Dr. John Day, Cardiologist

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How to End Loneliness with These 7 Strategies

Would you believe me if I told you that loneliness and social isolation was more dangerous to your health than smoking or even being an alcoholic?    How about twice as dangerous as being obese?

Do you ever feel alone in a room full of people you don’t know?  I know I often feel this way.

Over the last 20 years the number of people in America who said they have no one to talk to has tripled!  Is it the internet, our cell phones, or all of the demands that are placed on us that are causing us to feel more lonely and become more socially isolated?

Social Isolation

Why are we becoming more socially isolated?  Facebook was supposed to keep us in touch with friends and family, right?

This is something I see everyday in my cardiology practice.  Increasing job stress, family responsibilities, and our cell phones are making our lives more unmanageable.  The very technology that was supposed to make it easier for us to connect with others is paradoxically making us more socially isolated.

While I am fortunate to have a very close family, I must admit that with the many demands that I face it is hard for me to invest enough time in developing close friendships.  Do you have the same challenges?  Is this putting our health at risk?

Why Do Asians Live Longer?

According to the World Health Organization, 3 of the top 4 countries with the longest lifespan are all in Asia (Japan, Singapore, and Hong Kong).  What is it that allows Asians to live so much longer than the U.S. and the rest of the world?

Since my immersion in the Asian culture at the age of 19 as part of my volunteer church service within the New York City Chinese immigrant community, I have been fascinated with the very close social support system of Chinese families.

Multiple generations all live under the same roof.  Each generation contributes to the other generations in the home.  Everyone is needed and everyone has an important role to play.  No one is isolated and no one is put “out to pasture.”  This cultural approach is completely opposite our very independent spirit in the U.S.

We saw this same social support system in China’s Longevity Village.  In fact, a study of China’s centenarians in Bama, County where the Longevity Village is located, showed that 74% of the centenarians lived under the same roof with 4 or 5 generations!

Could this close family support system be the secret to their longevity?  Or is it the fact that very few people live alone in Asia?

Friends and Family Are the #1 Longevity Factor

In one of the biggest studies ever done to explore the role of friends and family on longevity, Dr. Julianne Holt-Lunstad from Brigham Young University (BYU), published a study of 308,849 people.  In this study she found that of all the common longevity factors, such as exercise, maintaining a healthy weight, or not smoking, that being socially connected was the most important.  Indeed, her study showed that people who were socially connected lived 50% longer!

With regards to mortality, here are the key findings of this study:

1. Social isolation is more dangerous than smoking 15 cigarettes a day

2. Social isolation is more dangerous than becoming an alcoholic

3. Social isolation is twice as dangerous as obesity

As a cardiologist, these data surprised me.  Is loneliness really more dangerous than smoking? In my cardiology training at Stanford University, I was taught that heart disease and longevity had more to do with diet, lifestyle, smoking status, and genetics than not having enough friends and close family members.

If these data are really true, why is it that so little is mentioned about the important role of friends and family members on the American Heart Association’s website?  I had to find out more…

A Behind the Scene Look at the Loneliness and Longevity Study

To get a better understanding of the implications of this study, I was able to catch up this week with the lead researcher, BYU’s Dr. Julianne Holt-Lunstad, who is currently living in the Netherlands on a sabbatical research assignment.

I asked Julianne how she even became interested in this subject.  She shared with me that she has been interested in the role of friendships and family relationships to cardiovascular health and longevity for the last 10-15 years.  She told me that she always knew there was a link but even she was surprised that relationships have twice the impact on longevity as obesity and even carry more weight than smoking 15 cigarettes a day or being an alcoholic.

Her study involved pooling all of the data from 148 previous studies on the subject to draw an even stronger statistical correlation.  To help explain the results of this study, she has published additional research showing that relationships can influence our blood pressure, heart rate, and stress levels.

While having strong relationships can certainly help us to eat better, exercise more, or even go to the doctor’s office regularly, Julianne shared with me that these factors were not even included in the results of her study.  In other words, the longevity benefits of relationships go beyond just trying to live healthier to be around longer for your family and friends.

Is it Social Isolation or Perceived Loneliness that Increases Risk?

As part of my conversation with Julianne we touched on the topic of whether it is actually loneliness or just perceived loneliness that impacts our lifespan.  This topic lead nicely into her most recent research which you may have seen in the news recently.

