May is Mental Health Awareness Month, and to kick it off, US Surgeon General Vivek Murthy released an 81-page report that says the US is in the midst of a loneliness epidemic. But how pervasive is loneliness in a dense urban environment like New York City, where we interact so often with dozens of people every day just to do our jobs?
The answer is that it is common and manifests itself in a very specific way. Jillian Richardson, author of Unlonely Planet and founder of Joy List, joined WNYC this week to discuss community-building events in New York City. Dr. Gneesha Kaul of Weill Cornell Medical Center, who works directly with immigrant populations, also attended.
The following interview has been lightly edited for clarity.
Sean Carlson: Gillian, I want to start a journey where you write about urban loneliness and give people the tools to deal with it. How did you feel when you heard Dr. Mercy’s comments about loneliness earlier this month?
Gillian Richardson: Let’s be honest, loneliness is one of those problems that on the surface seems a little superficial, so that someone as prominent as the Surgeon General could say, “No, this is actually a health crisis.” I was very happy. Really makes me hopeful for the upcoming Battle Against Loneliness fix.
Dr. Kaul, what did you think of what Dr. Marcy said?
Dr. Gneesha Kaul: As a refugee health researcher, what has been most meaningful to me is the high-risk population, including those from ethnic and racial minority groups, LGBTQ+ individuals, survivors of domestic violence, and other disadvantaged groups. It was the Surgeon General’s point about the community.
I see people living in poverty and having to work multiple jobs to make ends meet, without the opportunity to spend time with family and friends and feeling lonely. I see young immigrants who are separated from their families and children. I think the concept of resilience contributes to that misunderstanding.
The human body and mind can experience and still endure a great deal of strain and trauma. But its survival leaves a mark both physically and psychologically. As the Surgeon General does, I think it’s very important to recognize that marginalized communities are indeed at high risk in this epidemic of loneliness.
Gillian, as I said earlier, New York is a big, bustling city. Even though you can go about your business and there are people everywhere at all times, you can still feel very lonely. What do you hear from New Yorkers and New Jerseyans who are actually experiencing loneliness, and how has the pandemic changed that?
Richardson: I feel like New Yorkers in particular have this sense of shame when they don’t have the community they think they should have. There are often inner stories like this that people tell themselves. You need to build meaningful relationships. I live in this crowded city. What’s wrong with me that I don’t have the kind of close relationship I really crave? “
And the reality is, like you said, in a big city like New York City, people are so busy that it’s actually hard to make friends. There is a social scene, especially with young people going to bars and yelling at each other with loud music on. Spaces to connect weren’t really designed for deeper conversations or lasting relationships. And the pandemic is making this even worse. Sociability is a skill. it’s muscle. It says that the more interactions you have with people in a week, the easier, more enjoyable, and less anxiety-inducing you will be.
So, of course, it’s going to be a little awkward to start interacting with people if you’re following social distancing protocols. And when we get lonely, our brains change and start scanning for so-called neutral social cues. For example, if you’re at a party and you look someone in the face, they give you a kind of neutral look.
You are lonely, so your brain can perceive that as a negative sign. And we really start to think, “Okay, people don’t want me around. I’m not good at socializing.”
One of the big stories in recent weeks has been the immigration crisis. In addition to the many New Yorkers who are already living here as immigrants, refugees, or who have emigrated from other states, there are others living in cities far from their homes. Dr. Kaul, you mentioned that you talk to a lot of immigrants in his practice. Can you tell me how loneliness manifests itself for them?
cowl: Many of my refugees and asylum-seeking patients are so relieved to have been forced out of their homes by the war, violence and persecution, and at the same time, to be integrated into the New York City community. I am grateful for that.
But at the same time, there is also a deep yearning for life as it once was. It should be remembered that of the 140 million forcibly displaced people around the world, only a small fraction end up in countries such as the United States and Canada. In other words, people who come as refugees and asylum seekers had the social networks, skills and financial security to cross multiple borders.
Many of the people who see us in our clinics and research centers have very strong family ties. They had successful careers as teachers or medical professionals. They had strong social networks before they came to the US, but they often lose their core circle of friends and community here.
And it is a dramatic shift in perceived social status and relationships. We recently had a patient working as a paralegal in his home country who had been persecuted for being gay and had applied for asylum in the United States. He didn’t speak much English so it was difficult to connect with others. He had chronic illnesses, including heart disease, likely the result of past trauma, but he didn’t have the time or money to see a doctor regularly. What caused his loneliness was the loss of what he had rather than simply the current situation.
Gillian, do you think it’s possible for people living in family units or older people living with children or with each other in a retirement community to feel isolated?
Richardson: Oh, 100 percent. I think that loneliness is often exacerbated by the presence of family. When we were teenagers, there was this thought, ‘Oh my god, this family won’t understand me. And it can be very traumatic for many young people, especially if their identity is not accepted by their families. Exactly, there is the feeling that “I am not seen, I am not heard, I am not understood.” And after being with this family for years at a time, you can leave that family with the feeling, “I’m not okay.”And it takes a lot of effort as an adult to really fix it.
Dr. Coul, another big piece of news that we’re keeping an eye on is the case of Jordan Neely, who was murdered by another subway passenger. The case is now being prosecuted by the Manhattan District Attorney. But the situation described in Mr. Neely’s life is very common, isn’t it? People who feel that no one cares about their situation are probably homeless or otherwise homeless or mentally ill. You may have experienced something like Many New Yorkers know that when they get on the train or sit on a park bench, their neighbors look away, if not away. What effect does it have on people’s mental health and what do you hear from people in such situations?
cowl: In the context of the Surgeon General’s report, multidimensional trauma challenges are highlighted when people are not only experiencing loneliness and isolation, but also have mental health ailments. I’m here. What is the complex trauma of living in poverty, lacking housing security, experiencing post-traumatic stress at the sight of a family death like Jordan Neely? How it affects and how harmful it can be when a person goes through so many experiences. Are there multi-layered issues that have gone unaddressed for years by family, friends, and the surrounding community? And can the effects of this kind of trauma be mitigated or reversed? have downstream effects on disease.
