Researchers are working on a pill for loneliness, as studies suggest the condition is worse than obesity

By | August 13, 2019

The volunteers at the University of Chicago’s Brain Dynamics Laboratory, all otherwise young and healthy, were tied together by really only one thing: nearly off-the-chart scores on the most widely used scale measuring loneliness.

Asked how often they felt they had no one they could turn to, how often they felt their relationships seemed superficial and forced, how often they felt alone, left out, isolated or no longer closer to anyone, the answer, almost always, was “always.”

The volunteers agreed to be randomly dosed over eight weeks with either pregnenolone, a hormone naturally produced by the body’s adrenal gland, or a placebo. Two hours after swallowing the assigned tablet, the university’s researchers captured and recorded their brain activity while the participants looked at pictures of emotional faces or neutral scenes.

Studies in animals suggest that a single injection of pregnenolone can reduce or “normalize” an exaggerated threat response in socially isolated lab mice, similar to the kind of hyper vigilance lonely people feel that makes them poor at reading other people’s intentions and feelings.

The researchers have every hope the drug will work in lonely human brains, too, although they insist the goal is not an attempt to cure loneliness with a pill.

Lead researcher and neuroscientist Stephanie Cacioppo has likened using a drug to rubbing frost from a windshield. Loneliness increases both a desire to connect with others, and a gut instinct for self-preservation (“if I let you get close to me, you’ll only hurt me, too”). People become more wary, cautious and self-centred. The idea is to help people see things as they are, “rather than being afraid of everyone,” Cacioppo said in an interview with Smithsonian.com.

For some, the idea of a pharmacological buffer against loneliness is just another sign of the creeping medicalization of everyday human woes: Wouldn’t a pill for loneliness only make us more indifferent, more disconnected? Is it really the best we can do to fix the modern world’s so-called epidemic of loneliness?

Life is loneliness

Headlines suggest we’ve become consumed by loneliness, a new generation of Eleanor Rigbys half a century after the Beatles lament for the lonely: Why are 30somethings lonely? What You Need to Know about the Loneliness Epidemic. Loneliness is a human catastrophe. A recent Angus Reid Institute survey found that nearly half of Canadians sometimes or often feel alone. In the U.S., the number of Americans who feel they have no one with whom they can speak to has tripled since 1985.

“God, but life is loneliness, despite all the opiates, despite the shrill tinsel gaiety of ‘parties’ with no purpose, despite the false grinning faces we all wear,” Sylvia Plath wrote in journals published nearly four decades ago. Today, people across the West are reporting higher levels of persistent loneliness than ever before.

But is the epidemic real? Are we truly more lonesome than generations past, or have we simply lost the capacity, the tolerance, to be alone? Are the digital technologies that enable us to have instant contact and faux friendships distancing us from meaningful ones? Is it fair to pin the blame on our digital culture, or is the course of western politics, the rise of populism and individualism really the cause?

To those testing the loneliness pill, a “therapeutic” little helper, the epidemic is certainly real.

“Imagine a condition that makes a person irritable, depressed and self-centred, and is associated with a 26 per cent increase in the risk of premature mortality,” Cacioppo and her late husband, John Cacioppo, wrote in The Lancet last year. Around a third of people in industrialized countries report feeling lonely, one in 12 severely so, and the proportions are increasing, they warned.

The Angus Reid study, conducted in partnership with the faith-based think tank Cardus, found that four in 10 Canadians surveyed said they often or sometimes wished they had someone to talk to, but don’t. One quarter said they would rather have less time alone, led by 18- to 34-year-olds. Women under 35 expressed more feelings of loneliness than any other age group.

In a poll of 20,000 Americans last year, nearly half said they lack companionship or meaningful relationships. One in four Americans rarely or never feel as though there are people who really understand them. Six in 10 Britons recently told pollsters their pet is their closest companion.

Imagine a condition that makes a person irritable, depressed and self-centred, and is associated with a 26 per cent increase in the risk of premature mortality

“Nearly 30 million Americans live alone, many not out of preference,” said Christophe Lane, author of Shyness: How Normal Behavior Became a Sickness. In Canada, the proportion of the population living in one-person households has quadrupled over the past three generations in Canada to 28 per cent in 2016, from seven per cent in 1951.

Life expectancy is growing, fertility rates are falling and the population is aging. We’re marrying later and having fewer children, if any at all. Technology means we can do almost all we need to do from home without physically interacting with a single human soul, and a chronic lack of connectedness, of being on the social periphery, can be seriously harmful, even deadly.

Studies suggest loneliness is more detrimental to health than obesity, physical inactivity or polluted air. Chronic loneliness, and not the transient kind that comes with a significant life disruption, such as moving cities for work, or the death of a partner, has been linked with an increased risk of developing or dying from coronary artery disease, stroke, elevated blood pressure, dementia and depressed immunity.

