Why Is the Loneliness Epidemic so Hard to Cure?

In the early months of 2020, as the Covid-19 pandemic settled over the country, a psychologist and Harvard lecturer named Richard Weissbourd approached his colleagues with a concept for a new kind of study. Loneliness, or the specter of it, seemed to Weissbourd to be everywhere — in the solitude of quarantine, in the darkened windows of the buildings on campus, in the Zoom squares that had come to serve as his primary conduit to his students. Two years earlier, he read a study from Cigna, the insurance provider, showing that 46 percent of Americans felt sometimes or always alone. In 2019, when Cigna replicated the study, the number of lonely respondents had grown to 52 percent. God knows what the data would say now, Weissbourd thought.

“Initially, the idea was, OK, we’ve got a problem that’s not new but is obviously affecting lots of us, and that is now more visible than ever — it’s more present than ever,” Weissbourd told me. “What I really wanted was to get under the hood. Like, what does loneliness feel like to the lonely? What are the potential consequences? And what’s causing it?”

Finding answers to these types of questions is a notoriously difficult proposition. Loneliness is a compound or multidimensional emotion: It contains elements of sadness and anxiety, fear and heartache. The experience of it is inherently, intensely subjective, as any chronically lonely person can tell you. A clerk at a crowded grocery store can be wildly lonely, just as a wizened hermit living in a cave can weather solitude in perfect bliss. (If you want to infuriate an expert in loneliness, try confusing the word “isolation” with “loneliness.”) For convenience’ sake, most researchers still use the definition coined nearly three decades ago, in the early 1980s, by the social psychologists Daniel Perlman and Letitia Anne Peplau, who described loneliness as “a discrepancy between one’s desired and achieved levels of social relations.” Unfortunately, that definition is pretty subjective, too.

In order to understand the current crisis, Weissbourd, who serves as the faculty director of Making Caring Common — a Harvard Graduate School of Education project that collects and disseminates research on health and well-being — created a 66-question survey, which would be mailed to approximately 950 recipients around the United States. With the exception of a couple of straightforwardly phrased items — “In the past four weeks, how often have you felt lonely?” — a majority of the queries devised by Weissbourd and the project’s director of research and evaluation, Milena Batanova, approached the issue elliptically, from a variety of angles: “Do you feel like you reach out more to people than they reach out to you?” “Are there people in your life who ask you about your views on things that are important to you?” Or: “Has someone taken more than just a few minutes to ask how you are doing in a way that made you feel they genuinely cared?”

Several weeks later, the raw results were sent back to Weissbourd. “Frankly, I was knocked back,” he told me. “People were obviously really, really suffering,” and at a scale that dwarfed other findings on the topic. Thirty-six percent of the respondents reported feeling chronic loneliness in the previous month, with another 37 percent saying they experienced occasional or sporadic loneliness. As Weissbourd and Batanova had hoped, the answers to subsequent questions helped clarify why. Among the cohort identifying as lonely, 46 percent said they reached out to people more than people reached out to them. Nineteen percent said no one outside their family cared about them at all.

The struggle was particularly conspicuous in young respondents, ages 18 to 25, a sizable majority of whom reported acute feelings of loneliness in the previous month. Unsurprisingly, those subjects said, the pandemic had made them lonelier; in some cases, they had effectively withdrawn from a world that no longer had much meaning to them.

In February 2021, around the time Harvard announced its plans for the resumption of in-person classes, Making Caring Common published the results of the survey. “We have big holes in our social fabric,” Weissbourd said in a news release accompanying the paper, which he had titled “Loneliness in America.” Almost immediately, the emails and calls — from reporters, from other researchers and from lonely Americans who saw themselves reflected in the research — began pouring in. They did not stop arriving for several months. “My read was that the pandemic had exposed and turbocharged an existing problem,” Weissbourd told me. “Everything was being accelerated.” And it continued to accelerate, long after the world reopened: In March 2021, a quarter of adult respondents to a Gallup poll said they felt lonely for “a lot” of the day; that same month, the portion of young people dealing with the emotion on a regular basis was close to 40 percent. The Gallup numbers have since dropped somewhat, but not everyone has reaped the same benefits: The American Psychiatric Association says that 25 percent of U.S. residents are lonelier today than they were before the pandemic.

