Loneliness: an incommunicable disease?

Abstract

ATOMISATIONFor many people the experience of isolation did not begin with the current pandemic.Loneliness has long been a problem on both sides of the GP's desk, but with opposing consequences.Socially alienated patients are more likely to experience health problems, and a desire for companionship can motivate a visit to the GP. 1 Conversely, GPs who find themselves without professional support or collegiality have an increased chance of leaving the profession.2,3 The lonely patient is more likely to be in the surgery, and the isolated doctor less likely to be there.It is a poignant image: two contrapuntal lonelinesses, neither of which finds solace in the other.The problem of patients' social isolation has attracted attention from many quarters in recent years, with a ministerial appointment, a national campaign, and research from scholars of public health, neuroendocrinology, sociology, psychology, and history.The former surgeon general of the US states that combatting disconnection is the 'greatest challenge facing us today'.4 The health effects are still debated: loneliness is associated with, but perhaps not fully responsible for, cardiovascular and neurological morbidities, inflammatory dysregulation, and a contributor to early mortality.[5][6][7] Yet medicalisation can only take us so far in understanding isolation: biomedicine may be able to identify some of the physiological consequences, but it is unlikely to proffer any meaningful therapies for a condition that historians and sociologists have located, inter alia, as the result of increased affluence, 8 surging inequality, 9 and modernity's individualistic obsession with self-cultivation.10 This is a problem, like racial inequality or environmental pollution, that saturates the