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Why Social Isolation Makes Us Sick
A Theory
Although scientific and medical research is rapidly demonstrating a clear and di
rect connection between social wellness and its impact on emotional and physical
health, the scientific community has yet to publish anything universally accept
ed as a definitive cause. Not being either a scientist of doctor I can venture w
here they cannot. I offer the following as a theory for your consideration.
I believe the reason we get sick as a result of social isolation is because we a
re social animals and that feeling isolated causes us to experience chronic stre
ss. The symptoms of chronic stress and social isolation are identical. It is the
stress, or rather the harmful hormones associates with stress, that makes us si
Scientific and medical researchers have investigated the question regarding why
social isolation has such a negative impact on our mental and physical health, f
or many years. That it does have a negative impact on our mental and physical he
alth is now generally accepted but not why it does. The question has been invest
igated by professionals in the fields of psychology, neurology, oncology, cardio
logy, and every other field of medicine and science you can imagine except the o
ne which I believe provides the answer
In every case scientists have investigated the problem as if the answer was to b
e found in the individual, despite the obvious paradox of this approach to a soc
ial issue. Professionals have poked and prodded countless individuals to try to
find the answer without ever stepping back to see the bigger picture the way a z
oologist would, looking at an animals entire ecosphere.
No researcher I am aware of has yet examined the detrimental effects of social i
solation from the zoological perspective. Yet if a zoologist was called to a zo
o to diagnose a health problem with one of the animals, what are the first few b
asic questions he or she is going to ask the zookeeper?
Is their diet appropriate?
Is their physical environment appropriate i.e. is it the right size, temperature
, etc?
Are their emotional needs being met i.e. are there things they like to do or nee
d to have? Do they have the right living space?
Are their social needs being met? Are there others of their own kind they can in
teract with?
Notice how doctors dealing with you may investigate various forms of the first t
hree questions, but rarely the fourth.

Why would this disconnection from others have such an impact?

Social animals can be defined by two primary characteristics
they depend on each
other to get food and to defend themselves. In other words, they depend on each

other for their survival. Some predators, such as wolves or lions, use a coordi
nated attack. They cannot execute such an attack alone and thus alone cannot acq
uire food. Other social animals defend themselves from predators by grouping clo
sely together and uniformly facing the threat or by using alarm calls. Social an
imals will defend their food resources as well as themselves and weaker animals
in the group.
Social animals are evolved or designed in such a way that the survival of the in
dividual depends on the other members of the group, whether that be a pod of wha
les, a pack of wolves, a pride of lions or a herd of elephants. They literally c
annot survive alone.
Therefore individuals feeling cut off from their group will naturally be in a st
ate of high anxiety. In physiological terms they are highly stressed, meaning sp
ecific physiological and emotional changes will be taking place.
These changes are made to happen when the hypothalamus, a small region of the br
ain that links the nervous systems to the endocrine system raises the alarm. The
job of the hypothalamus is to maintain stasis, that is, the status quo, the nor
mal function of the body. It s like a thermostat. If things change too much, the h
ypothalamus directs the endocrine system to try to correct the situation. The en
docrine system then produces biochemicals, or hormones, to affect the changes re
One of the main hormones produced when the endocrine system tries to restore the
bodies normal function is Cortisol. Cortisol is the primary stress hormone. It
increases sugars (glucose) in the bloodstream, enhances the brain s use of glucose
and increases the availability of substances that repair tissues.
Cortisol also curbs functions that would be nonessential or detrimental in a fig
ht-or-flight situation. It alters immune system responses and suppresses the dig
estive system, the reproductive system and growth processes.
The complex alarm system also communicates with regions of the brain that contro
l mood, motivation and fear.
Higher and more prolonged levels of stress, and therefore cortisol in the bloods
tream, have been shown to have the following negative effects:
Impaired cognitive performance
Suppressed thyroid function
Blood sugar imbalances
Decreased bone density
Decrease in muscle tissue
Higher blood pressure
Lowered immune system function
Systemic inflammation
Increased abdominal fat
Compare the above changes in the body due to the presence of cortisol as a resul
t of long term stress with the symptoms I listed earlier common to social isolat
Generally decreased feeling of vitality, less energy and feeling tired more ofte
Greater likelihood of chronic illness such as heart disease, cancer, diabetes, e
More frequent bouts of sickness, such as colds or flu, and longer recovery times
Longer recovery times from injury.
Regular feelings of loneliness.