Last year, the U.S. surgeon general, Vivek Murthy, issued a 71-page advisory warning of an American “epidemic of loneliness and isolation,” with all the danger that classification implies. Murthy has estimated that a lack of social connection currently affects more Americans than, say, diabetes or obesity. Together with a concurrent decision by the World Health Organization to make loneliness a “global public health concern,” the surgeon general’s report has helped nudge the emotion into the same cultural position held by depression in the era of “Prozac Nation” and anxiety in the early aughts: a celebrity condition to be unpacked in an apparently endless cascade of front-page articles and self-help books (see: “A Practical Guide to Overcoming Loneliness” or “The Path Out of Loneliness”). There are now hundreds of podcast episodes devoted to loneliness, as well as a slew of start-ups like Belong Center, an anti-loneliness nonprofit.

Japan and Britain, where loneliness is as much a concern as it is in the United States, even appointed ministers of loneliness — government officials tasked with plumbing the depths of the crisis and ameliorating it, whether through public awareness campaigns (“Your hobbies and interests are important.”) or initiatives, like one in Britain, in which mail carriers were asked to check in with the elderly residents on their routes. Murthy, for his part, has suggested that entertainment companies might create more content that “reinforces the core values of connection.” Individuals, he adds, should consider “being a positive and constructive participant in political discourse and gatherings (e.g., town halls, school board meetings, local government hearings).”

What all these various efforts share, to one degree or another, is the idea that the solution to loneliness is only a phone call, or an email, or a text, or a friendly door knock away — that the key to closing the gap between perceived and realized levels of interpersonal relations, on a societal scale, is ultimately a matter of restoring a world that has slipped away from us.

But at best, this sort of thinking reflects a misunderstanding of how we live now (and how we’ll live in the future). At worst, it serves as a distraction from the real issues. As research like Weissbourd and Batanova’s demonstrates, when we talk about loneliness, what we’re actually talking about are all the issues that swirl perilously underneath it: alienation and isolation, distrust and disconnection and above all, a sense that many of the institutions and traditions that once held us together are less available to us or no longer of interest. And to address those problems, you can’t just turn back the clock. You have to rethink the problem entirely — and the potential solutions too.

Compared with other ailments of the mind, loneliness is a surprisingly modern concern: Although large segments of the world have probably always been anxious, have always been depressed, have always been wrathful, they were not always lonely in the specific (and negatively connoted) way contemporary experts understand the emotion today. In her 2019 book, “A Biography of Loneliness,” the historian Fay Bound Alberti goes so far as to argue that before the 1800s, practically no one in the Western world spent much time discussing loneliness at all.

Which is not the same as saying that no one was familiar with the word: It gets dropped in Shakespeare’s “All’s Well That Ends Well”; in Samuel Johnson’s dictionary (“disposition to solitude”); and in “Robinson Crusoe,” a novel published in 1719. Still, as Bound Alberti writes, in most pre-19th-century literature, “there was no emotional experience necessarily attached to solitude.” If anything, it was often nice to be alone. It was as good as a spa day. You try living in a single-room farmhouse with 14 members of your family. You would crave some isolation, too.

In the appendix to “A Biography of Loneliness,” Bound Alberti includes a graph depicting incidences of the word “loneliness” in a database of English-language works printed between 1550 and 2000. From 1550 to 1800, the line hovers somewhere between zero and 0.0001 percent. Then comes the 1820s, and the line charges vertiginously upward, like a mountaineer ascending a cliff. No mystery there. The world was changing, fast. War, mechanization, the rise of the metropolis, war again. Communities disintegrated — sometimes as a result of conflict and sometimes because the residents believed they could find better opportunities elsewhere. People moved out of small towns and into vast, anonymous cities. As they did, they sought a new etymology to explain the emotional cost; when we look at Bound Alberti’s graph, that’s very likely what we’re seeing.

In the 1950s, a small cohort of American scientists began grappling, for the first time, with the causes and effects of this new modern malady — in the process establishing what is today the growing field of loneliness studies. Among them was David Riesman, a sociologist who framed the emotion as being inextricably entangled with absence. Postwar America was prosperous, Riesman allowed, but prosperity had encouraged Americans to care about the wrong things. “Other-directedness,” he called it in his best-selling book, “The Lonely Crowd,” which he wrote with Nathan Glazer and Reuel Denney. Today we would call it FOMO: Americans were constantly peering over their neighbors’ fences, admiring the barbecue kit, the pool. When they failed to get those things for themselves, loneliness set in.

Others were inclined to see the emotion as something significantly scarier — a genuine medical syndrome, potentially widespread, on the level of depression or mania. “I am not talking here about the temporary aloneness of, for instance, a person who has to stay in bed with a cold on a pleasant Sunday afternoon while the rest of the family are enjoying the outdoors,” Frieda Fromm-Reichmann, a German-born psychiatrist, wrote in a groundbreaking paper called “Loneliness,” which was published posthumously in 1959. Nor was Fromm-Reichmann referring to wistful artistic solitude or the raw emotions that arise after the loss of a spouse. Her interest was in truly debilitating loneliness, of the type she observed in growing rates in her patients — loneliness that was “nonconstructive if not disintegrative” and that led to “the development of psychotic states. It renders people who suffer it emotionally paralyzed and helpless.”

