Nancy, thanks so much for sharing this article.
Linda G.
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Subject: [ourplace] Researchers Confront an Epidemic of Loneliness - The New
York Times
BLACKPOOL, England — The woman on the other end of the phone spoke
lightheartedly of spring and of her 81st birthday the previous week.
“Who did you celebrate with, Beryl?” asked Alison, whose job was to offer a
kind ear.
“No one, I…”
And with that, Beryl’s cheer turned to despair.
Her voice began to quaver as she acknowledged that she had been alone at home
not just on her birthday, but for days and days. The telephone conversation was
the first time she had spoken in more than a week.
About 10,000 similar calls come in weekly to an unassuming office building in
this seaside town at the northwest reaches of England, which houses The Silver
Line Helpline <https://www.thesilverline.org.uk/> , a 24-hour call center for
older adults seeking to fill a basic need: contact with other people.
Loneliness, which Emily Dickinson described as “the Horror not to be surveyed,”
is a quiet devastation. But in Britain, it is increasingly being viewed as
something more: a serious public health issue deserving of public funds and
national attention.
Working with local governments and the National Health Service, programs aimed
at mitigating loneliness have sprung up in dozens of cities and towns. Even
fire brigades have been trained to inspect homes not just for fire safety
<http://health.nytimes.com/health/guides/specialtopic/safety/overview.html?inline=nyt-classifier>
but for signs of social isolation.
“There’s been an explosion of public awareness here, from local authorities to
the Department of Health to the media,” said Paul Cann, chief executive of Age
UK Oxfordshire and a founder of The Campaign to End Loneliness
<http://www.campaigntoendloneliness.org/> , a five-year-old group based in
London. “Loneliness has to be everybody’s business.”
Researchers have found mounting evidence linking loneliness to physical illness
and to functional and cognitive decline. As a predictor of early death
<http://pps.sagepub.com/content/10/2/227.abstract> , loneliness eclipses
obesity
<http://health.nytimes.com/health/guides/symptoms/morbid-obesity/overview.html?inline=nyt-classifier>
.
“The profound effects of loneliness on health and independence are a critical
public health problem,” said Dr. Carla M. Perissinotto, a geriatrician at the
University of California, San Francisco. “It is no longer medically or
ethically acceptable to ignore older adults who feel lonely and marginalized.”
In Britain and the United States, roughly one in three people older than 65
live alone, and in the United States, half of those older than 85 live alone.
Studies in both countries show the prevalence of loneliness among people older
than 60 ranging from 10 percent to 46 percent.
While the public, private and volunteer sectors in Britain are mobilizing to
address loneliness, researchers are deepening their understanding of its
biological underpinnings. In a paper
<http://www.cell.com/cell/abstract/S0092-8674(15)01704-3> published earlier
this year in the journal Cell, neuroscientists at the Massachusetts Institute
of Technology identified a region of the brain they believe generates feelings
of loneliness. The region, known as the dorsal raphe nucleus, or D.R.N., is
best known for its link to depression
<http://health.nytimes.com/health/guides/symptoms/depression/overview.html?inline=nyt-classifier>
.
Kay M. Tye and her colleagues found that when mice were housed together,
dopamine
<http://health.nytimes.com/health/guides/test/catecholamines-blood/overview.html?inline=nyt-classifier>
neurons in the D.R.N. were relatively inactive. But after the mice were
isolated for a short period, the activity in those neurons surged when those
mice were reunited with other mice.
“This is the first time we’ve found a cellular substrate for this experience,”
said Dr. Tye, an assistant professor at the Picower Institute for Learning and
Memory at M.I.T. and a senior author of the paper. “And we saw the change after
24 hours of isolation.”
Photo
Credit Jon Krause
John T. Cacioppo, a professor of psychology at the University of Chicago and
director of the university’s Center for Cognitive and Social Neuroscience, has
been studying loneliness since the 1990s. He said loneliness is an aversive
signal much like thirst, hunger or pain.
“Denying you feel lonely makes no more sense than denying you feel hunger,” he
said. Yet the very word “lonely” carries a negative connotation, Professor
Cacioppo said, signaling social weakness, or an inability to stand on one’s own.
The unspoken stigma of loneliness is amply evident during calls to The Silver
Line. Most people call asking for advice on, say, roasting a turkey. Many call
more than once a day. One woman rings every hour to ask the time. Only rarely
will someone speak frankly about loneliness.
Yet the impulse to call in to services like The Silver Line is a healthy one,
Professor Cacioppo said.
On a recent afternoon, Tracey, a Silver Line adviser, listened as a caller in
his 80s embarked on a nostalgic trip down his list of favorite films. The next
caller serenaded Tracey with “Oh What a Beautiful Morning
<http://www.scoutsongs.com/lyrics/beautifulmorning.html> ,” on his harmonica.
Once the harmonica player had hung up, a call came in from an 88-year-old man
with an avalanche of memories to share: dogs he had owned, boats he had
captained, London during the blitz. Tracey, a former nurse, listened patiently
for 30 minutes.
“It can be really fascinating when people talk about things like London during
the bombing,” she said after the call ended. “It’s important to remember the
rich lives people have led.”
Silver Line workers leave it up to the caller to mention whether they are
feeling lonely. Still, the advisers are trained to listen for signs of unhappy
isolation, and gently lead the conversation accordingly, perhaps offering to
link the caller to a Silver Line Friend, a volunteer who makes weekly phone
calls or writes letters to those who request it.
