Feel Better, Live More with Dr Rangan Chatterjee - The Hidden Health Crisis: How It Affects All Of Us And What We Can Do About It with US Surgeon General Dr Vivek Murthy #462

Episode Date: June 18, 2024

Have you ever felt lonely, even when surrounded by people? Do you struggle to forge meaningful connections in today's fast-paced, technology-driven world? If so, you're not alone. Loneliness is on the rise in many countries around the world and more people than ever before are feeling alone and isolated. In today’s episode of my Feel Better Live More podcast, I'm joined for the second time by Vice Admiral Vivek H. Murthy - the 21st Surgeon General of the United States. He received his bachelor’s degree from Harvard, his medical degree from the Yale School of Medicine, and his Masters in Business Administration from the Yale School of Management. In his role, Dr Murthy helps to advance the health and wellbeing of all Americans and has worked to address several critical public health issues. In our conversation, we discuss the growing epidemic of loneliness and its impact on our health. Vivek shares profound insights on the far-reaching consequences of loneliness, which extend beyond mental health to include physical health problems, including an increased risk of stroke, dementia, heart disease, and premature death.   We delve into the root causes of the loneliness epidemic, exploring how fundamental shifts in technology and culture have altered the way we connect with others. Vivek emphasises the importance of taking social risks, building communication skills, taking regular social media breaks, the life changing benefits of volunteering, and he talks about the idea that simply dedicating just 10-15 minutes per day, to work out our social muscle will very quickly start to deepen our connections with the world around us. This thought-provoking conversation is for anyone looking to foster authentic connections in an increasingly disconnected world and deepen the relationships that matter most. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Buy tickets for my stage tour https://drchatterjee.com/tour Thanks to our sponsors: https://boncharge.com/livemore https://drinkag1.com/livemore Show notes https://drchatterjee.com/462 DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Pause and just ask yourself a couple questions. Do I have people in my life who know me for who I am? Do I have people in my life with whom I can truly be myself? I can be authentic. Do I have people in my life who would show up for me in a crisis? The answer really matters. And if the answer to any of those questions is, I'm not sure,

then that might tell you that this is a place where you need more attention in your life. Hey guys, how you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee, and this is my podcast, Feel Better, Live More. Did you know that loneliness is on the rise in many countries around the world? It's crazy, isn't it, that in the modern world, with all of our fancy technology, where in theory we should be more connected than ever before, so many people are feeling alone and isolated. Well, in today's episode, I'm joined for the second time on my podcast by Vice Admiral Vivek H. Murthy, the 21st Surgeon General of the United States, who has served

under both President Obama and President Biden. As the highest ranking doctor in the United States, Dr. Murthy's role is to advance the health and well-being of all Americans. He received his bachelor's degree from Harvard, his medical degree from the Yale School of Medicine, and his master's in business administration from the Yale School of Management. Now, if you're a longtime listener, you may recall that Dr. Murthy first appeared on this podcast all the way back on episode 114 to discuss his first book together, Loneliness, Health and What Happens When We Find Connection. This latest conversation actually took place a few months ago when Vivek was in the UK to speak alongside myself at the World Happiness Summit. In our conversation, we explore the root causes

of the loneliness epidemic, exploring how fundamental shifts in technology and culture have altered the way we connect with others. Dr. Murthy also shares his insights on the far-reaching consequences of loneliness, which extend beyond mental health to include physical health problems, including an increased risk of stroke, dementia, heart disease, and premature death. So what can we actually do about this, both individually and collectively? Well, Dr. Merzi has plenty of practical ideas, which he shares throughout our conversation. Yes, there is a need for systemic policy change to create environments that encourage genuine social interaction. But on an individual level,

Dr. Murthy talks about the importance of taking social risks, building our communication skills, taking regular social media breaks, the life-changing benefits of volunteering. And he talks about the powerful idea that simply dedicating just 10 to 15 minutes each day to work out our social muscle will very quickly start to deepen our connections with the world around us. Given that human beings are such a social species and thrive in connected groups, I think that addressing loneliness is one of the

most urgent issues we need to tackle for our health and our happiness. Dr. Murthy is someone who deeply cares about improving the health of the world around him and it truly was an honour to sit with him once again. loneliness is a topic you are incredibly passionate about i've heard you say before that the impact of loneliness is greater than the impact of obesity so i wonder if right at the top of this conversation you could spell out just how damaging is loneliness and why does it affect our physical health so much? Well, this is not something I learned about in medical school for sure.

And it's surprising to many, but the health impact of loneliness and isolation is really profound. And it teaches us that loneliness is so much more than a bad feeling, but when people are struggling with being disconnected from each other, it actually is associated with an increased risk in depression, anxiety, and suicide.

So it really impacts on mental health. The impact on our physical health is also profound, even though perhaps even more surprising, which is that there's an increase in risk for stroke and heart disease and dementia, as well as premature death. And with premature death, like this increase in mortality that we see associated with being lonely and isolated is on par

with the impact of smoking. And it's even greater than what we see with obesity. And I mentioned that because we are trained in understand that smoking and obesity, these are classic public health issues. But it turns out that addressing loneliness and isolation is just as important because the impact on our wellbeing is just as profound. For someone who's listening, Vivek, who has never heard about the impacts of loneliness before, I think they may intuitively

understand, sure, it can affect your mental wellbeing. Who wants to feel isolated? Who wants to feel as though they don't have someone around them to open up to, to share things in their life with? But I don't think people know or intuitively understand, I should say, the impact on our physical health. When you say that loneliness is as harmful as smoking, I think for some people they'll go, well, how does that work? What's going on there? Surely smoking 15 cigarettes a day

is more harmful than being lonely. But of course the data says that that's not the case. Yeah, and it's a legitimate question. And in fact, I too wondered the same thing. How is it that loneliness actually impacts your health in this way, your physical health in particular? And so I had to study this more deeply, understand it as I delved into this subject.

