Addressing Loneliness and Social Isolation: Tips from a Child Psychiatrist

Recently the US Surgeon General, Vice Admiral, Dr Vivek H. Murthy, issued a national advisory on loneliness, social isolation and lack of connectedness in our country. The advisory pointed out that collectively we are experiencing an epidemic of emptiness and isolation as a nation.

The report from the US Surgeon General highlights statistics that are staggering, if not alarming, starting with the fact that 50% of Americans identified themselves as suffering loneliness, and this was before COVID19 which exacerbated this existing condition, placing individuals that are experiencing loneliness and social isolation at risk for many physical and emotional health risks, including cardiovascular disease, dementia, depression, anxiety and premature death.

Social connectedness has been trending downward. The level of trust in our communities is also declining, in the 1970’s around 45% of the population had trust in their communities but that figure is now at about 30%. Many have become more suspicious of those around them, maybe contributing to the increase in polarization seen in our country.

I would like to review these concerns from my perspective as a child adolescent psychiatrist and an administrator in public mental health. I will include some concerns that I encounter daily in my clinical practice with children and their families and extrapolate to a broader societal perspective.

Some common causes of loneliness, social isolation and emptiness are linked to experiences of loss and trauma. These experiences can be accounted by adverse life events, which include losses, excessive stress, emotional, physical or sexual trauma, and dissolution of families which can occur by premature death, illness, separations, or divorce.

On a broader societal level, there are many potential factors that can lead to this collective void, loneliness and disquiet feelings in our society that include: an accelerating pace of life, more distractions, an increased preoccupation with consumption, excessive work schedules and less time for winding down. We rely more on multitasking to improve our productivity throughout our busy days. We also tend to focus more on technology and social media to be more efficient and interact with others.

We attempt to deal with individual and societal loneliness by turning to activities and interactions that focus on immediacy, seeking immediate entertainment, fast food, anything that is at our fingertips that provokes a fast response.

In my clinical practice, I focus my attention on improving the mental health of my patients and supporting their concerns. I frequently come across many patients that are seeking a quick fix to their complex problems, which is understandable. We should be empathic because everyone is seeking relief from their suffering, but we often realize that it will require an intensive and longer collaborative approach.

I am reminded of a popular song in the 1980’s by Huey Lewis: “I want a new drug” one that can make me feel good, but without bad effects or concerns. As a society we have come to rely more frequently on all sorts of addictions to confront and deal with this collective void. We are constantly searching for fast relief and quick solutions.

Let me present a composite of a complex clinical case to demonstrate this dilemma. A female adolescent who presented with multiple psychiatric hospitalizations, suicidal urges, chronic self- mutilation, eating disorder, drug addiction, and feelings of hopelessness and helplessness. She felt progressively more disconnected from the outer world and that her family had given up on her, mostly because they thought they could not support her unless she stopped her “negative behavior”. At one point, we encouraged her to invite her estranged father to a session. Despite his difficulty in comprehending his daughter’s maladaptive behaviors, he was able to express his love and support for her and a commitment to stand by her through this difficult journey. Both seemed to cross a threshold in her care at this point by making a genuine connection and commitment to each other.

I recognize that this case presentation is complex and maybe not the experience of most readers. My point here though is that even in very challenging situations, human connection, empathy and support for those that are suffering, feeling lost and hopeless can go a long way in impacting and improving their lives.

So, how can we address this loneliness and help fill the void in the individual and society? At the family level, parents can help prevent and provide their children with skills that can make them more resilient by providing consistent warmth (affection), firmness (consistency and structure) and supportive attention to their children’s interests. Parents can protect them from potential trauma, yet, if this happens, children’s experience and feelings need to be validated and supported.

Children also benefit from consistent discipline, that entails guidance, limit setting, modeling, and helping them learn from their mistakes. It is important that they express verbal and physical affection to each other on an ongoing and regular basis.

We should encourage children to participate in activities that build their social skills, helping them separate from their digital and social media and participate in family, social activities, team sports and other creative activities. This will ensure that children and adults have adequate sleep and rest time. We can instill a sense of collaboration and shared experience with others.

On a broader society level, we must find a balance between our busy work schedules and set aside time for meaningful activities, social interactions, exercise, meditation, mindfulness, spiritual activities, reading or engagement in creative activities. We can also use some of our time for reflection and staying in the moment.

In conclusion, it is important to slow down and “smell the wonderful flowers” at our disposal and take time to truly engage and share with others. We have an expectation to prepare the next generation to embrace and nourish the skills that took thousands of years to develop. This becomes more apparent and urgent as we compete with machines and technology that diminish these skills and our humanity.