A study published in May found lonely people have shorter telomeres, which are found at the end of chromosomes, like the tip of a shoelace. Telomeres get shorter every time a cell divides, and shorter telomeres are considered a sign of accelerated aging. Loneliness and isolation have been linked to mental health problems — depression and anxiety — even in other social species, like rats.

Loneliness has also been blamed for helping fuel the opioid crisis, political upheaval and lone shooters. Lonely people “turn to angry politics” when they have a void to fill, Arthur Brooks, president of the American Enterprise Institute, wrote in The New York Times. The man accused of killing 22 people at a popular Walmart store in El Paso, Texas, last weekend was an “extreme loner,” the Los Angeles Times reported.

Still, loneliness, in and of itself, isn’t a disease, but a feeling, a discrepancy, as the Cacioppos have described it, between our “preferred and actual social relationships.” Feeling alone isn’t the same as being alone. And being alone doesn’t mean feeling alone. People can feel lonely in a crowd, coupled or uncoupled.

“Loneliness is a conscious, cognitive feeling of estrangement or social separation; an emotional lack that concerns a person’s place in the world,” cultural historian Dr. Fay Bound Alberti wrote in the journal, Emotion Review.

Yet despite its prevalence, people don’t often talk about loneliness. “It’s the psychological equivalent to being a loser in life, or a weak person,” John Cacioppo, who spent decades studying loneliness before his sudden death last year, said in a 2013 TED Talk. Denying loneliness, he told his audience, is like denying we feel hunger or thirst.

The human brain is an incredibly social organ. So much of it is dedicated to creating and nurturing relationships, said neuroscientist and author Dean Burnett. “A great deal of our interactions aren’t for any particular purpose beyond the interaction itself, which cements and enriches social bonds.”

Think of gossip, or chatting, he said. It’s not really so much the actual exchange of information that’s important, Burnett said, but how long we spend gabbing. “We are an intensely social species, arguably the most social of all.”

Yet modern urban life leaves many people feeling adrift, left out, alone, said Dr. Allen Frances, one of the world’s foremost psychiatrists.

“Internet social networking helps some find a place of virtual belonging,” the emeritus professor of psychiatry at Duke University said. But online relationships provide only the shadow of real ones. “They can be a life raft for those who have nothing else,” he said. “But they can also be an anchor that drags people into even more isolation.”

In their book, Bored, Lonely, Angry, Stupid: Changing Feelings about Technology, from the Telegraph to Twitter, Susan Matt and Luke Fernandez argue that today’s modern technologies have raised hopes for constant sociability, while making us seriously paranoid about being lonely.

Matt and Fernandez read diaries, letters and memoirs of 19th and 20th century Americans when researching their book. They also interviewed living Americans, many in their home state of Utah.

“One thing we found in our research is that contemporary individuals living in this digital world feel more surprised that they’re lonely,” said Matt, a professor of history at Weber State University. “And, so, they worry about it more. And psychologists have made it more of a pathology than it was before.”

The emotion associated with feeling lonely has changed over time, and it doesn’t mean the same thing it meant to generations before us, she said. “It’s very clear from reading 19th century letters and journals that people felt lonely, or ‘lonesome,’ as they called it. And they didn’t like it, but they also weren’t surprised by it.”

An emblematic example is a Google Ngram, which lets users track how English words and phrases have appeared in published works. The word “solitude” was used much more in the 19th century and has been in steady decline since, Fernandez said. “Conversely, the world loneliness has been increasing.”

When 19th century people experienced aloneness, some clearly longed for social connections. “But often they followed up with the next sentence, ‘God will be with me,’ or ‘I’ll use this time to improve myself,” Matt said.

Put another way, people back then didn’t see the state of being alone as inherently bad or harmful.

The term “loner” only emerged in mid-20th century America. In the ’60s and ’70s, journal articles explored loneliness in the suburbs, as people moved from cities. Modern culture, with its more mobile population, can be a factor in the uptick in loneliness, Burnett said.

“The modern nature of work means it’s common to have to chase employment, for companies to pick up sticks and relocate, and people will invariably go where the opportunities are, because they need to, to survive,” he said, adding there are fewer communities of yesteryear, where everyone knows what their role is and who their neighbours are.

Again, Burnett adds, there are many ways in which this is a good thing. “The old communities were undoubtedly restrictive and stifling, especially for women and those lower down the hierarchy who wouldn’t have opportunities to achieve anything beyond suffocating gender roles and restrictions.”

As to why loneliness seems more of a thing lately, Burnett said part of it could come down to the modern belief that we have to be happy, all the time.

“The brain can’t sustain being constantly happy, it’s not good for us,” said Burnett, author of The Happy Brain: Where Happiness Comes From and Why. “But encouraging the belief that not being happy means something is wrong sets people up for impossible goals. So loneliness becomes the norm.”