There's a lot more to understand here, by the way, and that's one of the reasons more research is needed. We see the effects very clearly, how those effects come about, like what biological processes are taking place in the body is where the understanding has to strengthen. But there's some theories as to how this happens. One is, and the one I'll mention

is particularly focused around inflammation in our body. It turns out that when we are lonely and isolated from one another, that actually puts our bodies in a stress state. Now, a stress state in the short term can be good, right? If you get stressed before an exam or before you make a big presentation at work, sometimes that can rev you up and focus you

and you can perform better. But when stress is chronic, when it's prolonged in our lives, that's when it can start to do damage, right? And that's when we see that that stress can actually lead to ill effects on our mental and physical health. And particularly with stress, what we see is that it can be associated with increased levels of inflammation in our body, which can over time damage tissues

and blood vessels, increase our risk of cardiovascular disease and other illnesses. So stress and inflammation may be an explanation in part for why loneliness, especially chronic loneliness, lead to the health impacts. And lastly, just consider this also as a parallel. Like we're all familiar with the concept of like lifting a heavy object, whether it's at the gym or in your house

when you're moving things. And you know, if you go to the gym and you lift a weight and you curl it a few times and you put it down, over time that become, you can get stronger and stronger. But what if you pick up a really heavy weight, you curl and contract your muscle and then you hold it like that for three hours? Like imagine the damage that that would do

like to your muscle. That's the equivalent of what happens with short-term stress versus long-term stress. Short-term stress potentially can help you get stronger. But when your distress is chronic, when it's prolonged, it can start to damage you. And that's essentially what chronic loneliness does. When I explain the impacts of loneliness to my patients,

I always do it through the lens of the stress response because it kind of makes so much sense that a million years ago or 200,000 years ago in our hunter-gatherer tribes, if we were by ourself and we didn't have our tribe around us, well, our very clever body would be preparing us. They know that we're vulnerable.

If we were to get attacked, the body prepares us preparing us. They know that we're vulnerable. If we were to get attacked, the body prepares us for that. So increases inflammation, increases how quickly our blood will clot. Because of course, if we get attacked by a wild predator, instead of bleeding to death, the blood's going to clot and it's going to save our life. And I really like that way of thinking about it because I've certainly found that patients get it when you explain it like that, they go, yeah, of course, it kind of makes sense. And it's interesting, I've heard you say before

that loneliness has always existed in humanity, but today it has a different flavor. Yeah. What do you mean by that? Well, I think the human experience is to be lonely from time to time, just like the human experience is to be hungry or thirsty from time to time. Loneliness ultimately is a signal our body's sending us when we lack something we need for survival.

If we respond to that by filling that need with food or drink in the case of hunger or thirst, or in this case with human connection, the case of loneliness and it goes away. So it's been part of the human experience. We recognize it. The problem and the interesting flavor of loneliness today is sort of the following.

Like number one, we're finding that young people are actually struggling with greater levels of loneliness than older people, right? And this is a bit counterintuitive because people typically think, well, when you're younger, you're at school, you're around other kids. When you're at university,

you're surrounded by other students as well. You've got a family around you. Like, why would you be lonely, right? But in the US, for example, we are finding that the rates of loneliness among young people are double that among those who are 65 and older. And this type of data showing a skew

toward those who are younger is popping up in other countries as well. The other thing that's different about the flavor of loneliness today compared to let's say 40, 50 years ago is that fundamental changes in shifts in technology have just fundamentally altered how we interact with one another,

such that we can be around lots of other people, but be completely disconnected from them. I think about, for example, the recent university tour that we did in the United States and where we spent a lot of time talking to students about their experiences of loneliness. And I will say just parenthetically that these events, by the way, of all the events I've done, you know, as a public official over a number of years, were the ones that seemed to generate the

most engagement and demand because young people are feeling and experiencing loneliness so intensely. But what they often talked about was the fact that they had lots of people around them on college campuses, on university campuses. But they said the culture has changed such that it's not easy to just go up and talk to someone anymore. People have their earbuds in, they're looking at their phones,

they're on their laptops in the dining hall. And they say it's just, the culture just isn't anymore or it isn't easy to make it easy to actually go up and talk to one another. That is fundamentally different from how we have existed for most of humanity. Like we didn't exist for years in a situation where we were all together,

yet weren't talking to one another or engaged with one another. So this has led to a circumstance where millions of people around the world are surrounded by others, yet feeling disconnected from them, feeling like people don't know them, feeling like they're alone.

And that means that we've got to do something different than just trying to throw people together in a room and hope that they feel better. Because as this has gone on over time, young people in particular are telling us that not only are they on technology and with people online more than they are in person, but they're also saying that their comfort

with in-person interaction has diminished. And the pandemic played a role in this as well for young people who went through the isolation in particular of 2020 at a very sensitive time in their development, in their social and psychological development. And many of them tell us today that they feel that the pandemic made them age backward,

that it made it harder for them to actually interact with others socially. And they're still trying to catch up to that. So that's all the flavor of loneliness that I look at and see today. And I particularly worry about it when it comes to young people. There was a book,

I think it was published in around 2015, 2016 called Reclaiming Conversation by Sherry Turkle from MIT. I'm not sure if you're familiar with it. I found that book such a fascinating read. And I remember clearly that she made the case in that book that youngsters, for want of a better term, the children, the teenagers growing up today, many of them, as you just mentioned, prefer to communicate electronically for a number of reasons. But one of the points she made was that from the interviews she conducted, people were saying, yeah, I prefer it because it's more predictable. I can take my time. I can edit.

I can make sure that I have crafted the perfect text message to send. Whereas of course, in real life interaction, like we're doing now, we have to respond in real time. We may get something wrong, we may jumble our words or whatever. We can't edit before we speak. And it really made an impact on me that. So I thought, wow, we're fundamentally changing how people are communicating. We are editing first before we connect. Instead of connecting first, I'm not saying edit second i don't think we should be editing we should be having those real life interactions but it is becoming more of a problem isn't it it is and and we usually share that example it's it's very it's really timely and and in my head poignant because there are two primary challenges

that are introduced by that situation. One is an authenticity gap and the other is a skill gap. So if I, one of the things that's powerful about being in person is it's easier to sort of, you know, for people to understand who you are and where you're coming from because they're hearing what you're saying unedited. They're also looking at your facial expressions,

your body language, your tone, like all of these things contribute to how we connect with and understand each other. When I just see the texts that you've sent, that's also, I know that that's curated, edited, sanitized, whatever it might be. My question is, what's he really thinking? Who am I really talking to? Do I really get where he's coming from, what's he really thinking? Who am I really talking to?

