Julie O'Flaherty and Imelda Ferguson, Offaly-based clinical psychologists
IN March 2019 we wrote in this column about the importance of social connection and the harmful effects of being isolated from each other. Little did we know that barely a year later we would actually be urged to socially isolate and socially distance in order to protect our physical health from a virus nobody had ever heard of, Covid-19.
So why did we find social distancing so difficult over the past few months? Why do we still miss easy social connection? The answer is that human beings are social beings. Over millions of years we have evolved as a species and become hardwired to interact with others, particularly in times of stress. Indeed social connection, be it through membership of tribes, religious groups, communities or families has helped humans evolve and be safe. We do better psychologically if we have at least one close and loving reciprocal relationship in our lives. We have long understood that human beings do not do so well when we are socially isolated from each other. Today’s article will revisit the topic of social connection and isolation in the light of the current Covid-19 restrictions and advice.
Neuroscientist and psychologist at the University of Chicago, John T. Cacioppo views social isolation as a drive, just like hunger and thirst. In his opinion, while social media technology can connect people in a virtual way, it can actually make you feel lonelier if you don’t actually also connect fact-to-face with other humans.
His research examined the impact of loneliness. He found that lonely people are more hostile. They tend to eat more sugar and fat. They have greater resistance to blood flow in their veins, which can lead to high blood pressure. Lonely people produce more of the stress hormone, cortisol; this leads over time to impaired immunity, poorer sleep and cognitive decline in older age.
Clifford Singer, an American psychiatrist and geriatrician, tells us that social isolation with or without the perception of feeling lonely can have as large an effect on mortality risk as smoking, obesity, sedentary lifestyle and high blood pressure. Researchers, Holt-Lunstad and colleagues (2015) at Brigham Young University in Utah found a 29% increased risk of mortality over time from social isolation and 26% increase in mortality risk from perceived loneliness. Similarly UK based research conducted in 2012 found significant associations between poor social relationships in general (social isolation and loneliness) and risk of coronary heart disease stroke.
From a psychological point of view, when we are alone we are more likely to turn our attention inward instead of outwards towards other people. We can get caught up in our own thoughts, which have evolved to be more negative than positive. We have no one to bounce our worries or fears or frustrations off and we can find it harder to distinguish fact from fiction.
The psychological literature on loneliness and social isolation indicates that both can lead to various psychiatric disorders and emotional problems such as depression, anxiety, poor self-esteem, alcohol abuse, suicidal behaviour, sleep problems and contribute to personality disorders. Animal studies carried out by neuroscientists at Caltech in the USA have found a link between social isolation and aggression, fear and hypersensitivity.
Although we have not been living with Covid-19 for more than a matter of months there is already evidence that the virus is causing a spike in anxiety and depression levels in both community and psychiatric populations. We have both seen this in clinical practice in the past few months. This can be attributed to a number of factors: worry about catching the virus for ourselves and others; the uncertainty surrounding the virus such as how, when and if we can eliminate or find a vaccine for it or how we can learn to live with it; the impact on our livelihoods and the economy; the impact on our children’s schooling and access to educational facilities. Having to isolate from our loved ones over the past few months has no doubt also had a negative impact on mental health.
So how can we balance the very important need for social connection with the social restrictions that will continue to be in place as we move into the second half of 2020? We know that having moved along through the phases involved in reopening our country, that we do not have to socially isolate the way in which we had to in April and May. More elderly members of our community have been allowed out of their 'cocoons'. However, many people remain fearful of the virus and continue to reduce social activity and interaction. We do still have to socially distance and how much will determine the busyness of our pubs, clubs, restaurants and gyms for example. It may determine how our young people return to school and college in September.
For our mental wellbeing and fitness we need to balance the real, physical threat of the virus with a return to somewhat normal social functioning and engagement with social activities. We are all familiar with the health advice by now. For example, we know that if we socially distance and observe cough and sneezing etiquette, perhaps wear a mask particularly when in indoor public spaces and continue to sanitise our hands and things we come in contact with, then we are being personally and socially responsible in managing this virus.
Community groups such as active retirement groups and men’s sheds are hugely important as is social prescribing which aims to refer people to non-clinical activities (anything from crochet class to learning the ukelele) as a means of positively influencing mental wellbeing. Returning to these activities even if they are altered somewhat in light of the virus will be important for mental fitness.
Similarly with our young people; returning to their sporting activities over the coming weeks is going to be important for keeping them occupied and physically and mentally healthy. Going for a socially distanced walk with a friend can clear the mental cobwebs and help prevent us getting stuck in worry loops and over-thinking such as fortune-telling and catastrophising. Adjusting to this 'new normal' is going to be required of all of us as we move forward in the next few weeks and months, but the evidence is that it will be worth it both physically and psychologically.
Julie O’Flaherty and Imelda Ferguson are chartered clinical psychologists, both based in private practice in Tullamore, Co Offaly. Through Mind Your Self Midlands, they run courses on Positive Psychology and Mindfulness through the year. They can be contacted through the Psychological Society of Ireland www.psychologicalsociety.ie (Find A Psychologist section) or on their Facebook page, Mind Your Self Midlands.