Loneliness is something everyone experiences at some point in their life. However, for some people, prolonged periods of feeling lonely can negatively impact their mental health.
Pam Qualter is a Professor at the University of Manchester’s Institute of Education. She studies loneliness throughout life - particularly in adolescence - and is looking to better understand its link to depression. We spoke to Pam ahead of her appearance at this year’s Mental Health Science Meeting.
Great to speak to you, Pam – can I begin by asking what got you started with studying loneliness?
Thanks for having me! I remember a class I went to at University, where the lecturer was talking about loneliness. I had experienced loneliness as a child – my family moved around a lot, so I’d establish some good friendships, but then a year later we’d have to move and I’d have to start all over again. I was a really lonely kid.
However, the lecturer was saying that it wasn’t possible to feel loneliness as a child. I was sitting there thinking, “that’s not my experience at all – am I really that strange!?” It sparked a bit of self-evaluation - I didn’t think my experience was that unusual. That spark led to a third-year project to study it further, which then led to a PhD – and it all snowballed from there.
We now know that children and adolescents actually do experience exactly the same loneliness that adults do. Loneliness is that intense feeling of disconnect, because of a mismatch between the social relationships we want and the relationships we have.
I’m not ashamed that I have that personal experience of loneliness, in fact I like it – having that experience means I really can try and understand the experiences of other people.
How common is loneliness?
It’s incredibly common – though I have some issue with the idea that there is an ‘epidemic of loneliness’, which is something we hear about in the media. It suggests that there is something pathological about feeling lonely, something abnormal – and I don’t think there is.
My colleagues and I have looked at the prevalence of loneliness in different age groups. What we have found is something like a U-shaped curve across the lifespan – where loneliness peaks in adolescence, dips down in mid-life, and then peaks again in later life.
In adolescence, we’re trying to work out who we are, and which group we fit into – which can be a very isolating experience. However, in old age, the challenge to our relationships is that we’re losing people. Maybe we’re not able to get out to socialise as often as we were, or maybe we’re losing friends and partners to ill health.
Between these two peaks, in ‘middle age’, people generally score lower on measures of loneliness. However, there may be certain people who are prone to loneliness, such as carers, the unemployed, or new parents with their first child.
You led the BBC Loneliness Experiment, the largest study on the topic ever conducted. What was the most interesting thing you found?
The BBC Loneliness Experiment was a study I conducted in 2018, in collaboration with the Radio 4's All In The Mind programme, the Wellcome Collection, and colleagues from Brunel and Exeter Universities. We carried out a survey with just under 55,000 people over the age of 16, to gather their opinions on loneliness and relationships.
What I found most surprising was the stigma that people attach to themselves if they feel lonely. People didn’t think badly of other lonely individuals at all. But people who scored high on loneliness felt very negatively about themselves, and so they would conceal it – they felt there was a real shame in telling other people.
Let me give you an example: not long after we released the results of the BBC Loneliness Experiment, I overheard a conversation on the train between two young men. They were talking about how they thought a friend of theirs was probably quite lonely – it was a very kind conversation, they obviously wanted to help. But they admitted that “there’s no way he’ll tell us”, so they didn’t feel they could reach out to him.
It’s fascinating - loneliness is such a universal experience that most of us feel at some point, and yet that doesn’t stop us feeling really ashamed when it happens to us. We need to get better at sharing our personal experiences of loneliness.
When does loneliness become a problem for our mental health?
Feeling lonely definitely impacts your wellbeing, without a doubt – it’s a horrible experience. But for mental health, the issue comes for individuals who don’t come out of loneliness – who remain lonely for months or years - and never establish the relationships they want, or don’t deal with their inner turmoil.
Most of the research around loneliness and mental illness has focussed on the link with depression. Some researchers have found links with suicidal thoughts and with anxiety, but more research is needed to pin that down.
What we know about loneliness and depression is that there seems to be a two-way relationship. We know that adolescents who feel very lonely may show more depressive symptoms – but also if you’re depressed to start with, feelings of loneliness are more likely to arise.
So, it’s not always the case that the loneliness comes first then the depressive symptoms come after, it could work the other way round. That means there’s not going to be a simple fix.
What’s needed to break this link between loneliness and mental illness?
What I’ve proposed again and again is that we need cognitive behavioural therapies (CBT), focussed not only at depression but also at loneliness.
This kind of CBT starts with getting people to challenge the assumptions and interpretations they have about social relationships. We know that people who feel lonely for a long time tend to have very distrusting beliefs about relationships. Even if they do establish what seem like close relationships, they don’t trust that person to, say, keep secrets or support them or help them – the normal things you’d expect friends to do. CBT can help to challenge those beliefs.
What’s currently being provided to tackle loneliness?
The UK Government is funding a lot of programmes around loneliness, but they’re mostly focussed on providing people with access to social groups – with the idea being that if you make a friendship, you’re not lonely anymore. I think this is too simplistic.
Although those kinds of groups will help some people, for the chronically lonely, they just aren’t going to work – they will still be very distrusting of any relationship they build. I also think the kind of ‘meet new people’ interventions would work much better if people got together over a shared interest or hobby, rather than just being lumped together because they feel lonely!
It’s also crucial that we intervene at adolescence, and not just because teenagers feel lonely a lot – if we can give young people the knowledge and the strategies to cope with loneliness, we can set them up for life. The Government has said that loneliness will be taught in schools as part of the new PSHE curriculum about relationships – I really hope this happens.
Finally, what do you hope for the future? What needs to happen next?
I really want us to be able to develop suitable interventions to combat chronic loneliness, I don’t think we’ve cracked it yet. But to do that, we need to properly understand how loneliness works, and we need better evidence on the link between loneliness and mental illness, beyond depression.
However, I can feel that the tone of the conversation around loneliness is changing. If we can take that forward, through things like MQ’s Mental Health Science Meeting, we can keep that momentum going to help people manage their loneliness, and not be ashamed to talk about it.
Pam will be speaking at this year’s Mental Health Science Meeting – an event bringing together researchers across different disciplines to explore cutting-edge new ways to understand, treat and prevent mental illness. To find out more, click here.
Last updated: 29 January 2019