“The loneliest moment in someone’s life is when they are watching their whole world fall apart, and all they can do is stare blankly.” – F. Scott Fitzgerald

 

Loneliness is never easy to endure, yet during times of mandatory social isolation and distancing, such as millions of Americans are experiencing during the COVID-19 pandemic, it can be particularly damaging. Among its many effects, loneliness can exacerbate and bring upon a host of mental and physical conditions.

Social Isolation and Loneliness May Increase Inflammation

A study by researchers at the University of Surrey and Brunel University London found a potential link between social isolation and loneliness and increased inflammation. Although they said the evidence they looked at suggests that social isolation and inflammation may be linked, the results were less clear for a direct link between loneliness and inflammation. Researchers said both are linked with different inflammatory markers and that more studies are necessary to further understanding of how social isolation and loneliness contribute to poorer health outcomes.

What we do know about the stay-in-place recommendations during the COVID-19 pandemic is that those who live alone, or who may be infirm or sick and isolated from family members, may feel loneliness and being cut off from social contact more deeply. Many who suffer from comorbid conditions, may also experience an increase in inflammation.

Gene Expression May be Changed Through Loneliness

University of Chicago researchers found that loneliness triggers changes in gene expression, specifically leukocytes, the immune system cells that are involved in protecting the body from viruses and bacteria. Researchers found that chronically lonely people have an increased expression of genes that are involved with inflammation and a decreased expression of genes involved in antiviral response. Not only was loneliness and gene expression predictable a year or so later, but both were also apparently reciprocal, each being able in time to propagate the other.

It will be interesting to see results of studies conducted after the coronavirus pandemic abates somewhat to learn whether loneliness and gene expression are, indeed, reciprocal as well as what further associations between the two can be confirmed.

People With Dementia are at Higher Risk for Loneliness

A 2016 report from Alzheimer’s Australia found that people suffering from dementia and their caregivers are “significantly more lonely” than the general public and that their experience levels of loneliness are similar. Both those with dementia and their caregivers have smaller social circles and tend to see outsiders less frequently, although those with dementia are at even greater risk for loneliness due to diminished social contacts.

Since many individuals suffering from dementia, whether in nursing homes or being cared for by family members in their own residences, are more prone to loneliness than those who are not afflicted with the debilitating condition. Couple dementia with COVID-19 and the loneliness experienced may become overwhelming.

Loneliness Makes Managing Stress More Difficult

The stress associated with being quarantined for having or coming into contact with someone diagnosed with COVID-19 is all too real for thousands of individuals. The stress of caring for a loved one or family member quarantined for the virus in no way diminishes personal stress being cooped up and responsible for caregiving during the homebound stay.

First-responders and healthcare professionals caring for seriously ill patients with COVID-19 is another prevalent situation today, one that causes an increase in stress levels and may precipitate a feeling of loneliness even during a time of intense workload. Finding ways to manage stress during this extraordinary and unprecedented worldwide phenomenon is much more difficult.

Besides the immediate stress, there’s also secondary traumatic stress that people experience, resulting in feelings of loneliness, guilt, exhaustion, fear, and withdrawal. According to the Centers for Disease Control and Prevention (CDC), it’s important to actively seek out ways to cope with stress during COVID-19, taking good care of yourself, realizing that everyone responds differently to stress and to allow yourself time to recover after the direct threat is over.

Sleep Quality, Fatigue, Concentration and Indecisiveness Worsen With Loneliness

Research published in Lancet on the psychological impact of quarantine reported on a study that found of hospital staff who cared for or came into contact with those with SARS, being quarantined was itself most predictive of acute stress disorder. Furthermore, that same study found that quarantined individuals were more likely to report symptoms of irritability, indecisiveness, poor concentration, fatigue and exhaustion, and insomnia consistent with the loneliness and social isolation they felt during the quarantine.

Another study mentioned in the Lancet article cited the fact that post-traumatic stress disorder (PTSD) symptoms were reported by hospital workers three years after quarantine, lending credence to the belief that loneliness and isolation can have long-lasting mental health consequences.

Those who are most at risk during the COVID-19 pandemic include those with compromised immune systems, underlying medical conditions, such as asthma, serious heart disease, obesity, diabetes, chronic kidney disease, and liver disease. Older individuals and those confined to nursing homes or long-term care facilities are considered highly vulnerable to experiencing severe illness from coronavirus.

Loneliness Serves as a Contributing Factor in Substance Abuse

According to the National Institute on Drug Abuse (NIDA), the current COVID-19 pandemic may hit those with substance abuse “particularly hard.” In particular, those who regularly take opioids or have diagnosed opioid use disorder (OUD), or use methamphetamines, those who smoke tobacco, cannabis, or vape, can be at special risk for serious coronavirus complications to their lungs. Homelessness, being hospitalized and isolated or quarantined at home also elevate the risk of increased loneliness.

Furthermore, among the general public, even those not quarantined due to contracting the virus or caring for someone who has it, serious stress and caregiver fatigue may lead them to try coping with drugs or alcohol. An increase in impulsive behavior, engaging in risky activities as a coping mechanism to avoid painful feelings of loneliness, loss, financial devastation, and a diminished sense of hope for the future appears also increasingly tied to the COVID-19 pandemic.

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This article was originally published on Psych Central.

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