But how? And why? What ultimately moved our understanding forward was the application of biological science. “Echocardiograms, brain-imaging technology, blood and urine tests. Using those, you could actually measure what was going on inside the body of a lonely person,” the psychologist Louise Hawkley told me recently. You could move past the anecdotal to the provable.

Hawkley has been researching loneliness for nearly 30 years — along with her mentor and friend, the late psychologist John Cacioppo, she has overseen or worked on nearly a hundred publications that illustrate, in often graphic detail, the physiological toll loneliness takes on the lonely. It is thanks to Cacioppo and Hawkley, for example, that we know loneliness raises our blood pressure, negatively alters our cognitive functions, is associated with Type 2 diabetes and shortens our life spans. (Subsequent studies have linked the emotion to suicidality, Alzheimer’s and leukemia.) When Vivek Murthy, in his 2023 advisory, writes that loneliness “is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety,” he is largely referencing work done by Cacioppo and Hawkley.

In one of their most innovative experiments, designed to show that loneliness can cause poor health instead of merely correlating with it, they hired a hypnotist to coax a handful of test subjects into a state of heightened loneliness. Once it was induced, the subjects’ blood pressure and inflammation levels surged. “We could essentially manipulate the physiological condition by changing how lonely they felt,” Hawkley says. “And those same people, when they were made to feel not lonely” — when the hypnosis was reversed — “everything bounced back.”

In the mid-2000s, Hawkley and Cacioppo funneled their combined research to date into a framework that Hawkley described to me as a “sort of grand evolutionary theory of loneliness.”

The results, released nearly two decades ago in The Journal of Research in Personality, manage to get at the roots of our present-day predicament as incisively as anything I’ve encountered. In essence, Hawkley and Cacioppo argue, early Homo sapiens, outgunned by all manner of long-toothed beasts and without natural armor, achieved safety through community — they learned “to employ and detect deceit, and to communicate, work together and form alliances,” as the authors have it. Or the successful ones did, anyway. (The rest were eaten.) Gradually, our brains evolved to prioritize togetherness, and conversely, to generate an anxiety response when we failed to find it.

Imagine the warm sensation you feel on walking into a room full of friends. Now imagine being excluded by the same friends by a game of catch — an example from a study cited by Hawkley and Cacioppo. According to them, brain scans of the excluded participants demonstrated “neural activation localized in a dorsal portion of the anterior cingulate cortex that is implicated in the affective component of the pain response.” A mouthful, but you get the gist: To Hawkley and Cacioppo, the subjects’ pain was evidence that loneliness was a biological signal, not dissimilar to a rumbling stomach. “What hunger does for food, loneliness does for social relationships,” Hawkley told me. “It’s supposed to motivate us and tell us we need more people around us or that we need support. It tells us that something is wrong.”

In worst-case scenarios, loneliness becomes a self-fulfilling prophecy — a snare that tightens with each effort to shrug it off. What you sometimes see is the onset of a kind of feedback loop, Hawkley told me: A person desperately wants not to be lonely, but fear and anxiety have convinced them their loneliness reflects a fundamental undesirability. “They are absolutely certain that they’re not worth talking to, that no one likes them, that they’re not a good person and that it’s all their fault,” Hawkley says. “The brain is being hijacked.”

In 2021, Daniel Maitland, a psychologist and associate professor at the University of Missouri-Kansas City, devised an EKG-based pilot study in which he assembled a group of self-identified lonely people and asked them to participate in a series of relationship-building exercises. The moment the test subjects were asked to disclose something personal to their peers, the readings on the monitors strapped to their chests escalated, indicating that vulnerability was a major stressor on their nervous systems.

There are two ways to parse these results. The first is that Maitland’s subjects were lonely precisely because intimacy was naturally fraught for them. The second is that they were trapped in their own heads, in thrall to Hawkley’s feedback loop. For these subjects, advice about attending a local town hall or church basement bingo, however well meaning, would be likely to fall flat, partly because of the fear impulse it would engender. But partly, too, because that variety of community gathering feels so antique and unappealing to many of us — the relic of a bygone era.

