. The problem with loneliness is that when you’re sitting at home feeling crushed by rolling waves of

FOMO, the last thing you feel confident about doing is playing with other people – loneliness hurts. Literally. Research by Naomi Eisenberger, professor of social psychology at UCLA, found that brain scans measuring the neural activity of people who were upset about being excluded from a game revealed increased activity in two regions of the brain associated with physical pain — the dorsal anterior cingulate cortex and the anterior insula. ‘We think this is why people talk about rejection as literally hurting — the brain processes emotional and physical pain in similar ways,’ she says. ‘Because being connected is so important to us as a species, researchers think the attachment system may have piggybacked on to the physical pain system over the course of our evolutionary history, borrowing the pain signal to highlight when we are socially disconnected.’

ME, MYSELF AND I

When it comes to your vulnerability to feelings of loneliness, a Cambridge University study earlier this year identified specific genes linked to the emotion. Analysing variations in more than 450,000 people, researchers discovered that people who described themselves as lonely had 15 genetic variations in their DNA not present and correct in those who didn’t so readily define as lonely. Not exactly hard evidence, but interesting all the same. Meanwhile, the Co-op/british Red Cross report identified ‘life transitions’ – such as becoming a mum, bereavement, divorce/separation, health problems and mobility issues – as key triggers for loneliness (for more on the toll life changes can take, head to page 57). The takeaway is clear: loneliness is messy, and commonly triggered by a combination of innate biology and your social situation. Catherine Asta Labbett, who runs a womenfocused psychotherapy clinic, has identified specific moments in a woman’s life when loneliness is more likely to strike. ‘Break-ups, for instance, can cause friendship groups to disconnect,’ she says. ‘Watching your old life through the images that pop up in your social feed can create a real sense of missing out and a grief-type response. It’s not simply about being alone – you’re experiencing the loss of deep emotional connections.’ While getting hitched has been found to reduce levels of loneliness, it’s no guarantee. ‘There are women existing in marriages where they describe feelings of emptiness,’ says Labbett. ‘Staying in a relationship where there is little or no love and intimacy can cause mental health problems.’ This resonates – for me, there was no greater feeling of loneliness than all the nights I cried myself to sleep while a (now) ex lay in bed beside me after another evening of fighting. ‘You’re not only facing a fear of being alone, because you know this isn’t what a healthy, longlasting relationship looks like, but you’ve lost intimacy; human touch, compassion, kindness,’ adds Labbett.

LONE WOLF

The problem is that acknowledging you’re lonely can be difficult. ‘Loneliness and shame often go hand in hand. You’re conditioned from a young age to be popular, to have friends, so admitting to others that you’re lonely can make you feel vulnerable and ashamed, as though you’re incapable of connecting with other people,’ says Labbett.

This was the case for journalist-turnedlife-coach Felicity Morse, author of Give A F**k: A Brief Inventory Of Ways In Which You Can. ‘In 2015, I had the best job at the BBC, a good flat and supportive family. But I was also desperately, excruciatingly lonely. The type of loneliness where you can bear professional conversations, laugh with friends, share surface problems, but then avoid going home so you don’t have to be alone and face a sliding ache that feels like a slow death. I spent so long in that place that I started to think that loneliness wasn’t the problem, it was me.’ The turning point for Felicity came one Friday night. ‘The loneliness was too painful, so I took all the pills I could find and passed out.’ Waking up on Monday morning, she realised, ‘I had sufficiently isolated myself from everyone else that I could disappear for a weekend and no one would worry. It was a wake-up call.’ Professor Cacioppo noted that one of the challenges of dealing with loneliness is that it ‘rarely travels alone’, often existing alongside depression. But they’re not the same thing. ‘Loneliness reflects how you feel about your relationships; depression reflects how you feel, period,’ he wrote. ‘Whereas loneliness urges you to move forward, depression holds you back.’ When they clash, it can lead to stalemate.

LONESOME TONIGHT?

For Felicity, she felt the impetus to change her situation. As well as getting therapy, she reached out. ‘I think the only antidote to loneliness is community – a group of people with whom you have some shared interest or connection, who will notice if you isolate yourself and come and find you,’ she says. ‘It’s not about outsourcing all this to one person in the form of a partner, it’s about having a group who you can be real with, who will show up for you like family.’ The argument for tackling loneliness on a national level – Theresa May, alongside Tracey Crouch, recently announced £20 million of new funding to help lonely people via community initiatives – has scientific basis. In a paper published in the Journal Of Personality and Social Psychology, Professor Cacioppo found loneliness to be contagious. ‘Our social fabric can fray at the edges, like a yarn that comes loose at the end of a sweater.’ Because, as people become more lonely, they withdraw and resist social interaction, leaving their friends less connected and more prone to withdrawal. His answer? ‘Targeting the people on the periphery to help repair their social networks and to create a protective barrier against loneliness that can keep the whole network from unravelling.’ Not a one-person job. So, do I need to tackle my loneliness levels? While it can’t be clinically diagnosed, loneliness can be measured by answering questions on the UCLA Loneliness Scale. (A few examples: How often do you feel that there is no one you can turn to? How often do you feel outgoing and friendly? How often do you feel left out?) Filling it in, I felt pretty confident – after all, I feel fine. Yet, as I totted up the numbers, I saw my score sail past the ‘low’ category and take root right in the middle of the spectrum. Though not a cause for alarm, it did reveal some home truths. As with Eleanor Oliphant, sometimes ‘fine’ isn’t enough. I occasionally feel misunderstood, I’m actually quite shy and I’m not immune to those fears of missing out (on what, though, I’m never quite sure). However, I’ve also developed strategies to counter my loneliness. I invest more in my friendships than I did in my twenties, I do volunteer work and, on days when I’m working from home and start to feel twitchy, I relocate to a local cafe instead. Unknowingly, I’ve already put in place my own anti-loneliness strategy. Loneliness might hurt, but we feel it for a reason: when those feelings start to rumble, it’s a sign to reach out. ‘I tell my clients to understand the experience as part of their particular journey,’ says Pullen. ‘To ask themselves what meaning it has in their lives – what they can learn from it and what needs to be changed – it can take courage to change the way we’re living our lives, but it can be the beginning of a fantastic adventure.’ For emotional support, Samaritans can be contacted on 116 123

‘It’s not simply about being alone – you’re experiencing the loss of deep emotional connections’