Dear (name),
My heartfelt thanks for the feedback from so many of you. Our give and take enhances spread of the message about poor mental health care. Keep your ideas coming. Thanks also to those who have encouraged friends and colleagues to sign up on my website (robertcsmithmd.com). The Prometheus Books copy editor now has the book manuscript, and we are progressing toward publication in March 2025.
Today, I want to address an issue of particular importance to everyone but especially those with mental health problems: loneliness and social isolation. The revered seventeenth-century English scholar, poet, and cleric, John Donne (1572-1631), best articulated why loneliness is so devastating, “No man is an island, entire of itself; every man is a piece of the Continent, a part of the main.”
The recent US Surgeon General’s Report by Dr. Vivek Murthy (https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf) underscores how crucial our social connections are, not just to our social lives but also to our mental and physical well-being. Frighteningly, Dr. Murthy tells us that one of every two US citizens experienced loneliness before the COVID-19 pandemic, which, as you know, markedly worsened Americans’ sense of isolation. For example, the Kaiser Family Foundation reported an 11 percent occurrence of depression and/or anxiety before COVID-19 in 2019. Frighteningly, it rose to the range of 40 percent by 2020, early in the pandemic. This means that the virus-induced isolation led to a new mental disorder in over 80 million Americans—mostly cared for by untrained clinicians (if they received any care). And the adverse impact did not disappear when the isolation cleared at the end of the pandemic in 2023: 49.9 percent of young adults continued to experience depression and/or anxiety. Not surprising, especially with 47 percent of the US population in shortage areas for mental health care, 90 percent of Americans believe we have a bona fide mental health crisis.
Halder: Humans Need Connections (CC0)
Loneliness and social isolation also have consequences beyond depression and other mental illnesses. They lead to increased physical disease problems with a greater risk for cardiovascular disease, dementia, stroke, and premature death. How big a risk factor? The mortality impact of loneliness matches that incurred from smoking 15 cigarettes per day. That’s a greater risk than obesity and physical inactivity.
What can we do individually? In addition to talking to a lonely or isolated person and expressing empathy, we can be even more effective by touching, recalling that’s how we were comforted as infants. Because a baby doesn’t have meaningful language until about 4 years of age, its relationships with mother and others occur primarily by touch and other nonverbal means. They nonverbally express their needs—crying—to achieve the response of a soothing touch. Even after that age, though, the comforting impact of touch remains implanted in our psyches. A recent research study from Nature Human Behavior (https://www.ncbi.nlm.nih.gov/pubmed/38589702) describes how critically important human touch is to both mental and physical health. In a meta-analysis of 137 studies that evaluated nearly 13,000 individuals, the researchers found touching especially effective for assuaging pain, depression, and anxiety in adults; and for enhancing weight gain in newborns. The type of touching made little difference, but its frequency directly related to the benefit (although it should not be prolonged). Perhaps surprising, knowing the toucher made little difference in adults and children, while familiarity with the toucher (mother) was critical in newborns. Finally, men experienced less benefit from touching than women. Tabakpolska: Mother and newborn (CC0)
Back to Dr. Murthy. In a refreshing departure from the usual federal report, he takes a personal direction. He asks us to pay better attention to one another, to look out for others’ needs, and to value our relationships. To quote him, “Our individual relationships are an untapped resource—a source of healing hiding in plain sight. They can help us live healthier, more productive, and more fulfilled lives. Answer that phone call from a friend. Make time to share a meal. Listen without the distraction of your phone. Perform an act of service. Express yourself authentically.” And, we can add, don’t hesitate to touch. Shaking hands, a pat on the back or arm, and a gentle embrace can go a long way.
Take care and be well. Give someone a hug!
Bob
Robert C. Smith, MD