In 2005, both CBS and ABC News reported that according to a 1985 survey done by the University of Arizona and Duke University, individuals were found to have an average of three close confidantes. Today, that average has declined from three to two, a decrease of one-third over approximately twenty years. In addition, about 25% of individuals today feel that they have no one in which they can confide. Sociologists conducting this study described this drop as “dramatic”.
In the book Animal Miracles, a story is told about senior citizen Jeff Fyfe who lived alone in Sidney, Australia, and he preferred it that way. He seldom answered the phone, perhaps because he was hard of hearing. His wife had died years earlier, and only six-year-old Trixie, an Australian kelpie-border collie mix, kept him company. He seldom received visitors except the occasional welcome visit from his daughter who tried her best to keep in touch with him.
One day . . . wham! It felt like a baseball had slammed into his head. He tried to get up from his bed but found that he couldn’t move his left arm or leg. Frightened, he desperately tried to make sense of what was happening to him. The phone rang. It was probably his daughter calling to remind him of her scheduled visit in nine days. However, Jeff couldn’t drag himself over to the phone. He was completely unable to move. He concluded that he must have suffered a stroke while he was asleep. Since he was a social recluse, no one would miss him. He began to scream, but no one heard him, no one, that is, except Trixie.
The temperature in Jeff’s house was at least 90°F. With no way of getting water, he realized that he would die a slow, miserable death. He drifted off to sleep and woke up crying for water, only to realize that no one was there to bring him any. Or was there?
It wasn’t a neighbor who eventually figured out the meaning of his hoarse, mumbled cries. Jeff could hear his dog lapping water from her bowl, making him even thirstier. He wished that Trixie could bring him water. In jumbled words he muttered his request. Perhaps an angel interpreted his garbled speech, “Tri…wader.” Trixie jumped up on Jeff’s bed and released a snoutful of water into his mouth. Mouth-to-mouth hydration, you might call it.
For days, each time Jeff would call out for water, Trixie would come. Her water bowl ran dry, but the dog ingeniously got a towel and dipped it in the toilet bowl. Gratefully, he sucked on the soaked towel. Days passed. The phone rang occasionally. After nine days, his daughter did come, and he was rushed to the hospital. In spite of his ordeal, Jeff survived.
The Power of Two
When I read this story I became alarmed. Jeff’s ordeal could have been cut short considerably had he encouraged social connections and had someone checking on him every day. His daughter knew Jeff loved his independence, but either she failed to recognize that independence without regular social support can become dangerous or perhaps a more likely scenario: she was uncomfortable with her dad’s hermit tendencies and did not know what to do about it. Or maybe he was uncooperative and did not want to live with anyone.
Ellen White calls this need for social connections the “law of mutual dependence.”1 Solomon expressed it this way: “Two are better than one, because they have good reward for their labor. For if they fall, one will lift up his companion; but woe to him who is alone when he falls, for he has no one to help him up. Again, if two lie down together, they will keep warm. But how can one be warm alone? Though one may be overpowered by another, two can withstand him, and a threefold cord is not quickly broken.”2
As a community are we reaching out to lonely individuals who are pinned down by mental illness or limited because of some personality quirk? Perhaps they are paralyzed with fear or are in need of encouragement. Although we hesitate to admit it, we have individuals in our church, on our campus, and in our community who are as limited in their ability to reach out for help as those who have more obvious physical impairments. Gentle caring on a regular basis and in a manner they would consider acceptable and appropriate, might afford some comfort to these souls.
Jeff would have received help much sooner had he had available systematic support and relationships. Today, some of us need to go beyond our busy schedules and develop a systematic plan of giving encouragement to those around us. Others of us need to reach out above our pride and stifling, mundane schedules and seize precious opportunities to receive support from others.
