People around the world have taken unprecedented safety measures during the COVID-19 pandemic. Physical distancing is critical for slowing the spread of infectious diseases, but experts suggest solitude carries its own health cost: Social isolation can affect mental health.
Currently, COVID-19 physical distancing spotlights the negative effects of social isolation on mental health, but isolation and the loneliness that can result were a widespread problem even before the pandemic. A Pew Research Center survey conducted in 2018 found that 1 in 10 Americans feel lonely or isolated all or most of the time.
Social isolation is not necessarily bad; most people crave solitude at least occasionally. Being alone can be relaxing, meditative, and rejuvenating. Social isolation typically refers to solitude that is unwanted and unhealthy.
Socially isolated people may lack friends or close coworkers, and they often feel lonely or depressed. They can suffer from low self-esteem or anxiety. The following symptoms associated with social isolation are warning signs of unhealthy social isolation:
- Avoiding social interactions, including those that were once enjoyable
- Canceling plans frequently and feeling relief when plans are canceled
- Experiencing anxiety or panic when thinking about social interactions
- Feeling distress during periods of solitude
- Feeling dread associated with social activities
- Spending large amounts of time alone or with extremely limited contact with others
Social isolation can involve emotional isolation, which is an unwillingness or inability to share one’s feelings with others. When socially isolated individuals lack emotional interaction and support, they can become emotionally numb — detached from their own feelings.
When experts study isolation’s causes and impacts, they distinguish between social isolation and loneliness.
Social isolation is an objective lack of social relationships or infrequency of social contact. Loneliness is a subjective feeling of isolation. A person can be socially isolated but not feel lonely. A person can also feel lonely when they are surrounded by people.
Nonetheless, isolation and loneliness are very much linked. Studies of loneliness’s causes, symptoms, and impacts shed light on the potential negative effects of social isolation.
Many circumstances can cause people to be isolated from others or to choose self-isolation:
- Intimate partner violence. People in abusive relationships sometimes avoid contact with family, friends, or coworkers because of an unwillingness to reveal their true situation.
- Loss of loved ones. Isolating after the loss of friends or family members can be common, especially among seniors who have lost many loved ones in their age group.
- Mental health issues. Issues such as anxiety, depression, and low self-esteem often result from social isolation, but they can also cause it.
- Remote location. Individuals who live in remote areas or who are geographically separated from family and friends due to job duties (military service, for example) can experience feelings of isolation.
- Physical impairments. Physical challenges that limit mobility can reduce an individual’s ability to interact socially. Some people with physical disabilities feel ashamed of their disability or appearance, which can make them reluctant to interact socially. Hearing and vision impairments can also create a sense of isolation.
- Social media. Communication via social media helps some people stay connected to others, but it can lead to isolation if it becomes a substitute for meaningful conversations and in-person socialization.
- Unemployment. Shame associated with losing a job or being unable to secure new employment can lead individuals to self-isolate.
Social isolation can also result from physical distancing measures such as those necessitated by the COVID-19 pandemic.
Physical distancing involves avoiding close or frequent interaction with the aim of limiting the spread of infectious diseases. COVID-19 precautions have included quarantining. This is the practice of separating someone who is thought to have been exposed to disease, limiting their movement, and monitoring their health. Quarantining works to help keep an infectious disease from spreading. Potentially exposed people, even those not experiencing symptoms, can be identified, isolated, and, if called for, treated.
Physical distancing guidelines mandated by government officials during the COVID-19 pandemic have shut down or curtailed attendance at venues where people gather, including schools, churches, restaurants and bars, movie theaters, and sporting events.
Physical distancing measures have also caused a profound shift in workplace interactions. Many businesses adopted work-from-home policies, while others were forced to close due to the effects of reduced consumer activity. A study conducted by a Stanford University researcher found that 42 percent of the U.S. labor force was working from home full time during the COVID-related economic shutdown, while 33 percent were not working at all.
With activities related to work, school, church, and leisure reduced or eliminated, opportunities for regular, in-person interactions are typically limited to home environments. COVID-19’s sudden, severe reduction in social interaction has resulted in many people feeling lonely.
Mental and physical health are interconnected. Social isolation’s adverse health consequences range from sleeplessness to reduced immune function. Loneliness is associated with higher anxiety, depression, and suicide rates. Isolation and loneliness are also linked to poor cardiovascular health and cognitive function:
- A study led by an epidemiologist at Newcastle University concluded that deficiencies in social relationships are associated with a higher risk for coronary heart disease and stroke.
- A study published in The Journals of Gerontology concluded that loneliness was associated with a 40 percent increase in the risk of dementia.
