Alone among people - does loneliness make you sick?

Loneliness is a basic human experience and yet a major social challenge. Prof. Dr. Mazda Adli deals with the psychosocial implications of loneliness.

We need to talk... about loneliness in the urban jungle

Loneliness is a basic human experience and yet a major social challenge. The feeling of a lack of belonging and of being isolated from the social environment is something we encounter at least once or more frequently in our lives. Prof. Dr. Mazda Adli from the Fliedner Klinik in Berlin, Germany deals with the psychosocial implications of the feeling of loneliness and in his lecture "We need to talk... about loneliness" appeals for the removal of taboos on the subject in public discourse and in the healthcare system.

Translated and adapted from the original German version.

Not least because of the pandemic-related social isolation and the resulting psychological effects, medicine and politics have increasingly turned their attention to the problem of loneliness in recent years. Prof. Dr. Madza Adli, director of the Fliedner Klinik Berlin, is a psychiatrist and stress researcher and spoke with those affected, interested parties and experts about the topic.

What do we mean by loneliness?

Loneliness is a double-edged sword and should not be confused with the basic human need of being alone - "creative loneliness", according to Prof. Dr. Adli, the self-chosen and temporary separation in order to find the self. The burdening feeling of loneliness, caused by the lack of closeness and belonging to a social environment, is experienced by many sufferers as emotional pain.

According to Prof. Dr. Adli, loneliness is a sub-form of social stress and, in combination with social isolation, is one of the strongest stressors for mental disorders. Through the release of the stress hormone cortisol, the body reacts to social stress as it would to a pain stimulus - a stimulus that many sufferers refer to as soul pain.
"Being able to feel loneliness as something akin to pain has been set up by evolution as a biological alarm signal. It indicates to us as social beings that the social support we have has fallen below a critical threshold at which there may be survival disadvantages because we no longer participate in the cooperative system in a sufficient way", explains Prof. Dr. Adli. The feeling of loneliness is thus a biological deficiency signal and increases in intensity when the sense of belonging no longer corresponds to social inclusion.

Taboos and misconceptions

In public discourse, the idea remains steadfast that admitting to being lonely is embarrassing and therefore should not be addressed. Humans are social beings, Prof. Dr. Adli argues, and feel a loss of status and face when disclosing their loneliness, which is tantamount to a social failure of maximum magnitude. In this context, Prof. Dr. Adli quotes a Tuareg saying that says: "Loneliness is not sad if it is heeded" and emphasises that it is a matter of looking and paying attention to those affected so that loneliness is de-tabooed.

Contrary to the general assumption that loneliness predominantly affects older people, studies show that the peak age is around 30 years. However, the factors why we primarily experience loneliness differ by age group. While older people list reasons such as illness or the death of a life partner, for younger people it is the workload and the time-related lack of social relationships that trigger loneliness.

Loneliness is a big city phenomenon

According to Prof. Dr. Adli, it is - statistically speaking - predominantly big-city singles living alone who are most affected by loneliness. "Paradoxically, it takes other people around you to feel lonely. When you are one among many and you feel you don't belong, the feeling of loneliness arises", says Prof. Dr. Adli.

Currently, every fifth person in Germany lives alone. The German Federal Statistical Office expects a further increase by 2030, when it is estimated that almost a quarter of the total population will be living alone. In German cities with more than 500,000 inhabitants, 29% of people live alone. Berlin is the front-runner among the federal states with a population rate of 31%. About one third of Berlin's population lives in a single household.

According to Prof. Dr. Adli, counteracting systematic loneliness is a task for civil society and politics. Public mental health strategies are indispensable here. Public places are needed that have a "public health" mission. These are parks, cultural institutions and places of gathering where everyone is allowed to participate in social interaction and interpersonal exchange. Participation in public life is what keeps people mentally healthy and prevents loneliness.