Have you heard about the loneliness epidemic? The U.S. Department of Health and Human Services has called attention to the public health crisis of loneliness, isolation, and lack of connection in the United States. That’s why we had a conversation with Eugene (Gene) Beresin, MD, MA, and Khadijah Booth Watkins, MD, MPH, from The Clay Center for Young Healthy Minds at Mass General Hospital. Dr. Beresin is also the author of Child and Adolescent Psychiatry and the Media, Music (part of an Arts for Health series), and most recently, Ways to Help Your Lonely Teen.
It’s normal for parents to worry about their children. The good news is that you’re not alone. There are resources and people you can rely on for support. Continue reading to learn more from Dr. Beresin and Dr. Booth Watkins.
What's your current understanding of the epidemic around loneliness and isolation, particularly for children and teens?
The loneliness epidemic started long before the COVID-19 pandemic. Loneliness has been a major factor in young people's lives for the last two decades. The loneliest age groups of the population are Gen Z and Millennials.
Anyone born between 1981 and 1996 is considered a Millennial. Generation Z comprises people born between 1996 and 2010.
This is a new development because older adults have historically been known as the loneliest age group. Although there are only theories, there are several suggested causes. Many people say that social media is the low-hanging fruit and the “cause.” However, social media can be both a blessing and a curse. During the lockdown, digital media was a critical way for young people to connect with each other. More research is needed to determine the exact role of social media in fostering loneliness.
In my view, there are several things that make young people lonely. One is overscheduling. This generation is working 24/7 because there’s more pressure towards academic achievement and community involvement. They need to play a sport, learn an instrument, and have an internship. However, the teen brain needs time to process and rest. So, it may be that overscheduling is what drives many young people to overuse social media—the lack of time for real face-to-face engagement.
Another challenge for young people is the concerns around national and global problems. For example, the troubling statistics around climate change, mass shootings, and sexual assault may indicate conditions that promote loneliness. Plus, the disparities, particularly among the Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual (LGBTQIA+) community, people of color, and immigrants, may be other social forces that lead to loneliness. They're worried about these things. Interestingly, during the pandemic, there were rallies that brought people together. However, the result overall is that many young people are worried about inheriting a world of insecurity, danger, and war. This has escalated depression, anxiety, stress, loneliness, and even suicide among this population.
Khadijah Booth Watkins, MD, MPH
Media, in general, has played a major role in the loneliness epidemic. More than ever, kids are acutely aware of when they are left out. For example, you didn't necessarily know if you weren't invited to a party before the digital age. Before online and social media, comparing yourself with societal pressures wasn’t so accessible. This includes everything from body image to academic performance. With today’s heavy reliance on digital media, kids are measuring themselves to sometimes unrealistic expectations. Online, people tend to focus on the highlights while leaving out the hard work and challenge it took to get there. We’re having a youth mental health crisis of depression and anxiety that exacerbates feelings of loneliness.
Gene Beresin, MD
It’s important to note that loneliness is a normal stage of life for teenagers. They’re going through a transition to form an identity of their own while being part of a group. As they grow, they’re naturally supposed to separate from family to be more autonomous and independent. Although that can be exciting, it’s also a loss for kids. At the same token, it's also a loss for parents. So, developmentally, loneliness is a normal part of adolescence. When you compound it with all these other factors, that combination is extraordinarily challenging.
Can you share any tactics or behaviors that mitigate feelings of loneliness for kids?
Khadijah Booth Watkins, MD, MPH
It’s important to acknowledge and understand that comparison is the thief of joy, and everybody's different. Everybody's body is different, and you are a unique individual. We don't have to fit into this exact mold. So, if you’re on social media and looking at someone’s image or accomplishments, it’s important to separate who you are and what makes you happy. It’s less about disconnecting from media but rather being aware of how you feel when you’re on social media.
Questions kids can ask when scrolling social media:
- Are you happy?
- Are you fulfilled?
- Are you gloomy?
- Are you sad?
- Are you frustrated?
- Are you afraid?
- Do you feel safe?
It’s critical to connect with your feelings when you're using social media. It's one way to lessen the comparison of your experience to those you see online. Remember that people leave out a lot of key details, and you’re often only seeing the finished product. Having that knowledge about how realistic social media is will help you challenge what you see and hopefully give it less power.
Gene Beresin, MD, MA
Kids can't do it alone. They need the support and understanding of their parents, mentors, coaches, and teachers. They need space to build relationships, hang out, and be social creatures. It’s important for them to feel that they're making a contribution. Giving releases oxytocin in the brain, which fosters connections between people. So, any time of the year, and especially when tragedies happen, giving to others helps bring them together and makes them feel less lonely and more connected. For example, there were many positive feelings combating loneliness by making a contribution following 9/11, the Boston Marathon, natural disasters, and the pandemic. Human beings are pack animals. We need each other; the more we can interconnect in real-time, the more we can combat loneliness.