Before the modern era, nobody was ever truly alone because the idea of God was there

It’s not clear which sex is lonelier. Men tend to have higher loneliness scores than women, cultural historian Bound Alberti said, arguably because women are encouraged to talk about their feelings.

But younger women reported more loneliness in the Angus Reid survey. Perhaps younger women are under the greatest pressure when it comes to societal expectations, Burnett said. Women are expected to look attractive, but not too attractive, “to be self-sufficient but submissive, have kids, but not too early or too late. Engaging with others is a big demand when you’re constantly worried about being judged.”

But linking such statistics to a loneliness “epidemic” is problematic, Bound Alberti said. “It’s not always clear whether we are talking about isolation or social circumstances, which can change — how many of these women are new mums, for instance,” she said.

We can expect to be lonely at some moments in our lives, especially transitional ones, and she wonders what different emotions and life experiences are being lumped under the broad idea of “loneliness.”

In Bound Alberti’s new book, A Biography of Loneliness: The History of An Emotion, she argues loneliness is a product of neoliberal individualism. Using a series of case studies, from social media to Queen Victoria to Sylvia Plath, she shows how emotions change over time.

“And while it’s true that people could have experienced discontent attached to the state of being alone,” she said, the nature of solitude has changed. “Before the modern era, nobody was ever truly alone because the idea of God was there.”

Individualism and nationalism took away the safety blanket that meant we automatically “belonged” to some sense of community, whether that was good or bad, adds Bound Alberti, co-founder of the Centre for the History of Emotions at Queen Mary University of London. “At its extreme, individualism states that we are not only disconnected from others, but in competition with them.”

The rise of populism can further pit people against others — blacks, Mexicans, immigrants — while at the same time creating a seeming sense of belonging. The “Make America great again” rallying campaign slogan “theoretically represents a common purpose — or a new ‘religion,’ given how evangelical Trump’s rallies can appear,” Bound Alberti said “But it’s based on exclusion, division and difference.”

Still, she and others say the word “epidemic” isn’t particularly helpful. It suggests the problem has a will of its own, that it’s somehow inevitable, that it’s a medical disorder and not a social ill stemming from major structural changes to our cultures, lifestyles and relationships.

But Fernandez and Matt don’t want to trivialize loneliness in any way. “Isolation is at best uncomfortable, and can be far worse,” Matt said.

There is simply no lever they can pull to feel more connected

Technologies have primed us to believe that we can have an endless number of friends and constant sociability, she said. “The idea is that, you can go to the web, and you’ll never be alone, even at night. On Twitter, Facebook or a dating app, there is supposed to always be someone there. Earlier generations knew there were times when you were just going to have to sit by yourself. You hoped to break that up with social events, but you didn’t expect a constant flood of people into your life.”

“Scrolling through other people’s feeds can also make people feel like they’re failures, inferior, excluded — lonely,” Burnett said.

Henry David Thoreau lived off the grid for two years in a cabin he built for himself, where he wrote some of the more celebrated texts in American political thought, Fernandez notes. But even Thoreau didn’t want only solitude (when he tired of being alone, he traipsed into Concord, Mass., and had dinner with confidant and friend Ralph Waldo Emerson).

For many people — single, working mothers, the elderly in nursing homes, the overworked, the broke  — “there is simply no lever they can pull to feel more connected,” psychologist Vicki Ohm-Lannerholm wrote on Mad in America. The poorest social groups report the highest levels of loneliness, and people with mental illnesses are the loneliest on the planet, adds Frances. Psychiatric patients are “terribly neglected in, and extruded by, our society.”

There’s no simple solution, and no pill that’s going to make the lonely less numb. But knowing that loneliness ebbs and flows, and that it can be shaped by the “loneliness industry” can help us develop a deeper understanding of the experience, Fernandez said. We need a better understanding of who is lonely, why and, Bound Alberti said, what community means in the 21st century.

Everyone agrees we need to provide more and better care to the elderly. In the English town of Burnham-on-Sea, “chat” benches are being installed in town parks to help combat loneliness. (“Sit here if you don’t mind someone stopping to say hello,” the signs read.) British GPs are “social prescribing” dance, cooking and art classes to the lonely.

Friendly benches are one thing. Drugs are another, and Lane asks whether it’s wise to try to use them to dial down the brain’s alarm system in the lonely.

He notes how Cacioppo has also researched the effects of giving the hormone oxytocin to those with chronic loneliness. But recent studies suggest the hormone intensifies “in-group” bonds, Lane said, heightening the ugly emotions of xenophobia, race prejudice and ethnocentrism.

“Pharmacologically speaking,” he said, “we don’t appear to get the benefits without added — and often unforeseen — costs.”

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