References

AARP Public Policy Institute, PPI

ACP Advocacy | Health Policy Issues and Health Care Reform (acponline.org)

Additional writings of Donald H. Marks, physician-scientist

• Reliable news sources: personal list used by Donald Harvey Marks, http://bit.ly/3kECPvr  

• Fake News: Everything You Need to Know,  http://bit.ly/345cj95 

• Best Online Free Fact-Checking Tools, https://docs.google.com/document/d/e/2PACX-1vRWVlRgrRAQ9xZ-xCAdZ5mrfOHzniLT7wAJJ519qQwlGKVNRJql76ZAm-jCd8oUWQ/pub

• Fact-Checking: The Ways We Can Fight Fake News,  http://bit.ly/3qudEyX

• Infodemic: the epidemic of information, http://bit.ly/3fV7BgN 

• The Curious Case of Deepfakes  http://bit.ly/3GZJdXh   

• My personal list of Red Flags, Dog Whistles, Buzzwords, Hot Button words and meaningless caricatures  that will drive toxic algorithms to heat and twist elections and trigger hatred on social media.  http://bit.ly/3TcuT4I

• Einstein, Relativity and Relative Ethics,  https://bit.ly/3gWWH9t  

• What I Haven’t Told My Family on the Meaning of Time. https://bit.ly/374cpzJ

• Jonas Salk, Polio Vaccine and Vaccinating Against Hate, https://bit.ly/3xjtosh 

• Link to my Favorite Books📚 (and recent read list) https://bit.ly/3ok9Ux

• Elitists Neocons Neolibs, oh my. What are they, who are they, and why should I care? http://bit.ly/3LMrs0e 

• Undermoney. Techno economic political thriller by Jay Newman. Reviewed by Donald Harvey Marks  https://bit.ly/3Fa4wqb 

• How Woke can we be? The meaning of Woke  https://bit.ly/3Fd7fPy

• Loneliness and Isolation in the age of COVID-19.  https://bit.ly/3AMnCz1 

• My thoughts on remarks made by JFK at Amherst College in 1963.

https://docs.google.com/document/d/1X8JjB-9grX6R66oypFNEuCgaMx0fX2b81u58zW4NGb4/edit?usp=drivesdk

Presented by: Donald Harvey Marks, physician and scientist

 https://bit.ly/3AMnCz1

What is loneliness? Most people will say that we are lonely when we feel sad and unhappy about being socially isolated. Loneliness can be normal, and is only an indicator of underlying disease when feelings become excessive, all-consuming, and interfere with daily living. Loneliness is an unpleasant emotional response to perceived isolation. Loneliness is also described as social pain—a psychological mechanism which motivates individuals to seek social connections. It is often associated with an unwanted lack of connection and intimacy. Loneliness overlaps and yet is distinct from solitude. Solitude is simply the state of being apart from others; not everyone who experiences solitude feels lonely. As a subjective emotion, loneliness can be felt even when surrounded by others. While those with chronic illness may already be familiar with what it's like to face long periods of time alone at home, most of us are used to getting out daily; even those who are retired or don't work usually make trips to run errands or visit friends. To have all of that stop suddenly is jarring, to say the least. For many people; one who feels lonely, is lonely.

While those with chronic illness may already be familiar with what it's like to face long periods of time alone at home, most of us are used to getting out daily; even those who are retired or don't work usually make trips to run errands or visit friends. To have all of that stop suddenly is jarring, to say the least.

Whether you are quarantined due to suspected exposure to infectious diseases such as COVID-19, staying home because you are in a high-risk category like older, kidney, heart, chronic lung disease, or at home to help prevent the spread of infection, you may find yourself unprepared for the feelings of loneliness that will likely follow.

Overall suggestions to Overcome Loneliness and Isolation

• Stay in touch with your friends and family through phone calls, video chats, or social media.

• Join online communities or groups that share your interests or hobbies.

• Volunteer for a cause that you care about or help someone in need.

• Learn something new or pursue a personal project that gives you a sense of achievement.

• Practice gratitude, mindfulness, or meditation to cope with negative emotions.