Links between social isolation and serious medical conditions are not fully understood, but ample evidence supports the connection. A study published in the American Journal of Epidemiology linked social isolation with higher risks of premature mortality. The Centers for Disease Control and Prevention (CDC) points to loneliness and isolation as serious public health risks.
Some effects of social isolation are specific to pandemics or other public health situations that require people to physically distance. Loneliness and depression can go hand in hand with anxiety and fear about the dangers associated with the event that made physical distancing measures necessary.
Plus, people sometimes experience anger and resentment about health and safety measures they find unnecessary or too restrictive. Even people who are supportive of safety-related isolation and quarantine can experience frustration and irritability.
Some groups face challenges that increase their risk for isolation and loneliness:
- Immigrants. Language barriers, cultural and economic challenges, and limited social ties can contribute to social isolation for immigrants.
- Marginalized groups. LGBTQIA people, people of color, and others who routinely face discrimination and stigma can feel socially isolated.
- Older adults. Older people often live alone. Hearing or vision loss can contribute to their social isolation.
Strategies for addressing social isolation’s negative impacts vary depending on the severity of the related symptoms and effects.
It is important for individuals dealing with social isolation to have self-care strategies. This is particularly true when the factors contributing to isolation present real barriers to accessing outside resources.
For example, a disease outbreak can limit in-person access to health care. People who live in remote areas may not have easy in-person access to mental health professionals.
Individuals can lessen isolation’s negative effects by taking steps to address the challenges isolation presents:
- Engage in relaxing activities. Exercise and stretching, reading, listening to music, meditation and prayer, journaling, and hobbies can help relieve stress that can be associated with isolation.
- Follow a routine. Daily routines promote a sense of purpose and normalcy.
- Maintain healthy habits. Eating well, getting enough sleep, and engaging in physical activity can promote better mental health.
- Stay connected. If conditions limit in-person contact, phone calls, email, texting, social media platforms, and videoconferencing can be used to stay in touch.
- Stay informed. Keeping in the loop can be particularly important for those isolated due to a dangerous threat, such as a disease outbreak. Learning the facts about their risk can help people avoid feeling panicky. That said, controlling media consumption is also helpful –– too much exposure to negative news can feed anxiety.
Some people affected by COVID-19 lockdown measures find they are afraid to leave isolation. Anxiety or dread as a response to returning to work, school, or other outside activities can stem from a fear of infection. Fears can also be triggered by the change itself. Leaving the relatively secure and stable environment of one’s home introduces uncertainties and disrupts routines that many people have integrated into their “new normal.”
Individuals suffering from the effects of social isolation should be mindful of their symptoms and seek help from experts if they persist or become severe.
Therapists help by exploring underlying issues related to isolation or self-isolation. For example, a person’s isolation may be a sign of depression or an anxiety disorder.
In addition to identifying underlying issues, a therapist can develop a treatment plan that helps people regain a sense of control over their social lives. Types of therapy used to treat social isolation include cognitive behavioral therapy (CBT) and exposure therapy:
- Cognitive behavioral therapy. CBT is a talk therapy that helps people become more aware of negative or inaccurate thoughts that affect their behavior. CBT sessions can help individuals identify misperceptions and reshape negative thinking.
- Exposure therapy. Exposure therapy programs help people break avoidance and fear patterns. During exposure therapy sessions, in a safe environment, individuals are exposed (in person or in their imagination) to situations they avoid. They confront fears, process emotions, and manage anxiety.
Individuals who experience any of the following should consider consulting a medical or mental health professional:
- Confused thinking
- Delusions or hallucinations
- Excessive feelings of anger or fear
- Extreme swings in emotion
- Inability to cope with daily problems
- Major changes in eating or sleeping patterns
- Numerous unexplained physical ailments
- Prolonged depression
- Social withdrawal
- Substance abuse
When circumstances limit in-person contact, people can connect with a mental health professional by phone or videoconference.
Some isolated people can find it difficult to ask for help. When others keep an eye out for those who might need assistance but be hesitant to ask, they can play a part in lessening isolation’s negative effects on the community.
Public health professionals lead efforts to address widespread health issues such as social isolation. For people interested in serving on public health’s front lines, Tulane University’s Online Master of Public Health (MPH) degree supplies tools to improve health outcomes for entire communities.
Offered through Tulane’s School of Public Health and Tropical Medicine, the MPH program encompasses a full range of public health practices, including biostatistics and data science, environmental health sciences, epidemiology, global community health and behavioral sciences, and health policy and management.
Designed for early and mid-career professionals called to service in public health, Tulane’s Online MPH program develops community-informed, socially conscious practitioners who can assess health risks and their implications for social justice. Program graduates promote health equity and create healthier communities for all.