You can be surrounded by people and still feel completely alone. What makes loneliness particularly concerning is that it can remain hidden, gradually affecting sleep, mood and behaviour, while also taking a toll on the heart, brain and overall health. For this reason, loneliness has increasingly become a public health challenge that calls for prevention, early detection and appropriate intervention.
Loneliness and Social Isolation
It is important to distinguish between two concepts that are often used interchangeably: social isolation and loneliness.
Social isolation is an observable and measurable condition that refers to having a limited network of relationships, infrequent contact with family, friends or the wider community, or insufficient support when it is needed. It may be reflected in fewer visits and phone calls or limited participation in social activities. However, social isolation does not necessarily mean that a person feels lonely. Someone may live alone and feel perfectly comfortable and content because they have a small but deep, secure and meaningful circle of relationships.
Loneliness, by contrast, is a subjective emotional experience that arises when a person feels that their relationships do not meet their psychological and social needs in terms of their number, depth, closeness or mutual understanding. It is therefore less about the presence of other people and more about the quality of the connection with them. A person can feel lonely even while surrounded by family or colleagues and actively participating in gatherings and social occasions.
This is why a person’s social life cannot be assessed simply by counting the number of friends or social encounters. Someone may be surrounded by many people yet feel profoundly lonely, while another person may have only a small circle of relationships and still feel secure and fulfilled. The true measure is the quality of those relationships, the sense of belonging they provide, and having at least one person whom we trust and can turn to when we need support.
Numbers Reveal the Scale of the Problem
The World Health Organisation stated in its 2025 Global Report on Social Connection that one in six people worldwide experiences loneliness, and that loneliness is associated with more than 871,000 deaths each year. This does not mean that loneliness directly causes death. Rather, it is associated with factors that increase the risk of illness and premature death.
Loneliness is also not confined to older adults. Adolescents and young people, individuals living with chronic illnesses, and those going through major life changes such as bereavement, divorce or retirement may also be particularly vulnerable.
Depression and Loneliness
The relationship between loneliness and depression works in both directions. Sadness or exhaustion may gradually lead a person to withdraw from social gatherings and activities. As contact decreases, so too may the support they receive, while the feeling that others do not understand what they are going through can intensify. This may deepen their isolation and worsen symptoms of depression and anxiety.
At the same time, prolonged loneliness can contribute to lower self-esteem, increased negative thinking, and disruptions in appetite, sleep and concentration. What begins as an emotional experience can therefore develop into a pattern that affects several aspects of daily life.
Loneliness and Heart Health
Chronic loneliness is associated with a prolonged stress response in the body, accompanied by sleep disturbances, reduced physical activity and unhealthy behaviours. It may also be associated with increased inflammation, elevated blood pressure and impaired blood sugar regulation, all of which can affect cardiovascular health.
A 2024 longitudinal study conducted by researchers at Harvard University found that persistently high levels of loneliness among people over the age of 50 were associated with a 56 per cent relative increase in the risk of stroke compared with those whose levels of loneliness remained low.
Loneliness and Brain Health
The effects of loneliness may also extend to brain health and cognitive abilities. The brain benefits from conversation, the exchange of experiences, learning and a sense of purpose, all of which provide continuous cognitive and emotional stimulation.
When loneliness becomes chronic, it may occur alongside sleep disruption, depression, inactivity and persistent stress. Over time, these factors can affect memory, concentration and brain health. A large scientific analysis found that loneliness was associated with an approximately 31 per cent higher risk of dementia.
This association, however, does not mean that dementia is inevitable. Some early cognitive changes may themselves cause a person to withdraw socially and experience greater loneliness. This makes early observation and assessment particularly important.
Why Has Loneliness Become a Public Health Issue?
Loneliness does not always arise from within the individual. A person may live in an environment that offers few opportunities to meet others, face difficulties with transportation, or encounter barriers related to work, language or disability that make it harder to build meaningful relationships.
When such circumstances persist, loneliness can affect health, workplace performance and academic achievement. It can also place additional pressure on healthcare services and weaken social cohesion. For these reasons, loneliness has become a public health issue requiring policies that consider vulnerable groups and environments that encourage social connection and participation.
At the same time, not every passing feeling of loneliness should be regarded as a medical condition. The important consideration is whether the feeling persists and begins to affect a person’s health and daily life.
Preventing Loneliness: A Shared Responsibility
Preventing loneliness begins with creating communities in which social connection is accessible and safe, while giving people genuine opportunities to develop a sense of belonging.
In schools, this can include promoting friendship and inclusion and identifying students who become socially withdrawn at an early stage. In workplaces, organisations can foster a culture of mutual care, provide confidential psychological support and train managers to recognise withdrawal or sudden changes in performance.
Healthcare centres can also play an important role by incorporating questions about relationships and social support into health assessments and connecting people who need assistance with appropriate services. Community councils, mosques, clubs and voluntary initiatives can likewise provide regular opportunities for people to meet and build meaningful connections.
Technology can serve as an important bridge, particularly for those separated from family and friends by distance. However, it can also increase isolation when it replaces genuine relationships or becomes a form of passive browsing and constant comparison with others. Its use should therefore ideally lead to a meaningful conversation, a face-to-face meeting or participation in a trusted group.
Breaking the cycle of loneliness can also begin with simple, regular steps: calling someone we trust, sharing a meal with a family member, taking a walk with a neighbour, or joining a voluntary or sporting activity. It is equally important to identify health-related barriers that may cause people to withdraw, such as hearing loss, chronic pain or difficulties with mobility, and address them so that individuals can regain their ability to communicate, participate and remain connected to their communities.
Conclusion
Loneliness is neither a weakness nor a personal failing. Experiencing it from time to time is a natural part of being human. However, when loneliness becomes persistent and begins to affect sleep, mood and everyday life, seeking help is a sign of awareness and strength.
Recognising loneliness early, strengthening meaningful relationships and creating communities that make connection possible are essential steps towards a healthier, more connected and resilient society.
By: Dr Badreyya Al-Harmi, public health consultant
