Chapter Three: Loneliness and the pandemic

overview of the chapter

In the podcast episode, I spoke with Dr. James Lyda about loneliness during the pandemic and what we can do to address it. This chapter will help you understand how loneliness affects us and how the pandemic has exacerbated its effects, particularly on college students. Moreover, this chapter also provides the resources mentioned during the episode and adds additional ones that can help us overcome loneliness.

The first section will delve into understanding what loneliness is and what influences it, along with the negative effects that it can have on our health and how it can be comorbid with mental health disorders. The second section will explore the particular factors that contribute to the high rates of loneliness among university students. Building off of the conversation with Dr. Lyda, the third section explains which pandemic factors have worsened loneliness and how we can address them. The next section will list and explain the resources mentioned during the podcast episode, as well as additional resources. Finally, the last section will outline which aspects of loneliness remain unaddressed in the current research.

What Influences Loneliness?

Loneliness is defined as a subjective experience that arises when social connections, relationships, and interactions are not perceived to be sufficient (Labrague et al., 2020). Therefore, loneliness can be thought of as a state of mind. One could be surrounded by friends, family, or other types of social connections and may still feel lonely.

As Dr. Lyda mentioned in the podcast, humans are social beings, with the average person spending around 80% of the time they are awake with other people (Cacioppo et al., 2009). Connections with other human beings are essential and the negative impact of social isolation and loneliness on subjective well-being, physical health, and heightened mortality risk has been well documented (Cacioppo et al., 2009; Holt-Lunstad et al., 2015). Although loneliness may seem trivial to someone unfamiliar with the research, it has been associated with a greater risk for mortality, depression, and suicidal behavior (Diehl et al., 2018). Individuals who experience loneliness are more likely to have higher rates of cardiovascular disease, alcoholism, and suicidality (Simon & Walker, 2018). Even prior to the Covid-19 pandemic, loneliness was considered a major health challenge, with countries like the UK even appointing a loneliness minister to help counter the negative effects of widespread loneliness (Yeginsu, 2018).

But what causes a person to experience loneliness? And why can it be so persistent? There are various factors that can contribute to loneliness but the most prominent ones tend to be environmental factors such as social isolation, the death of a significant person, and sleep deprivation (Cherry, 2020; Simon & Walker, 2018).

To explain how social isolation can impact loneliness, perhaps it is better to talk about the other extreme first – having a sense of belonging. As explained by the Self Determination theory, people are driven to find a need for connection or a sense of ‘belongingness’. Thus when one feels like they don’t belong in a social group or setting, they may feel lonely (Wei et al. 2005). Moreover, being deprived of those social connections entirely or being socially isolated can also lead people to feel lonely.

Social isolation can be a self-reinforced characteristic because when an individual is perceived to be lonely, others may reduce their social interactions with them and the individual may also disengage in interactions with others, reinforcing the perceived feeling of isolation and loneliness. Other factors, like sleep loss, have been found to create reinforcing feedback loops that make loneliness more persistent. One study published in Nature found that sleep deprivation leads individuals to have a behavioral profile consistent with loneliness through interviews and fMRI scans (Simon, & Walker, 2018). Sleep-deprived participants had more social distance from others and chose to withdraw more compared to the control group that was not sleep deprived (Simon, & Walker, 2018). Therefore, sleep loss can be a self-reinforcing cycle that engrains social withdrawal.

Another well-cited paper found that loneliness happens in clusters within a social network and can extend to 3 degrees of separation (Cacioppo et al, 2010). Most of the time, loneliness occurs at the periphery of a social network, and the study found that the spread of loneliness was stronger than the spread of perceived social connections (Cacioppo et al, 2010). Therefore, it is important to understand the social systems and context in which lonely individuals find themselves to understand the causal connections and reinforcing feedback loops that may lead them to feel lonely.

understanding loneliness among undergraduate students

Loneliness for college students can be a significant challenge and in a 2017 survey by the American College Health Association, 68% reported feeling very lonely in the previous 12 months in a sample of 48,000 college students in the US (The Foundation for art and Healing, 2020). College students comprise the group with the highest prevalence of loneliness (Diehl et al., 2018). In addition to the causes listed above, many college students face other factors that make them more likely to feel lonely. The transition from high school to university brings forth many changes ranging from social, geographical, and behavioral (Diehl et al., 2018). Students are faced with a new social environment where they have to make new friends. Many students travel outside their home states or countries to new locations where they may not be familiar with anyone. Additionally, the increased diversity found in college campuses can create ‘pockets of isolation’ among minority students who do not ‘belong’ to the majority groups (Iarovici, 2014). These factors can lead students to feel lonely and isolated, especially during their first year of university.

Similarly to a general population, loneliness is associated with depression and poorer physical health among college students (Iarovici, 2014). Moreover, lonely students have a higher risk of poor sleep, substance use, susceptibility to illness, self-harm, and suicidality (Ebesutani et al., 2015; Schinka et al, 2012).

the role of the pandemic

Up to this point, I haven’t mentioned the impact that the Covid-19 pandemic has had on student loneliness. Although the research remains ongoing, it is clear that the pandemic has had a significant impact on student loneliness. The Covid-19 pandemic has brought a lot of disruption to the social activities and routines of most individuals. These disruptions are exacerbated among students, making them more vulnerable to social isolation and loneliness. Due to mandatory lockdowns, enforced social distancing guidelines, colleges closing, and classes moving online, the social networks that students are normally a part of, have been severely constrained.