Increased likelihood of depression.

Decreased level of happiness and satisfaction with life in general.
Shorter life spans
Social isolation causes chronic stress, which causes systemic inflammation, whic
h causes severe, long term tissue damage and has a negative effect on emotional
well being.
That is how social isolation makes us sick and shortens our lives.
Yet there is another reason for the negative impact on our mental health when s
ocially isolated, one I do not believe is connected to hormonal changes.
Friends are a sounding board and interactions with them provide us with feedbac
k regarding our thoughts and feelings. Without friends who will provide us hones
t and unbiased feedback, we can easily become lost in the maze of our own though
ts. There are probably many, many processes involved but I know of and can relat
e two examples here.
Often when we are thinking about a problem in our lives, we can go round and roun
d in our minds and never come to a conclusive decision. If however we call a fri
end and talk it over with them, we often come to see our way more clearly. Why?
What happens that make the difference? I believe it is the fact that having to a
rticulate our thoughts and convey them to another using speech is the reason. En
gaging the part of the brain required to speak, seems to have an effect on our t
houghts. Our friend may have offered no advice whatsoever and yet after the conv
ersation we somehow are clearer about what we must do. I believe this is one of
the reasons that friends help keep us from descending into mental disorders.
Another reason is that they help provide us with guidance in the most literal s
ense of the word. If left to our own thoughts, we slowly become unsure about our
own mental health. That uncertainty itself then becomes a contributing factor.
Without feedback from others, we can indeed become increasingly eccentric if not

The importance of this function was brought

ence. As we were out walking one day one of
asked, Am I ok?
She was of course asking
ic or was on the path to something worse. I

home to me by the most simple experi

my dearest friends turned to me and
me to tell her if she had become eccentr
assured her that she was perfectly f

A seed of doubt had entered her mind. A seed I was pleased to see vanish instant
ly with my assurances. Yet without a friend to provide such assurances what happ
ens to that seed?
It appears that just as we need each other in order to maintain a healthy physic
al system, we need each other, literally, to maintain healthy minds. Just as wit
h our physical health, we are not meant to function independently but interdepen
dently. Without another trusted friend to provide us with feedback regarding our
mental functioning, we are much more likely to become lost. Friends are the nor

th star of emotional wellness.

In the research thus far into social wellness, there are two interesting finding
s. One is a finding by the U.S. based Gallup organization reported by Tom Rath i
n his book on social wellness in the workplace titled, Vital Friends . After workin
g with eight million different records, they found that physical and emotional s
ocial wellness indicators did not markedly improve until a person had four frien
ds. Further, the wellness indicators did not rise with additional friends beyond
four. It seems that according to this research at any rate, four is the magic n
Tom and the Gallup organization offer no explanation for this however once again
, I have my own theory and that is that four is the minimum number for a group o
f humans living in primitive circumstances required to survive, and that the mo
st ancient centers of our brain know this and react accordingly.
Regardless of the fact that we do not know for sure why the four friend effect occ
urs, it does and we must work with the reality that it does. If we don t, our bodi
es will react with their painful and damaging biochemical motivators regardless
of our intellectual objections.
Other research into social isolation seems to indicate that connecting with a fr
iend on at least a weekly basis, although not necessarily the same one, is neces
sary to maintain physical and emotional health factors. Given that the week is t
he pulse of modern life, this is a simple metric to use as a target to keep us o
n track. I have no doubt that the origins of whatever the timetable actually is,
is much older.

Television is primarily about people and relationships and has become our surrog
ate social circle. We gave up having friends for watching Friends . Film and telev
ision have done more than any other force to change our concept of our selves wi
thin society. Where once we understood the interdependence of our lives we have
been relentlessly presented with the ideal of the self made man , the rugged indivi
dual, as if this was our nature and our highest, truest self. But as social anim
als we are not evolved or designed to be individuals but rather to be interdepen
The willingness to initiate a social connection depends on our level of trust in
general and that too has declined significantly over the past four generations.
80% of the members of the generation born between 1900 and 1930 believed most pe
ople could be trusted. By the time the generation born after 1970 were on the sce
ne, only 40% of them believed most people could be trusted.
The average person in North America now has just two friends and that figure has
been on the decline for the past twenty years. Additionally, on average 25% of
the population lives alone, an increase from 18% just twenty years ago. Keep in

mind that that is the average. The figure is much higher in urban than in rural
areas. For example, according to the Statistics Canada 2001 census, the number o
f people living alone in my home town of Victoria, British Columbia, was a stagg
ering 49%. Every other household has just one occupant.

