Sana* still does not know what she was running away from. As an 18-year-old thrust into the labyrinths of Mumbai, she tried to escape loneliness by travelling listlessly in local trains from one end of the city to another, with no destination in mind.
Five years later, having moved to Delhi, she is still not free from the shackles of chronic loneliness. But instead of trying to drown out her emotions in blurring crowds, she confines herself to her room, binge-watching Netflix.
“I don’t want to see people with other people or people with a sense of purpose because both are elusive to me,” she says. “Connecting to someone is very hard, because you never know how someone will react. Everybody reacts to what you say, but nobody empathises anymore and that hurts,” she says.
Her angst finds an echo in Olivia Laing’s 2016 book The Lonely City: Adventures in the Art of Being Alone . “You can be lonely anywhere, but there is a particular flavour to the loneliness that comes from living in a city, surrounded by millions of people,” Laing writes.
Mental health experts, too, affirm that loneliness is increasingly a disease of urban modern life.
“It is like the ‘water, water everywhere, but not a drop to drink’ situation in India right now,” says physician and psychiatrist Shyam Bhat. “We have people everywhere; we are one of the most populated countries in the world. But, ironically, loneliness is becoming one of our biggest problems,” says Bhat, who heads Mindfit, the multi-city mental health and wellness service of cure.fit healthcare.
Bhat, who has specialised in both internal medicine and psychiatry, explains that loneliness is a state of mind where people feel they cannot truly connect with anyone around them. This means that one can feel lonely in the midst of people.
At Mindfit, which handles more than 150 consultations a day, more than 40 per cent of clients under the age of 30 showed signs of loneliness in some form or other, Bhat says. Parul Tank, a Mumbai-based consultant psychiatrist and therapist, says that at least 20 per cent of her clients admit experiencing feelings of isolation and loneliness.
Globally, loneliness is a problem that affects not just the elderly, as many would think. The Maryland-based National Center for Biotechnology Information (NCBI), which is a part of the United States National Library of Medicine, states in an article of 2013 that loneliness is most prevalent during adolescence, with more than 70 per cent of adolescents experiencing recurring loneliness at age 18; this rate declines to 60 per cent by ages 35–40, and 39 per cent for older adults.
A 2018 study by Cigna, a global health service company in the US, found that generation Z (18-22 age group) and millennials (23-37 age group) are lonelier than older generations.
Though similar data are not readily available for India, the National Sample Survey Office in 2004 reported that 4.91 million Indians lived alone. While loneliness may not be unique to cities alone, mental health experts affirm that it is increasingly becoming more of an urban phenomenon. Clearly, feelings of kinship may be waning in the fast-lanes of city life.
Tarun*, who moved to Bengaluru from Kochi in Kerala for college education when he was 18, describes the feeling of loneliness in the city as exhausting. “It weighs on you unlike anything else,” he says.
The evenings are especially trying for him. “It is almost like the whole place goes dark and you are stuck inside a few concrete structures. Those times give you anxiety attacks and a deep sense of loneliness. Everywhere you look there are high-rises... (There is) no space to think, no space to breathe. Always hustling,” he adds. “Then there is the loudness of the city. The constant honking, hollering and road rage that you come across all too often,” Tarun, now 23, laments.
In the darkening dusk, alone in his room, his feelings of isolation become more acute. “I don’t think I can ever overcome it,” he says.
Experts warn that such extreme feelings of isolation severely impact a person’s health, and can even prove fatal. The Cigna study, for instance, states that loneliness has the same impact on mortality as smoking 15 cigarettes a day, making it even more dangerous than obesity.
A high degree of loneliness precipitates thoughts of suicide, Alzheimer’s disease, and other forms of dementia, and adversely affects the immune and cardiovascular system, states another NCBI article dated 2013, which also cites loneliness as a latent cause of hospitalisation.
“An increase in mortality has been correlated with both loneliness and social isolation... A recent meta-analysis indicated that social isolation, loneliness, and living alone increased the possibility of death by 29 per cent, 26 per cent, and 32 per cent, respectively,” says an NCBI article in March 2018.
Not surprisingly, policymakers around the world are now waking up to this worry. Last year, the UK government appointed a Minister of Loneliness for a nation that has a staggering 9 million lonely people. “For far too many people, loneliness is the sad reality of modern life,” former Prime Minister Theresa May said in a statement then.
By adversely impacting the body’s autonomic nervous system, endocrine, metabolic and immune systems, loneliness accelerates the risk of heart disease, depression, diabetes and anxiety, says Bhat. “Loneliness is one of many conditions at the interface of body and mind, but unfortunately, the medical system is such that mind and body are separate disciplines,” he adds.
Calling it a “new age epidemic”, Venkatesh Babu GM, consultant psychiatrist, Department of Mental Health and Neurosciences, Fortis Hospitals, Bengaluru, says loneliness can be seen as both a cause for and consequence of various mental disorders, especially depression. Social isolation is a potent but little understood risk factor for morbidity and mortality, he says.
Explaining why cities in particular precipitate feelings of disillusionment and estrangement, Babu says that while people in villages and small towns build and nurture their social networks with the people around them, city-dwellers have fewer opportunities for developing such ties. Many of them move from city to city for education and employment, leaving even less room for forging meaningful social relationships.
