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One can feel lonely anywhere, but the loneliness that comes from feeling alone in a big city despite living cheek-by-jowl with so many other people is a different thing altogether. As Olivia Laing puts it lucidly in her book The Lonely City: Adventures In The Art Of Being Alone, “Loneliness doesn’t necessarily require physical solitude, but rather an absence or paucity of connection, closeness, kinship: an inability to find as much intimacy as is desired."

Loneliness isn’t about whether we live alone, it’s about  feeling alone, says psychologist John Cacioppo of the University of Chicago, US, in an email interview. “Chronic loneliness (being and feeling lonely for a long time) is a modern-day epidemic," says Prof. Cacioppo, who has been studying this subject for over two decades. 

This sort of isolation has long been associated with old age—parents struggling to come to terms with grown-up children leaving home and moving away; poor health; and not knowing how to utilize their spare time. Over the past 10 years, however, health experts have seen an increase in this phenomenon in the younger age group as well.

Bengaluru-based psychiatrist Shyam Bhat, for instance, has seen a three-fold increase in the number of patients experiencing chronic loneliness, many of them in the 25-35 age group. Madhumita Ghosh, clinical psychologist at Fortis Hiranandani Hospital in Mumbai, too, has seen a similar increase in the same age bracket.

Sameer Malhotra, director (mental health and behavioural sciences) at Max Super Speciality Hospital, Delhi, who sees at least seven people in a week in the 22-40 age group, says many of them complain of chronic loneliness. “Most people complaining of chronic loneliness are those who have moved to bigger cities from smaller places to realize their aspirations." 

Till a few decades ago, nobody knew about this phenomenon in India, says Bhat. “But now things have changed. People are becoming more isolated—the need for privacy is increasing and tolerance for compromise is reducing. Our communities and family structure have also changed with the demise of the joint family system and there is an exponential increase in the number of nuclear families and single people. Unfortunately, there is no government data on the spread of this phenomenon." he adds. Erratic schedules, lack of meaningful relationships or break-ups, increasing workload, long commuting hours and the pressure/need to prove one’s worth through materialism, too, have resulted in people distancing themselves from others, adds Ghosh.

Besides the lack of empathy and time for each other, experts blame the dual character of the online world for fuelling chronic loneliness. “If used as a tool to enrich and increase the frequency of face-to-face interactions, social media tends to be associated with lower levels of loneliness. But if you look at it as a replacement for the face-to-face, it can flood you with loneliness," says Prof. Cacioppo. 

According to a study published earlier this year in the journal Developmental Psychology, the possibility of loneliness increasing  is higher at the age of 30. “A sense of lack of purpose and dissatisfaction with life that typically occurs during early adulthood can make loneliness creep in," says Maike Luhmann, a psychologist at the University of Cologne, Germany, and co-author of the study. He says that having a fulfilling job, a partner and other healthy social relationships help in preventing chronic loneliness to a certain extent. 

Read the symptoms

The consequence of this loneliness is more than just the emotional toll it takes. A study published in 2009 in the Scandinavian journal Acta Psychiatrica Scandinavica found that living in a city almost doubles the risk of schizophrenia. Nature, in 2011, published a research that said the “brains of urban dwellers become physically more susceptible to stress compared to their country counterparts" because of social fragmentation, noise, lack of control, subordination and overcrowding.

Moving beyond mental health, chronic loneliness is also known to increase the likelihood of death by heart disease, diabetes, stroke, cancer, even suicide, says K.K. Aggarwal, national president-elect of the Indian Medical Association, and president, Heart Care Foundation of India. “Chronic loneliness can also hurt the sleep cycle, result in higher blood pressure and risk of stroke," he warns. Studies have also shown that loneliness can result in an increase in alcohol consumption and less exercise. 

Explaining the thinking process of a chronic loner, Cacioppo says: “You tend to be more concerned about yourself because you think no one else is concerned about you. The focus is always only on the self. This process is so fundamental that it occurs even when we have no awareness of it. As a result, people show poorer social skills and less empathy." But how do we know that this feeling of loneliness is not healthy and can affect us? “Humans are social animals. Still there are times when we feel isolated and ponder over it. But the next day we move on with lives. However, if that feeling continues to stay for over a week and starts affecting your day-to-day function, you should instantly hit the panic button and see a counsellor/psychologist,"says Ghosh.

Agrees Luhmann: “Chronic loneliness is not a clinical diagnosis; there exists no general criteria or cut-offs for diagnosing it. Certainly, the longer the state of loneliness lasts, the more serious it is." 

The onus of seeking help lies on the person who is experiencing it, says Bhat. “Of course, family and friends can help, but this problem is such that many people can mistake it for the person being an introvert. As a result, it can aggravate and result in depression," says Bhat.  

Loneliness can often be confused for depression because of similar symptoms. “Both have separate emotional constructs. Having said that, chronic loneliness can lead to depression. It is actually a unique risk factor for depression: People who feel chronically lonely are at an increased risk of developing depressive symptoms," says Dr Malhotra. “The best way to differentiate between them is to carefully notice the patterns and kinds of stimuli that trigger these conditions," he adds.

Build relationships

Is there a cure for the chronic urban loneliness? “Yes, of course. Our fast-paced lives in the big city can make us lose our social connections. This includes one’s partner, close and remote family members, friends, neighbours and colleagues. Take time out to build them," suggests Luhmann. Get a dog if you can, says Prof. Cacioppo, adding, “If you have a dog, you are likely walking the dog daily and, in so doing, you meet other people who also have a dog. And that’s how you meet new people and form relationships." If you are new in the city, get out of your comfort zone and meet people and make friends, advises Dr Malhotra. 

Most importantly, stop checking your Facebook feed every 5 minutes and notice the world around you instead, says Ghosh. “Life is about balance. Stop running the race against time for a while. Take a break every now and then. Indulge in some creative activities over weekends, pursue something you like, something that gives you inner joy. This kind of solitude will help you perform better at work, studies, anything and everything," she says.  

German sociologist Georg Simmel once said that “one nowhere feels as lonely and lost as in the metropolitan crowd", but the hectic pace of life in the big city can also be a window to know more about ourselves. “You just need to steal the moments and introspect, and understand what needs your attention and what not," says Ghosh

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