In addition to the impact of societal changes and technology, some individuals a

re more likely than others to neglect their social wellness. Three personal leve
ls of existence can contribute to an individual s finding themselves with a dimini
shed circle of friends they are the biological, sociological and psychological.
The biological level is your personal DNA. You were born with a certain nature a
nd if you are a shy and quiet person you are naturally going to meet with and co
nnect to fewer people.
The sociological level is your culture of origin. If you come from a culture whe
re eye contact is not encouraged, or where good girls don t talk to strangers, you w
ill naturally find it much more difficult to connect socially.
The psychological level is your personal conditioning, the behaviors you have le
arned over your lifetime. If you have conditioned yourself to spend the majority
of your time in activities such as reading or watching TV, you will have far fe
wer opportunities to connect to others.

Another reason social isolation happens is aging. The older you get the more an
effect attrition has on social wellness because people rarely notice the fact th
at the size of their social circle is steadily shrinking. It is an insidious pro
cess. In every dimension of our life, if we are not consciously working to grow
and improve our health, nature takes its toll. If you do not exercise regularly
you get weaker and unhealthier. If you do not save and invest, your financial he
alth suffers. Similarly if you are not constantly investing in your social welln
ess, it is decreasing.
The size of your social circle has been decreasing since you left school. It dec
reased when you started working because you had less time and energy to spend wi
th your friends. It decreased when you started a family for the same reason. It
decreased when you retired because you lost whatever few social connections you
had with your coworkers. If you do nothing to reverse the situation it will decr
ease dramatically when you become elderly and the members of your small circle o
f close friends begin to pass on.
People leave our social circle for innumerable reasons. Some are mentioned above
but over the years those in our circle of friends simply get married, have chil
dren, move on or move away. Slowly, imperceptibly to most of us, our circle of f
riends diminishes.
Another cause of social isolation, especially in western societies, is the only o
ne mindset. This highly romantic mindset considers intimacy to be exclusive, some
thing that can be experienced with only one other person and that person is your
husband or wife or equivalent. If that relationship comes to an end, as it does
over 50% of the time, the parties are left with no one with whom they share an
intimate connection.
This only one belief also assumes that all our needs, every part of our being, can
be successfully expressed and shared within the confines of that exclusive rela

tionship. Since this is highly unrealistic and unlikely, we can often be isolat
ed in some form even while in a loving relationship. A part or parts of us are c
hronically isolated because they are shared with no one.
The wisest and healthiest couples cultivate and nurture a wide circle of friends
to no less a degree than a single person does and for the same reasons. I belie
ve this attitude is one of the greatest gifts loving partners can give each othe
Unfortunately, most of the factors that increase social isolation such as techno
logy and declining levels of civic involvement and trust, are only getting worse
and social wellness is decreasing dramatically.
One of the challenges of making a commitment to improving your social wellness a
nd growing your social circle is the fact that you won t like everyone you meet. I
t is a simple fact of life that if you get out there, you will encounter folks w
hose company you don t care for. It s a package deal. This will seem so obvious to s
ome that they may wonder at the point of writing about it, while to others, it h
as real potential to derail their plans.
Whether or not this is an issue for you depends to a very large degree on your n
ature, on what type of person you are. Some people naturally find it more diffic
ult to emotionally deal with those whose personal style seems to conflict with t
heir own. Keep in mind that this is perfectly natural and even more likely if yo
u are an introvert.
When I was thinking about improving my own social wellness, I knew my own histor
y, which was to eliminate from my life everyone who I didn t like for some reason.
Guess what? Nobodies perfect! You can find something about anybody not to like.
So of course I had eliminated everybody and ended up alone. Brilliant. I decide
d then that if I wanted to improve my social wellness I had better find a differ
ent strategy because the one I had used up till now clearly wasn t working.
I decided I needed to expect to like new the people I would meet. I would need t
o assume that there are things about them that I would like if I took the time t
o learn about them and get to know them. I also knew that I would need to accept
others with personal styles very different than my own.
Also, once I met them, I decided I would need to look for and focus on what I co
uld find to like about the other person. This is the meaning behind the quote, I
never met a man I didn t like by Will Rogers. It means that liking others is not a
reaction but an intention.