As was mentioned in the episode, according to an Active Minds Survey of 2,086 college students, 80% reported experiencing loneliness and isolation during the pandemic period (Active Minds, 2020). One study found that in a sample of 564 young adults, loneliness increased from January to April/May 2020, with worse outcomes for women (Lee et al., 2020). Another study that sampled 233 student nurses found that nearly 90% experienced moderate to severe levels of loneliness during the start of the pandemic (Labrague et al., 2020).

Students who were once immersed in thriving social networks on their campuses have been pushed to the periphery of social networks by partaking in remote learning in their homes. It is highly plausible these students who now find themselves in the periphery of social networks are experiencing higher rates of loneliness than before the pandemic.

useful resources for undergraduate students

So how can students remain connected during these socially distanced times? Technological tools have come to be incredibly handy in helping us maintain social connections despite the geographical distance. In the age that we are living in, not only students, but everybody can remain connected through video calls, digital gatherings and events, phone-calls, and joint virtual activities like Netflix parties, a Google Chrome extension that allows concurrent streaming of movies or tv-series.

Moreover, as mentioned in the podcast episode, I highly recommend using the App Nod since it was specifically to help students build meaningful social connections (Grit Digital Health, LLC and Hopelab, 2020). The app features various prompts and ideas for students that help them connect with other students. An RCT measuring the impact of Nod found that four weeks of use of the app helped prevent loneliness and depression among the students who were most at risk during the beginning of the academic year (Bruehlman-Senecal et al., 2020). However, one limitation of the study is that on average the participants did not engage extensively with the app, which raises questions about the specific elements of Nod that were most useful for users.

Another resource mentioned in the episode is an initiative called the Unlonely Project (The Foundation for Art and Healing, 2021). This project raises awareness about the negative effects of loneliness and promotes creative arts approaches to reduce it. They also host an annual film festival that features short films that inspire and enlighten viewers (The Foundation for Art and Healing, 2021). You can visit their website to watch different films.

references

Bruehlman-Senecal, E., Hook, C. J., Pfeifer, J. H., FitzGerald, C., Davis, B., Delucchi, K. L., … & Ramo, D. E. (2020). Smartphone App to Address Loneliness Among College Students: Pilot Randomized Controlled Trial. JMIR mental health, 7(10), e21496.

Cacioppo, J. T., Fowler, J. H., & Christakis, N. A. (2009). Alone in the crowd: the structure and spread of loneliness in a large social network. Journal of personality and social psychology, 97(6), 977.

Cherry, K. (2020, March 23). The Health Consequences of Loneliness. Retrieved March 13, 2021, from https://www.verywellmind.com/loneliness-causes-effects-and-treatments-2795749

Diehl, K., Jansen, C., Ishchanova, K., & Hilger-Kolb, J. (2018). Loneliness at universities: determinants of emotional and social loneliness among students. International journal of environmental research and public health, 15(9), 1865.

Ebesutani, C., Fierstein, M., Viana, A. G., Trent, L., Young, J., & Sprung, M. (2015). The role of loneliness in the relationship between anxiety and depression in clinical and school‐based youth. Psychology in the Schools, 52(3), 223-234.

Grit Digital Health, LLC and Hopelab. (2020). An app to reduce loneliness on college campuses. Retrieved February 21, 2021, from https://heynod.com/

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Iarovici, D. (2014). Mental health issues and the university student. JHU Press.

Labrague, L. J., De los Santos, J. A. A., & Falguera, C. (2020). Social and emotional loneliness among college students during the COVID-19 pandemic: the predictive role of coping behaviours, social support, and personal resilience.

Lee, C. M., Cadigan, J. M., & Rhew, I. C. (2020). Increases in Loneliness Among Young Adults During the COVID-19 Pandemic and Association With Increases in Mental Health Problems. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 67(5), 714–717. https://doi.org/10.1016/j.jadohealth.2020.08.009

Schinka, K. C., VanDulmen, M. H., Bossarte, R., & Swahn, M. (2012). Association between loneliness and suicidality during middle childhood and adolescence: longitudinal effects and the role of demographic characteristics. The Journal of psychology, 146(1-2), 105-118.

Simon, E. B., & Walker, M. P. (2018). Sleep loss causes social withdrawal and loneliness. Nature communications, 9(1), 1-9.

The Foundation for Art and Healing. (2021, January 26). The UnLonely Project. Retrieved February 21, 2021, from https://www.artandhealing.org/unlonely-home/

The Foundation for Art and Healing. (2021, January 26). UnLonely Film Festival 4. Retrieved February 21, 2021, from https://www.artandhealing.org/uff4/#

The Foundation for Art and Healing. (2020, January 29). Campus Loneliness Fact Sheet. Retrieved March 13, 2021, from https://www.artandhealing.org/campus-loneliness-fact-sheet/#:~:text=In a 2017 survey of,the American College Health Association.&text=Nearly 35% of students frequently felt anxious.

Wei, M., Shaffer, P. A., Young, S. K., & Zakalik, R. A. (2005). Adult Attachment, Shame, Depression, and Loneliness: The Mediation Role of Basic Psychological Needs Satisfaction. Journal of Counseling Psychology, 52(4), 591–601. https://doi.org/10.1037/0022-0167.52.4.591

Yeginsu, C. (2018, January 17). U.K. Appoints a Minister for Loneliness. Retrieved March 13, 2021, from https://www.nytimes.com/2018/01/17/world/europe/uk-britain-loneliness.html