Loneliness: A Global Pandemic
Mother Theresa once said, “ Loneliness and the feeling of being unwanted is the most terrible poverty”.According to the Britannica Encylopedia, loneliness is defined as the distressing experience that occurs when a person’s social relationships are perceived by that person to be less in quantity, and especially in quality, than desired. Despite the advancement of technology, loneliness is still prevalent. Loneliness has been increasingly becoming a chronic disorder amongst the youth and the old. This truly becomes an issue of a lack of awareness of mental health amongst the public. Following the appointment of a minister for loneliness in the UK, this implies that the developed economies have started to realize the effect of loneliness on their economies.
According to the WHO report in 2015, more than 322 million people have depression that is approximately 4 per cent of the world’s population. The number of people suffering from depression has increased by 18.4 per cent in a period of ten years between 2005 to 2015. According to the World Economic Forum, they can be as low as 4.4 per cent (in Azerbaijan), in other countries (such as Denmark) as many as 20 per cent of adults report being either moderately or severely lonely. According to the Economist report of 2018, over 9 per cent of adults in Japan, 22 per cent in the US, and 23 per cent in the UK always or often feel lonely or isolated(ref fig 1).
According to the European Union’s Joint Research Center Report of 2018, nearly 30 million European adults feel lonely. The European Union’s Joint Research Center Report of 2018 also makes a statement that loneliness is more prevalent in eastern and southern Europe as compared to the Northern and western part of the continent.
From Our World in Data of comparing the loneliness in a period of 2005 to 2018, The differences in the prevalence of loneliness across countries are very large. At the bottom of the list, Denmark, Switzerland, Sweden and the US all have rates below 30%, while at the top of the list Greece, Israel and Italy have all have rates of close to or above 50%. The BBC had launched the loneliness study with 55,000 participants from various parts of the world on the Valentines Day of 2018 and making it the world’s largest loneliness survey back then. The survey stated that nearly 40% of the 55,000 people aged between 16–24 were feeling lonely.
In 2004, the National Sample Survey Office reported that 4.91 million people in India were living alone and suffered from loneliness. More recently, the National Mental Health Survey of India (2015–16) reported that prime risk of an increasing concern in India; that children and adolescents are susceptible to mental disorders; and, mental disorders, including depression and anxiety, affect nearly 10 per cent of the population. A nationwide survey conducted by NIMHANS in 2016 estimated that around 13.7 per cent of India’s population suffered from different mental illnesses, with around 10.6 per cent of them requiring immediate attention. The study concluded that residents from urban metros, where isolation and stress are more pronounced, had greater prevalence across different mental disorders. In 2016, the Centre for the Study of Developing Societies in partnership with Konrad Adenauer Stiftung conducted a survey of the attitudes, anxieties and aspirations of India’s young population (aged 15–34 years). The findings, released in April 2017, revealed that 12 per cent of the youth reported feeling depressed often, and 8 per cent said they felt lonely quite frequently. According to a survey conducted in India by the Agewell Foundation in the year 2017, it was found that on a sample size of 15,000 elderly people, nearly 47.49 per cent suffer from loneliness. According to the research article “ Social isolation, loneliness in older people pose health risks “ published by the National Institute of Ageing on 23rd April 2019, about 28 per cent of older adults in the United States, or 13.8 million people, live alone, according to a report by the Administration for Community Living’s Administration on Aging of the U.S. Department of Health and Human Services, but many of them are not lonely or socially isolated. At the same time, some people feel lonely despite being surrounded by family and friends.
According to the European Union’s Joint Research Center Report of 2018
Causes of Loneliness
After seeing the extremely high number of people reporting loneliness in various parts of the world irrespective of the economic progress of the country, its high time that we understand the causes of loneliness. The causes of loneliness must be addressed in two age groups by considering the youth and older people. When the youth being abused by either verbal or physical means tends to create a profound influence in one mind. This pushes the person to alienate himself from the society. A fear of not being able to fit in a group or peer pressure which has been seen in various academic establishments and workplaces tend to push a person to prefer being lonely rather than being alone. The ability of not being able to bear the loss of someone special is cited as one of the major reasons for chronic loneliness by the leading psychiatrists across the globe. The unemployment amongst the youth in various developing and developed countries has pushed the youth into an isolated bubble called loneliness. The difference in income is yet another financial cause that leads to loneliness. According to the clinical report “ The Impact of Social Media on Children, Adolescents, and Families” published in the PEDIATRICS, the official journal of the Academy of Pediatrics in the year 2011, the social media platforms were being a major cause of loneliness, anxiety and depression amongst the youth and young adults.
The World Health Organization predicts that one in five nearly 2 billion people will be aged 60 or older by 2050, double that of 2015. According to the UN data, the number of persons aged 80 years or over is projected to triple, from 143 million in 2019 to 426 million in 2050. Loneliness in the elderly people is caused due to various physical, emotional and psychological reasons. Despite retirement is said to be a period of rest from work, the elderly people often crave to meet them which happens once in a blue moon after retiring from the business chores. The loss of their loved ones still creates a deep impact on their mental health and pushing them into a dark world called loneliness. Poor health and lack of financial support prevents them from socialising with the society.
