Call To Mind: Seeking Connection

For people of all ages, social connections are critical to health and wellbeing. Experts say we are inherently social creatures — hardwired to engage and depend on others for support throughout our lives.

Doctors and health researchers have signaled concerns about loneliness for decades, and forced isolation during the COVID-19 pandemic introduced many more people to daily struggles with loneliness. 

How important are social connections? How does loneliness impact a person’s mental and physical health? And are people looking for social connections in the right places?  

MPR News shares “Seeking Connection,” a special broadcast from Call to Mind, American Public Media’s initiative to foster conversations about mental health. The special explores the relationship between loneliness, mental health and the power of social connections.    

Three experts on isolation and social connections join Call to Mind host Kimberly Adams: Dr. Elias Aboujaoude, Dr. Julianne Holt-Lunstad, and professor Carla Perissinotto.

Here are some key moments from the conversation. The broadcast special includes the experts’ complete input on the matter, the latest data on loneliness in the U.S. and reporting from different parts of the country telling the stories of adults who have struggled with loneliness and have found ways to overcome it. 

The following transcript has been edited for length and clarity.

Click the audio player above to listen to the full program or get more information about the program on Call To Mind’s official website.

What kinds of health conditions can be affected by loneliness?

Dr. Julianne Holt-Lunstad: We have very good evidence loneliness impacts a variety of physical health conditions, including both short-term and long-term health effects. This is independent of age or any kind of lifestyle factor. The feeling of loneliness, or even just being isolated, can be thought of as a state of threat because, throughout human history, humans have needed to rely on others for survival. When this state of activation is heightened for long periods of time, the biological process of inflammation in our bodies can occur. Chronically elevated inflammation has been linked to depression, dementia, cardiovascular disease, cancer and diabetes. Global data indicates that loneliness is associated with a 26 percent increased risk for earlier death, and isolation a 29 percent increased risk for earlier death.

Why is finding quality relationships so important for people dealing with loneliness?

Holt-Lunstad: Relationship quality matters and not all relationships are entirely positive. As we strive to address this issue of isolation and loneliness, it may be tempting to just simply increase social contact, without any kind of attention to the type of contact. If we fail to take into account quality, we may have unintended consequences such as conflict or straining relationships. We all need social connection and we can start to look at various quantifiable aspects that measure the quality of our social connections: the number of relationships in our social network, the interaction frequency and the types of interaction.

How healthy are online relationships and interactions, especially for somebody who is lonely?

Dr. Elias Aboujaoude: They can be very healthy. We prescribe online dating for folks who have social anxiety disorder and who really struggle with initiating contact with people. The challenge is when these relationships stay online and end up not providing the support that the person needs in real life. There is an aspect to online connections of all kinds, an aspect that's really easy come, easy go. During COVID-19, we have come to appreciate what a double-edged sword that the whole virtual realm has become. On the one hand, it made life possible during a pandemic. On the other hand, we have grown much more conscious of how lonely you can be in that world, even when you have 400 friends on Instagram and 600 followers on Twitter. 

What's your advice for people who use the internet or social media to meet people?

Aboujaoude: In order to keep those relationships and connections healthy they should look to transpose the relationship offline rather quickly, or at least incorporate an offline component to the relationship if that's a possibility. They should also look for possible red flags in their social connections, for example, when the bulk of their social relationships are now social media relationships, but they hardly connect with anyone offline. That's a sign to me that maybe the person needs to recalibrate. Maybe the person needs to find more equilibrium in their social lives than they currently have.

Who is at the highest risk of loneliness?

Carla Perissinotto: For the longest time, we saw that older adults have a higher risk. When we get older, our physiologic reserve, which means our ability to bounce back from an illness when something happens to us, is just smaller. We're not as resilient in that sense. But what we're finding now is actually younger generations and children are at very high risk. I would love to blame social media and technology for everything, but I don't think that's the full picture. There are other things that predict risk like coming from a traditionally marginalized group. That's going to increase your risk of loneliness, because of feelings of belonging. 

Is the American health care system set up for older people to age well and stay socially connected?

Perissinotto: Even though we are not prepared, we can be, but it takes making that commitment and changing how we define health. In the last five years, we've seen a turn of the tide, we've seen this turn in social determinants of health, which is everything that we've ignored for decades and healthcare suddenly starts coming into medical encounters. Julianne Holt-Lunstad and I just published an article in the New England Journal of Medicine, talking about a framework to help clinicians assess loneliness and isolation in healthcare settings. We proposed a very simple framework called EAR: the E is for educate, the A is for assess and the R is for respond.

• Listen to the full “Seeking Connections” special, explore the relationship between loneliness and mental health and witness the power of social connections for people of all ages.

• To find mental health resources or to listen to Call to Mind’s past programs visit the official website CallToMindNow.org 

• Follow Call to Mind’s social media accounts: Twitter, Facebook and Instagram.