Particularly susceptible are the youngsters who move out of home to take up jobs in other cities after finishing their education, says psychotherapist Chetna Duggal, an assistant professor at Tata Institute of Social Sciences, Mumbai. No longer moored to their family or educational community, they tend to feel isolated and alone, she adds.
The pressures of work and the need to succeed may also leave no time or inclination for nurturing social relationships. “Everyone is busy, focused on moving up the career ladder, and prioritising only themselves,” rues Sanghavi PS, a 23-year-old Bengaluru resident.
Perfunctory relationships are almost the norm in cities, adds Megha*, a 52-year-old Kochi resident. She points out that some people, especially the young, prefer this as it gives them a sense of privacy and anonymity. But then there’s a flip side to this. “It is when you need help that the difficulty crops up. I was ill a few months ago and I had no one to turn to for help. What do you do in such situations,” she asks.
Babu says that in urban milieus, people usually end up building their social networks at their workplaces, social clubs or on social media platforms, all of which are “mostly superficial and need-based”.
Various other factors — such as high work demand, single parenting challenges, longer commutes, high stress levels and technological advancements such as smart phones and virtual engagements — limit actual socialisation, he says.
Take the case of Arpitha Benny, 25. Having grown up in Gadchiroli in Maharashtra, she was conditioned to the close-knit relationships of her town. But loneliness struck her when she moved to Chennai for college, and later to Mumbai for work.
Through the week, she says, her friends are busy working or commuting back and forth, leaving little scope for meaningful, face-to-face interactions. “And even when you go back home, you are on your own. My roommate is older to me. I don’t really connect with her. So, yes, there are times when I feel really lonely,” she says.
Adds Tank, “Some of them (young people who seek help) say they are engaged during workhours, but don’t know what to do after work. A lot of them say they dread weekends because there is nothing to do the whole day.”
Why is loneliness increasingly striking the youth? “I think we grow up faster,” says Tank. Unlike their parents’ generation, today’s youngsters have a greater say in their choice of education, jobs and place of living. But what’s lacking are the coping strategies required to deal with all of this, she notes.
Experts equally blame social media for many of these ills. These platforms inculcate a deep sense of dissatisfaction because of constant comparisons, leading to envy and a regular need for external validation, says Babu.
“Thus, people start opting for virtual engagements whenever they are confronted with unpleasant real-life experiences and fail to acquire much-needed social skills, communication skills and emotional self-regulation,” Babu adds. These factors add to their feelings of loneliness.
Technology is also set to aggravate loneliness, Bhat points out. “I can see a day when we wouldn’t want to interact with people... As technology takes over many service-related jobs, it will further reduce human interaction and increase loneliness.” he says.
Bhat recalls 19th century German philosopher Arthur Schopenhauer’s analogy about human beings and porcupines in winter.
“We are like the proverbial porcupines in winter. They need each other for warmth and so they come close, but when they huddle together, they cannot help hurting each other because of their sharp quills. This is the predicament of the human condition, worsened by urban life. We want more space and privacy than previous generations, but, at the same time, we crave connection. We seek togetherness and yet are more impatient and intolerant of one another.”
Human connection, he says, is an essential need for human happiness. “But the way we have structured our lives today has made connection harder, with the result that more people are lonelier and more depressed than ever before,” he says.
How does a person snap out of loneliness? In the case of Pallavi Shivakumar — swamped by loneliness when she moved to Berlin from her home city, Bengaluru — the family helped.
The 29-year-old student, doing her second masters, recounts life in Germany. “Wherever I go, I get a ‘hi’, say at the elevator or anywhere for that matter. And when I leave, they say ‘bye’. I would give them a 100 per cent for their manners,” she says with a laugh. “But ‘how are you’ is a question no one asks. It is like it is not worth their time. And even if they do, you have two seconds to answer, and the expected answer is ‘I am fine’,” she says.
Her family’s support and incessant assurances played a pivotal role in assuaging her loneliness, she adds. This reaffirms experts’ take on how this epidemic of loneliness in cities can be addressed, as they emphasise on the need for strong connections beyond the scope of work and transactional relationships.
But developing effective interventions is not a simple task because there is no single underlying cause of loneliness.
“Different people may be lonely for different reasons, and so a one-size-fits-all kind of intervention is not likely to work,” writes Julianne Holt-Lunstad, a professor of psychology and neuroscience at Provo, Utah-based Brigham Young University, in a May 2019 article published by American Psychological Association.
Bhat stresses that a qualified psychotherapist can help a person cope with the internal emotional barriers that come in the way of social connections. These may include past traumatic experiences, insecurities, anxiety, low self-esteem and a self-critical nature, he adds.
Duggal advocates greater sensitivity at workplaces.
“I think workplaces really need to think about what young people who are coming in early in their careers might be going through... I think it has to be a much more systemic response rather than expecting that young people will find human connections and support systems on their own. That would be absolving ourselves of any responsibility.”
Raising awareness about mental health is important, Bhat stresses, adding that it should be a part of school curricula. “It is a glaring omission that, as a society, we don’t teach our children how to handle their emotions and feelings. That needs to change,” he says.
As for adults, he says the key is to be aware of the need for human connection. “It’s not a luxury, not an add-on to your life. It is as vital to your well-being as healthy food and clean water.”
Shivakumar, whose family helped her fight the overwhelming feeling of isolation, would endorse that. Loneliness is no longer much of a foe, she says. It’s just a friend who occasionally pays her a visit.
(*Names changed to protect identities)