How to fight loneliness: NYC mental health experts weigh in
May 20, 2023, 4:01 p.m.
The fact that we live in the biggest city in the U.S. doesn't mean we're not lonely. In fact it may make the problem worse.
May is Mental Health Awareness month and to kick it off U.S. Surgeon General Vivek Murthy issued an 81-page report that says the US is in the midst of a loneliness epidemic. But how prevalent is loneliness in a dense urban environment like New York City, where we often interact with dozens of people a day just going about our business?
The answer is that it's common and it manifests itself in very specific ways. Jillian Richardson, the author of Unlonely Planet, and the founder of the Joy List, joined WNYC this week to discuss community building events in New York City. We were also joined by Dr. Gunisha Kaur from Weill Cornell Medical Center, who deals directly with migrant populations.
The following interview has been lightly edited for clarity.
Sean Carlson: Jillian, we wanna start with you as you write about loneliness in the city and work to give people tools to cope with it. What was your reaction to hearing Dr. Murthy’s comments earlier this month about loneliness?
Jillian Richardson: Honestly, I was thrilled because loneliness is one of those issues that on the surface can seem a little bit superficial, and so to have someone who is as prominent as the surgeon general say, “No, this is actually a health crisis.” It really makes me hopeful for the future of loneliness-fighting fixes in the future.
Dr. Kaur, what did you think when you heard Dr. Murthy's remarks?
Dr. Gunisha Kaur: As a refugee health researcher, the most meaningful aspect to me was the surgeon general's note of high-risk communities, including people from ethnic and racial minority groups, LGBTQ+ individuals, and survivors of domestic violence, amongst other disadvantaged groups.
I see people who are lonely because they live in poverty and have to work multiple jobs to make ends meet so they don't have an opportunity to spend time with their family and friends. I see young migrants who have families and children, but who are separated from them. I think the notion of resilience contributes to that misconception.
The human body and mind can experience enormous strain and trauma and still endure. But that survival leaves traces both physical and psychological. I think it's really important to acknowledge that, as the surgeon general does, marginalized communities are actually at high risk in this epidemic of loneliness.
Jillian, as we said earlier, New York is a big, bustling city. You could go about your business and while there are people everywhere all the time, you can still feel very lonely. What do you hear from New Yorkers and New Jerseyans who do experience loneliness? And how did the pandemic change that?
Richardson: I feel like especially New Yorkers have this sense of shame when they don't have the community that they think they should. There's this kind of inner narrative that people tell themselves that's so common: “I'm an adult, I should be able to make friends. I should have meaningful relationships. I live in this jam-packed city. What's wrong with me that I don't have these close-knit relationships that I really crave?”
And in reality, like you said, it's actually harder in a big city like New York City to make friends because people are so busy. There's such a social scene, especially for younger people going to bars, shouting at each other over loud music. Spaces to connect are not really designed for deeper conversation and for lasting relationships. And the pandemic has only made this worse. Socialization is a skill. It's a muscle. It's a thing where, the more you interact with people, the more interactions you have in a week, the easier and the more fun and the less anxiety inducing it becomes.
And so, of course, if you're following social distancing protocol, it's going to be a little bit awkward to start interacting with people. And when we're lonely, our brain changes and starts scanning for what we call neutral social signals. So say you're at a party, you look at somebody's face, they're giving you kind of a neutral gaze.
Your brain, because you're lonely, might perceive that as a negative sign. And we really just start to think, “Okay, people don't want me to be around. I'm bad at socializing.” And it just becomes this negative spiral.
One major story the last few weeks has been the migrant crisis: People who find themselves in the city far from their original homes in addition to the many New Yorkers who already live here as immigrants or refugees or moved here from other states. Dr. Kaur, in your medical practice you mentioned that you talk to a lot of migrants. Can you tell us how loneliness manifests for them?
Kaur: Many of my refugee or asylum seeking patients simultaneously feel so relieved that they have been able to escape the war or violence or persecution that drove them from home, and thankful that they have been able to embed themselves within communities in New York City.
But simultaneously, there is this deep longing for life as it used to be. We have to remember that of the 140 million forcibly displaced people worldwide, a very small fraction come to countries like the United States or Canada. So the people that come as refugees and asylum seekers are the ones that had the social networks, the skills, the financial security to be able to cross multiple international boundaries.
Many of the people that we see in our clinic and research center had very tight family connections. They had successful careers as teachers or healthcare professionals. They had strong social networks before coming to the U.S. and here they often have lost their core friend circles or communities.
And that is a dramatic shift in perceived social status and human connection. I had a patient just recently who is a paralegal in his home country, and he had applied for asylum in the US because he was persecuted for being gay. He didn't speak English well and found it difficult to connect to others. He had chronic conditions like heart disease, likely as a result of the prior traumas that he had experienced, but didn't have the time or money to see a doctor regularly. It was more the loss of what he had than simply his current situation that was a driver of his loneliness.
Do you think, Jillian, it's possible for people who do live in family units to feel isolated, or older adults who are staying with their kids or one another in a retirement community?
Richardson: Oh, 100 hundred percent. I think that often your family unit can really exacerbate a feeling of loneliness. When we were teenagers, there's this idea of, “Oh, this family doesn't understand me.” And that can run really deep in a traumatic way for a lot of young people especially if your identity isn't accepted by your family. There's truly this feeling of, “I am not seen, I am not heard, I am not understood.” And if you're staying with this family for years at a time, you can leave that family unit with a feeling of, “I am not okay.” And that takes a lot of work as an adult to really repair that
Dr. Kaur, another big news story that we've been following is the case of Jordan Neely, who was killed by another subway passenger. That case is now being prosecuted by the Manhattan District Attorney. But the circumstances described about Mr. Neely's life are very common, right? People who feel like nobody cares about their situation, maybe experiencing homelessness or other forms of housing insecurity, mental illness, maybe all of the above. Many New Yorkers know that when they board that train or sit on the park bench, their own neighbors will look away, if not move away. How does that affect people's mental health and what do you hear from people who are in those situations?
Kaur: In the context of the Surgeon General's report, it illuminates the challenges of multidimensional traumas when people experience loneliness or isolation, but also have mental health illness. When they live in poverty, when they lack housing stability, when they have post-traumatic stress like Jordan Neely did from seeing a family member die, what is the effect of that compounded trauma and how detrimental can it be when a person experiences so many layered issues that go unaddressed for years by their family or friends or the community around them? And can the effects of these kinds of traumas be mitigated or reversed? Giving people access to healthcare or reducing poverty have downstream effects on social connections and mental health illness.