So why do these technological and digital advancements matter so much? Aren’t we supposed to be celebrating, and feel even more connected; why then has loneliness become pervasive? The significance in letter writing, other non-digital connections and face to face interaction lies in the idea of being kept in mind; the intention and thoughtfulness behind the letter writing makes it profoundly special. So does the intention carve out time, leave everything behind, and visit someone.

What’s unique and particularly special is the effort to sit and write- putting one’s thoughts into written words, seal the letter in an envelope, stamp, and post it. Carving out time to visit someone or meet someone shows how much one cares and appreciates that person, in comparison to digital messaging from a distance. So how face to face interactions or letter writing any different to the instant text messaging, or interacting via Facebook, Instagram, or other digital interactions. These different channels of engaging are not the same, and they can never be the same.

Real connections are not digital. Digital connections can never replace real human connections in real time. 

Real connections and digital connections

We experienced a paradigm shift in the past few years; we now live in a digital era, pivoted by the Covid 19 pandemic, which propelled us into the digital world. There is no way back from the digital world, we must embrace what the use of technology brings- the good and the bad. We cannot however ignore the fact that despite these advancements, loneliness remains a societal issue that needs attention. While the digital world has enhanced our ability to connect en mase, it has also deduced the true and rich human connection we make through face-to-face interactions, or other non-digital contact, such as letters and face to face interactions.

What is loneliness?

Loneliness is a complex and distressing emotional state that arises when a person feels emotionally disconnected, or isolated from others. The irony is that one can have many people around them but still feels emotionally disconnected from them. Loneliness is a subjective feeling and an internal experience of being alone, even when surrounded by other people.

Loneliness can be characterized by feelings of sadness, emptiness, and a lack of social connection or meaningful relationships-hallmarks of depression and anxiety. Loneliness is not solely determined by the number of social interactions a person has, but rather the quality and depth of those interactions. In the case of people who have thousands and millions of followers of social media, it does not translate to them not feeling lonely, or having deeper connections.

Loneliness has a negative impact on mental, physical health, and ones self esteem as well as overall sense of self. Chronic loneliness can lead to increased risk of depression, anxiety, and other health problems. The risk is even higher when one feels lonely while going through challenging life situations.

The difference between loneliness and being alone

In his work with children, Psychiatrist and Psychanalyst Donald Winnicott (1958) exposited the difference of being alone and loneliness. He emphasised on the healthy state developed in the capacity to be alone, in which he indicated to be a sign of emotional maturity. I see this as expanding one’s window of tolerance, where one can subjectively bear a range of emotions without relying on external world for distraction, or to gain reassurance.

Being alone means one feels content in their own presence, without the need for stimulation or distraction from the external world, for example in having may friends in the digital world and not having any close relationships and connections. This means there are many people who are not alone, and surrounded by people, but feel very lonely- not alone externally, but feel very lonely internally. Having many digital friends can become a defence against feeling lonely, however it does not mitigate the internal loneliness. On the other hand, one cannot have any digital friends, and have a few friends who they have deep connections and meaningful relationships with.

As highlighted above, loneliness refers to a state of feeling emotionally disconnected or isolated from others, even when surrounded by people. It is a subjective feeling of being alone, regardless of physical proximity to others. Loneliness can be a result of lacking meaningful relationships, social support, or a sense of belonging. This can be a real issue if one is othered due to their gender, sexuality, race, class and other social factors. It can also be very present when one emigrates to a new country or moves to a new place where they are a minority and don’t feel that they belong.

On the other hand, being alone simply means being in a state of solitude or not being in the presence of others. Being alone can be a choice or preference, and it does not necessarily imply feelings of loneliness. Many people enjoy spending time alone and find it rejuvenating or peaceful, while others feel lonely due to lack of connections.

In short, loneliness is an emotional state characterized by a sense of isolation and disconnection, while being alone refers to the physical and state of not being with others. One can feel lonely even when surrounded by people, and conversely, one can be alone but not feel lonely.

