Social Isolation and Loneliness

Isolation vs loneliness

They are related but not the same:

• A person can live alone with few contacts yet not feel lonely.
• A person can be surrounded by others yet feel deeply lonely.

Both carry health risks, and doctors and community services now ask about both.

Who is at risk

• older adults, especially those living alone, widowed, or with limited mobility
• people with hearing loss or vision loss
• people with chronic illness, disability or chronic pain
• caregivers (caregiver stress)
• people who have recently moved, retired, lost a job or been bereaved (grief)
• young adults and teenagers, particularly with heavy passive social media use
• people with depression, anxiety or social anxiety disorder
• LGBTQ+ people, immigrants and people facing discrimination
• people with limited income or transportation

Health effects

The 2023 US Surgeon General's advisory on loneliness and isolation summarized evidence that lacking social connection is linked to:

• higher risk of premature death, comparable to some well-known risk factors such as smoking
• increased risk of heart disease and stroke
• increased risk of dementia in older adults
• depression, anxiety and suicide
• poorer sleep, weaker immune function and higher inflammation
• worse recovery from illness and more hospital visits

Signs of social isolation and loneliness

• spending most days alone or with very little contact
• feeling left out, empty or unwanted
• loss of interest in activities or hobbies
• neglecting self-care, meals or the home
• poor sleep, fatigue
• increased alcohol use or screen time to pass time
• low mood, irritability or anxiety
• in older adults, missed appointments, weight loss, and confusion

When to see a doctor

A primary care doctor can:

• screen for depression and anxiety
• check hearing and vision and arrange aids
• review medicines and physical health problems that limit going out
• connect you with social workers, community programs or "social prescribing" services
• refer for talking therapy

Ways to reconnect

• Small, regular contact: a weekly call or video chat with a friend or relative.
• Shared activities: clubs, faith communities, classes, walking groups, sports, choirs or hobby groups.
• Volunteering: helping others builds connection and purpose.
• Senior centers and community programs: many offer meals, exercise classes and transport.
• Pets: caring for an animal can provide routine and companionship.
• Use technology wisely: active, two-way contact helps more than passive scrolling.
• Treat barriers: hearing aids, mobility aids, transport services.
• Therapy: CBT can help address unhelpful thoughts that keep people withdrawn, such as expecting rejection.

For families and friends

• check in regularly, especially after a loss or illness
• invite isolated relatives to activities and help with transport
• help set up video calls or simple devices
• watch for signs of depression, neglect or confusion

Frequently asked questions

What is the difference between social isolation and loneliness?

Social isolation is an objective lack of social contact or relationships. Loneliness is the feeling of being alone or disconnected, regardless of how many people are around. Both can harm health.

How does loneliness affect health?

Loneliness and isolation are linked to higher risks of heart disease, stroke, dementia, depression, anxiety, poor sleep, weakened immunity and earlier death. The effects are similar in size to some major lifestyle risk factors.

How can older adults reduce isolation?

Helpful steps include regular phone or video contact, joining senior center or community activities, volunteering, getting hearing and vision checked, using transport services, and talking to a doctor about low mood.

Can social isolation cause depression?

Yes. Prolonged isolation and loneliness increase the risk of depression and anxiety, and depression can make people withdraw further. Treating both the mood problem and the isolation works best.