• Seek professional help if you feel overwhelmed or depressed by loneliness."

Loneliness and Social Isolation

A recent systematic review Social isolation, loneliness in older people pose health risks | National Institute on Aging (nih.gov)  

found a significant association between social isolation and loneliness and poorer mental health outcomes as well as all-cause mortality: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death. 

For this reason, it's important to take care of your mental health during times of decreased social interactions.

It's normal to feel stress when faced with staying indoors and interacting less with people, especially when that is added to the underlying stress of worrying whether you will catch coronavirus, the flu or other illnesses. These factors could increase your chances of developing a mental health issue, like anxiety or depression. More on that later. 

While social distancing refers to avoiding large gatherings of people, staying a certain distance from others in public like 6 feet, and only going out of the house for essentials, it can still start to feel a lot like "cabin fever." You might also feel stigmatized if you are isolated because you've contracted the virus or you suspect you may have contracted the virus.

What's the best way to get through a period of isolation, such as we had from COVID-19? There are many strategies that you can employ to ensure your well-being and good mental health. Most of these involve either finding ways to distract yourself (keep busy) or finding ways to connect with others (despite the circumstances).

Distraction works to help you avoid ruminating about everything that is wrong, which is a risk factor for becoming depressed. In this way, taking on little projects or finding other forms of distraction can help to keep your mood level.

In contrast, staying social in non-traditional ways can help you to feel less isolated and combat loneliness. If you are unable to go places or interact socially with many people at this time, you might be wondering what you can do. Below are some ideas on how to manage your feelings of loneliness during these times.

Keep a Schedule

Even if you are isolated at home, try to keep to a regular schedule as much as possible. While loneliness can feel like it will never end, trying to make these days feel as "normal" as possible will help you to get through. Start each day with a plan of a few things that you will do, keep a daily diary about how you are feeling and what you are doing, and keep a symptom log if you are managing illness, so you at least feel like you are being proactive about the situation.

Stay Informed

People with up-to-date health information and advice on precautionary measures have better psychological functioning and resilience. While you do not want to feed your anxiety and fear through constant updates about the state of coronavirus, keeping abreast of health information may give you an edge when it comes to protecting your mental health (and as a result, reducing the impact of loneliness).

Watching too much news, reading too many articles, and consuming too much content can be overwhelming. You might decide to check the news twice a day. Or you might decide to limit your time on social media if everyone is talking about the virus, politics and other hot button issues. Make sure you seek sites that give factual information about what you can do to stay healthy. Avoid fake, misleading and inflammatory news. Use only reliable news sources. Send a message, text or email to me for my article on handling fake news, reliable sources, and hot button issues. 

While staying informed, understand that it’s OK to skip or take time off from content you find particularly distressing or triggering. https://t.co/wQ5GMriiqj

Stay Active

While it's easy to focus exclusively on how to manage your mental health and loneliness directly during a crisis, we sometimes forget that our physical and mental health are delicately intertwined. If you spend weeks of isolation not getting any exercise, this will have a detrimental effect on your ability to cope mentally. You might try to:

• Practice tai chi or yoga or do at-home low-impact workouts by following YouTube videos.

• Go for walks around or in your building or neighborhood (or walk on a treadmill if you have one and are concerned about going outside).

Do Something Meaningful

Loss of sense of meaning can contribute to loneliness. If you are finding that you feel not just bored, but also as though you are losing your sense of self, then a loss of meaning might be affecting you. All of us want to feel like we belong and that our life has importance, which is why incorporating meaningful activities into each day is important. Doing something meaningful each day, even if only for a short period, will give you a sense of purpose and identity.

• Sign up for an online course and do a bit of work each day.

• Create a family tree using genealogy websites.

• Sign up to be an online volunteer.

Connect With Others

Perhaps the best thing you can do to combat loneliness during this period of isolation is to connect with others in non-traditional ways. While you may not be able to visit with family and friends in person, that does not mean that you cannot connect.

Family and Friends

If you are comfortable using technology, there are numerous ways you can stay in touch with friends and family. If you prefer more traditional ways of communicating, there are still options for you. You might:

• Send a handwritten letter or postcard.