Loneliness: A silent pandemic 

In my role as a therapist, one of the key complaints l hear in my practice is people who are experiencing profound loneliness, which often develops into depression and anxiety, or perpetuates it. The Office of National Statistics (ONS) reports that one in six adults suffer from moderate to severe depression; these numbers have risen since the pandemic which isolated many people from their loved ones and support networks due to the lockdowns.

Although we are out of the pandemic, we are still haunted by the effects of it which lingers today-poor mental health is one of them. Psychiatrists, GPs, and other prescribers are not keen on enquiring about the social context behind anxiety and depression, yet loneliness is often a big factor in anxiety and depression presentations. Their focus is on symptomology-a medical approach based on assessing whether one meets the diagnostic criteria for depression or anxiety, which often co-exist. If one does, they will be prescribed antidepressants or anti anxiety medication. The NHS England reports that in England alone, a staggering 8.6 million people was prescribed antidepressants between 2022-23.

Taking a psychosocial approach to depression and anxiety, a key precipitant of depression and anxiety is loneliness and stress. Stress is often exacerbated by poor or lack of support. Loneliness happens when one lives a life where there is no emotional connection with others- a combination of stress and loneliness is a catalyst for anxiety and depression.

From my experience as a therapist, loneliness affects everyone; however, it is appears to be more prevalent in people who are not in relationships (single/divorced/widowed), older adults, introverts, people who live away from their primary home, and notoriously so in people who have extremely busy lives that seem to be full lives, but not making time for themselves or others. The later are likely to have many friends, yet they feel lonely. Some people in this category have thousands (even millions) of followers and friends on social media, yet they feel lonely. So why this contradiction? Digital connections are not real connections, the digital world is an illusory realm where relationships s are defined by liking each other’s pictures and statuses, not really knowing each other deeply.

Loneliness is behind the surge in alcoholism, and problematic narcotic use. People who feel lonely are more likely to develop alcohol dependency or habitual substance misuse as a way of coping with loneliness. From an attachment perspective, (Bowlby, 1969) this could be viewed as one having a disorganised/insecure attachment with something they can control, to compensate for the healthy/secure attachment they could have with humans. If one is able to develop a secure attachment with others, and not feel lonely, they are likely not to rely on alcohol or illicit substances.

Alcohol does lead to poor mental health, and can worsen symptoms of anxiety and depression as well as cause insomnia. Poor physical health related to alcohol includes the more severe related alcohol related diseases such as liver cirrhosis or Korsakoff Syndrome (dementia). Alcohol and drug misuse is also linked to higher incidences of domestic violence, risk behaviuors such as drink driving, and suicide.

Benefits of digital platforms

While the online and digital interactions have their disadvantages which feeds into loneliness, they also have some positives. Online connections can be beneficial in widening the reach of people in different parts of the world, and easy interactions through the platform instead of letters, emails, phone calls or face to face. This can be of huge significance to people who may have emigrated to parts of the world where they are disconnected from friends or getting people of a common purpose together for example University or class alumnis.

The online platforms can also enhance one's self-esteem, especially for people who experience social anxiety, and find face-to-face interactions challenging. The distance in online platform can allow some people to express themselves more fully, something they may not be able to do in the real world.

Humans as social beings

We are social beings at the core, and bonding in real time is key. We seek social connections and thrive by being in the company of others. Human contact releases oxytocin, an anti-stress and "love" hormone- that’s why we are drawn to smiling at a stranger across the room, or hugging our friends when we meet. We have an innate desire for connection through touch and social interaction.

Solitude goes against our human nature. That’s why the NICE guidelines for depression emphasises on behavioural activation, which is fundamentally engaging in positive social activities, that enhances one’s mood and activates emotional states. Isolation and lack of social stimulation is viewed as contributing factors to depression and anxiety. Social interactions and engaging in social activities releases dopamine which is a "feel good" hormone, essential for our physical and mental health.

Our ancestors thrived by living in communities and connections was a therapeutic part of their survival as groups of people who didn’t have sophisticated mental and physical health care systems. They took care of each other and made sure if one is sick, they go back into the cave and get looked after by the elders who told them stories and nursed them to health. However, the world we live in right is very individualistic -each man for himself, and God for us all. This is harmful and a big source of loneliness as individualism leads to people believing that they cannot rely on others but themselves. We have been socially conditioned to believe that asking for help is a sign of weakness; hence why many people feel even lonelier and experience stress through dealing with challenging situations alone.