In 2000, Robert Putnam, the Harvard political scientist, published “Bowling Alone,” a book that famously documented a steady erosion in membership of organizations and groups that once bound so many Americans together — granges and churches, unions and library reading circles, athletic clubs and neighborhood improvement associations. Nearly a quarter-century on, the trend lines identified by Putnam have not been reversed. If anything, they’ve grown more pronounced, as have the related data on household status and family: In 2024, American marriage rates are far lower than they were at the midcentury mark, while the number of one-person households in the country has more than tripled to 29 percent.

Needless to say, marriage doesn’t negate loneliness — plenty of bad or abusive marriages are chillingly sad for the people locked inside them — and a single-person home is not synonymous with a lonely one. Still, it’s impossible to look at the aggregate data from the 1950s onward, including a new survey by Gallup on weekly attendance of religious services, which sank last year to 21 percent of the U.S. population, and not feel that something has been lost.

“I’m not suggesting that we should become more religious, but I want to just suggest to you that religious communities are a place where adults engage kids, stand for moral values, engage kids in big moral questions, where there’s a fusion of a moral life and a spiritual life,” Weissbourd said at a talk held in March at the Harvard Kennedy School of Government.

“A sense that you have obligations to your ancestors and to your descendants, where there is a structure for dealing with grief and loss,” he went on, repeating his opening caveat. “I feel urgently like we have to figure out how to reproduce those aspects of religion in secular life.”

Earlier this year, Weissbourd and Batanova conducted a follow-up to their 2021 loneliness survey, adding an open-ended prompt in which lonely respondents could try to account for the presence of the emotion in their lives. Many subjects cited a lack of “meaningful connection” as the primary culprit. This was true whether or not human companionship was available to them. Physical proximity wasn’t always the issue. Emotional proximity usually was. Consider the young mother who frets that her existence has been reduced to caring for her baby, or the respondent who complains that his or her “partner is only interested in the phone.” A third subject admits to having plenty of family around but to being undervalued by them. “Am surrounded,” a fourth writes, by people “who only are present in my life because am useful.”

Work — the office — appears to be of little help. Fewer Americans are finding purpose and meaning in their careers, and the ones who do are laboring in a drastically altered landscape. Post-pandemic, office buildings in every major city remain empty; something like 22 million Americans now work from home, communicating with their colleagues through Zoom or Slack. Whether or not you believe that “virtual commuting” is good for productivity, it is demonstrably bad for community building. A July report by Jeffrey Hall, a professor of communication studies at the University of Kansas, and a team of researchers asked 4,300 Americans to talk about their social circle; most respondents said they had met their close friends through school or work. But the numbers were skewed by age: People 51 years or older were more than twice as likely to have met at least one close friend at work as people under 30. “Removing the social aspect of work further encourages remote workers to keep their jobs at arm’s length,” Hall wrote in The Wall Street Journal. “This detachment could have the twin effects of maintaining a better work-life balance but leave workers lonelier than they would be had they made office friends.”

The residue of the pandemic, for all of us, has proved difficult to scrub away. Studies have shown that we emerged from quarantine with less ability to make eye contact or conduct ordinary conversation with acquaintances. “The interactions that make us less lonely come naturally to us, but they still need to be practiced, or our skills atrophy,” Ian Marcus Corbin, a Harvard Medical School philosopher and senior fellow at Capita, which helped fund Weissbourd’s study, told me. “And in 2020 and 2021, a lot of people who were in a formative period of their lives saw those muscles atrophy.” Concurrently, the usage of “frictionless forms of interaction,” like self-checkout displays or meal-delivery apps, ballooned. Corbin sees these developments as evidence of “cocooning”: a retreat into a digital world that provides everything you need except the thing you need the most, which is the “meaningful connection” mourned by respondents to Weissbourd and Batanova’s survey.

When I spoke this year with Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University, she summed up the aggregate effects of these losses in a cascade of statistics she had apparently committed entirely to memory. “You look at the data from 2003 to 2020, and you see that time alone has gone up in America, while time spent with friends and family has gone way down. Time spent with others, companionship levels: It’s all down,” she said. “Then if you examine data from the national Crisis Text Line, which has information from 1.3 million texts, you see the No. 1 issue people are reporting has to do with relationships. One in three texts is related to relationship stress; one in five involves lack of human connection. In some cases, disconnection is happening due to feeling lonely. In some cases, a person is objectively isolated.” She added: “We may lack social support; we may have poor-quality relationships. It all signals that we’re not having our social needs met.”