Do I really get where he's coming from? Get who he is? And all that is harder online. So it's easier to be authentic in some ways, have an authentic connection when you're in person, which is why I always say that five minutes of in-person time with someone is so much better sometimes

than half an hour of texting back and forth with somebody because you can just understand somebody more deeply. But the other part in additional authenticity is the skills part. So the truth is like in real life, we need to know how to interact with other people, whether that's doing a job interview in person, whether that's interacting with a customer,

with a neighbor, whether that's asking somebody out on a date, if you're younger or figuring out how to negotiate conflict in a relationship. These are all things we have to do in person. And the question is, where do we build the skills to do that? And if you're growing up in an environment

where you don't have those opportunities because most of the interaction is online, then what happens is you start to go down a downward spiral where you become less and less comfortable with in-person interaction, so you avoid it. Yeah. And then you tilt more toward online interactions, which makes you even less comfortable with in-person

and down and down the spiral goes. And then what you do is then you send kids off to university where they have to interact with people in person and it's a very difficult experience for them. And you, I don't blame students in university because if you've grown up for the last number of years without that skillset, because most of your interactions have been on, you know, online, then you're going to be, it's going to be harder for you. So somewhere we need to help young people build those skills, build that muscle for in-person interaction.

It's ultimately more fulfilling, but that doesn't mean it's always easy. Just in the same way that the first time you go to the gym, if you've never worked out, like it's uncomfortable initially to lift weights, to be on a treadmill, to like run, you're gonna feel tired. It might be a little bit painful,

but then you build strength and ultimately you're in a much better place. Yeah. It's fascinating. As you were talking then, I was taken back to my childhood and a couple of things came up for me. One is, you know, when we were kids, mobile phones did not exist. So most families, most households would have a landline phone certainly in the uk yeah and i remember as a teenager if i wanted to get hold of one of my friends from school to arrange something i had to phone the landline talk to my friend's parents and ask you know interact with an adult basically before you could get hold of your friends. And we took that sort of stuff for granted, but the generation today,

because of mobile phones, they're bypassing having to talk to an adult. I'm not saying, you know, there aren't benefits to that, but you do miss out on developing that skill of talking to this adult who you may not know very well. You have to, you know, exchange pleasantries with them. They may ask you questions, which, you know, you then have to answer. So that's the first thing, which I thought was interesting. The second thing, it's funny, the second thing it's funny recently um i i had a meeting with my team an in-person meeting to do with this podcast and i was reflecting with my wife afterwards and saying you know what i just assume everyone finds it easy to be in groups and interact but i shouldn't make that assumption because not everyone does and some people get intimidated in large groups

and they don't know what to say. And I feel I've always found it really easy. I don't know if that is an innate skill. I don't think it is. I think it was something that my mother drilled into me. So I can remember at the age of 12, Vivek, on our street, five doors down, a new family arrived. I remember my mum said to me,

okay, this afternoon, I want you to go knock on the door, introduce yourself, because they've got a boy who looks like he's your age. I'm like, what? Just go round? Mum's like, yeah, I want you to go and knock on the door, introduce yourself to his parents and say, you know, if he doesn't have any friends, he wants him to play with it. You're just down the road. I didn't like it. I can't say I was excited about doing that, but that's the kind

of stuff my mom would kind of make me do. And it's funny. I think that's totally relevant to what you're talking about because as a kid, society through landlines and other things made me interact with other people like all kids had to. But also I think on a family level, my parents, my mother in particular, would probably recognize that this is an important skill and make me go into my zone of discomfort, practice, as you say, it's a skill and get better at it. So now as an adult, I find it really, really easy. I love that your mother did that.

I mean, it's a powerful thing. And what I love that your mother did not do is she didn't say, well, because this is a little challenging or uncomfortable for Ranga and he doesn't need to do it. But she said, I'll support you through it, but it's important to do. And then you built a skill as a result. And I think in the same way that parents might encourage their child to take music lessons, you know, and to learn to play the piano or the violin, or might encourage them to join a basketball team, even though they're not great initially and then they build skill.

I think we have to actually look at social interaction in the same way. And perhaps 40, 50 years ago, we didn't have to do that, but we're living in a different time right now where the default is not anymore that young people just develop and build all of these in-person social skills because the environment has changed,

the technology environment in particular. Like when I was growing up, I remember that my parents, I was really shy and introverted as a kid. And so it was actually hard for me to like go and just make friends and stuff. But I remember my parents would recognize that. And they did something very similar to what your mom did is they made me, they knew which neighbors had kids, right? they made me, they knew which neighbors had kids, right? And so they made me go to the neighbor's house, knock on the door and ask the parents if the kid was free to play, right?

And I hated doing this initially. I was like, oh God, I don't want to do that. Because, and the big worry, the reason I didn't want to do it is I was scared what would happen if they said no. Yeah, of course. I don't want to feel rejected like that as a kid. And I still remember the neighbor across from us ultimately said no. He's like, no, I'm too busy. I got homework. Right.

And I felt like crushed. Right. And I was like, this is like, why did I do this? I feel so embarrassed. I knew I shouldn't have gone. Yeah. I knew I shouldn't have gone. But then like, but they would keep doing things like that. Like when we had, we had a tragedy in our school where a couple of kids were driving to get lunch and got into a car accident and tragically one of them died. And the kid who made it, who thankfully was survived was somebody that we had known. I wouldn't say he was the closest of friends,

but he was a friend. And I remember my parents said to me, call him, go over and visit him and make sure he's okay. And I was like, I don't know if he wants me to come over. What am I supposed to do? I was in school, grade school at the time. But they literally drove

me to his house, dropped me off there. I am knocked on the door. And I still remember to this day, like we ended up spending like two hours together, just like walking. We didn't talk anything about what happened, you know, about the just tragic car accident. How are you doing? We just talked about other stuff, what was going on in his family, you know, you know, about what was happening with basketball, this, that, whatever. But at the end, like when I left, he said, Hey, uh, uh, thank you

for, for coming over. That actually meant a lot to me. And I was like, oh my gosh, I didn't realize that you could have that kind of impact from both people. I felt like great too. But it was a reminder to me that what my parents were encouraging me to do was to take social risk. And we all need to be able to take a little bit of risk socially

in order to forge meaningful connections, right? If we can't tell somebody that, hey, I like you, I'm interested in you, I would love to take you out for lunch or just spend time together or take a walk, we may never find a relationship that's fulfilling to us, right? If we don't feel comfortable having a conversation with somebody who's sitting in the cafeteria or is in our class, we may never develop

the friendships that ultimately like change our life. And same at work. Like if we're not able to talk to work colleagues, we may not develop good relationships at work. And I just think that this is a muscle that we have to build. And as parents, we got to help our kids build. It doesn't mean that we can't do it compassionately and with support, but I do think it means that we have to build. And as parents, we got to help our kids build. It doesn't mean that we can't do it compassionately and with support, but I do think it means that we have to be able to tolerate some discomfort or at least set the expectation for our kids. You know, this may not be easy.

