What Is The Price Of Social Isolation?

“It is a rare person who can cut himself off from mediate and immediate relations with others for long spaces of time without undergoing a deterioration in personality.”

— Harry Stack Sullivan, 1892-1949

Harry Stack Sullivan, a psychoanalyst who practiced early in the last century, argued that only through the development of relationships with others do we grow, thrive and heal. His “Interpersonal Theory” has proven to be an important part of how we understand ourselves and the roots of anxiety and depression. Though much has been learned since Sullivan’s day, the simple truth of his work has stood the test of time.

So, how are we doing now, as we’ve been cut off from others for almost a year? What are the short- and long-term effects on our mental health when engaging in relationships becomes difficult, if not impossible?

A 2004 Toronto study on the effects of quarantine conducted by Dr. Laura Hawryluck found: “High prevalence of symptoms of depression among those who had been quarantined … [and that] higher levels of anxiety were found to be related to greater social distancing.”

She and her team also reported that the longer the period of quarantine, the greater the likelihood of developing symptoms of PTSD, avoidance behaviors and anger.

A trailblazing pioneer in recognizing the effects of social isolation, Dr. Julianne Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University, found in studies published in 2010 and 2015 that “the effects of social isolation and loneliness … were long-term … Loneliness and isolation are linked to a 30 percent increase in having a stroke or developing coronary artery disease.”

Dr. Rob Ellis studies the history of mental health at the University of Huddersfield, U.K. In an October 2020 article published in History Today, titled “Are we adequately prepared for the toll this pandemic will take on mental health?” Dr. Ellis writes: “We know from Spanish Flu that the neuropsychiatric effects of pandemics — including depression and greater reliance on mental health care — are likely to appear … We should also be aware of the hidden impact on mental well-being that could be with us for years to come.”

Holt-Lunstad also discovered in her research that “when we lack proximity to trusted others, our brain and body may respond with a state of heightened alert. This can result in increased blood pressure, stress hormones and inflammatory responses, which, if experienced on a chronic basis, can put us at increased risk for a variety of chronic illnesses.”

In my own practice, I hear daily of the toll the current extended period of social isolation has taken. Increased depression, heightened anxiety and exacerbation of all previous mental health diagnoses are common.

Younger, single individuals in particular have struggled more during this period than any other in their lives. Most eschew the idea of dating virtually, in favor of waiting until they can meet again in person. Some have met on a socially distanced walk, others for coffee outside, but the meetings are brief and next steps (if desired) are taken with a feeling of risk.

Those in their first years of college, and in their first years of work, have been impacted disproportionately. Statements like “When is it going to end?” or “I want to meet someone — I want to go out again” and the frequent, “I’ve lost a year of my life” are common.

Many who were highly social pre-pandemic, who never suffered from clinical depression or anxiety before, are now showing signs of these. Individuals whose business and social lives depended highly upon events now often tell me they feel utterly lost without this part of their lives. Only since COVID-19 have they realized the degree to which they depended upon these gatherings as key to their overall sense of well-being.

Another thing I often hear is that everyday casual exchanges, which were once taken for granted, are disappearing. Zoom work calls rarely encourage the simple banter that made up what turns out to be a significant part of the emotional experience of work. There’s no longer reason to ask, “Tell me about your weekend,” or “How was your vacation?”

One individual commented, “The random people I used to bump into on the way to the gym, or as I left work, a quick chat with a colleague on the way home … all gone now. I really miss that.”

We don’t often think about our emotional connection to co-workers, or the impact the simple mutual recognition of seeing the same faces daily on the subway platform had on us. The kind of human connections that arose spontaneously, those we never thought about, are important to our sense of well-being.

Overall, what I have found in my own practice, and in those of my colleagues, is that many who never experienced mood disorders are experiencing them now. I am seeing more depression, anxiety, addiction, increased use of substances in general, and, for some patients in early recovery, relapse. Those who suffered prior to the pandemic with any mental health-related illness are experiencing that diagnosis with greater intensity.

Early in the last century, Dr. Sullivan’s “Interpersonal Theory” posited that we only grow and thrive when we interact with each other. Today, the research of Holt-Lunstad and others has confirmed Sullivan’s theory: Social connectedness is, in fact, key to health. “Proximity to others,” Dr Holt-Lunstad found, “signals safety.”

So, what’s the best way to handle the feelings of anxiety, sadness and depression that most of us, to one degree or another, feel today?

One way is to look toward the advantage that technology now affords us. With the ability to connect digitally and virtually, individuals are reaching out to others in new ways. We are far less isolated when we engage with others in the virtual space.

We won’t know for some time what the long-term effects of this version of social engagement will be, but it seems today a powerful tool to help cope with these feelings.

Additionally, recognizing that, ultimately, we are not alone, that what we feel now, others, throughout the world, feel with us, brings some measure of comfort. Dr. Holt-Lunstad found, “The presence of a supportive person — or even just thinking about them — can reduce cardiovascular and neuroendocrine responses to stress,” and further that “the effects of social connection are long-term.”

When we think of ourselves as part of a community, we allow ourselves to connect emotionally to each other. That connection to another — knowing that they feel what we feel — is where healing begins.

Whatever may come, we face this yearning for yesterday together, gaining a measure of comfort from our shared experience.

Lisa Wolf, MSW, LCSW, holds a Master of Science from Columbia University and a Bachelor of Arts from the University of California, Berkeley. She is a practicing psychotherapist with offices in Bridgehampton and Manhattan. Her website is lisawolftherapy.com.

The contents of this column are for informational purposes only. Nothing found in this column is a substitute for professional advice, diagnosis, treatment or professional psychotherapy. If you are in crisis or experiencing suicidal thoughts, call 911 immediately.