Effects of Loneliness on Mental and Physical Health
According to the article “Perceived Social Isolation Makes Me Sad: Five Year Cross-Lagged Analyses of Loneliness and Depressive Symptomatology in the Chicago Health, Aging, and Social Relations Study” published in NCBI in the year of 2010, stated that loneliness holds a risk factor to various psychological and health outcomes. As stated by the above-cited study, loneliness has been a major cause of increased vascular resistance, elevated blood pressure, increased hypothalamic-pituitary-adrenocortical activity,under-expression of genes bearing anti-inflammatory glucocorticoid response elements (GREs), over-expression of genes bearing response elements for pro-inflammatory NF-κB/Rel transcription factors, impaired sleep, altered immunity, a progression of Alzheimer’s Disease, obesity and poor physical health. Loneliness has been associated with psychiatric complications like personality disorders, hypochondriasis, schizophrenia, suicidal ideation and behaviour and depression. According to the research article “ Social isolation, loneliness in older people pose health risks “ published by the National Institute of Ageing on 23rd April 2019, stated that loneliness in the elderly people can cause physical and mental complications like high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.
Following is a small video that can explain the impact of Loneliness on an individual's Mental and Physical Health
The Effects of Loneliness on The Economy of A Country
It must be noted that loneliness must be seen as an economic challenge along with the health and societal aspect. The hidden cost to combat loneliness adds a burden to the healthcare budget of a country. Caregivers who provide formal and informal support to the elderly people would be outnumbered due to the increasing number of elderly citizens suffering due to loneliness. There would be tremendous pressure on the health care system of a country to cater to combat loneliness which would lead to other physical and psychological complications. Especially pertaining to the loneliness experienced by the elderly people is due to neglect from the acquaintances and family members, the society tends to lose the moral values from the elderly. Developing countries like India are experiencing an acute shortage of psychiatrists. According to the 2018 reports from the Indian Union Ministry of Health and Family Welfare, the country needs around 13,000 psychiatrists. To achieve an ideal ratio of psychiatrists to population is about 1: 8000 to 10,000 but currently has just about 3,500 which is about one psychiatrist for over 2 lakh people. With regard to other mental health professionals, the ratio is even worse the need of Clinical Psychologists is 20,000 and there are only 1000 available; for Psychiatric Social Workers, the requirement is 35,000, but only 900 are available, for Psychiatric Nurses, we need 30,000 and only 1500 are available. According to the National Crime Records Bureau 2015, the entire mental health workforce, comprising clinical psychiatrists, psychologists, psychiatric social workers and psychiatric nurses, stands at 7,000, while the actual requirement is around 55,000. According to the “Investing to Save — The economic benefits for Australia of investment in mental health reform. (2018)”, stated that mental issues caused due to loneliness could cost nearly US $ 60 Billion per annum in health care, loss of productivity and other indirect costs. The economic burden of suicide in Australia also incurs direct costs, including coronial, ambulance and policing costs of $24 million per annum and costs due to the loss of future earnings of $1.6 billion over the life course. An effort to quantify the cost of loneliness in the US also found that among Americans aged 65 or older, social isolation costs the US government nearly $7 billion in additional health care costs per year. The World Economic Forum estimated that direct and indirect costs of mental health amount to over 4 per cent of global GDP, more than the cost of cancer, diabetes, and chronic respiratory disease combined. This could cost the global economy up to $16 trillion between 2010 and 2030 if a collective failure to respond is not addressed.
Ways To Combat Loneliness In The Society
The lack of handling loneliness could cost a major economic loss to the developed and developing countries.
Awareness that must be created amongst the citizens using social media and other online platforms about the consequences of loneliness.
In a country like India, psychiatrists charge nearly Rs 500 to Rs 1500 per sitting which isn’t quite feasible for many middle class and poor citizens.
The cost of visiting psychiatrists must be reduced to cater to the middle class and poor citizens by various Government Initiatives to promote mental health.
There is an acute shortage of psychiatrists in developing countries like India and other countries.
The government must set-up many institutions that promote psychiatry as a course. Psychiatry must be made a part of the Medical Curriculum in the Medical Colleges in the country.
The older people must be provided with some financial as well as medical support must be included in the budgetary and national health care policy of the government.
It must be truly appreciated that Singapore has started using gardening sponsored by the Government as a means to combat loneliness in older people from the year of 2019.
In a community,
We can have a get-together with the older citizens on a weekly basis. On a community level, we can create a learning environment where older people can share their experience and make new friends. We must learn to celebrate everyday acts of neighbourliness in the community.
Loneliness must be handled at the individual level too.
When an individual especially the youth who feels lonely, must go and talk to their friends and family members. The induvidual must try to reconnect with society by volunteering at various humanitarian NGOs. They must also look into taking care of their health by sleeping well and exercising daily.