A key thing inherent in these two mindsets is that I am focused on the other. In
this process, I keep in mind something from, The Likeability Factor by Tim Sander
s. In this excellent book on the art of making friends, he explains that finding
relevance is a key step in establishing friendship. Being friendly is a great beg
inning, but we take the relationship to the next step only with those we discove
r are relevant to our own lives in some way i.e. we have some mutual views or in
terests. The key here is that the only way to know if you have mutual interests
or views with someone is to find out about them!
A Special Note Regarding Introverts
One of the most significant differences in people is whether they are introverts
or extroverts, in the clinical sense. In a nutshell, extroverts get energized b
eing around others, the more the better. Introverts are the opposite. Being arou
nd others drains their life energy batteries. The larger the group, the stronger t
his effect. There is however a simple solution.
If you are an introvert, plan introvert activities and limit the numbers involve
d. Secondly, allow time afterwards to be alone. Being alone recharges an introve
rts batteries. Unlike extrovertes, introverts need alone time to process social
experiences. Simply manage the tempo of your social life like this.
The proverb It takes a village to raise a child, has its origins on the African co
ntinent. Efforts to determine its precise origins have proven fruitless. The phr
ase was popularized by Hilary Rodham Clinton in her 1996 book titled, It Takes A
Village .
I use the phrase here in a broader context and to refer to what I feel is the he
althiest form of social circle. I believe that since village life is what our bo
dies and minds are optimally evolved for, that such a social environment will be
both the healthiest for us and also provide the best chance for our personal ha
ppiness and prosperity. It is also my contention that it is the absence of these
particular social bonds that is the source of so many of our modern ills.
Physiologically, but more importantly neurologically, we have evolved little sin
ce the time tribal village life was the preeminent form of social structure abou
t ten thousand years ago. Millions of years of evolution crafted and perfected u
s for this form of survival and it is this social model that essentially made us
, flesh and bones, men and women, what we are today.
We are evolved with specific social needs and those needs are best reflected in
the social structures of village life
multiple generations working together, hel
ping each other, caring for each other, sharing stories and laughter, teaching o
ne another, dealing with challenges, tragedies and triumphs and breaking bread t
ogether. This web of inter-dependency is the social environment which the human
animal, a social animal by definition, is made for. It represents as it were our
ecological niche and therefore our optimal environment.
Therefore as you develop your own social circle, keep in mind that for optimal h
ealth, you need not only four close, personal friends with whom you can share an
intimate relationship but also friends old and young and from all walks of life
who will keep you mentally healthy by challenging you and helping you see thing
s from multiple perspectives. It takes village to raise a child yes, but it also

takes a village for the adult that child will become to live a long, happy and
fulfilled life.

The second part of this equation is frequency. It is largely a matter of probabi

lity, but the more time you spend with others, the more likely you are to discov
er if you have mutual ways, views and interests. If you encounter members of you
r new social circle on a regular basis, at least twice per month, you are very l
ikely to develop friendships with them if the other factors are present.
This is why our default strategy when feeling socially isolated is find a group a
nd join it. We instinctively know the two criteria, proximity and frequency, requ
ired to create new connections. The very fact that there is a group means the me
mbers will meet on some kind of regular basis. Unfortunately, this strategy does
not always work because the groups agenda, or reason for being, is likely not j
ust to meet new people, socialize and make friends. It is usually to play bridg
e, save the whales, win the cup or some other focus and efforts to simply social
ize are not always welcomed. However you can use the same simple strategy that t
hey do to achieve their ends to achieve yours, create social connectivity throug
h proximity and frequency.
Keep in mind that people prefer structure (as do all primates) thus
social events that take place in the context of an activity of some
imary reason is that it takes the focus off of the participants and
ess self-conscious. This is why things like games or sports are so

they prefer
kind. The pr
makes them l

By the same token, if you keep planning the same social activity then soon only
those interested in that specific activity itself will show up anymore. Those wh
o are interested primarily in the social aspect will soon drift away. Conversely
, by varying the activities you guarantee that only those interested in socializ
ing will continue to show up. The others will go join a bridge, tennis or hiking
club or whatever one meets their interests.

