Killing me softly

One of the starkest images of loneliness I’ve seen occurs towards the end of the British documentary Project Nim (2011), the story of a chimp raised like a child by pot-smoking primatologists in an idyllic farmhouse. After the research funds dry out, Nim is shipped off to a lab, which echoes with the fearful shrieks of caged primates and is injected with experimental vaccines. He’s abruptly ‘rescued’ from this hellhole, only to find himself in another one: a barren cage for abused equines, with a barrel and cardboard box for company.

Within weeks, the animal that once tumbled joyously in the dirt and eagerly gestured for bananas and drags of joints is replaced by a creature with slumped shoulders and a defeated air. He divides his time between two so-called activities: sitting on a tyre suspended from the ceiling and staring into space; and shuffling across the cage, shoving the barrel before him. Twice he is offered a TV set. Both times he hurls it against the wall. “Chimps are social animals,” his former primatologist housemate says. “You can’t just put a chimp in a box and expect him to be cool with it.”

Not long afterwards, I met a number of men who knew just how Nim felt — and could speak about it. They were former convicts who had spent part of their sentence in ‘the Box’— isolation wards in prisons in upstate New York. They spoke of days, months, even years of unrelenting boredom, suffocating loneliness, sleeplessness and anxiety. All of which, they said, eroded their concentration and memory; even their sanity. Such crippling isolation, psychologists and neuroscientists agree, damages the mind and the brain. But an increasing number of studies also show that the Box does not have to be real to affect us. Loneliness — the commonplace, bedroom-variety kind — can be lethal too.

A 2012 study, ‘Loneliness, health and mortality in old age,’ that tracked 2,000 people over the age of 50 over six years found that the loneliest were nearly twice as likely to die in the course of the study. This translated to a 14 per cent greater risk of dying, compared to their average peers. To put this in perspective: loneliness heightens the risk of early death twice as much as obesity, and about as much as a longstanding smoking habit.

Meanwhile, a 2015 meta-analysis of studies about the increased mortality risk associated with isolation showed that there was scarcely any difference between ‘objective’ and ‘subjective’ loneliness — that is, between living alone and feeling alone in a crowd. Those who lived alone, felt lonely, and those who had few social connections were associated with increased mortality risks of 32 per cent, 29 per cent and 26 per cent respectively.

The authors ended their paper with something of a call-to-arms. “Affluent nations have the highest rates of individuals living alone since census data collection began and also likely have the highest rates in human history, with those rates projected to increase,” they wrote.

None of this seems surprising when you consider the many ways in which loneliness is associated with poor health. The young who suffer from it have worse immunity, worse inflammation, and sleep punctuated by stress-driven ‘micro-awakenings’, while the old suffer higher rates of hypertension and cardiovascular trouble. A quick shuffle through Google Scholar throws up additional corroborating evidence. A 2002 study of 240 middle-aged civil servants conducted by epidemiologists at University College London found that lonelier people had increases in blood proteins and white blood cells, which accentuated their risk for narrowed arteries, strokes, and hypertension.

A 2012 study conducted by biochemists and gerontologists in Dublin measured both loneliness and blood glucose levels among 466 elderly. The loneliest had the highest blood sugar levels, and a propensity to obesity and Type-2 diabetes. Among the elderly, loneliness prefigures — even accentuates — cognitive decline. A 2007 study of 823 elderly people by neurologists at Rush University found that the loneliest among the group experienced double the risk of contracting Alzheimer’s disease.

Loneliness as a stressor

Loneliness’ lethal grip extends far beyond people and primates; as far back down the evolutionary ladder as mice, pigs, birds, rabbits, and fruit flies. Since we’ve all evolved to function within social groups, our system recognises the lack of company as a threat to our survival. And the prolonged lack of company, or even the impression that one’s social interactions are meaningless and vapid, can act as a damaging stressor.

While a short burst of stress makes us wake up in the morning, or jolts us alert when we face sudden threats, the prolonged experience of stress — which isolation or feelings of loneliness bring on — releases an unchecked dose of stress-propelled enzymes into the system. When this seeping continues unabated, it plays havoc with our neuroendocrine, immune and autonomic systems, which regulate bodily functions ranging from heart rate and respiration to digestion.

Recent studies by neuroscientists suggest that loneliness even causes us physical agony. One paper notes, “Because of the adaptive value of mammalian social bonds, the social attachment system… may have piggybacked onto the physical pain system to promote survival.” We behave in the presence of loneliness as we would when we sense a predator: by retreating into self-preservation mode, and evading company.

Head in sand

The few studies on loneliness in India only chronicle the extreme social rejection faced by the elderly. This is a pressing concern: by 2030, 198 million people will be aged over 60, according to statistics from the health ministry. But how many of our world-record-breaking contingent of 150 million young feel distressed and alone? We don’t know, and we’re not likely to hear about it, because of our self-image as a society teeming with ‘close-knit’ families, and because of how much we stigmatise loneliness and mental health issues.

In recent months, several close friends and relatives — married, single, young and middle-aged — have told me they suffer from pangs of loneliness and low esteem. They confessed that they’d gotten into the habit of avoiding people, and that the few social interactions they forced themselves into felt dissatisfying and hollow. Online interactions, which might have helped alleviate their loneliness, had the counterproductive effect of making them feel self-conscious and ashamed. Needing to hide from company felt especially anomalous when most of their peers’ lives on social media arenas seemed to teem with joyous group selfies, hyper-coloured dinner parties, and 500-person-strong friend-lists. They began to blame themselves — perhaps they were too boring, too negative, too socially inept? When I suggested that one of them seek a psychologist’s help, she snapped: “Oh, there’s nothing wrong with me.”

Whatever went wrong with Nim, he did eventually get better. His primatologist friend made sure to visit him often, and Nim was soon gesturing for sips of soda pop, and gambolling from one side of his cage to the other. Then, he acquired roommates: two gentle chimps named Mitch and Lou Lou, both refugees from the now-shuttered primate lab. Nim’s last few years were spent being groomed, playing and communicating with his old primatologist friend, and rolling around a beach ball with his new friends. He reminds us that the old Sartrean line need not always hold true. Good health is other people too.

Shruti Ravindranis a freelance journalist who covers science, environment, health and social justice

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