Factors behind loneliness in the 21st Century

Technology and social media

While technology has made it easier to connect with others, it has also led to increased feelings of loneliness. Many people spend excessive amounts of time on social media, which can create a sense of isolation as they compare their lives to others and feel left out.

Changing social structures

The traditional family structure has evolved, with more people living alone or away from their families. This can lead to increased feelings of isolation and loneliness, especially for older adults who may have limited social connections.

Urbanization and mobility

With the rise of urbanization and increased mobility, people often move away from their hometowns and leave behind established social networks. It can be challenging to build new relationships in unfamiliar environments, leading to feelings of loneliness.

Busy and demanding lifestyles

Modern life is often fast-paced and demanding, leaving little time for socializing and building meaningful connections. Work pressures, long commutes, and constant busyness can contribute to a lack of social interaction, leading to loneliness.

Mental health issues

Loneliness can also be a symptom or result of underlying mental health issues such as depression, anxiety, or social anxiety disorder. These conditions can make it difficult for individuals to engage in social activities and form connections.

Ageing population

As the population ages, older adults may face increased loneliness due to factors such as retirement, loss of friends or loved ones, and limited mobility. Age-related health issues can also contribute to social isolation.

How to cope with loneliness 

It is important to note that loneliness is a complex issue with multiple causes, and the specific reasons may vary from person to person. Addressing loneliness requires a multi-faceted approach that includes improving social connections, fostering community, and promoting mental well-being.

1. Build and maintain strong relationships. Invest time and effort in building and nurturing close relationships with family, friends, and loved ones. Regularly communicate and spend quality time with them.
2. Join social groups or clubs. Participate in activities or join clubs that align with your values, interests or hobbies. This can help you meet like-minded individuals and create new friendships and connections.
3. Volunteer or get involved in your community. Engaging in community service or volunteering not only gives you a sense of purpose but also presents opportunities to meet new people and make connections. Try new things- explore local charities, organisations and clubs.
4. Adopt a pet. Having a pet can provide companionship and alleviate feelings of loneliness. Pets can offer unconditional love and be a source of comfort and support. Pets can also give us a sense of purpose- being able to look after and nurture a an animal can be rewarding and help create meaning.
5. Engage in hobbies or activities you enjoy. Pursue activities that you genuinely enjoy, such as painting, playing an instrument, gardening, or reading. This not only helps you spend quality time but may also connect you with others who share similar interests.
6. Stay active and exercise regularly. Regular physical activity can boost your mood and overall well-being. Consider joining a gym, taking fitness classes, or participating in sports activities, where you can interact with others and potentially make new friends.
7. Practice self-care. Take care of your physical and mental well-being by practicing self-care activities. This can include getting enough sleep, eating a balanced diet, practicing relaxation techniques, and engaging in activities that promote self-reflection and personal growth.
8. Use technology minimally to connect and make time for face-to-face interactions. Utilize social media platforms, online communities, and video calling apps to stay connected with friends and family, especially if distance is a barrier. Make time to meet friends and families face to face instead of relying on social medial or text messages.
9. Embrace solitude. Expand your window of tolerance and capacity to be alone: While it's important to avoid chronic loneliness, it's equally important to learn how to be comfortable with solitude. Without doing so, we might end up in the wrong company to avoid being alone. Engage in activities that you enjoy alone, such as reading, taking nature walks, or practicing mindfulness, can help you appreciate and enjoy your own company.
10. Seek professional help if needed. If you are struggling with chronic loneliness, suffer from social anxiety or feel isolated, seek support from an accredited therapist. Therapists can provide guidance and strategies to cope with loneliness, improve social connections and address any underlying reasons why one may be feeling lonely in the company of others.

References

Bowlby, J. (1969) Attachment and Loss: Volume 1. Basic Books. New York,

Winnicott, D.W. (1958) The Capacity to be alone. International Journal of Psychoanalysis, 39: 416-420