Since the onset of the CoVid 19 pandemic one of the biggest concerns on the minds of health care providers and policymakers alike is how restrictions placed on social interactions impact mental health. Let’s start with a definition of loneliness by the American Psychological Association. They begin defining loneliness as “affective and cognitive discomfort or uneasiness from being or perceiving oneself to be alone or otherwise solitary. Psychological theory and research offer multiple perspectives: Social psychology emphasizes the emotional distress that results when inherent needs for intimacy and companionship are not met; cognitive psychology emphasizes the unpleasant and unsettling experience that results from a perceived discrepancy (i.e., deficiency in quantity or quality) between an individual’s desired and actual social relationships” (1).
Loneliness has a huge impact on mental health and is a major driver for some of the most common mental health concerns such as depression (2). It is easy to understand the connection between loneliness and mood disorders as they are both centered in the mind but, did you know that research shows that loneliness also increases the risk of poor sleep (3), type 2 diabetes (4), dementia (5), cardiovascular disease (6), and even catching a cold (7)? Further, meta-analytic data shows that loneliness increases the risk of earlier death by 26% (8). As incredible as it is, scientists have even been able to track specific markers of inflammation and general health such as CRP and fibrinogen in the blood (9), as well as, blood pressure, waist circumference, and body mass index (10) and have shown a negative correlation with loneliness.
So, what do we know about how CoVid-19 is affecting Canadians? Stats Canada found that in 2020, one in five Canadian (21%) of adults screened positive for at least one of the following mental health disorders: major depressive disorder, generalized anxiety disorder, or post-traumatic stress disorder (11). Stats Canada found that those who reported feelings of loneliness or isolation due to CoVid 19 were four times more likely to struggle with a mental health disorder and nearly 38% of Canadians reported feelings of loneliness and isolation due to the pandemic (11). This is clearly a pervasive issue.
In my practice since the beginning of the pandemic, I have seen a sharp rise in patients presenting with these disorders. I am often asked if I am being bombarded with questions about how people might boost their immune systems to help protect themselves. The answer is no; instead, I have been overrun with patients, both new and existing, trying to navigate their mental health since the onset of the pandemic. Some patients know what they are struggling with while others just know that things are not right. With the most recent set of restrictions that Alberta is enduring once again, I wanted to speak about how to help manage and prevent loneliness.
Find alternate ways to socialize:
Yes, we have heard this over and over, I know, but I would be remiss not to mention it one more time. Community is critical to mental health and must be prioritized. There are the usual channels: get-togethers within your government allowed groups, planning outdoor events, taking your events online, etc. See our Dec 2020 blog for more ideas ). Consider spicing up your “get-togethers” by having a theme, planning a game, or maybe consider just watching the same sports event or movie while on face time or zoom together with your tribe.
Reach out to people that you have not spoken to in a long time:
There is no time like the present to rekindle friendships and re-engage with your broader community or network. Consider sending an email, making a phone call, or even a good old-fashioned handwritten letter… you must admit these are fun to receive! If it has been a long time since you have connected with this person and you have lost their contact information try looking them up on different social media channels, this can be incredibly useful for finding long-lost contacts!
Learn a new skill or hobby:
Finding a new passion is a great way to ignite newfound excitement and motivation. All of us have something that interests us and the options are endless. You could: learn a new language, learn to paint, or draw, pick up gardening, learn to dance, brush up on your writing or public speaking skills; you could take a course on… well, just about anything! Learning helps us grow; it keeps us sharp, motivated and engaged. Did you know that here in Edmonton the Edmonton Public Library has a ton of free options to choose from? Check out their link here.
Protect your self-care:
I chose the word “protect “specifically. When we start to feel stressed, down, or isolated, self-care is one of the first things to fall off and, as we all know, this is when it is most important. Prioritizing self-care is critical and should not be at the end of what seems to be the never-ending “to do” list. Self-care should be at the top of the list and protected. Self-care is NOT selfish. It is quite the opposite - it allows you to recharge so that you can continue to give to others. Self-care is different for everyone. It is anything that makes you feel alive again and makes you feel more like yourself. It might be cuddling up with a good book, taking a bath, scheduling a massage or acupuncture appointment, giving yourself an at-home facial or pedicure, gardening, or spending some time on a hobby.
One part of self-care that is most important is movement. There is a plethora of research now all showing the benefits of exercise on mood and mood disorders. Remember this should be FUN! Choose something you enjoy.
