Although loneliness stems from a feeling of social isolation, ironically, it is one of the most unifying human experiences. Another ironic aspect of loneliness is that it can occur even when one is surrounded by people. Here Jagjit Singh’s wistful singing comes to mind: “Har taraf, har jagah, beshumaar aadmi, phir bhi tanhaiyon ka shikaar aadmi” (Everywhere, every side, are huge numbers of people, yet man is prey to loneliness).
The bad news is, in the midst of worsening statistics regarding loneliness, mental health disorders have overtaken cardiovascular disorders as the leading cause of morbidity in the world. The good news, however, is that loneliness is not all that difficult to fix. It requires human interaction, kindness, empathy, good listening abilities and the will to engage deeply ~ skills which most humans possess.
The Covid pandemic reinforced this: Although strict quarantine laws and social distancing protocols confined people to limited spaces for months on end it also brought out how meaningful connections can be forged between strangers. Housewives cooked for their sick neighbours, doctors conducted free global webinars and concerned youngsters stayed awake overnight, accommodating time zones online, to boost the morale of those friends accidentally trapped in other continents, unable to return due to travel restrictions. In short, people reached out. This was heartwarming.
Yet there are barriers to such interaction. Our social structure inhibits people’s natural tendency to connect with each other. We are discouraged from socialising with people of different backgrounds, race, religion, caste and economic class. In extreme cases, there are “honour killings” (a complete misnomer for an honourless act): wherein some family members would rather see one dead than non-conforming towards social norms. My observations are that wealthier citizens have greater opportunities to forge friendships and connect. The privilege of time and resources is used to bond with friends at parties, soirees and cultural events. Even professional’ ‘networking’ seems easier when consequential deals can be struck over a game of golf.
In contrast, a lower middle-class woman is typically hard-pressed for time to foster social connections with peers as her children, in-laws and family are dependent on her. Though physically surrounded by her family members, there can be limited empathy, leaving the woman no outlet to unburden herself. The suicide rates among women in India was twice the global average in the period between 2014-2020 as per a study in Lancet Public Health. More than 50 per cent were housewives. Having slaved all their lives, many women feel that their only time and ticket to earn some rest is when their daughter-in-law arrives to do an (unfair) share of work and they can finally put up their exhausted feet for good.
Regressive saas bahu TV serials and patriarchal thinking has promoted loneliness by vilifying a natural bond: daughter-in-law and mother-in-law. Two women in the same household can actually end up being the best of friends as they likely have to fight the same battles against issues such as local problems, roads, sanitation and patriarchal laws. Working women, though, have a professional circle of friends and acquaintances, and the burden of managing work in the office and a disproportionate share of household chores may leave them with limited time. Capitalism with its emphasis on more and more wealth creation, may induce loneliness.
The mindless pursuit of more power and money makes people sacrifice time with family and friends as they chase one corporate target after another. A deep connection with screens rather than humans or Nature is also a cause for feeling bereft. When performance-oriented workers retire, they lose the somewhat comforting sense of recognition brought on by the position they occupy; and since many have not developed genuine rich relationships with their own family and outside-of-work friends, they can suddenly find themselves feeling very isolated. The prevailing legal system in India may also be fostering loneliness. The anti-conversion laws of some states discourage people from practising another religion as it requires notifying the government of the shift.
It also requires proof of no collusion, adding practical challenges. In the recent past, these laws have been (mis)used to harshly crack down on citizens, most commonly minorities. New labour laws allow extended working shifts of 12 hours (compared to the traditional eight), leaving less time for employees to engage with friends and family. Even the recent stray dog judgement ignorantly penalised and restricted various aspects of free bonding between humans and street animals. Whereas the wealthy can afford domestic pets, stray dogs have been a great source of companionship for poorer people who don’t have as much space in their homes. Loneliness has several negative effects on the body and mind.
Well-documented studies in public health journals like Lancet and psychiatry and medical journals reveal that it can significantly increase the risk of depression and anxiety. It may promote suicide ideation. It is known to hasten cognitive decline and increase the risk of Alzheimer’s by up to 31 per cent in large population studies. As per a large meta- analytical study from the journal Heart, it also increases the risk of stroke and cardiovascular disease by 32 and 29 per cent respectively. Lonely people are more likely to perform poorly at work and have lower immunity.
The interim report of the World Health Organization (WHO) Commission on Social Connection (launched in 2023) has found a prevalence of loneliness in one out of every six people. Lower income countries and the teenage demographic are more impacted by loneliness. The UK was the first country to start a ministry of loneliness and a national policy to combat loneliness in 2018. An interesting development has been ‘social prescription’, wherein doctors customize and prescribe social integration activities which are then implemented through community link agents. Japan followed suit in 2021 with its own loneliness ministry as there was a spurt in suicide rates especially amongst women and children in the 2020s.
Several European countries, though they may not have a formal ministry, do have comprehensive policies to combat loneliness. Many policies include increasing the provision of shared public and community spaces and designing or residences that facilitate interaction. How impactful these measures have been is not easy to quantify but questionnaires are routinely designed and data gathered. In India, government counsellors are available at primary health centers and various NGOs help relieve some of the isolation especially faced by elderly people. How can we mitigate loneliness? Having a common cause greater than oneself which can impact our lives positively provides a deep sense of purpose and happiness, staving off loneliness.
It has also been historically useful to build such bridges for collective action ~ for example, mitigating global warming and fighting for human rights. Group interactions should be an important focus of urban planning. Resident Welfare Association (RWA) activities in colonies are a blessing for the elderly who are physically restricted. When my grandmother was paralyzed, she found great refuge and plenty of company in the weekly colony meetings which she attended in her wheelchair. As formal structured learning and decision-making decreases, it becomes essential for the elderly to supplement their mental development with socialisation. If one could keep learning by enrolling in various classes (a plethora of which are available free of cost), it would keep both the memory and intellect ticking as well as provide a cohort of like-minded people.
At the governmental level, infrastructure such as free common spaces like parks, libraries, and artisan-rich haats can help people connect. The government can also ensure through their administrative services that counsellors and self- help groups are appointed in every village. Young adolescents can benefit from the wisdom of elders. Stories of graceful fortitude such as those exhibited by refugees who lost entire families and material possessions during the partition of India and had to strike out on their own with limited means can inspire the young generation to take hardships and loss in their stride. We can deliberately build in mindful inclusion in our professional lives.
As a young student studying in the NHS system in the UK, my son would make it a point to spend hours talking to elderly patients who found it difficult to express themselves due to stroke or speech impediments. I too have learnt from my son to spend those extra few minutes talking to the patient when I go on ICU or ward calls in a hospital. The basics of improving loneliness involve open-mindedness and a kind heart. We can contribute strongly to mitigating this phenomenon ~ individually or collectively, in diverse ways ~ engaging with staff more meaningfully, calling up our elderly relatives, sharing our own experiences of loneliness, adopting a stray ~ there is no lone answer.
(The writer is a Delhi-based medical practitioner)