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What a cardiologist wants you to know about loneliness

Jonathan Fisher, MD
Conditions
November 12, 2019
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What is the unspoken fatal epidemic of our time? And the greatest predictor of overall health, happiness, job satisfaction, and resiliency? Loneliness.

As a clinical cardiologist, I am committed to the health and well-being of my patients.

As a recovering burned-out physician who suffered in silence for years while hiding this so well from others, I am committed to finding solutions to help my partners suffering so often in silence.

As a husband, father, and friend, I am committed to creating larger and larger cultures of connection that support us all to live our best lives and help the greater good.

Growing epidemic

According to a Cigna survey of 20,000 U.S. adults in 2018:

  • half of us routinely feel alone
  • half of us do not have one meaningful daily social interaction
  • one in four feels no one understands us
  • one in five feels there is no one we can talk to

Loneliness in our society has steadily increased over the last 50 years. And for a multitude of reasons, Generation Z (ages 18-22) is the loneliest generation. We haven’t begun to see the real societal consequences of this fact.

Causes

The sources of social isolation are countless and include personal habits of mind and fear-based thinking, decreased participation in a community group and organized religion, political polarization, a widespread breakdown social trust, and a loss of emphasis as a culture on the virtue of civility — in our workplaces, public places and homes. We escape from our loneliness by soothing the pain of disconnection in so many ways: our devices, our self-perpetuated emotions (fear, anger, rage, frustration, resentment), and our addictions. And these just add to the shame.

Shame

The word shame derives from the Proto-Indo-European root “skem,” meaning “to cover,” as in “to hide one’s feelings or actions from the view of others.

Unlike other sources of suffering, psychological and social suffering carries with it an inherent stigma. We are afraid of being judged for being “broken” or “weak.” So we keep silent. And we suffer in silence. And the cycle continues.

But so what? It’s just a feeling of loneliness, right?

Impact on behavior

Social isolation has far-reaching consequences on the mind, body, and behavior. A 2015 meta-analysis found isolation to be a stronger predictor of cardiovascular risk than smoking or obesity.

As providers and leaders of health care, are we to become attuned to the fact the loneliness among our patients and our colleagues profoundly impacts health-related behaviors: inactivity, quality, and duration of sleep, dietary choices, tobacco use, sexual health behaviors and adherence to treatment.

And we are all aware of how feelings of isolation — wedded to a feeling of helplessness — are core elements in the epidemic of burnout affecting roughly one-half of all U.S. health care providers.

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Impact on health

Compelling data on the crisis of social isolation and loneliness is reported: A 2017 overview of 40 systematic reviews on the public health consequences of social isolation and loneliness.

Bottom line: Loneliness impacts our overall health, well-being, longevity, cardiovascular disease outcomes, early death, depression, anxiety, cancer outcomes, suicide, and dementia.

Call to action

If we wish to live up to our mission as the vanguard of care, we as a health care system — from the C-suite to every last employee — must commit to screening and support for all of our patients and all of our providers and team members.

A real culture of connection leaves no one behind. A real culture of connection respects and celebrates the diversity of each of its members. A real culture of connection works to operationalize empathy which, with the right intention and tools, can be done.

We must shine a light on the epidemic of disconnection affecting us all in some way, and work together to find lasting solutions to create a feeling of inclusion for all inside and outside our health care system’s walls.

As humans, we are wired for connection.

We cannot survive and thrive without it.

What’s your solution? What will you do differently this week? At work? At home? Many resources and solutions are available online.

Once we begin to seek and share our solutions to the crisis of social isolation and loneliness, we are no longer alone.

Jonathan Fisher is a cardiologist.

Image credit: Shutterstock.com

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