Are You Screening Your Patients For Loneliness?

The mental health field has worked hard, and rather successfully I might add, at de-stigmatizing maladies such as depression and anxiety. So much so that people I treat seem increasingly more comfortable stating upfront that they’re feeling depressed, overwhelmed, or anxious, for example. There’s less obfuscation and reticence, and they simply speak up.

They’re not comfortable however, speaking up about feelings of loneliness. It’s tough for people to admit that they’re lonely – particularly if their life circumstances would seem otherwise. By digging deeper, I’ve had more patients than I could possibly count tell me, that in spite of their large nuclear families, work relationships and social networks, they still feel lonely and it has them feeling like a loser. Loneliness affects people of all ages and socioeconomic status. In addition to depression and anxiety, loneliness is associated with a reduction in life span, dementia and heart disease. In the workplace, it is linked to poor task performance, limiting creativity and impairing executive function and decision-making.

So why am I writing about this? Because for too long, I was guilty of bypassing a client’s internal emotions, opting instead to focus on the external symptoms I was observing. When I changed my treatment strategy and urged patients to just “tell me their story,” I was able to gain much better insight into the strong connection between loneliness and the mental problems I was attempting to address via medication or other interventions. Another reason I’m writing about this is although widespread, loneliness is not easy to define and therefore can easily be swept under the rug and operate in the shadows, so to speak.

What I learned from those for whom loneliness is a problem, is that they lacked a positive sense of connection to other people and felt as though they had no one to speak to about a personal problem.

Social Media to the Rescue

I’d argue that the social media phenomenon has created one of the greatest technological revolutions ever, affording us opportunity to connect with new people and resources like never before. It also serves as a conduit for re-connecting with people lost to us, whom we never would have been able to find, otherwise. But for those mired in loneliness, it can create the idea that one should have a “team” of friends – when in reality, if any of us have one or two really good friends, we’re fortunate. Having Facebook friends can support loneliness when someone is short on “likes” and long on getting “unfriended.” “Am I no longer meaningful, no one is commenting on my feed?”

Real-life relationships can suffer as well, because social media outlets serve as constant reminders of all the “friends” one could be interacting with electronically, making actual in person conversations shallower and less satisfying. And social media can be exhausting in that it can run the gamut from being extremely uplifting, to feeling depressed and overwhelmed – not a tasty recipe for those in search of friendships and support.

Screening for loneliness – particularly in patients presenting with depression and anxiety – has paid dividends for me, and I believe, for those affected by it. My suggestion is that you might consider doing the same.

The ways for combating loneliness are many, and are individualized and fine-tuned to our particular circumstances. To be successful though, meaningful connections that provide a sense of purpose which cultivate feelings of “belonging” is a must, and this is what I work on with my patients.

It often doesn’t include them making more friends.

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Attribution Statement:
Joe Wegmann is a licensed pharmacist & clinical social worker has presented psychopharmacology seminars to over 10,000 healthcare professionals in 46 states, and maintains an active psychotherapy practice specializing in the treatment of depression and anxiety. He is the author of Psychopharmacology: Straight Talk on Mental Health Medications, published by PESI, Inc.

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