Like in the beginning, the first time you go up and talk to somebody or ask them a question. I'll ask maybe just share just on a personal for my own kids. Like, okay, when my kids were, went through the first year of the pandemic, they were really young.

And it was a, like my son was four, my daughter was two at the time. And that was a really important time, social development for them. And before the pandemic, they were both like kind of pretty social kids, you know, like interact with strangers,

no problem, whatever, whatever. After the pandemic, after that, you know, year or so of just like largely not being, you problem, whatever, whatever. After the pandemic, after that year or so of just like largely not being around that many people outside of media family, they became incredibly shy. And we have spent the last few years trying to figure out, my wife and I, how do we get them to be comfortable with social interaction again?

And we got a lot of advice from like friends, from teachers, from anybody who would give us advice, you know, trying to figure out how to, because we knew that in a home, they were perfectly like social and everything. But with teachers, with other adults, even with sometimes with other kids, it was much harder for them.

So we would do these things with them where we would go to a part of town where, you know, it was a safe part of town and pretty friendly and there were a lot of tables there where people would just sit and eat at tables from restaurants close by and we would actually challenge them. We gave them a piece of paper

where they had three simple questions and they would take that paper up to a table and they would ask the adults the questions that were on those papers. And they would take that paper up to a table and they would ask the adults the questions that were on those papers. And they were like very, very simple. Might be like, I don't know, what's your favorite color?

Or what's your favorite flower? You know, things, simple things like this. But it was a challenge for them. We were challenging them to then interact in on a simple matter, with someone they didn't know. And we were there about 10 feet behind them. So they knew that like, you know, worst comes to worst, I can always run back to mom or dad.

But it actually sort of pushed them to get a little bit more comfortable with interaction. So I do think that this is a vital muscle that we have to build more intentionally than perhaps we've ever had to, like, you know, in recent history. And it's because fundamentally our social environment has changed

and we've got to help young people through that. Yeah, I think that's a really interesting way to look at it. In the past, the culture, the world around us probably meant that our innate ability to connect with other humans, that's what makes us who we are, would naturally be fostered and nurtured just because of the way we used to live. You had to do it. You couldn't sit at home on your smartphone and order your grocery shopping and whatever film you want to watch. You can do everything by yourself now. I was explaining to my son last week, I said, you know, in the 90s, if we wanted to watch something and it just come out, well, it would be in the cinema first. A few months later, it would be out on a videotape. And, you know, I said people on a Friday and Saturday night used to go to like Blockbuster

video store and actually wait in queue. And there was only like five videos and you'd have to bring it back and rewind it. And it was just And it's incredible to think how quickly things have moved on from that. And that may seem like just such a small thing. Of course, it's nice to be able to stream any movie you want at any time, but it comes at a cost. It comes at a cost where you no longer have to interact. You don't even have to talk to the guy behind the till at Blockbuster and, you know, speak to them and wait for them to go and find the video tape.

All those little things, I think we, I don't know, we've just taken it for granted. You see it everywhere now. And I think, yes, we can look at the lockdowns in 2020 and beyond in different countries and the impact that has had, but this was going on before then. Absolutely, it was. It may have been accelerated. It was going on before then. So I guess the natural progression

for me, and I'd love to hear your thoughts on this, is in the past, the norm was we were able to connect. Now it's not. So now we need to teach people proactively, probably in schools, we need to teach kids these skills. Parents maybe need to be taught by leaders and society that, hey, it's a really good idea to help your kids lean into their social discomfort because that's how they're gonna grow.

I think that's exactly what we have to do, both as parents and actually in our schools, is just recognize we have to proactively build the social muscle for our kids. Because I do think that the default mode has shifted from social to solitary, right? That's the default mode now. It is, I can be in my home

and get all my packages delivered, see whatever content I want on my computer screen, check on what's happening in my friends' lives on social media. I can do all of that alone, like in my house. I don't even have to go out and get groceries or food. So if that default mode is shifted, that means we've got to be proactive.

There's a parallel here to physical activity too, right? Like 500, well, maybe more than that, 500,000 years ago, people didn't have to think that much about whether they were getting FNF steps like in their day or how physically active they were. Like as a part of your day-to-day life, you were moving around a lot, you had to.

But now because we have developed more sedentary lifestyles, because sedentary is now the default, we have to be proactive about building physical activity into our day. And I think we're seeing a similar phenomenon when it comes to social health that, because we've defaulted to solitary, we've got to proactively build in social skill.

And I think it's not just skill, but social activity for adults as well. Like for many of us, it's not always easy to just get up the wherewithal to like go out and hang out with your friends, or to make plans, to have lunch with have lunch, you know, with an old colleague or to go see family. But that's something we've got to proactively do

because it just doesn't happen by default. And I mean, I look, I find even my own life, I've got to be more proactive than I was before. Otherwise I, as an introvert, I can find myself sometimes easily sliding into a phase where I could go days, you know, without really seeing anyone outside of my wife and my kids. And my wife will sometimes remind me, she'll be like, Hey, you know, we got to get out and like see people. And so I'm trying

to be much more proactive about that in my own life, but it's gotta be a, it's gotta be more intentional than before. You went on this college tour around America and you shared that there was a lot of engagement and college students were sharing just how lonely and isolated that they felt. Many people know that they feel lonely and or isolated. But I think there's many people out there who don't know that they're lonely. That they're so busy consumed with this hustle culture, working all the time, going from work to emails to social media to YouTube.

So you're constantly being engaged. And so I guess my question is, how do you know if you're lonely? How does someone hearing this say, okay, surgeon general, you're saying about the health problems of loneliness. I get it, I'm hearing you, but how do I know if I'm lonely?

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live more. That's drinkag1.com forward slash live more. That's www.drinkag1.com forward slash live more. So that's a really important question. And I do think you're right, Rangan, that our lives are getting faster and faster and filled more and more with things. That could be our job. It could be, you know, what we do on online. It could be all kinds of interactions. But the real question is, is about the quality of those interactions.

Are they fulfilling to us? Are they making us feel like we're seen, heard and understood? In many ways, there's a parallel here to diet, right? We can eat a lot of things. The question is, is it healthy for us? Is it gonna sustain us? And I worry that the diet that we're consuming,

our social diet, in many cases is not sustaining us. That if we're primarily relying on social media for our social sustenance, that those relationships, there may be a potentially a supplement to in-person interaction, but they're not a substitute. The way I think people know if they're lonely is to pause and just ask yourself a couple of questions. One, do I have people in my life who know me for who I am?

