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Is Loneliness Making My Mental Health Struggles Harder?

Social disconnection is a big problem in modern society. In 2018, Cigna surveyed 20,000 U.S. adults. Nearly half of respondents reported that they sometimes or always feel alone (46%) and/or left out (47%)[i]. The COVID-19 pandemic has only made the problem worse – many offices are still closed, gathering in large groups is discouraged, and travel is advised against. Most people are experiencing a lot less social interaction than they’re used to. It’s normal to feel lonely sometimes. But chronic loneliness has a serious negative impact on both physical and mental health. Conversely, maintaining strong social connections can serve as a tremendous protective factor against mental health struggles.

Our need for quality relationships goes back to the earliest humans and our hunter-gatherer societies – groups depended on each other and no one could survive on their own. Even today, as babies and throughout childhood, human survival depends on attachments to caregivers. Across studies of mammals, data shows that we are heavily shaped by our social environment and experience significant distress when our social ties are threatened or broken[ii].

We all have a specialized “social brain network” that manages our social relationships and interactions with others. Primates (monkeys) have a similar brain network. We have learned that the more social they are, the better they are at socializing and the stronger their network is – and it’s likely that a similar process happens in the human brain[iii].

Feelings of loneliness are often dismissed, but brain scans have shown that experiences like being shunned by a community, being excluded, and feeling isolated activates the same areas in the brain that respond to physical pain[iv]. This sends the brain into a hyper-alert state to prepare for danger, but can lead to errors in social thinking that cause us to misinterpret the information we take in. In other words, when we are lonely, we may misread the intentions of others as unethical, competitive, or threatening.

Loneliness has been associated with a number of poor mental health outcomes. It may be a response to a mental health condition (for instance, a common symptom of depression is social withdrawal) or it could be the trigger that initiates a mental health condition.

  • Depression: There is a strong relationship between feeling loneliness and depression. If you’ve been feeling socially isolated or lonely, negative self-beliefs and suicidal thinking may increase, while life satisfaction often decreases[v]. Self-isolation is also a common symptom of depressive episodes.
  • Anxiety: Because socialization takes practice, chronic loneliness can also lead to or exacerbate already existing social anxiety[vi]. Having a strong support system is a protective factor against anxiety, so if you don’t have that support, your general anxiety levels may increase and you could have a more difficult time with emotion regulation[vii]
  • Psychosis: The connection between loneliness and psychosis isn’t as well studied, though there does appear to be a significant connection. Loneliness has been linked to increased hallucinations and paranoid thinking, and the relationship may go in both directions (loneliness leading to psychotic symptoms, and psychotic symptoms leading to loneliness)[viii].
  • Substance Use: Substance misuse/abuse is prevalent in people dealing with chronic loneliness or isolation – it’s common to numb painful feelings with alcohol or other drugs. Loneliness is recognized as a risk factor in all stages of alcoholism[ix]. It can also have indirect effects on substance use due to increased stress[x]

Studies on social engagement and mental health show a relationship between loneliness and mental illness. And there is often a self-perpetuating cycle – symptoms limit connections and support, which leads to the loss of those supports as protective factors, which may increase symptoms, and so on.

Meanwhile, social integration and quality social ties promote positive psychological states like positive identity, self-work, and purpose[xi]. Making new (and meaningful) connections isn’t easy, especially during COVID, but it is possible to reduce the loneliness you may be feeling:

  • Consider community service or volunteering. If you are socially excluded or isolated, you may feel like you don’t have purpose or value. Giving back to your community can add more meaning to your life and you’ll probably meet some like-minded people to connect with. Make sure you’re being safe when around others (wear your mask, wash your hands often), and if you’re still worried about exposure to COVID, look into opportunities that occur outside or virtually. 
  • Work on alleviating stress. When lonely, our bodies produce more cortisol, the stress hormone, and we feel stress more intensely. Everyday obstacles will likely take a bigger emotional toll on people who don’t have strong social support. Try journaling, meditating, getting some exercise, or your other favorite stress reduction technique.
  • Expect the best from people. Because loneliness can alter your thinking, it’s common to anticipate that social interactions will go poorly. Try to challenge some of your negative expectations surrounding relationships.
  • Focus on quality relationships. Not every interaction will lead to a friendship – that’s normal. It’s much more beneficial to a have a few, strong relationships than many friends who you don’t feel truly connected to.

[i] Cigna. (2018). Cigna U.S. Loneliness Index: Survey of 20,000 Americans Examining Behaviors Driving Loneliness in the United States.

[iii] Platt, M. (2018, July 19). Wired to connect. PsychologyToday,

[iv] Novembre, G., Zanon, M., & Silani, G. (2015). Empathy for social exclusion involves the sensory-discriminative component of pain: a within-subject fMRI study. Social Cognitive and Affective Neuroscience, 10(2).

[v] Novotney, A. (2019, March). The risks of social isolation. APA Monitor on Psychology, 50(5).

[vi] Lim, M.H., Rodebaugh, T.L., Zyphur, M.J., & Gleeson, J.F.M. (2016). Loneliness over time: The crucial role of social anxiety. Journal of Abnormal Psychology, 125(5). doi: 10.1037/abn0000162

[vii] Lee, C.S. (2017, May 30). Interpersonal emotional regulation: How others help us reduce anxiety and stress.

[viii] Michalska da Rocha, B., Rhodes, S., Vasilopoulou, E., & Hutton, P. (2018). Loneliness in psychosis: A meta-analytical review. Schizophrenia Bulletin, 44(1). doi: 10.1093/schbul/sbx036

[ix] Mushtaq, R., Shoib, S., Shah, T., Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders, and physical health: A review of the psychological aspects of loneliness. Journal of Clinical & Diagnostic Research. doi: 10.7860/JCDR/2014/10077.4828

[x] Segrin, C., McNelis, M. & Pavlich, C.A. (2017). Indirect effects of loneliness on substance use through stress. Health Communication, 33(5).

[xi] Harris, M., & Orth, U. (2019). The link between self-esteem and social relationships: A meta-analysis of longitudinal studies. Journal of Personality and Social Psychology.