Establish a mindfulness practice:
Practicing mindfulness allows you to check in more effectively with yourself so that you can better understand when you might need to tune up your self-care practices, reach out to your community and when you need more support. It also helps to promote feelings of calm, stability, and groundedness so that you can more easily move through your day.
Be strategic:
It is so important to plan. While an impromptu phone or face-time call is always a great idea; planning for interactions is helpful in several ways. First, it helps to ensure both you and the other people/ person have made time in their schedule. Second, it ensures that you don’t forget to reach out and connect, preventing you from getting too far down the loneliness track before you realize. Third, it gives you something to look forward to.
When it comes to planning other activates such as classes, exercise, self-care, family time, etc. making a plan or even better a schedule to block off your time for those activities that are most important to you helps to ensure that these activities are prioritized. You might be thinking that you do not like the idea of having to plan every moment of your day, it feels like there is no freedom. I hear you; I felt the exact same way. While you don’t need to schedule every moment, the problem is that if you don’t block off and protect the time you would like to devote to things that are most important to you, it will be taken away by other less important or even meaningless items. So, I ask you - which option is taking away your freedom? Give it a try and see what you think.
I like to try to pull out the positives when I can, in my opinion, while we see the dangers of loneliness and the prevalence since the pandemic; I believe that our current global situation is shining light on a problem that has not have been addressed to the same extent in the past. As a health care provider, I am grateful that more attention and resources are being placed on this issue and mental health in general. If you are not aware, the Alberta government has created several resources and outlets for Albertans, you can learn more about this here. The one important suggestion that I believe they are missing is visiting your ND (I am a bit biased on that one, ha-ha). The other important takeaway I would like to impart is that if you are struggling with mental health since the pandemic, you are not alone and there is help.
References:
American Psychological Association. Retrieved May 25, 2021. https://dictionary.apa.org/loneliness
Erzen E, Çikrikci Ö. The effect of loneliness on depression: A meta-analysis. International Journal of Social Psychiatry. 2018;64(5):427-435. doi:10.1177/0020764018776349
Kent de Grey, R. G., Uchino, B. N., Trettevik, R., Cronan, S., & Hogan, J. N. (2018). Social support and sleep: A meta-analysis. Health Psychology, 37(8), 787–798. https://doi.org/10.1037/hea0000628
Brinkhues S, Dukers-Muijrers NHTM, Hoebe CJPA, van der Kallen CJH, Dagnelie PC, Koster A, Henry RMA, Sep SJS, Schaper NC, Stehouwer CDA, Bosma H, Savelkoul PHM, Schram MT. Socially isolated individuals are more prone to have newly diagnosed and prevalent type 2 diabetes mellitus - the Maastricht study. BMC Public Health. 2017 Dec 19;17(1):955. doi: 10.1186/s12889-017-4948-6. PMID: 29254485; PMCID: PMC5735891.
Lara E, Martin-Maria N, De la Torre Luque, A, Koyanagi A, Vancampfort D, Lzquierdo A, Miret M. Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studes. Ageing Research Reviews. 2019;52:7-16. doi.org/10.1016/j.arr.2019.03.002Get
Xia N, Li H. Loneliness, social isolation, and cardiovascular health. Antioxidants & Redox Signalling. 2018. 28(9);837-851. doi.org/10.1089/ars.2017.7312
Cohen S, Doyle WJ, Turner R, Alper CM, Skoner DP. Sociability and Susceptibility to the Common Cold. Psychological Science. 2003;14(5):389-395. doi:10.1111/1467-9280.01452
Leigh-Hunt N, Bagguley D, Bash K, Turner V, Turnbull S, Valtora N, Caan W. An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health. 2017;152:157-171. doi.org/10.1016/j.puhe.2017.07.035.
Smith K, Gavey S, Riddell N, Kontari P, Victor C. The association between loneliness, social isolation and inflammation: A systemic review and meta-analysis. Neuroscience & Biobehavioral Reviews. 2020(112):519-541. doi.org/10.1016/j.neubiorev.2020.02.002
Yang C, Boen C, Gerken K, Li T, Schorpp K, Mullan Harris K. Social relationships and physiological determinants of longevity across the human life span. Proceedings of the National Academy of Sciences.2016;113(3):578-583. doi.10.1073/pnas.1511085112
Statistics Canada. released: Mar 18, 2021. https://www150.statcan.gc.ca/n1/daily-quotidien/210318/dq210318a-eng.htm
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