Social Isolation, Loneliness, and Health
Scientists have discovered that perceived social isolation or loneliness predisposes individuals to diseases by increasing the body’s reactivity to stress and diminishing repair processes. According to studies, lonely individuals or those without adequate social support or companionship have less efficient sleep and poor wound healing. Researchers at the University of Chicago found this to be true in socially isolated young adults. These young adults rated their everyday stress as more tense and coped with it more passively than those who were socially involved.3
Dr. John Cacioppo from the University of Chicago also discovered in other studies that the social interactions lonely people do have are not as positive as those of other people, hence the relationships they have do not buffer them from stress as relationships normally do. Loneliness raises levels of circulating stress hormones and levels of blood pressure. It can gradually undermine regulation of the circulatory system so that the heart muscle works harder and the blood vessels are subject to damage by blood flow turbulence.4 Most surprising of all, in a survey Dr. Cacioppo conducted, doctors, themselves, confided that they provide better or more complete medical care to patients who have supportive families and are not socially isolated.5
Loneliness among middle and older age adults is an independent risk factor for physical inactivity and increases the likelihood that physical activity will be discontinued over time.6
Irish researchers found that loneliness and social networks independently affect mood and well-being in the elderly and that both loneliness and lack of social support significantly increase their risk for depression.7 Swedish researchers found that men and women who are living alone or are divorced are at a significantly higher risk of developing Alzheimer’s disease (AD) in their later years. In his study of 1,449 individuals, professor Krister Hakansson and associates found that those living alone in mid-life were 40-50% more likely to get Alzheimer’s. People who lived alone for their entire adult lives had double the risk for dementia while those who divorced in middle age and remained single had three times the risk for dementia.8
Isolation Promotes Inflammation
Animal studies show that social isolation produces significant inflammatory response, especially in females. Isolation, perceived or otherwise, increases pro-inflammatory agents in human beings, as well. On the other hand, studies show that those individuals who are socially integrated have fewer inflammatory markers.910 This is important because inflammation fuels most chronic and autoimmune diseases. Rodent studies also show that social interaction reduces the actual size of an infarct after a stroke.11 In contrast, loneliness increases inflammation even more after a stroke.
Social Support and Heart Attacks
Studies show that social isolation and/or loneliness predict morbidity and mortality from cancer, cardiovascular disease, and a host of other diseases. In fact, the body perceives loneliness as a threat. Research from the University of California suggests that loneliness or lack of social support could triple the odds of being diagnosed with a heart condition. Redford Williams and his colleagues at Duke University directed a study in 1992 on heart patients and their relationships. They discovered that 50% of patients with heart disease who did not have a spouse or someone to confide in died within five years, while only 17% of those who did have a confidante died in the same time period.12
The Mayo Clinic found that a low social support network is equivalent to many of the classic risk factors of one-year mortality from a heart attack (i.e. elevated cholesterol levels, tobacco use, and hypertension).13 In other words, a lack of friendships increases the risk of dying from a heart attack within one year, and the value of meaningful relationships is as important as lowering cholesterol, controlling high blood pressure, and smoking cessation in preventing a heart attack. Another study showed that after a heart attack, even having a perception of low social support predicted death or another reoccurring heart attack.14 In Japan, low social support was associated with a higher risk of stroke mortality in men.15
Friendships Reduce Risk for Periodontitis
Researchers from Harvard School of Health examined the association between social support, anger expression, and periodontitis in 42,523 male, U.S.-based, health professionals. Interestingly, in this study more than half of the men were dentists. They were free of a diagnosis of periodontitis at the start of the follow-up in 1996. Subjects who reported having at least one close friend had a 30% lower risk of developing periodontitis compared with those who did not have a close friend. Men who participated in religious meetings or services had a 27% lower risk of developing periodontitis compared with men who did not participate in religious meetings.16
Researchers at Carnegie Mellon University, Pittsburgh, studied the effect of loneliness on antibodies in healthy freshmen when given a flu vaccine. Antibodies are the immune system’s CIA agents, which help the white blood cells identify germs. They found that “elevated levels of loneliness throughout the semester and small social networks were independently associated with poorer antibody response to one component of the influenza vaccine. Those with high levels of both loneliness and a small social network had the lowest antibody response.”17
Loneliness also significantly reduces natural killer (NK) cell activity.18 Like efficient air force bombers, NK cells drop molecular bombs that penetrate viruses’ defenses. Some of their “bombs” attack the virus’ command center. They also destroy cancer cells. Early studies suggest that lonelier medical students and psychiatric inpatients had less efficient NK cell and killer-T* function than their counterparts who reported less loneliness. According to Janice K. Kiecolt-Glaser, “The support provided by social relationships can serve as a buffer during both acute and chronic stressors, protecting against immune dysregulation.”19
Another study found that women with breast cancer who perceived they had substantial social support had greater NK cell activity than those women who also had breast cancer, but little social support. Even in women with metastatic breast cancer, studies showed that greater quality of social support was associated with “lower cortisol concentrations in women,” which indicates healthier neuroendocrine function. However, cortisol levels were higher among patients “who reported less appraisal, belonging, and tangible support.”20 This is also true in women who have ovarian cancer.21
Adequate, helpful social support promotes adherence to health regimens and can act as a buffer against negative effects from disease. It also improves the efficiency of the immune system and the prognosis for stroke victims.