• Call someone on the telephone (particularly on days you are feeling lonely).

• Place calls using video chat services like FaceTime or Zoom.

• Post on social media or respond to others' posts on social media.

• Stay in touch by texting or instant messenger.

Online

In addition to staying in touch with family and friends, you can also combat loneliness by participating in online exchanges with other people around the world. These don't need to necessarily be your online "friends," but rather those with whom you share something in common and you communicate online.

Below are some examples of online connections that you can make.

• Joining and participating in meaningful but not-stressful groups about topics you are interested in, such as your religious circle, neighborhood council, environmental action, or Rotary,

• Signing up for online forums about your hobbies or interests

• Joining and playing multiplayer games such as Wordfeud

• Signing up for online sports games like fantasy football

Find Sources of Comfort

Finding ways to give yourself comfort even when you are feeling lonely can help to improve your mental health. Comfort measures that you can take even if you are alone include:

• Focusing on your pet

• Cooking healthy comfort food.  BTW, don’t drink alone. 

• Watching favorite TV shows or reading favorite books

• Practicing sleep hygiene to make sure you are getting enough rest, is important to mental health, and sleep disturbances are a sign of certain issues, including anxiety and depression

Create Something

There's a reason why artists enjoy becoming swept away by their work. Expressing yourself through creative means can be therapeutic, whether it involves painting, writing, dancing, etc.

If you're finding it hard to express what you are feeling, channeling your feelings into creating something can be cathartic. In addition, when you create something you enter the "creative magic zone," which can be a form of meditation in itself. For example, Practice writing in a journal each day.

Art Projects

• Complete a paint-by-number project.

• Start a needlework, knitting, or crochet project.

• Compile a photo album that you can share later with others.

• Work on an adult coloring book.

Home Projects

• Choose a space in your home and start an organizing project.

• Choose a room in your home and redecorate by moving things around or moving things from other rooms.

If you're having trouble coming up with projects, focus on the ones that you can do with what you already have on hand. Most of us will have a notebook, paper, printer, and access to the Internet. Using those few basic tools, you're sure to find something online to get you started. You could even focus on culinary arts like cooking or baking projects.

Distract Yourself

Another way to boost your mental health is to find healthy distractions. This might come in the form of reading, watching shows, listening to music, or finding other activities that interest you. Below are some ideas to help.

Read

• Go back and re-read some of your favorite childhood books.

• Join an online book club like the ones at Goodreads. You can friends me there, and follow my readings. 

• Give yourself a reading challenge by choosing a list of books you've always wanted to read or a list based on a theme (e.g., books set in places you've always wanted to visit).

• Read books of poetry if you find it too hard to concentrate on longer books.

• Read magazines on topics that interest you. You can follow me on Twitter and GetPocket to follow articles and books that I am reading.

• Listen to audiobooks through services like Audible or Scribd, or to podcasts, if you struggle to read or have vision problems. All smartphones have podcast players, and it you are unsure, reach out to your friends or family about this. 

Watch TV, Movies, and Videos

• Watch TED talks on YouTube on your computer or smartphone about topics that interest you. 

• Watch a series of movies on a theme (comedy movies will help to ease your stress).

• Watch a television series on a streaming service.

• Watch documentaries on topics you've wanted to catch up on.

Create or Listen to Music

• Go back and listen to your favorite songs from when you were a teenager.

• Create a playlist of happy songs and listen to those. If you have Amazon Prime, usc App you can ask me for my Mellow play list.

• Play an instrument such as the piano or guitar.

Other Fun Ideas

• Take a virtual tour: Many museums offer digital access to their collections including the Louvre and Guggenheim. You can find these online at the free service www.Eventbrite.com

• Play games that engage your mind such as Sudoku, crossword puzzles, solitaire, or online chess.

Plan for the Future

While it might feel like this loneliness will last forever, there will come a time that you'll be back to your usual routines. One way to feel less alone now is to make plans for the future or do things that help you to focus on the future. Below are some ideas.

• Make a "future list" of all the things you want to do.

• Plan a fun event for when you are out of isolation.

