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In May 2023, the U.S. Surgeon General—Dr. Vivek Murthy—issued a report that drew attention to an epidemic that affects 1 out of 2 American adults. Half of us are lonely.

Loneliness and social isolation, Dr. Murthy says, are urgent public health concerns, more widespread than smoking, diabetes or anxiety. It also turns out that loneliness poses severe risks to health and longevity.

Sharing his own expertise about the loneliness epidemic and what we can do about it, Dr. Daniel Knoepflmacher, Assistant Professor of Clinical Psychiatry, Director of the General Psychiatry Residency Program and Vice Chair of Education in Psychiatry at �鶹����, answers your FAQs and clarifies the major points raised in Dr. Murthy’s report.

What, exactly, is loneliness?

First, let’s define our terms: Social isolation is an objective condition, while loneliness is the emotional state that arises from it.

Loneliness can be a normal part of life, says Dr. Knoepflmacher. “It’s the distressing feelings we have when we have fewer social connections than we want and need. Being lonely is different from being alone, which might not be a bad thing. In fact, there may be times when we seek out solitude as an escape fromstress and business as usual.

“Loneliness and social isolation become detrimental when they persist for extended periods of time,” he continues. “We’re wired as human beings to connect with others. Our brains are designed for social connectedness. Our survival from birth into adulthood depends on it.”

What are the main causes of the loneliness epidemic?

We move more often than we did in the past.

Over the past several decades, people have been moving much more often. They leave their hometowns for college, relocate to new cities for work and move to a warmer climate for retirement. This trend can lead to separation from close family members, familiar communities and established networks of friends and neighbors.

We interact online instead of in person.

“We spend more time interacting with our screens and less time in face-to-face interactions with other human beings,” he says, including strangers. Buying clothes, ordering food and finding an answer to a question—these are examples of interactions that take place increasingly online.

Social media can connect us while at the same time decreasing live interactions.

Social media, despite having the word “social” in its name, has been a major contributor to the general decrease in live interactions and to a corresponding increase in feelings of loneliness, inadequacy and social anxiety, especially among teenagers.

The pandemic exacerbated the loneliness epidemic.

The COVID-19 pandemic exacerbated these trends—especially with its imposed isolation. We are still recovering from the impact of the pandemic on our lives at home, at work and in the community.

What are the consequences of loneliness for our physical and mental health? 

According to the Surgeon General’s report, social isolation increases the risk of premature death by 29 percent. It’s equivalent to the impact of smoking 15 cigarettes per day. Loneliness increases the risk of heart disease, stroke and dementia, as well as other serious medical conditions.

It’s also associated with lower academic performance and decreased productivity at work. And when it comes to older adults, social isolation accounts for an extra $6.7 billion in Medicare spending each year.

Can public health policy help to alleviate loneliness and social isolation?

Absolutely, Dr. Knoepflmacher says. “First, Dr. Murthy encourages his fellow physicians to take the problem seriously. That can spur more widespread adoption of socially focused medical care, where questions about social isolation and loneliness can become as routine as questions about smoking or diet.

“It’s also important to educate the public,” he adds. “People need to know that finding ways to address social isolation in their lives will not only reduce their feelings of loneliness but will significantly improve their health.”

The report, he hopes, will foster additional research into effective ways to reduce social isolation in our communities. As an example, he refers to his colleague, Dr. Joanne Sirey, who has studied interventions for addressing social isolation among older adults. Her research has led to effective programs that are now supported by the New York City Department for the Aging.

What else can communities do to bring people together?

Local policymakers can support the creation of spaces where people can come together to share experiences of art, music, the outdoors, history, sports, culture and religion—the things that make us human. “Technology is endlessly exciting,” he says, “but our society will become healthier overall if we can find ways for people to engage more often in the communal human experiences that existed long before the first computer chip was invented.”

When a patient shares with you that they’re lonely, how do you counsel them?

“If a patient tells me they’re lonely or struggling with social isolation, they’ve already won half the battle. Being aware of the problem and seeking help is the most important first step in addressing loneliness.”

Dr. Knoepflmacher goes on to explain that different types of psychotherapy target specific diagnoses, such as depression, anxiety, PTSD or borderline personality disorder. Loneliness arises in many mental health conditions, so it should be addressed routinely as part of the therapy.

“Typically,” he says, “I advise people to begin with their closest sources of support. People are often afraid to reach out for fear of being a burden, but more often than not they find that others are eager for the opportunity to be there for them.”

Another helpful option is to use already-existing resources in the community such as faith-based centers, libraries, affinity groups or volunteering.

And even technology can help foster new in-person relationships. “Meetup” groups, centered on shared interests, are a great example.

“I try to make sure that technology is used as a way to meet someone in person and not simply another instance of interacting with a screen. That said, connecting via Zoom or talking on the phone can be effective ways to combat social isolation.”

What else can individuals do to become more connected with others?

• Think about the people who are your closest connections. Choose someone to meet up with.
• Arrange to meet outside of your home whenever possible.
• Become active in one or more organizations you’re connected with, including those linked to work, shared interests or alumni associations.
• Remember that you’re not alone in feeling lonely—this is something that millions of people face. The key is to not accept it as a given.

“It’s also important to focus on helping others who are socially isolated,” Dr. Knoepflmacher advises. “They might not reach out to you, so if you’re concerned that they might be lonely, take the initiative to connect with them. See if you can get them to meet up with you at a local café or community center to share a cup of tea, talk, take a walk in the park or do whatever is most fun for the both of you. Think of it as a fun way to positively impact someone else’s health—in addition to your own!

Dr. Knoepflmacher is the host of the Department of Psychiatry’s offical podcast,  On the Mind, during which he engages in discussions with professors, researchers and expert practitioners at �鶹����.