Sophie Andrews, chief executive of The Silver Line, said she was surprised by
the explosion of calls shortly after the service began operating nearly three
years ago. The Blackpool call center now receives some 1,500 calls a day.
Ms. Andrews said she was most concerned not about those who called The Silver
Line, but those who were too depressed by their isolation to pick up the phone.
“We need to raise awareness with the people who are the hardest to reach,” she
said.
Professor Cacioppo lauds efforts like The Silver Line, yet he warns that the
problem of loneliness is nuanced and the solutions not as obvious as they might
seem. That is, a call-in line can help reduce feelings of loneliness
temporarily, but is not likely to reduce levels of chronic loneliness.
In his research
<https://static1.squarespace.com/static/531897cde4b0fa5080a9b19e/t/555601d9e4b0849a888ed857/1431699929973/toward-a-neurology-of-loneliness.pdf>
, Professor Cacioppo has shown that loneliness affects several key bodily
functions, at least in part through overstimulation of the body’s stress
response. Chronic loneliness, his work has shown, is associated with increased
levels of cortisol
<http://health.nytimes.com/health/guides/test/cortisol-level/overview.html?inline=nyt-classifier>
, a major stress hormone, as well as higher vascular resistance, which can
raise blood pressure
<http://health.nytimes.com/health/guides/test/blood-pressure/overview.html?inline=nyt-classifier>
and decrease blood flow to vital organs.
Professor Cacioppo’s research has also shown that the danger signals activated
in the brain by loneliness affect the production of white blood cells; this can
impair the immune system’s ability to fight infections.
It is only in the past several years that loneliness has been examined through
a medical, rather than psychological or sociological, lens. Dr. Perissinotto,
the University of California, San Francisco geriatrician, decided to study
loneliness when she began to sense there were factors affecting her patients’
health that she was failing to capture.
Using data from a large national survey of older adults, in 2012 Dr.
Perissinotto analyzed the relationship between self-reported loneliness and
health outcomes in people older than 60. Of 1,604 participants in the study
<http://archinte.jamanetwork.com/article.aspx?articleid=1188033> , 43 percent
reported feelings of loneliness, and these individuals had significantly higher
rates of declining mobility, difficulty in performing routine daily activities,
and death during six years of follow-up. The association of loneliness with
mortality remained significant even after adjusting for age, economic status,
depression and other common health problems.
Dr. Perissinotto is also interested in examining the link between loneliness
and suicidal thoughts, as there has been little research in that area. She
hopes to study The Friendship Line
<http://www.ioaging.org/services/all-inclusive-health-care/friendship-line> , a
24-hour, toll-free, loneliness call-in line run by the Institute on Aging in
San Francisco that is also a suicide prevention hotline.
Although plenty of research into loneliness takes place in the United States,
Britain remains well ahead in addressing the problem.
“In the U.S., there isn’t much recognition in terms of public health
initiatives or the average person recognizing that loneliness has to do with
health,” said Julianne Holt-Lunstad, a professor of psychology at Brigham Young
University, whose studies also link loneliness to deteriorating health.
Age UK <http://www.ageuk.org.uk/> , an organization similar to AARP in the
United States, oversees an array of programs aimed at decreasing loneliness and
coordinates efforts with fire brigades to look for signs of loneliness and
isolation in the homes they enter.
Another charity, Open Age <http://www.openage.org.uk/home> , runs some 400
activities each week in Central London — sewing circles, current events
discussions, book clubs and exercise and computer classes, held at church
halls, sport centers, housing projects — and its employees also visit people in
their homes to try to get them out and about.
“We try to work out what it is that’s preventing them from leaving the house,”
said Helen Leech, the organization’s director.
Men and women differ greatly in how they grapple with loneliness. Seventy
percent of the calls to The Silver Line are from women.
“We have this kind of male pride thing,” said Mike Jenn, 70, a retired charity
worker who lives in London. “We say, ‘I can look after myself. I don’t need to
talk to anyone,’ and it’s a complete fallacy. Not communicating helps to kill
us.”
Mr. Jenn runs a “Men’s Shed” in London’s Camden Town district, which aims to
bring older men together in a more familiar and comfortable environment —
working side by side in a woodworking shop. The concept began in Australia and
has since spread to Britain: There are now more than 300 Men’s Sheds
<http://menssheds.org.uk/> throughout England, Scotland and Ireland.
Keith Pearshouse, 70, a retired school principal, discovered the Men’s Shed
near his home after moving to London from Norfolk, England, in 2007 and
recognizing he was lonely.
“I was a bit anxious walking into a roomful of people,” said Mr. Pearshouse,
chatting amid the din created by a table saw, router and lathe at the Camden
Town shed, a 700-square-foot workshop in a local community center. “But I
immediately thought, ‘Yeah, this is a place that would work for me.’”
160Comments
Mr. Pearshouse, who had never worked with wood before he discovered the Men’s
Shed, showed a visitor a delicate wooden jar he was finishing. The pieces he
produces are gratifying, he said, but not nearly as gratifying as the human
connections he has made.
While Mr. Pearshouse is still a long way from sharing every little ache and
upset with his friends at the shed, he said his life would now feel much
emptier without the shoulder-to-shoulder way of confiding he has come to know.
As he spoke, he took the lid off his jar, and it gave a slight pop, signifying
a perfect fit.
A version of this article appears in print on September 6, 2016, on page D1 of
the New York edition with the headline: Healing the Lonely.