Loneliness can be defined as a feeling of uneasiness or discomfort from either being alone or perceiving oneself to be alone (Rubenstein & Shaver, 1982). It is associated with perceived social isolation, rather than objective isolation.
Symptoms of loneliness range from psychological to physical. Adjectives such as boredom, self-pity, sadness, empty, and ashamed have been used to describe the feeling of loneliness.
Rubenstein and Shaver (1982) have categorized behavioral symptoms of loneliness into four areas:
Sad passivity, which includes crying, sleeping, doing nothing, overeating, taking tranquilizers, and excessive drinking and drug use
Active solitude activities, which involve writing, listening to music, exercising, working on a hobby, studying, and working to avoid loneliness
Spending money through excessive shopping or buying unnecessary items
Social contact by reaching out to friends, engaging in social activities, and doing things to avoid being alone
Psychology of Loneliness: Theories and Research
Researchers have categorized loneliness into chronic and transient loneliness (Choi et al., 2012).
Chronic loneliness is a persistent, internal experience that often extends over a period of many years, regardless of the situation. Chronic loneliness may vary in intensity over time (Choi et al., 2012).
Transient loneliness is experienced for shorter periods of time and is usually the result of a particular situation or environmental factor (Choi et al., 2012).
From a psychological perspective, loneliness includes affective, cognitive, and subjective components. These components can be represented by the psychodynamic, cognitive, and existential approaches in psychology.
The psychodynamic approach to loneliness was first described by Fromm-Reichmann (1959), who based loneliness on early childhood experiences arising from a separation between parent and child and a lack of physical contact and loving intimacy.
According to the cognitive approach, loneliness results from thought processes. Loneliness results when an individual’s perception and evaluation of social networks are not congruent (Heinrich & Cullone, 2006). Many of today’s definitions of loneliness are based on this subjective experience of connection and internal need for relationship.
The existential approach to loneliness is based on a phenomenological outlook, the feelings of loneliness, and the human condition with regard to others (Jones, 1989).
Existentialism is a philosophical approach and looks at loneliness as a starting point. This approach attempts to understand what that experience is like for the client rather than trying to treat the symptoms.
The effects of loneliness on the brain
Research has demonstrated significant effects of loneliness on the brain and cognitive function. Feeling socially isolated is a large predictor of dementia and Alzheimer’s disease (Wilson et al., 2007).
Alzheimer’s disease has been predicted by the degree of loneliness, where those in the top decile of loneliness scores were 2.1 times as likely to develop Alzheimer’s than those in the bottom decile (Wilson et al., 2007).
Additionally, loneliness was inversely associated with performance on cognitive measures among 823 dementia-free older adults (Wilson et al., 2007). Loneliness was also associated with a faster decline in cognitive performance on a majority of cognitive measures over a four-year follow-up (Findlay, 2004).
Intelligence test results are also influenced by loneliness (Baumeister et al., 2005). In one study, researchers divided university students into three groups and provided false feedback after completing a personality profile and mood assessment.
Participants were told one of the following: that they had a personality profile indicating they would have rewarding relationships, that they would have a future alone, or that they were accident prone (Baumeister et al., 2005). Researchers concluded that the decline in cognitive ability was based solely on the idea or fear of being alone.
Similar research has shown that loneliness decreases cognitive performance skills and logical reasoning tasks. Baumeister et al. (2002) also found that telling individuals they would have a lonely future impaired self-restraint.
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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:
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.
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).
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.
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:
A guided meditation for loneliness - Live Sonima
3 Books on the Topic
There is a wealth of resources that address the issue of loneliness. These books provide a wonderful mix of practical guidance and professional experience to help readers live more emotionally fulfilled lives.
1. A Practical Guide to Overcoming Loneliness – Sally Alter
A Practical Guide to Overcoming Loneliness takes an informal approach to address a variety of issues that are associated with loneliness.
This mix of personal experience, self-help, and comforting advice is balanced with expert information and answers to living a happy life.
No matter what the root cause of loneliness is, this book can provide guidance and advice to assist with a multitude of problems.
The aim of positive psychology is to help people flourish. In some countries, it is a constitutional right to be happy, and here at PositivePsychology.com, we have many resources to share to assist in quests for happiness.
Skills for Regulating Emotions is a worksheet to help individuals regulate and cope with the distressful emotions associated with loneliness. It provides practical ideas for creating healthy habits and a guide to fact-checking negative thoughts that can stand in the way.
Writing a Love Letter to Myself is a great way to reflect on personal strengths and qualities. This can help build security in the absence of community as well as build confidence to make new connections with others.
Creating hope can be a powerful antidote to loneliness. Hope can help clients after suffering loss or provide a way out of the feelings of isolation, sadness, and depression that lack of connection provides.
Human beings are thoroughly social creatures and depend on connection for survival. Loneliness can have a dramatic impact on social, emotional, cognitive, and physical wellbeing.
With the prevalence of loneliness across the globe, understanding the psychology and the detrimental consequences it can have is an important first step. Learning the symptoms, signs, and ways to assess loneliness can guide individuals to the most appropriate treatment options.
There is hope for healing loneliness and finding connection, purpose, and meaningful relationships.
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Steen, O., Ori, A., Wardenaar, K., & Van Loo, H. (2022). Loneliness associates strongly with anxiety and depression during the COVID pandemic, especially in men and younger adults. Scientific Reports, 12.
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences110(15), 5797–5801.
Thurston, R., & Kubzansky L. (2009). Women, loneliness, and incident coronary heart disease. Psychosomatic Medicine, 71, 836–842.
Vedder, A., Stroebe, M., Schut, H., Boerner, K, Stokes, J., & Boelen, P. (2021). Loneliness in bereavement: Measurement matters. Frontiers in Psychology, 12.
Wilson, R., Krueger, K., & Arnold, S.(2007). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry, 64(2), 234–240.
About the author
Dr. Melissa Madeson, Ph.D., believes in a holistic approach to mental health and wellness and uses a person-centered approach when working with clients.
Currently in full-time private practice, she uses her experience with performance psychology, teaching, and designing collegiate wellness courses and yoga therapy to address a range of specific client needs.