Experts say there are distinct differences between anxiety and loneliness. Erdark/Getty Images
- Researchers say chronic loneliness is distinct from anxiety.
- They say it differs from anxiety in that it’s not a fear of social contact but rather a lack of motivation for contact.
- Experts say chronic loneliness needs specialized support that can include a residential setting and group therapies.
The COVID-19 pandemic and its isolating effects have touched nearly everybody.
This isolation has produced varying forms of loneliness in many people at times.
In particular, there are concerns over the extent of what’s being described in a new study as chronic loneliness.
The researchers say that despite overlaps, this type of loneliness and social anxiety are driven by different states of mind.
“The key conclusion is that chronic loneliness is a complex construct and should not be grouped with other disorders,” Dirk Scheele, PhD, a study author and researcher in the department of psychiatry at the University of Oldenburg in Germany, told Healthline.
“We might need to adapt interventions to reduce loneliness,” he added.
What the study revealed
The researchers explored the differences by comparing how people with high and low loneliness behaved in a social gambling task.
Participants played a computer game where they could make a safe bet and win a smaller amount of money, or make a riskier bet for a larger sum. If they took the riskier bet, they watched a video of a virtual human showing approval or disapproval.
People with social anxiety took the safe bet more often to avoid feedback from the videos, the researchers reported. People with high — or chronic — loneliness did not display this social avoidance.
By measuring the participants’ brain activity during the task, the researchers found people with social anxiety displayed signs of heightened anxiety as well as signs of reduced social reward.
Neither activity pattern appeared in people with high loneliness, indicating loneliness is unique, requiring its own interventions.
The importance of the research
Jana Lieberz, MSc, another study author and a researcher at the University of Bonn in Germany, said these findings could help clinicians hone in on more successful ways to help people manage chronic loneliness.
“Loneliness is very important when it comes to mental and physical health,” Lieberz told Healthline.
“We’ve known it is quite distinct from depression,” she added. Now, Lieberz hopes the distinction will be made from other conditions, such as social anxiety.
Clinicians who have reviewed the study say it may do just that.
“This is the first time I have heard of such a distinction between social anxiety and chronic loneliness in literature,” Dr. Julian Lagoy, a psychiatrist with Mindpath Health, told Healthline.
“I think these findings will definitely have a significant impact to understand loneliness and to help treatment of both loneliness and social anxiety,” Lagoy said.
What is chronic loneliness?
Understanding the difference between social anxiety, acute loneliness, and chronic loneliness can be challenging, since the result (usually social isolation) can be the same.
But they are distinct and unique, experts say.
Angeleena May, a licensed mental health counselor and the executive director for AMFM Healthcare, told Healthline that social anxiety can lead to loneliness, but it stems from a place of worry.
People who struggle with chronic loneliness often struggle with their core beliefs, embracing a feeling of not being worthy of friendship or love, May explained.
Acute loneliness, she said, is usually precipitated by some kind of event that a person can pinpoint such as a pandemic, whereas chronic loneliness can seem to have seeped in over time with no clear starting point.
And while chronic loneliness usually does result from what she calls “attachment ruptures,” those are not easily identifiable.
May noted that a person with chronic loneliness may not have experienced an exact trauma. It can develop from things more obtuse, such as a parenting technique your parent used on you.
Another important thing to understand: People with chronic loneliness are not always actually alone.
“Chronic loneliness feels like you are with a group of people but yet you don’t even exist,” Omar A. Ruiz, a marriage and family therapist in Wellesley, Massachusetts, told Healthline.
“You feel like you’re not seen or heard. You feel exhausted trying to socially engage with others. As a result, you start questioning and feel like you don’t even matter,” he said.
“Loneliness isn’t just about the absence of social interaction. It’s about the absence of meaningful, fulfilling social connection,” Sarah Greenberg, a licensed psychotherapist, board certified coach, and current director of clinical design at BetterUp, told Healthline.
“You can feel deeply lonely in a room full of people or deeply connected in solitude,” she said.
But loneliness, she added, can be difficult to recognize. And admitting we are struggling with it, “can be hard to admit, even to ourselves.”
Greenberg suggests anyone going through this should ask themselves questions similar to the ones researchers use to assess levels of loneliness:
- How often do I feel isolated from others?
- How often do I feel left out?
- How often do I feel a lack of companionship?
What to do
Ruiz said it’s important to first realize that chronic loneliness can be detrimental to long-term health and should be treated.
“Chronic loneliness can impact a person’s sense of worth, which then leads to a negative view of oneself,” he said.
“It also leads to a lack of close relationships, even with friends and family. Lastly, it can slowly develop [into] severe mental health problems that may lead to clinical depression, if untreated,” he added.
In other words: Don’t brush it off.
And yet, many do.
“Chronic loneliness is a substantial problem in our society and it is difficult to treat because a lot of people do not want to admit they are lonely in the first place,” Lagoy said.
Ruiz suggests people look at loneliness in a new light and consider medical intervention to help get past it.
“Even though chronic loneliness is not identified as a mental health disorder, the impact of it can be treated with the help of a therapist specializing in relationships,” he said.
Ruiz added that a relationship therapist can help by exploring the difficulties someone has with establishing meaningful relationships and help them rebuild their communication and social skills as a way to intimately reconnect with others again.
May said that unlike acute loneliness, when a person can often draw on experiences when they did not feel that way, chronic loneliness needs more in-depth support.
Digging into those core beliefs that are driving a person to the place of loneliness is key, she said.
To do that, one needs guidance and help.
Sometimes, May said, there’s value in a residential setting in which the person can both work with their therapist and in groups and then practice with others there.
Lieberz and Scheele hope their findings lead to more understanding of how to treat chronic loneliness, as well as an understanding of it and peeling away any shame around it.
“I want to compare it to stress,” said Lieberz. “Everyone knows (and understands) stress and feels fine saying they are over stressed. I hope the discussion around (and actions taken about) loneliness become open like that.”
“This should not be a stigma, but rather something to address,” Scheele said.