How Does It Affect Mental Health? 5 Effects
Loneliness is linked to a variety of mental health disorders including anxiety, depression, suicidal behavior, poor self-regulation, alcohol abuse, addiction, and eating disorders (Heinrick & Cullone, 2006).
Loneliness, depression, and grief
Loneliness and depression are both common emotions associated with grief, loss, and bereavement.
Research has found a greater intensity and frequency of loneliness among bereaved individuals, and it also plays a key role in levels of depression after someone has lost a partner (Vedder et al., 2021).
Symptoms of loneliness and depression are closely linked, and both are part of a normal grieving process.
Can loneliness cause anxiety?
There is a direct correlation between symptoms of loneliness and anxiety, particularly generalized anxiety disorder. However, the question of cause and effect is not clearly understood.
A longitudinal study of over 75,000 individuals found a direct association between both generalized anxiety disorder and major depressive disorder during the COVID-19 pandemic (Steen et al., 2022).
Feeling lonely can heighten anxiety since humans have a basic need for social connection, belonging, and protection from others.
4 Effects on physical health
- Loneliness does not just affect an individual’s psychological and emotional health; its effects appear to accelerate physiological aging and predict morbidity and mortality (Shiovitz-Ezra & Ayalon, 2010).
Research shows that there is a correlation between loneliness scores and mortality. Additionally, the length of time spent feeling lonely (in years) influenced signs of physiological aging (Shiovitz-Ezra & Ayalon, 2010).
- Loneliness also impacts cardiovascular health in both young and older adults. It has been linked to higher levels of HDL, cholesterol, hemoglobin concentration, maximum oxygen consumption, systolic blood pressure, and coronary heart disease (Thurston & Kubzansky, 2009).
- Quality of sleep and daytime functioning can be affected by loneliness (Cacioppo et al., 2002). Sleep is important for restorative effects, and quality of sleep is important for physical and intellectual functioning, mental health, and engaging in healthy lifestyle behaviors.
- Immune function is associated with loneliness. Loneliness is related to poorer antibody responses to vaccines, impaired cellular immunity, and lower natural killer cell activity (Pressman et al., 2005).
4 Loneliness Tests, Scales, and Questionnaires
Knowing the prevalence and detrimental effects loneliness can have on the general population, it has become increasingly important to find methods of measurement and assessment.
Tests, scales, and questionnaires can provide education and training for healthcare workers and practitioners. The following scales have been used in both research and practice and create an effective base for creating interventions and treatment for loneliness.
1. The UCLA Loneliness Scale (UCLA-LS)
The UCLA-LS is a well-established measure of loneliness that has been used in research studies for decades (Russell, 1996).
The scale is based on a subjective perception of loneliness where respondents rate items on a four-point scale from “never feeling this way” to “often feeling this way.”
While it is a valid and reliable measure of loneliness, it does not specifically address how long the participant has felt loneliness, so it does not distinguish between trait and state loneliness.
2. The De Jong Gierveld Loneliness Scale (DJG-LS)
The DJG-LS has also demonstrated reliability and validity in research studies (de Jong Gierveld & van Tilburg, 1999).
The 11-item scale is scored based on statements that participants select. It assesses emotional and social loneliness with a broader scope of questions compared to the UCLA-LS.
3. Steptoe Social Isolation Index
Steptoe et al. (2013) created an index of social isolation. Social isolation can be an indication of loneliness. This index involves a five-point scale, with one point assigned for each of the following factors:
- Unmarried/not cohabiting
- Less than monthly contact (including face-to-face, by telephone, or in writing/email) with children
- Less than monthly contact (including face-to-face, by telephone, or in writing/email) with other family
- Less than monthly contact (including face-to-face, by telephone, or in writing/email) with friends
- No participation in social clubs, resident groups, religious groups, or committees
People with a score of 2 or more were defined as being socially isolated.
4. The Lubben Social Network Scale (LSNS)
The LSNS is a short instrument designed to assess social isolation in older adults. It generally takes five to 10 minutes to complete and measures perceived social support from family and friends.
It has been used in research and in practical settings such as community hospitals, adult day care centers, assisted living facilities, and medical practices. The 10-item scale can guide caregivers as they monitor the needs of aging adults.