Do I have people in my life with whom I can truly be myself? I can be authentic. Do I have people in my life with whom I can truly be myself? I can be authentic. Do I have people in my life who would show up for me in a crisis, right? If you just think about those three questions, right? The answer really matters. And if the answer to any of those questions is, I'm not sure, right? Then that might tell you that this is a place

where you need perhaps more attention, like in your life and more focus to build that social wellbeing and social health. Now, some people know that they're lonely and many people just don't know what to do about it. Cause it's not easy to figure out, especially if you've been feeling like this for a while. But one of the things I think that's really important for people to know is that addressing loneliness doesn't have to mean that you have to, you know, rip apart your life

and turn everything upside down, quit your job, move halfway across the country. And you can start with small things that will actually help to build your connection. So we know, for example, that even if you were just to take 10 or 15 minutes a day, just to reach out to someone you care about for no other reason than just to check on them, to see how they're doing. It could

be a parent, it could be a sibling, it could be a friend, it could be anyone. But that done systematically over time will make you feel more connected. We also know that the quality of our connections really matter. Like I'll tell you one thing that I used to do that I'm not proud of is back in the day, I remember, I still remember when, dating myself a little bit here, but when phones developed, you could put like a headset into them. And I was so excited because that meant that I could wear a headset and be on a phone call and my hands would be free. And so that means I could do things with my hands.

I could sort the mail, right? I could maybe edit a document. I could do all kinds of things when I was still on the phone. That felt like it was making me more efficient. The reality is, is it was also making me more distracted from the phone call that I was having.

And so I would have this hour long conversation with a friend, but I'd be missing things, like the nuance, like in their tone, right? The sort of unsaid words and sometimes even the words themselves. So I think the other thing that we can do

if we really want to deepen our social connection is to think about how to make the time we do have with people really count by giving them our full attention. And that's where putting our technology away when we're interacting with friends over a meal or just in person conversation, that can really make a difference.

And the last thing I would just offer is that one thing that's like very clear in the scientific literature is that when we volunteer and help other people, it actually makes a difference for our health, our mental health and our physical health, but it also actually helps our social health as well. And when we volunteer and help others, whether that's volunteering formally

with an organization in our community, or whether it's simply helping people around us who might be having a difficult time, a friend or a colleague or a classmate, those are moments where we do forge a connection with somebody, but also where we remind ourselves that we do have something to give,

to contribute to others. And that's really critical, Rangan, because when a lot of people, when people struggle with loneliness, one of the tolls that it takes on them is that it erodes your self-esteem over time. It makes them think that I'm lonely because I'm not likable, I'm not lovable,

something's wrong with me. And I say that as somebody who felt that for many years, you know, when I was struggling with loneliness, I felt like something was wrong with me. I was so ashamed that I didn't wanna even tell my parents or my sister who I knew loved me unconditionally, but it felt embarrassing to tell them that I was feeling lonely.

Cause again, it felt like something was wrong with me. But when we serve others, we remind ourselves that that's not true, that we have something valuable to offer and that that's not true that we have something valuable to offer and that that's always within us i think it's a great point you make about being of service to others but also saying that it doesn't have to be a formal volunteering role because that can become off-putting to someone who may consider themselves very busy may actually be really busy for whatever reason.

And hearing the benefits of volunteering, which are fantastic, might put them off and go, yeah, but well, I'm too busy. There's no way I've got time to give three hours a week to an organisation. But being of service to others can be, it can be so small.

Like I'm, you know, I don't live in London. I'm currently in London for the happiness conference and to talk to you and a variety of other things. So I'm staying at a hotel. And I would argue that being of service can also mean like I did this morning, there was a cleaner, a cleaning lady in the hotel. I took the stairs down from my room and she was cleaning the stairs this morning. There was a cleaner, a cleaning lady in the hotel. I took the stairs down from my room and she was cleaning the stairs this morning.

And I said, hey, how are you doing? Thanks so much or something like that. And she didn't speak much English, but you could tell she appreciated that someone had taken the time to interact with her. I smiled at her. She smiled back at me. I went on with my day.

She went on with her day. Now I know that that has a positive benefit for me and for her. And I would argue, well, that's an act of service as well. Absolutely is, yeah. I mean, simply put an act of service is anything that helps sustain and support the wellbeing of somebody else.

And that could be a kind word. It could be a kind act. It can take just a brief moment in time, but that what you did on the stairwell is so beautiful. Right. And it probably didn't take a lot of time. It didn't. Right.

And you didn't have to plan it and put it in your calendar and block it off, you know, weeks in advance. It was something you spontaneously did, but it sounds like both of you felt better at the end of it. And that's actually why like the loss of day-to-day interactions that we have with people in the grocery store or the post office

or in any other kind of store, why these actually are profound because those are all opportunities for us to have small interactions with one another. Like you're standing in line at the grocery store waiting with somebody, even just saying hello to the person next to you can make actually a difference in how you feel.

Even there's data that shows that when people are walking up and down the street, when one person smiles at the other, it actually makes a measurable difference in how that person who is smiled at feels long after the interaction actually takes place. Yeah. Right at the start of this conversation, we spoke about the direct health consequences of loneliness, right?

But there's also an indirect consequence. It's something I'll be thinking a lot about this year is I'm always thinking about the behaviours, the lifestyle behaviours that the public have, that my patients have had. You know, why is it that we often choose to do things that we know are not in our best interests, right? You're in public health, so there's a lot of public health advice out there about alcohol consumption, what we should be doing with our diets, you know, how we should be living our life, how many sugary drinks we should be having, all that kind of stuff. And I think that more and more, one of the reasons I believe that some of this public health guidance doesn't work that well, and I appreciate who I'm talking to as I say this,

that well. And I appreciate who I'm talking to as I say this. One of the reasons why I don't think it works so well for a lot of people is that it's too much of the what and not enough of the why. And I think loneliness really speaks here. If we're making the case that there's a loneliness epidemic around the world, more and more people are feeling isolated. We know that mental health rates are going up. We know that obesity is going up. We know that type 2 diabetes is going up. And we think the answer is more education for the public. But what if it isn't? What if it isn't saying that too much sugar is going to be detrimental to your health? What if it's saying, well, what if your sugar consumption is a downstream consequence of the fact that you feel isolated, you feel alone? So let's say, you know, I'm away from