• Make a bucket list or goals list of things to do in your lifetime.

Practice Self Compassion

Most importantly, practice self-compassion during this difficult time. If you find yourself saying things like "I shouldn't be feeling this way" or pushing away difficult emotions, this will only make your loneliness persist. Instead of resisting your feelings, find ways to be accepting of them as coming and going. This helps to take away their power and ease your unhappiness. If you are struggling, reach out for help.

Show Compassion to Others

It might seem counterintuitive, but if you are struggling yourself, sometimes offering help to others who are feeling lonely can make you feel less lonely yourself. Make a phone call, send a text, send a letter, or comment on someone's social media posts. Be supportive and offer words of encouragement.

The Health Consequences of Loneliness

Replika chatbots

Coping as an Older Adult

Older adults (aged 65+) may be particularly susceptible to loneliness during coronavirus. This group is most likely to self-isolate due to fear of infection, while also potentially having fewer supports in place to feel less lonely. Baby Boomers, in particular, may be the most affected by this pandemic.

• Make phone calls to relatives on a regular schedule, so that they can check in with you and learn about your needs.

• Ask for help from family members when you need it and be specific about how they can help.

• Check to see if your community offers specific shopping hours for seniors so that you can shop for food during low-risk times when absolutely necessary.

What This Means For You

If you find yourself with poor mental health while isolated during coronavirus and aren't able to pull yourself out of feelings of anxiety, depression, or fear, it is important to reach out for help. Let’s be more clear exactly what is depression - a mood disorder that causes a persistent feeling of sadness and loss of interest. Depression affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

Symptoms of depression include:

Feelings of sadness, tearfulness, emptiness or hopelessness.

Angry outbursts, irritability or frustration, even over small matters.

Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports.

Sleep disturbances, including insomnia or sleeping too much.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

Memory difficulties or personality changes

Physical aches or pain

Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication

Often wanting to stay at home, rather than going out to socialize or doing new things

Suicidal thinking or feelings, especially in older men

If you or your loved ones or those close to you bring up the possibility of depression, then reach out for help. 

Consider calling a crisis line or an online therapy service to find out about options. While it's normal to feel afraid and lonely at a time like COVID-19 pandemic, declining health, loss of a job or someone close, worsening mental health could indicate the need for outside help

When to see a doctor

If you feel depressed, make an appointment to see your doctor or a mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your doctor or mental health professional.

Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Use that same number and press "1" to reach the Veterans Crisis Line.

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

Key Takeaways

    Social isolation and loneliness are linked to poor mental and physical health.

    Using non-traditional ways to stay in touch with other people is an important way to combat loneliness.

    There are many creative ways to deal with loneliness and add variety to your everyday routine.

     Be prepared to recognize when you or someone close to you needs help.

In summary, loneliness is a normal and universal human experience that can be challenging to deal with, especially during the COVID-19 pandemic. However, loneliness is not a permanent state and can be overcome by taking positive steps to connect with others, find meaning in life, and take care of ourselves. Remember that you are not alone and that there are many resources and people who can support you.  

Helpful Links and Suggested Readings

"Chatbots: The Illusion of Companionship Without the Demands of Friendship"

https://www.cmswire.com/customer-experience/chatbots-the-illusion-of-companionship-without-the-demands-of-friendship/?utm_source=pocket_mylist

https://psyche.co/guides/how-to-feel-less-lonely-as-work-and-family-quieten-down-later-in-life?utm_source=pocket_mylist

Virtual Contact Alone Did Not Mitigate Loneliness for Seniors During COVID-19 https://www.verywellmind.com/virtual-contact-made-older-people-lonely-5195594

Overwhelmed By COVID News? Here's What To Monitor And What To Skip. https://www.huffpost.com/entry/covid-news-what-to-monitor-and-skip_l_61eef632e4b010a5a233d434?utm_campaign=share_email&ncid=other_email_o63gt2jcad4

The Verywell Mind Podcast on ways to stay strong even if you feel lonely:  The Verywell Mind Podcast 

The Health Consequences of Loneliness

How to Cope With Anxiety About Coronavirus (COVID-19)