Permission to use the scale can be obtained through the Boston College School of Social Work.
How to Overcome Loneliness With Therapy
From a therapeutic approach, reducing feelings of loneliness involves fostering a sense of connectedness as well as modifying perceptions of social isolation.
Symptoms of loneliness, depression, anxiety, and emotional distress can be treated, but it is critical to address the root cause: cognitive biases, underlying concepts of social threat, hypervigilance, and individual need for social relationships.
Therapists, counselors, and support groups can help individuals identify the negative thinking patterns and core values that lead to loneliness. Additionally, therapy can provide resources to cope with loneliness, improve social connections and communication, and give a safe space for feelings of loneliness and other emotions.
Individuals can learn to move through grief, develop effective interpersonal skills, and build confidence to branch out and connect with others. Professionals can help clients overcome social anxiety, which is often an underlying cause of loneliness.
3 Interventions and Treatment Options
Interventions for loneliness can be categorized into three different approaches: individual treatments, group interventions, and environmental approaches (Choi et al., 2012).
1. Individual treatments
Individual treatments for loneliness include Cognitive-Behavioral Therapy, psychodynamic therapies, and talk therapy to improve communication and solitary skills.
Therapists work with clients to identify anxious and avoidant thoughts and behaviors around social interactions to help them develop adaptive thought patterns and habits.
By learning appropriate coping skills, clients can interact and connect with others to develop healthy relationships.
2. Group interventions
Group interventions include group therapy to teach and practice social skills, communication, and emotional regulation in a group environment.
Groups can provide clients with immediate feedback in a safe environment and help normalize any social anxiety that may be the root cause of loneliness.
Group therapy may also include bereavement groups that allow individuals who are struggling with similar losses (causing loneliness) to connect.
3. Communities
Environmental treatment options explore interactions at the community level. They involve community awareness programs and restructuring social settings.
Things such as community events, block parties, game nights, and planned activities can help reduce social isolation.
Encouraging clients to get involved in volunteer activities and participate in community activities can create connections and help them develop relationships surrounding shared interests.
3 Counseling Worksheets and Activities
Worksheets and activities are wonderful ways to address loneliness in and out of therapy sessions. Providing individuals with tools allows them to take control of their own emotional wellbeing.
1. Three-Step Mindfulness
This Three-Step Mindfulness Worksheet helps lonely individuals shift their attention from the past or future (grief or anxiety about not having connection) to the present moment. By developing this internal awareness, clients can tolerate the waves of loneliness whenever they hit.
2. Self-Care Checkup
One of the best ways to overcome loneliness is to care for oneself. The Self-Care Checkup can guide individuals toward mental, physical, emotional, and social ways to care for themselves.
3. Emotional Wellness Worksheet
The National Institutes of Health provide wonderful Emotional Wellness worksheets that can address issues with and related to loneliness. From coping with loss to improving sleep and developing resilience through challenges, these tools can aid a variety of issues that cause loneliness.
Can Meditation Help? 3 Tips and Strategies
Meditation and mindfulness are helpful in dealing with a variety of negative and distressing emotions associated with loneliness.
These practices can help individuals learn to tolerate uncomfortable feelings and avoid turning to maladaptive coping behaviors.
Below you will find a helpful selection of options with which to establish a meditation practice.
1. Learn mindful compassion
Loving-kindness meditations are specifically useful to help with loneliness, as they teach self-compassion and increase the ability to develop social connection.
Make use of these loving-kindness meditation scripts, which encourage individuals to extend kindness to themselves and let go of fear and anxiety to embrace happiness and acceptance.
2. Pick a specific time and location
Our article on mindfulness meditation provides a multitude of videos and scripts to help individuals begin a mindful meditation practice.
Meditation is most effective for loneliness if it is done regularly and with consistency. Picking a specific location and time of day to spend five to 10 minutes of uninterrupted practice is a great way to start.
3. Radical acceptance
The most powerful aspect of meditation is its ability to help individuals observe and even embrace the negative feelings associated with loneliness.
By recognizing the emotions and accepting them in a nonjudgmental way (not thinking of them as good or bad), the negative sensations become less intrusive and controlling, allowing the lonely person to find space for more joy and connection. Follow this guided meditation to find a happier space:
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