home at the moment. So I haven't seen my wife or my kids this morning, right? And let's say I didn't sleep well, which was true last night in a hotel room, and I wasn't feeling my best self and I hadn't interacted with the lady who worked at the hotel this morning and got that little buzz of human connection, it's not impossible that that would have led to me going to a coffee shop and needing more sugar to numb that feeling of isolation. So this is a really good point you're bringing up. And it's very astute, because I think you're right that the why matters. And I think people's behavior and their choices

are usually a response to something deeper. Exactly. That's happening inside of them. And you put it really well. One of my worries is that a lot of our responses sometimes are a response to pain that we may be feeling. That pain may manifest in different ways, as uncertainty, as like sadness, as anger,

as vulnerability, however it may be. But as human beings, when we feel pain, our natural instinct is to find a way to relieve it, right? And we may reach for different things to relieve that pain. Maybe it's something healthy, like maybe talking to a friend, maybe it's going for a run or exercising to help boost your mood,

but it could also be something to make you feel better in the moment that may have bad consequences for your health. Like to your point, some eating something that's unhealthy cause it gives you a momentary joy, takes away the pain, smoking a cigarette, doing drugs, whatever it may be. And look, I say this as somebody who like,

I think part of this is about knowing ourselves, like what are our tendencies, right? Like, and I'll tell you that like in, I don't know that I've shared this before, but it's true in my own life. I know that I love sweet things, right? I've got like 32 sweet teeth. And I noticed like early on that when I was stressed,

I would eat, right? And specifically I would eat sweet things. And I started to notice that actually in high school and it was true in college. And as I got older and my metabolism slowed down, like I started to put on weight, because I was doing that. And the thing is nobody really knew this,

like about me because I was never, it was never obvious what was happening. You could keep it under the radar. I could keep it under the radar. And like people like I wasn't, my weight wasn't so out of the range of normal that someone thought that there was a problem, but I knew my body, right?

And I knew that not only was it affecting my weight, but it was affecting how I felt in terms of making me sluggish and et cetera, and depleting me of energy. But in the short term, it's what I needed. So what I had to do, it took years to figure that out, years for me. But what I had to then do is say to myself, okay, how do I figure out a healthier way to respond to the pain of stress? And it's when I realized that there were several things happening at the same time. Like I was living alone at that time. And so I didn't

have any natural pop-off valves for social interaction. I was living away from family. So I didn't have any family close by and like healthy relationships are natural buffers for stress. Yeah, exactly. And when we don't have them, it amps up our stress and increases our pain.

And I was also living in Boston at the time, which was really cold and half the winter and having grown up in Miami, which is really warm. I didn't want to go outside, right? So I wasn't exercising as much. I wasn't going out in nature and I wasn't socializing, which are three really powerful ways to reduce stress. And instead I was eating sugary stuff, right?

So it's not to say, just to be clear that from time to time that people want to have a treat, there's nothing wrong with that. Birthday party, have a cake, like whatever, do your that. Birthday party, have a cake, whatever, do your thing. But I think if we ask, if we all examine like our own behavior and think about our lives, we may and ask ourselves the question,

how do we respond when we're stressed? How do we respond when we're in pain? That question may take us down some interesting paths because some of those responses might be healthy, but maybe you're like me and you might realize that, hey, some of my responses maybe aren't so good for me. And I had to then figure out, okay, how do I increase my access

to these positive responses to pain? How do I actually proactively make it a point to pick up the phone and call a friend when I'm feeling stressed? How do I actually change my living situation so I'm closer to people I care about. How do I, my wife also now reminds me when I'm feeling stressed and it's clear

that my mood is like dwindling down. She'll send me to the gym to be like, just go downstairs, go lift something heavy, go run, do something, but you'll feel better when you come back, you know, and she's right. And I also, you know, started building a list of like content that I find inspiring and uplifting. Like they're usually short videos or speeches

that kind of excite me or inspire me. And so that's a resource that I go to. So sometimes when I come back and I'm feeling like down at the end of the day, like before what I would do is I would get something sweet from the fridge and I would eat it. And now increasingly what I try to do

is actually dip into one of those videos, watch it and it'll make me feel better after like two or three minutes. It'll inspire me again. So we all need our toolbox of things we can reach for during moments of stress or pain. But I think that you're absolutely right. If we don't try to understand

what people's underlying mechanisms are for responding to pain and stress in their lives and how that manifests in their behavior, then we're just throwing information to people about food, which is, and I don't think that the, having been as a doctor, as you are as well, someone who's like talked to patients a lot over the years about lifestyle change,

information is a small part of what people need. It's necessary, but it is vastly insufficient when it comes to ultimately changing how we live. Yeah, thank you for sharing that. I totally agree, it's that self-knowledge, that self-awareness that we need. Like you realize that when you're stressed, when you're feeling stressed,

one of the things you might do is turn to sugar. I think many people listening to this right now will absolutely resonate with that. And simply the awareness of knowing that is huge. Once you know that, you just create a bit of distance between the behavior and you. You just create that gap where you can start to make different changes. Now, interestingly enough, we're likening the social world to the exercise world in the sense that you can work out your social muscle just as you can work out your physical muscle. Now, here's the thing, exercise is a very powerful way of managing stress and discomfort, but it takes effort. And actually, if you're lucky enough to have friends and family, picking up the phone to phone one of them is easier than going to

the gym, right? So in terms of making it easy for people, I actually think this really aligns with your message. We're not saying don't go to the gym, don't move your body at all. But if you know that that's your trigger, well, what would happen if you made your default response when you're feeling a bit low or feeling a bit down, not the sugar, not YouTube, not online shopping, but picking up the phone to your friends or your parents or whoever you have in your life. That's assuming, of course, you do have someone in your life. So I think that's really powerful for people.

I guess, though, these are individual things that we're talking about at the moment. How can we as individuals recognize the stress, recognize the loneliness? How can we take steps individually? But I guess there's a wider cultural, societal narrative going on here, isn't there? And I guess you're pretty fresh off this college tour of America. What does it say about us as a culture? What does it say about the United States of America that college students in this great nation are feeling lonelier than ever before? I mean, that's not just an individual issue, is it? That's a cultural societal thing

that I guess needs societal solutions as well. Well, that's absolutely true. Yeah, because we didn't get here by individuals solely just changing their behavior on their own or willy nilly. We got here because the environment around us changed and it changed in ways that made social interaction harder and further out of reach. And it fundamentally changed the nature of interaction and dialogue.