Relationships and Youth
Connectedness is essential to children’s well being, as well. A sample of 2,022 students (999 boys and 1,023 girls) ages 12-14 years was measured at two time points twelve months apart on school connectedness and mental health symptoms (general functioning, depression, and anxiety symptoms). After adjusting for any prior conditions that could have led to mental health problems, the authors of the study reported stronger than previous evidence of the association with school connectedness and adolescent depressive symptoms and a predictive link between school connectedness to future mental health problems.22 Early studies suggest that there are substantial percentages of violent youth who do not perceive themselves to be liked by classmates and who report loneliness.
Hospitality Reduces Hospitalization
Our sympathies are to overflow the boundaries of self and the enclosure of family walls. There are precious opportunities for those who will make their homes a blessing to others. Social influence is a wonderful power. We can use it if we will as a means of helping those about us.”23
A more integrated society encourages the development of an integrated individual. Our happiness and health depend upon the harmonious development of the physical, mental, social, and spiritual aspects. Too much introversion, be it in individuals, families, or social cliques, eventually leads to social disconnection, which limits our outreach and undermines the health of individuals, the church, and society.
White, E.G., The Review and Herald, Sept 17, 1889, paragraph 20.↩
Ecclesiastes 4:9-12, The Bible, KJV.↩
Hawkely, L.C. and Cacioppo, J., Loneliness and pathways to disease. Brain, Behavior, and Immunity, 17 (2003) S98–S105.↩
Cacioppo, J. and Patrick, W., Loneliness: Human Nature and the Need for Social Connection, New York : W.W. Norton & Co., 2008. ISBN 978-0-393-06170-3.↩
Hawkley, L.C., et al, Loneliness predicts reduced physical activity: Cross-sectional & longitudinal analyses. Health Psychol, 28(3):354-63, 2009.↩
Golden, J., et al, Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. Int J Geriatr Psychiatry, Mar 9, 2009.↩
Loneliness Sparks Risk of Dementia, http://www.internationalreporter.com/News-3949/loneliness-sparks-risk-of-dementia.↩
Steptoe, A., et al, Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Psychoneuroendocrinology, 29(5):593-611, 2004.↩
Why loneliness may damage the health, news.bbc.co.uk/1/hi/health/6991584.stm.↩
Craft, T.K., et al, Social interaction improves experimental stroke outcome. Stroke, 36(9):2006-11.↩
Williams, R., Social factors impact risk for heart attack and disease, http://www.selfhelpmagazine.com/article/heart-attack.↩
Mookadam, F. and Arthur, H.M., Social support and its relationship to morbidity and mortality after acute myocardial infarction. Arch Intern Med, 26(164):1514-8, 2004.↩
Burg, M.M., et al, Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial: the effects of treatment. Psychosom Med, 67(6):879-88, 2005.↩
Ikeda, A., et al, Social support and stroke and coronary heart disease: the JPHC study cohorts II. Stroke, 39(3):768-75, 2008.
fn16. Merchant, A.T., et al, A prospective study of social support, anger expression and risk of periodontitis in men. Harvard School of Public Health. J Am Dent Assoc, 134(12):1591-6, 2003.↩
Pressman, S.D., et al, Loneliness, social network size, and immune response to influenza vaccination in college freshman. Health Psychol, 24(3):297-306, 2005.↩
Koenig, H., The link between religion and health: Psychoneuroimmunity and the faith factor, Oxford University, 2002.↩
Kiecolt-Glasser, J.K., et al, Psychoneuroimmunology and psychosomatic medicine: back to the future. Psychosomatic Medicine, 64:15-28, 2002.↩
Psychosomatic Medicine, 62:337-245, 2000.↩
Journal of Clinical Oncology, 23(28), 2005, p.7105-7113.↩
J Clin Child Adoles Pscyhol, 35(2):170-9, 2006.↩
White, E.G., The Ministry of Healing, 1905, p. 353-4.↩