Traditionally, the moments Americans have been most afflicted by loneliness have also been moments of major societal change: It is no accident that David Riesman wrote “The Lonely Crowd” in the age of TV dinners and white picket fences that separated one neighbor from the next. “There’s a cyclical nature to it,” says Eric Klinenberg, a sociologist at New York University and the author of “Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone.” “You look through the literature, and you can read anxiety about loneliness in the early 1900s, when everyone started listening to the radio. Or later, when we worried that cars would lead to us driving away from our families and neighborhoods in search of something new. You can read it in the ’60s and ’70s, with the sexual revolution and the rise in divorce rates. Throughout, loneliness is a ready-made discourse, right? It’s always there for us” — our go-to explanation for the recurring sensation that the culture is changing too fast and leaving us behind.

If the loneliness “epidemic” today feels uniquely profound, Klinenberg believes, it is only because the current dislocation is occurring at an unprecedented scale. “We’re the first people in the history of the earth to see the conditions of social life change in this way,” he says. “And they’ve changed dramatically.” Political dysfunction, global warming, a waterfall of mental health crises — and on top of it all, a transformation, in the internet, in the way we communicate.

The easiest way to respond to these dislocations, and to try to account for the loneliness they elicit, is to wish them away — to try to jam the genie back in the bottle. Weissbourd calls it a “palpable nostalgia for old modes of closeness,” and it’s everywhere in the responses to his and Batanova’s follow-up survey, from earlier this year, in which subjects were asked if Americans today are lonelier than they were in decades past and if so, why. “Previous generations,” one respondent writes, “weren’t as self-centered and helped each other more.” Another speaks of a time when individuals “lived in closer proximity” and “relied on family members to a greater extent.” “It took a community,” a third says, “to survive.”

This sentiment, too, colors many of the various proposed policy fixes, like Britain’s mail-carrier plan or the 2023 guidance from Murthy, who suggests near the end of his advisory that lonely individuals “reach out to a friend or family member” and that parents encourage their children to participate in structured, in-person activities “such as volunteering, sports, community activities and mentorship programs.” One implication is that shrinking the gap between realized and desired social relations, and thus conclusively ending the loneliness epidemic, will merely be a matter of recreating, in some sort of updated form, the types of community alive in an older era.

Unfortunately, history rarely works that way. “One big problem I have with the current rhetoric around loneliness is that we treat it as if it’s permanently going in only one direction,” Klinenberg told me. “It’s not. It’s a more interesting phenomenon than that” — and more nuanced. When loneliness gripped the Western world during the Industrial Revolution, everyone didn’t suddenly retreat to their ancestral villages; the radio didn’t make us permanently lonely. We built new communities in the city, far from our families; we used radio to expand our world and to talk to people on the other side of the country. We adapted. And as hard as it may be to accept, the path out of loneliness in 2024 lies almost certainly via a similar route — forward, forward.

There are signs that a similar mass evolution is already underway. Take the smartphone, a device that gets a lot of blame for our lack of physical connection and that has simultaneously led to other, but no less meaningful, forms of togetherness. “I wrote an entire book about online dating, and to give you one example, I know as much as anyone about how much it can suck to be on Tinder,” Klinenberg says. “I also know the internet is the main way people meet their spouses these days. I think about cases of people who have rare diseases and are able to share information and get better care and feel connected because the internet allows them to do so. I think about trans kids, who are at risk of distress because they feel so rejected and alone in some families and are now able to talk to people like them — to get messages that affirm them.”

None of which is to say we won’t still need physical togetherness — only that there may be less of it, and the physical togetherness that does persist may look different than it did for our ancestors. Ninety-six thousand Taylor Swift fans singing in sync, the thunder of a crowded football stadium and then a gazillion internet threads in which the attendees relive and post photos and remember the euphoria of their shared experience. A romance that exists partly in the real world and partly online, and in which emotional closeness is not diminished but enhanced by a steady stream of the sort of soul-baring disclosures that social media apps can facilitate.

There may be bumps, hurdles and obstacles, but as is the case with Cacioppo and Hawkley’s evolutionary theory, those bumps could be part of the learning process, the adaptation process. Part of the drive that forces us together.

Squint, and you can see it: a scenario in which the loneliness crisis today is really a mass period of acclimatization. It’s a bridge, an evolutionary step, during which we make our peace with certain trade-offs and realities — that in 2024, we’re not all going to race to rejoin the local grange. That we’re not all going back to church or temple or the mosque. That our kids may grow up far from their grandparents and aunts and uncles — far from the towns where we were raised. That the workplace will remain diffuse, tethered by Zoom meetings and the occasional in-person happy hour. That we may often see friends more on FaceTime than we do in real life. And most important, that despite it all, we’ll find one another again.

Max Guther is a Berlin-based illustrator known for his hyperreal isometric 3-D style, often using an unfamiliar perspective from above.