Friday, January 24, 2020

Loneliness Is a Health Problem



This essay was based on the article “Is There a Cure for Loneliness? found in the December 2019/January 2020 AARP.  The following are past writings pertaining to loneliness: 1. Existentialists have identified one of the painful truths of mankind - he is lost based upon the self-awareness of his existence 2. Sociologist Emile Durkheim in his classic study  “Suicide ,”explored the breakdown of social connections 3.Erich Fromm described,  in depth, the trend to withdraw from the world because of  automation and conformity in  his  insightful” Escape from Freedom” 4. Sociologist David Riesman in” The Lonely Crowd “analyzed the impact of the “other directed” individual as he related it to   interpersonal connections in society 5. Psychologist Henry Murray and others have identified psychological needs of Affiliation, Achievement, Aggression, Power and Possession and how these needs interact and interfere with human relationships thereby contributing to the concept of loneliness.  
The added cost to Medicare is almost $7 billion a year resulting from people living in isolation. Loneliness shortens lifespan, kills more than heart disease, contributes to Alzheimer’s, and affects high blood pressure, suicide and even the common cold. It’s been said that it’s more dangerous than obesity and the equivalent of smoking 15 cigarettes a day.
We do not have a restricted definition of loneliness. For example, findings from over 70 studies on loneliness that followed 3.4 million participants for an average of seven years were divided into three groups. The three groups included the following: 1. Those lacking from sufficient social connection or being socially isolated from other people-behavioral 2. Those that described themselves as very lonely-[emotional and/or psychological testing] 3. Those that lived alone-behavioral. The researcher found that the definition didn’t matter nor whether these participants were healthy at the time the study. All three these groups statistically had an early death.
Essentially, the statistics on loneliness were based on feelings; physical isolation; marital status; number of close friends and family members; the amount of television watched; declining marriage rates; and increasing rates of childlessness. The definition doesn’t seem to matter as it included perception, psychological testing and behavioral descriptions.  Loneliness was also related to unsatisfactory interpersonal relationships. Other loneliness  symptoms included: alcohol, drug and food addiction; wars; nationalism; hate groups; divorce; online shopping; electronic devices; social network; physical and mental illness. In other words, the concept of loneliness is complex, prevalent, long explored, with many tangled components.
There was another complication or component of loneliness. According to the DSM, the bible of mental health diagnoses, some of the descriptions of symptoms -feelings and behavior pertaining to loneliness can be found in the diagnostic category of depression which is an Affective Disorder. However, loneliness as a diagnosis, was not found in the DSM.
 Furthermore, with the body or physical side, researchers had identified in subjects who were lonely, activity in white blood cells suggesting a state of alert. It’s as if, white blood cells were responding to a bacterial infection or inflammation. Hans Selye’s research on the stress or the general adaption syndrome came to mind with the increase of cortisol that disrupted equilibrium resulting in an attack to one’s immune system. It’s our body’s production of antibodies that make us more vulnerable to diseases.  There are two psychometric measures of stress- The External Stress Index and The Internal Stress Index .These two instruments provide numerical values for levels of stress. Of course included in these indices are life events, thoughts and emotions that correspond to states of loneliness. In other words loneliness was a prime example of the body- mind connection. It demonstrated the power, significance and interplay between the two.
Treatment for the causes of loneliness are limited to say the least. Treatment could be a  dose of naproxen  [Aleve] to reduce the bodies inflammatory responses; a selective serotonin reuptake inhibitor [SSRI] to reduce  a sense of social threat that underlies long-term loneliness; or cognitive behavioral therapy [CBT] to personalize and teach individual coping and engaging strategies.
Loneliness is a significant health, social and economic problem in our country and called an epidemic in Great Britain. With that being said, let’s hypothesize that an individual presented to the psychotherapist the following as a presenting problem for treatment “I’m lonely and I need tools, based upon my personality, to help me.” If the person was willing to pay out-of-pocket fees that would be acceptable. However, if the person-patient expected that his health insurance company would pay the therapist, for treatment, he would be wrong. It’s the collusion between the health insurance companies that decide what presenting problem or diagnosis are going to be reimbursed. Obviously, their decision has nothing to do with health. And we call them health insurance companies? We should rename them exploitive companies. Their primary goal has nothing to do with health but only with collecting premiums to reinforce their profits. They know how to exclude and have developed sophisticated strategies to deny third-party payment for service. And, why do you want to keep your health insurance company? Expose the fraudulent behavior, contact your representatives. Demand that these companies provide real health insurance based on health and wellbeing.

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