Once again, this was another large meta-analysis study which included 70 independent studies of 3,407,134 people followed for an average of 7 years.  Here are the key findings of Julianne’s even larger study:

1. People who reported feeling lonely were 26% more likely to die

2. Socially isolated people had a 29% increased mortality

3. People who live alone were were 32% more likely to die

As you can see from this data that both living alone and the subjective feeling of loneliness were both powerful risk factors for an early death in this study.  Julianne shared with me that when both were present this was a particularly dangerous sign.

At our very core, we are programmed to be socially connected.  When we live disconnected lives it impacts our hearts and our health.  Our very survival depends on our ability to meaningfully connect with others.

How to End Loneliness with These 7 Strategies

Based on our work in China’s Longevity Village and from landmark studies, like Dr. Julianne Holt-Lunstad’s work discussed in this article, I now encourage my cardiac patients to spend more time with friends and family.  The healing that comes from close relationships likely offers more long-term benefits than any medications or procedures I can offer.

Social isolation and perceived loneliness, can both be difficult to overcome.  As I am, by nature, an introvert I have had these same struggles as well.  Let me share with you 7 strategies that I have found helpful.

1. Reach Out to Others

I realize that when you feel lonely the natural tendency is to expect others to reach out to you.  The important thing to remember is that studies show that 90% of people report feeling shy or lonely as well.

In reality they are hoping that you will reach out to them as they are feeling the same way.  Break the ice and be the one who reaches out first.  Be the person to talk to the person sitting next to you at the school function, church meeting, or the sporting event.

2. Focus on the Needs and Feelings of Others

Sometimes when people are feeling lonely they have too much bottled up inside of them. When they then do get the chance to talk with others they dominate the conversation.

My grandmother was this way at the end of her life when she was more socially isolated.  When I regularly reached out to her it was hard for me to share my feelings as she needed to talk.  I knew she was lonely and would let her talk. This is something that I often see with my lonely patients as well.

If we are feeling lonely inside it is critical to remember to also be interested in the needs and feelings of others when we have opportunities to connect.  If you want to end loneliness then others need to feel that you really care about them.  Give others the chance to share their feelings.

If they feel you care they will love you back.

3. Reconnect with Old Friends

It is always easier to reconnect with an old friend than to find a new friend.  With the powers of the internet, nearly every old friend can be found.

As I have reached out to old high school friends, medical school classmates, and extended family members, I am always amazed at how excited they are to be reconnected. Life is too short to live without our old friends!

I challenge you to connect with one old friend this week.

4. Volunteer

Unfortunately, only 27% of Americans take advantage of all the health benefits that come with volunteering.  Volunteers, by definition, are more socially connected in ways that really matter.  Perhaps this is why studies show that volunteers are happier, healthier, and even live 22% longer!

I have found that my volunteer opportunities keep me connected to people I would never have connected with otherwise.  Volunteering can take on many different forms.  It could be at your church or even your local hospital or elementary school.  There is so much you can contribute!

5. Get a Dog

Many studies have shown that having a pet, especially a dog or a cat, can help to prevent heart disease and increase your lifespan.  While there are many possible explanations for these benefits, one of the most important, and least understood, is the benefit of companionship that comes with an animal.

Perhaps this is why the American Heart Association recently published a position statement recommending pets, especially dogs as the data are strongest with dogs, as a way to prevent heart disease.

Believe or not, dogs will actually help you to connect with more people.  Everyone loves a friendly dog.  Dog owners also tend to congregate at parks and schools where dogs can be exercised.

6. Find People Like You

While the internet, Facebook, and Twitter can paradoxically make us feel more alone, these technologies do have the capability of helping us to identify more people like ourselves.  With a simple search you can instantly find thousands of people just like you.

Once you identify these people look for opportunities to meet in person.  If you are that person who loves to quilt or scrapbook you may be amazed to find that there just may be a group meeting in your neighborhood!

7. Don’t Forget Your Family

Of all the strategies listed, this is probably the most important. Our families are key to our happiness and our health.  This is something that they understand in Asia and many other areas of the world.

While we don’t have to live as multigenerational families under the same roof, we do need to stay in touch with our family.  I realize that sometimes it can be hard with our busy lives but from a larger perspective our lives really do depend on it!

What have you found that works to prevent feeling lonely?