Some Basic Guidelines

Here are some basic guidelines, which can be applied to almost any wellness dime
physical, financial, social, emotional etc. but they apply universally.
Take the long view
It takes time to nurture relationships because of the critical role trust plays.
It does not matter if a relationship is friendship, romantic or any other, it w
ill take time to build the trust characteristic of meaningful relationships.
Also the number of meaningful relationships one has declines naturally over time

if new relationships are not created. No relationships last forever and if new
relationships are not formed to replace them, a gradual decline in social wellne
ss will result.
Take A Holistic approach
It s easy to see in this dimension that a positive or negative relationship in one
area of your life will affect all your other relationships. Just as in the phys
ical or material dimensions, imbalance simply will not work in the social dimens
ion. An unhealthy relationship will drag the others down while a positive relati
onship in one will bring energy and other benefits to the others.
Do it regularly
There s another aspect of this principle which is that the relationship you have w
ith another is not the same thing as the other. Relationships are living things
which require regular care and attention. Simply being with the other does not
at all mean you spent time investing in the relationship any more than just stan
ding in a gym is the same as working out. The relationship between you and anoth
er is a unique and separate thing from the two of you and requires regular focus
and attention.
Put in more than you take out
It s easy to take your relationships for granted. If you take more than you give i
n a relationship you will soon find that the relationship is over. The key to pu
tting in more than you take out of a relationship is twofold: taking responsibil
ity to create opportunities to spend time together and focusing on the other and
the quality of your relationship when you share those opportunities.
Study the science
There is a technical aspect to everything, including relationships of any kind.
Relationships should not be reduced to clinical experiences, however there are m
any things that can enhance any relationship. For example, understanding individ
ual personality types or preferred communications styles or group dynamics, can
all translate into the ability to be gracious and considerate or provide support
or leadership as required. The quality of graciousness is no accident.
Do intervals
Regular, in person contact is essential to both establishing and maintaining rel
ationships. They will be deepened however by spending some focused time together
on a regular but less frequent basis. Just the two of you, just your family, or
just your group of friends on a getaway together.
The key here is focus and intensity, so spend the time together doing something
that makes each of you stretch. That is what will bring the new and lasting dime
nsions to your relationships.
Maintain discomfort
Due to the inevitable fact of attrition over time of almost all meaningful relat
ionships, it is necessary to regularly be creating new ones. The word new should b
e your clue that some form of discomfort is a necessary aspect of this. It may b
e the discomfort of trying some new things, of going out when you don t really fee
l like it, inviting people into your home, of balancing multiple relationships
or of risking rejection.
Some types of people will feel these discomforts more than others however choosi

ng to avoid this discomfort will lead to a gradual decline in social wellness.

Have a plan
As with the other wellness dimensions, being clear about your goals is no less i
mportant in regards to relationships whether they concern friends, your partner,
your family or your community. If you want to create new relationships, or nurt
ure or improve existing ones, you will need to be clear about your goals and you
r plans.
Modify rather than try to eliminate habits
If you like to go for long walks by yourself, keep doing that, but also start in
viting someone new sometimes or join groups or others who also like to walk. If
the recreation group you belong to is not providing you with social benefits, jo
in one that does. If you are not finding kindred spirits at work, volunteer to w
ork at an organization you feel some resonance with.
Cross train
Variations: Engage in a variety of social activities
indoor, outdoor, small and
large groups, at venues or in homes. Each time you do you will strengthen your e
motional ability to feel comfortable and confident in any social situation. Your
social fitness level will increase.
Alternatives: Go out to dinner with some friends then host a pot-luck. Go to a p
lay with some friends
then host a murder mystery party. Go with a group to watch
a sports event then host your own horse-shoes tournament on a beach.
Options: Go out to dinner with one other person
then with five. Go on a day trip
with a group then an overnight trip. Do something with just singles, just coupl
es or just guys.
90% pure
Sometimes you just won t feel up to your plans and good intentions. If you don t cut
yourself some slack you will think of this as failure instead of focusing on yo
ur accomplishments. The process of adapting to a more healthy social life requir
es time to assimilate and rest and develop new social muscle . This is especially t
rue of introvert types who need time alone after social interaction. As long as
you focus on your averages and trends you will know the difference between backs
liding and balance.
The Basics Rule
In any wellness program, you have to maintain the basics. The basics rule for soci
al wellness is to maintain a regular, varied social life. Applying the basics ru
le, ask yourself if you:
Participated in at least one social activity this week.
Did something social this month which you rarely did in the past.
Extended an invitation to someone this month.
The following are three critical indicators social wellness:
You are connecting with the same person or group on a weekly basis.
You can pick up the phone and call any one of at least four friends any time for
any reason.
You made one new close, personal friend this year.