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What we actually need to do address the epidemic of loneliness

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The U.S. surgeon general recently issued a landmark advisory on the startling epidemic of loneliness and social isolation in the United States. The report shone a bright light on the dire consequences of loneliness — including the fact that prolonged loneliness can cause the same health impacts as smoking 15 cigarettes a day.

This call to action was much needed. It pushes the medical community and policymakers to give loneliness the same attention and ferocity as other major health issues. We need to rise to meet this moment. 

We must challenge the status quo and address loneliness as an independent medical condition — just like heart disease or cancer. And, like other diseases, loneliness cannot be fixed with cursory or surface-level changes. 

Loneliness is a profound, overwhelming feeling that one cannot connect with others. Importantly, this condition is different from — but connected to — social isolation, or physical separation from others. With loneliness, even though an individual may be surrounded by people, they can still feel a deep emotional separation.

Traditionally, loneliness has been considered a factor related to other mental health conditions — like anxiety and depression — but not an independent illness. But research increasingly indicates that it’s a separate beast entirely. 

That’s because loneliness fundamentally rewires people’s brains. Consider, for example, one study from German researchers of expeditioners in Antarctica, who were alone while they conducted experiments. Compared to a control group, those who were socially separated lost volume in their prefrontal cortex, which is responsible for decisionmaking, and in their hippocampus, which assists with learning and memory.

Research also indicates that loneliness can reduce the prevalence of a specific protein in the brain crucial for cognition and memory. Additionally, the condition can increase the production of stress hormones.

Once loneliness takes hold, it can unleash and fuel an array of deadly health issues, including heart disease, anxiety, depression, stroke and more. 

Physicians should be able to diagnose people with loneliness as a separate medical condition. As such, health officials should give the condition its own ICD-10-CM code. Beyond just establishing a formal billing process for loneliness, this would unlock a host of benefits for people nationwide. 

For one, it would ensure that the medical community and policymakers could better track and address trends in loneliness across the country. For example, with a disease like breast cancer, researchers often broadly track who the disease is afflicting and where they live. When they identify a hotspot or anomaly, they can search for root causes, create recommendations and allocate resources accordingly. 

With an ICD-10-CM code for loneliness, researchers would be able to do the same thing. They could identify the areas and demographic groups in which the disease is most prevalent and develop more effective solutions. 

A specific code would also ensure that doctors could provide consistent care and receive proper reimbursement from insurance companies. Without a code, it’s difficult for providers to move forward with regular and specific treatment. In insurers’ eyes, it’s like treating a patient for nothing. Moreover, a code could ensure medical professionals could track and compare various treatment methods — unlocking better solutions for patients. 

We already have ICD-10-CM codes for pretty unusual medical issues – like being pecked by a chicken or bit by a pig. So forgoing a medical code for something so insidious and widespread as loneliness is ludicrous. 

The Surgeon General’s report also outlines six pillars to combat loneliness. Those pillars include ideas like creating a culture of connection, reforming our relationship with technology, and creating community structures that promote interaction, including parks, libraries and playgrounds. 

To be sure, these steps could help address loneliness to some extent, particularly by tackling social isolation. But they won’t do anything to help those who are already experiencing deep, all-encompassing loneliness. 

A person with loneliness can’t just walk to a library or talk with a friend and feel better. They also can’t just scale back their interaction with social media and all of a sudden feel a sense of belonging. 

In fact, telling a person with loneliness to visit a park with friends would be akin to telling a person with depression to just cheer up. Remember, the individual’s brain has literally changed. People experiencing loneliness need rigorous ongoing support, skilled intervention and comprehensive, personalized guidance to reconnect with their community. 

Loneliness needs to be treated with special, intensive care. I challenge my fellow leaders, regardless of industry or affiliation, to treat this disease with the gravity it merits.

Cindy Jordan is the co-founder and chief executive officer of Pyx Health, which supports individuals dealing with loneliness.

Tags Healthcare Loneliness Mental health Surgeon general

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