Loneliness as a Component of Psychiatric Disorders

Richard Booth, PhD

Disclosures

Medscape General Medicine. 2000;2(2) 

In This Article

The Affective Dimension: How Lonely People Feel

It seems intuitively true to suggest that the most direct way to discover how people feel about themselves is to ask them. In fact, as mentioned above, with some exceptions this appears to be a valid way of determining whether people are lonely. Russell[14] found that subjective statements of personal loneliness were significantly correlated with psychometric measures of loneliness such as the UCLA Revised Loneliness Scale. But how do lonely people feel about themselves and their lives? How do they actually describe themselves?

Many researchers have asked lonely people to give self-descriptions, and the findings look remarkably consistent across the bulk of the literature. In reviewing the loneliness literature, one is struck by the fact that, if there is a negative self-descriptor available, lonely people seem to apply it to themselves. Lonely people self-describe in very negative ways that span a large range of self-deprecating characteristics. Examples of these are feeling worthless, empty inside, unacceptable, and separated from others. They also say they feel alone and lonely, vulnerable, relationally inadequate, and spiritually empty. They indicate that they feel pessimistic, disliked, and unappreciated. A number of lonely people say they feel angry at others because they perceive that these others are unwilling to rescue them from their loneliness. This is a particularly interesting perception, since it assumes that other people possess the capacity but nonetheless refuse to "remove" the loneliness that is being experienced. This is another illustration of the unrealistic expectations that some lonely people have; we might also refer to it, in a certain sense, as "magical thinking." It is clear from these self-descriptions that lonely people are unhappy people and that, when their loneliness becomes chronic, depression is a likely correlate.[26,27]

Notwithstanding that lonely people feel negatively about themselves and their interpersonal lives, as well as angry toward "unhelpful others," is it appropriate to pathologize loneliness or to think about loneliness in terms of a psychiatric dysfunction? This becomes an even more salient question because loneliness is so pervasive and because virtually everyone is probably lonely at some time in her or his life. But, if dysfunction is taken to mean, as Comer defines it, an interference "with daily functioning," loneliness is clearly dysfunctional. Comer continues, "It so upsets, distracts, or confuses its victims that they cannot care for themselves properly, participate in ordinary social relationships, or work effectively."[28] Loneliness can also be considered maladaptive, since, as Sarason and Sarason argue, "Describing behavior as maladaptive implies that a problem exists; it also suggests that vulnerability in the individual, inability to cope, or excessive stress in the environment has led to problems in living."[29] If we assume these definitions of dysfunction and maladaptation suffice, loneliness is arguably both dysfunctional and maladaptive. Many problems exist for lonely people that lead to preoccupation with their loneliness and a behavioral repertoire that is counterproductive in terms of ameliorating their own condition.

Numerous psychological risks accompany loneliness, including that of rejecting other people even though the company of these others constitutes the only alternative to loneliness. Moreover, lonely people tend to be more shy and normless, lower in self-esteem, higher in public self-consciousness, and higher in external locus of control than nonlonely people.[9]They also tend to behave in a more self-focused, less responsive manner when interacting in cross-sex dyads, and they talk about themselves more than they ask about others, suggesting a certain narcissistic self-preoccupation and lack of empathic concern with the welfare of the other.[18] Other researchers have found that loneliness in college students is linked to problems such as alcoholism, as well as to suicide,[30,31] and Russell[14] reports that high levels of anxiety accompany loneliness and that loneliness is often accompanied by high depression scores on the Minnesota Multiphasic Personality Inventory(MMPI). Although this is only a sample of the findings concerning the many risk factors associated with loneliness, it appears that loneliness warrants consideration as a potentially serious dysfunction. This is perhaps even more true when we examine the relationship between loneliness and depression.

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