And all of that had consequences for our social lives. I think to address that then, in addition to the individual actions, we got to think about how to change the environment to make social interaction easier again. And part of that is about protecting us against some of the, sadly, the harmful elements in our world right now, including technology, right? So tech is ultimately a tool. That's how we use it that determines whether it helps or hurts us.

And if we want, for example, social media to be a tool that can benefit us and not harm us, we have to ensure that the platforms are actually safer, right? So right now, just take adolescence for a moment. We know that adolescence is a time of, a very sensitive time of brain development for people. It's a time when young people are more sensitive to social interaction and social suggestion. When you have platforms that are full of features that seek to maximize how much time young people are spending on them,

that make them in their own words, feel more addicted to the platform and stay up losing sleep, using it at night. When you have platforms that also prey on the fact that young people are at a stage where they will crave social affirmation, right? And so you develop like buttons and other tools to allow people to sort of crave

and pursue positive affirmation from others. When you build platforms like that, you end up dramatically shifting people's time, you know, from the in-person world to the online world, right? And the truth is that we should do with social media what we've done with cars, right? Which is to have basic safety standards

that for young people in particular, protect them from some of these addictive features and features that will essentially manipulate their brain and their behavior to spend more time online, to compare themselves constantly to others and to shred their self-esteem. So that's not something that a parent or a child can figure out on their own,

but it is something that policy makers can and should do, just as we did for automobiles decades ago. Now in the UK, there's already been movement toward doing that with creating age appropriate design codes and trying to put in policies that will move toward what I was just discussing. We have to do that in other countries as well. In the United States,

we have to do much more when it comes to actually putting in federal safety standards so that kids have protection, you know, when it comes to social media. So that is at least one of the systemic changes that we have to make. But I would also say that at a systemic level, we have to recognize that

if these are skills and tools that all people need in their lives, skills for interacting with others, starting conversation, understanding your emotions and other people's emotions and managing them, that that's something we can no longer assume people will get on their own.

So we have to think how can schools play a role in providing children with the social, emotional learning and tools that they need in workplaces? How can we recognize that connection matters both for work and outside of work and actually create both cultures and practices of connection. And I'll give an example,

something simple we do in our office. We have something very simple that takes 10 minutes a week, right? Called our humans of OSG, humans of office of the surgeon general exercise. And it's almost surprisingly simple, but it involves a group of us and all of us coming together. We'll designate, you know, once a week,

we'll ask two people to be the designated chairs for that week. And we'll have one of them interview the other for 10 minutes. And it's just an interview about their life. It doesn't require a whole lot of preparation. If you and I were doing that interview and one of our meetings are then,

I might ask you questions like, hey, so where'd you grow up? What did you dream of doing when you were younger? Like, who are the people who you looked up to when you were a kid? Who stuck up for you? Like, who made a real difference in your life? As you got older, like, what was your first job? What was like, you know, a time where you felt really excited about life? Was there a time where you realized you wanted to go in a completely different direction? And what do you do for your hobbies? What inspires you now? What movies do you direction. And what do you do for your hobbies?

What inspires you now? What movies do you love watching? What do you go back to again and again, when you're looking for inspiration? I may ask you any number of questions like this, but I'll tell you this Rangan, in those 10 minutes, we often come to learn more about someone that we've worked with for maybe six months or a year

than we learned in that entire time before. And that's because we're learning about the human side of them. This is what workplaces can do as well. So the bottom line is to solve a profound challenge with loneliness, we need individual and societal action. And this is a place where schools and workplaces, where government can play a profound role

and where all of these organizations are on them. They used to bring us together, whether they're volunteer organizations, recreational leagues, sports leagues, faith organizations, participation in all of these has been declining in many of our countries, particularly in the United States. We have to revive that, right?

Because people need places and spaces where they can gather, but they also need a culture, that is built around us coming together to celebrate, to play, to pray, to work and to support one another. And ultimately that is how we get through this deeper challenge of loneliness. Yeah.

You mentioned social media and you mentioned some of the things that policymakers can do to put safeguards or restrictions in place. You have spent many years as a regular doctor seeing patients interacting one-on-one. Yeah. a regular doctor seeing patients interacting one-on-one. Over the past few years, first of all in the Obama administration and now in the current administration in America, you're serving as Surgeon General.

So this is no longer one-on-one, it's one on 300 million or so, right? People have been talking about the perils of social media or inappropriate social media use for years. Just on this podcast alone, we must've been talking about this for the lifetime of this podcast, which is over six years now.

I guess I'm really interested as someone who works in public office, are you optimistic that anything is changing here? You say that in the UK, some restrictions are being put in place. I guess I don't see much evidence of real change happening. don't see much evidence of real change happening. And what I see is a lot of parents feeling bad, but not knowing what to do because they say, well, I don't love the fact that my 13 year old is on social media, but all of his friends are. So I feel I have no choice, for example. Now I know your kids are a bit younger than mine. As we record this conversation, my son is 13, my daughter is 11. None of them are on social media at all. And I know for my son, he may be the only one in his year who's not on social media. Now, for me as a parent, there's this fine balance between doing what you believe is right for your child,

balance between doing what you believe is right for your child, but also allowing them to fit in with their peers. And I make a lot of compromises on things that I don't particularly like so that my kids can fit in with their peers. But on social media, from the data that I've seen, that is not something I'm willing to change my view on. Now, to be fair, it hasn't been one of these things with my kids yet where they're saying, no, I really want to go on. But I know my son said last week, he may be the only kid in his year who's not on Snapchat, for example. So this is my career. This is what I stand for. So I may find it easier than other parents, I may find it easier than other parents potentially. But as Surgeon General, how do you see that situation?

I can do what I think is right individually as a parent, but I keep hearing about policy change and the tech companies need to do better. But are they? Like, are you optimistic about that? Or, you know, you're in public office, so you may be involved in those conversations. Are there signs that things are changing? Or is it quite pessimistic? Before we get back to this week's episode, I just wanted to let you know that I am doing my very first national UK theatre tour. I am planning a really special evening where I share how you can

break free from the habits that are holding you back and make meaningful changes in your life that truly last. It is called the Thrive Tour. Be the architect of your health and happiness. called The Thrive Tour, Be the Architect of Your Health and Happiness. So many people tell me that health feels really complicated, but it really doesn't need to be. In my live event, I'm going to simplify health and together we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life, and I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to drchatterjee.com forward slash tour,

and I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now, journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better decision making and reduce symptoms of anxiety and depression. It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships. There are, of course, many different ways to journal and as with most things, it's important that you find the method that works best for you. One method that you may want to consider is the one that I

outline in the three-question journal. In it, you will find a really simple and structured way of answering the three most impactful questions I believe that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes, but the practice of answering them regularly will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much it has helped them and how much more in control of their lives they now feel. Now, if you already have a journal or you don't actually want to buy a journal, that is completely fine. I go through in detail all of the questions within the three-question

journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal or click on the link in your podcast app. I think this is really one of the defining issues that's going to determine whether we ultimately make headway in supporting the mental health of kids or not. And that's how we manage the harms of social media. And it does require policy solutions. I ultimately, let me tell you my view of what's happening in policy. I think that social media has been around for nearly 20 years at this point, nearly 20 years.