Whether through planned activities, joining a club, or participating in casual sports, it allows kids to connect with other kids in person. Another thing that teens and young adults can do is learn how to have civil conversations as opposed to what we see on the news from some of our political leaders. Civil conversations help foster acceptance and connectedness. Listening to each other and validating each other helps one feel connected. It also teaches conflict resolution. It's important that young people learn how to resolve conflicts, whether it's with relationships or ideas. This is how they learn to understand and accept different points of view. Being able to empathize with others will help them learn how to agree to disagree. One of the silver linings from the pandemic was for the first time, many parents, teachers, and caregivers realized the importance of social and emotional learning.
The more we can incorporate social and emotional learning, the more I think kids will feel connected and included rather than isolated and lonely.
Khadijah Booth Watkins, MD, MPH
Whether you’re a parent, caregiver, or faculty member, your role is to encourage connections among young people. You can do this by prompting questions. For example, if it’s a weekend or holiday, ask your children who they want to hang out with or who they haven’t seen in a while. Help them plan to facilitate opportunities for them to connect with their peers.
Gene Beresin, MD, MA
Another way of combating aloneness is using creative arts, such as storytelling, journaling, music, and dance. There's been so much research done on the value of creative arts, particularly with other people. There's great healing power in doing creative arts in a group. People should also utilize standard self-care practices like meditation, good diet, exercise, and getting the right amount of sleep.
What are some things parents can look out for when it comes to loneliness?
Khadijah Booth Watkins, MD, MPH
Loneliness is connected with both mental and physical health because it is stressful. Stress impacts the body, so you might notice changes in sleep or relationships. Loneliness can appear as someone on edge, moody, irritable, overwhelmed, or anxious. We’re more vulnerable when we’re stressed, so we might start engaging in risky behaviors. This includes unhealthy habits, such as overeating, substance use issues, or other lifestyle habits.
We learned from the pandemic that part of what made it so hard was that we were lonely and isolated from people. Stress and loneliness can leave one more susceptible to cardiovascular disease, hypertension, a weakened immune system, and even joint pains. Parents might also notice that their kids are more isolated and withdrawn from their peers. For example, if your child would typically accept a party invitation but then declines. Keep in mind that loneliness can affect the body in several ways, so it can appear differently from child to child.
What advice would you give adults wanting to help their children or teenagers?
My recommendation is to speak up and ask questions. Parents and caregivers should start talking with kids about this topic—and many other issues in their lives—as early as toddlerhood. The earlier you start these conversations that raise these issues, the more aware young children become. This helps them be more attentive to the various factors that cause loneliness. They should also seek support from other adults who they can relate to.
Even teachers can start by giving kids vocabulary about feeling lonely as early as preschool. If they seem isolated or disconnected—ask them why. These conversations should begin very early and should continue through adulthood.
Khadijah Booth Watkins, MD, MPH
I would reiterate that parents don't have to worry alone and should lean on other parents or family members. Resources are often available at school through a guidance counselor or social worker. You can also reach out to your primary care doctor. Resources are scattered around, but the most important thing to remember is that you don't have to figure it out on your own. Help is all around you.
Another often untapped resource is grandparents. Elders in all societies help to share narratives. That’s why leveraging folks in your family and your community is crucial. They can share a wealth of knowledge to help manage hard times or defeat adversity.
My mother died at 102 years old. My children and grandchildren would ask her for stories. She’d tell them about the Great Depression and how she’d play the piano in department stores for pennies. She’d talk about the tree that fell on her house or when the big blizzard broke the basement pipes. These narratives help young people know that adversity can be managed. It teaches them how people can get through hard times together. We don't have to go at it alone when we're all part of a community.
Is there a difference between loneliness and solitude?
Pediatrician and psychoanalyst Donald Winnicott talked about the capacity to be alone. He said it is one of our most significant achievements with our kids. For example, have you ever tried to put a 3-year-old to bed when there's a party downstairs? You’d say good night, and the kid would scream. Young children need to learn how to welcome solitude. Learning how to use alone time to reflect, process, and self-soothe is vital.
Some people can't tolerate aloneness, so I think the notion of solitude and being alone is an emotional achievement. Loneliness, on the other hand, implies loss and grief, and that's intolerable to many. For these, we need to find ways of combating that difficult situation.
Everyone can communicate with kids, whether it’s parents, caregivers, teachers, mentors, coaches, or probation officers. Anyone can be a role model who listens and validates a child’s feelings. This helps teach them the golden rule: treat others as you would treat yourself.
When we have frequent conversations and young people feel seen, known, and heard, the outcome is less loneliness. The result is more connections and secure attachments.
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