Mayday! Mayday! We’re Lonely

PSYCHIATRIC VIEWS ON THE DAILY NEWS

You may have noticed that the Psychiatric Times editors have so importantly welcomed us to Mental Health Month. I am not quite sure, though, that we really want such a month, because such months are meant to help us focus on problems that need fixing. In other words, we might not need “May is Mental Health Month” if our collective mental health was doing well enough or at least improving. It is not.

Note, too, that the focus designated for this month is mental health, not mental (or psychiatric) disorders. Achieving mental health is not the same as treating mental disorders. Reaching the self-actualization pinnacle on Maslow’s hierarchy of psychological needs is quite different than eliminating symptoms and functioning limitations due to various disorders.

This is why yesterday’s column on rejection is so relevant to this mental health month. It is also why I am focusing on loneliness today. There are so many social psychiatric problems like this one that influence our mental health and that call out for our help in a “Mayday!” series. They include the isms like racism, the antis like antisemitism, the social phobias like Islamophobia, and others like burnout, cults, and climate deniers.

Because of our mental health and mental ill health problems, I have been advocating in other columns for a psychiatrist at the highest levels of our US presidential administration to provide consultation and advice. Although we still do not have one, currently we have the closest to that—a Surgeon General with strong interest, dedication, and knowledge about mental health: Vivek H. Murthy, MD. We social psychiatrists recognized that way back in 2015 when he received the annual Humanitarian Award from the American Association for Social Psychiatry (AASP).

Yesterday, Murthy exemplified this concern with his guest essay for The New York Times titled “Surgeon General. We Have Become a Lonely Nation. It’s Time to Fix That”. Not only did he present all the disturbing data about this epidemic, but he told his own story of loneliness, how hard it was to recognize, and how he got over it.

Hot off the press, as I was finishing this column early this morning, he released his promised “national framework to rebuild social connection and community in America.” If not successful, the health and mental health adverse repercussions are significant. I would include undue loneliness as one of the social psychopathologies that were previously mentioned in this article.

Why now? Loneliness has been rising for years, connected to the increase of online relationships compared to live ones. Then, about 3 years ago, the COVID pandemic came. Although the pandemic and the necessary self-isolation seems to be slowing down, it probably contributed much to the escalation of loneliness, because live relationships were not only an unwelcome disruption for many individuals, but they could even have felt threatening due to the invisible virus, eliciting a fight or flight response. Many of us may still be on edge and cautious of encountering people in a live situation. Others, who are more fortunate, may have seen an increase in closeness with loved ones.

The other challenge may be recognizing that one is more lonely. You can be lonely around others. It is the quality of the connection that matters.

Certainly, this loneliness can spill out into clinical psychiatry and our therapeutic alliances. The fear and uncomfortableness of the loneliness may even partially explain a preference for telepsychiatry when live interactions are possible.

One guidepost is to think back to before the pandemic and reflect on how satisfying our relationships were. Did you feel socially fulfilled then? Do you now? Our souls need the satisfying nourishment of good people as much as our bodies need the adequate nourishment of good food.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. To create a better world, he is an advocate for treating mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism. He serves on the Editorial Board of Psychiatric Times™.