Fighting loneliness, a quiet devastation

BLACKPOOL, England – The woman on the other end of the phone spoke lightheartedly of spring and her 81st birthday the previous week. "Who did you celebrate with, Beryl?" asked Alison, whose job was to offer a kind ear.

"No one, I …" And with that, Beryl's cheer turned to despair.

Her voice began to quaver as she acknowledged that she had been alone at home not just on her birthday, but for days and days. The telephone conversation was the first time she had spoken in more than a week.

About 10,000 similar calls come in weekly to an unassuming office building in this seaside town at the northwest reaches of England, which houses the Silver Line Helpline, a 24-hour call center for older adults seeking to fill a basic need: contact with other people.

Loneliness, which Emily Dickinson described as "the Horror not to be surveyed," is a quiet devastation. But in Britain, it is increasingly being viewed as something more: a serious public health issue deserving of public funds and national attention.

Working with local governments and the National Health Service, programs aimed at mitigating loneliness have sprung up in dozens of cities and towns. Even fire brigades have been trained to inspect homes not just for fire safety but for signs of social isolation.

"There's been an explosion of public awareness here," said Paul Cann, chief executive of Age UK Oxfordshire and a founder of the London-based Campaign to End Loneliness. "Loneliness has to be everybody's business."

Researchers have found mounting evidence linking loneliness to physical illness and to functional and cognitive decline. As a predictor of early death, loneliness eclipses obesity. "The profound effects of loneliness on health and independence are a critical public health problem," said Dr. Carla Perissinotto, a geriatrician at the University of California, San Francisco. "It is no longer medically or ethically acceptable to ignore older adults who feel lonely and marginalized."

In Britain and the United States, roughly one in three people older than 65 live alone, and in the U.S., half of those older than 85 live alone.

While the public, private and volunteer sectors in Britain are mobilizing to address loneliness, researchers are deepening their understanding of its biological underpinnings. In a paper published earlier this year in the journal Cell, neuroscientists at the Massachusetts Institute of Technology identified a region of the brain they believe generates feelings of loneliness. The region, known as the dorsal raphe nucleus, or DRN, is best known for its link to depression.

John Cacioppo, a professor of psychology at the University of Chicago and director of the university's Center for Cognitive and Social Neuroscience, has been studying loneliness since the 1990s. Cacioppo lauds efforts like the Silver Line, yet he warns that the problem of loneliness is nuanced and the solutions not as obvious as they might seem. That is, a call-in line can help reduce feelings of loneliness temporarily, but is not likely to reduce levels of chronic loneliness.

The very word "lonely" carries a negative connotation, Cacioppo said, signaling social weakness, or an inability to stand on one's own.

The unspoken stigma of loneliness is amply evident during calls to the Silver Line. Most people call asking for advice on, say, roasting a turkey. Many call more than once a day. One woman rings every hour to ask the time. Only rarely will someone speak frankly about loneliness.

And men and women differ in how they grapple with loneliness. Seventy percent of the calls to the Silver Line are from women.

"We have this kind of male pride thing," said Mike Jenn, 70, a retired charity worker who lives in London. "We say, 'I can look after myself. I don't need to talk to anyone,' and it's a complete fallacy. Not communicating helps to kill us."