And I think that we have largely failed as society to put any meaningful safety measures in place or to demand any meaningful data that shows us that the platforms are safe. And instead, what we're seeing is accumulating evidence of harm. When I issued a Surgeon General's advisory last year on social media and youth mental health, some of the things that I laid out was that kids who are using three hours or more

of social media per day, they face double the risk of anxiety and depression. Keep in mind that the average use in the United States right now among adolescents is 4.8 hours a day, right? Of social media, not like other screen time, social media. And there are other things who nearly half of adolescents in the United States

say that using social media makes them feel worse about their body image. Many of them, a third of them in fact, are staying up until midnight or later on weeknights on their devices and much of that is social media time. So that means compromising sleep, which we know impacts mental health of young people. So these are all the harms that we're seeing.

And I do think that this represents a societal and a policy failure to not have safeguards in place. Now, on the brighter side, I do think that there has been in the United States, I will say, more movement in Congress, you know, from both parties there to say, ha, this seems to be a problem. There are harms that are occurring to our children. We should do something about it. My worry and what I have said publicly and directly to our lawmakers is that it is unacceptable

that that has still not translated to real change, right? So that if you are a child, if you are a parent right now, your experience online is substantively not that different as what it was a year ago, three years ago, five years ago, in terms of protection. The problem with this, the platforms are evolving a lot, you know, and they're saying that they're putting safety measures in place,

but I'll tell you as a doctor, as a scientist, as a parent, what I wanna know is where's the evidence that shows me all those changes the platforms are making are making it safer for my kids. Where's the evidence that shows me that kids changes the platforms are making are making it safer for my kids? Where's evidence that shows me that kids are no longer at greater risk for anxiety and depression when they use these platforms? That data is not there.

So I think that we have a, we're seeing more movement among legislators, but it has not translated in many cases, especially in the United States case, to actual change in the experience of young people. What that's meant, Rangan, and this is really unfortunate, is it's meant that the entire burden of managing this has fallen on the shoulders

and continues to fall on the shoulders of parents and kids. And so that's fundamentally, I think, what is problematic right now. And so if you're a parent, like what you did for your kids of having them wait to begin using social media is what my wife and I are planning to do for our kids. But I know that this is really hard for parents, right? Like to be, when your kid comes to you and says,

everyone else is on it and I'm gonna be left out. Do you want me to be even lonelier? You know, by being the only one not on social media, that's a really hard situation for a parent to manage. There are also parents who tell me, well, if it's unsafe, how come kids are allowed to use it? Like there's a fundamental disconnect here. And finally, keep in mind that many of the platforms

say age 13 is when you can use these platforms. They're not enforcing that, right? So in the United States, we have 40%, four zero percent of kids eight through 12 who are actually on social media. How does that happen if you're actually enforcing any rules? So parents are in this conundrum, but I do think that to make what you did for your kids and what I hope to do for mine feasible and more

sustainable for more parents, to do that will require parents to actually band together and work together and to help and support one another. Because this is hard to do on our own, but imagine in your class, if there were three other kids whose parents had all talked to each other and to you and said, you know what, this is going to be hard to do on our own, but you know, we're going to actually do this together because we're all concerned. Then like your kid wouldn't be the only one. That's what, like, I'm worried that in our class, like in my kids' classes, even though they're younger, kids are still engaging with technology, but parents talk about everything under the sun

on our listservs, on our text chats, because they're literally about 70 text messages I get per day from all of the parents on our text chain. Talking about all kinds of things, sports clubs, afterschool activities, this, that, and the other. But no one's talking about technology and how we manage it for our kids, even though I know parents are struggling with it.

So we have to, these parents engaging with one another would help do a lot of things. One of the things that would help do is try to get past the shame that so many parents are feeling right now when they feel like I'm a failure because I don't know how to manage social media for my kids. And I want those parents, any parent out there

who's listening now to know that if you're struggling with social media with your kids, that this is not all your fault. It's not all on your shoulders. This system is designed to make it hard for you. The platforms are designed to maximize how much time your kids are spending. It's not your kids are deficient in willpower

or that you're a failure as a parent. This is a problem we've got to support one another like on solving. Yeah, and also going beyond social media and technology, the modern world, certainly I can say in my country, the UK, in your country, the US, people are stressed out, they're burnt out. And for that individual family,

sometimes they're just, the parents are so busy just trying to do their job, put food on the table and get by. Some people say you need stronger parenting. Parents just need to say no, but I don't think it's that simple. I think so many parents are under so much pressure. The easiest thing is to do, yeah, okay, fine. Everyone's on it. What harm can come of this? I do think the schools play a role here as well. I don't know how the school system works in America compared to the UK. One of the reasons that my wife and I chose the school where my son is currently at, the high school, was because they have a policy until the children are 16, they can have a phone, but when they come in,

the phones are taken off them and they get given them back at the end of the day. Oh, okay. Which for me, I was like, okay, I'm in. I'd prefer a completely phone-free school, but at the same time, I recognise like, okay, I'm in. I'd prefer a completely phone-free school. But at the same time, I recognize the world has moved on. If people are getting buses, 20, 30 minutes to work,

the ability to communicate with your child, it's just different now. So I get that. But that was literally one of the determining factors. Now I say that recognizing that not everyone can choose whether kids go to school. But for me, that literally was one of the main factors at play. And imagine this, I'm gonna imagine if more schools actually had policies like that, phone-free policies,

which I think are powerful and important, then kids, more parents would have the option, right? Just to know, okay, yeah, the school my kid's going to is gonna support them in drawing these boundaries. So I love what you've done, you know, with the choices that you're making. And my hope is that those kinds of choices can be available to more people,

but that's going to require schools actually having those kinds of phone-free policies. It's going to also require ultimately parents being able to have a voice in calling for those policies in their schools. Because right now, look, I believe, and we say this in the United States, I think it's true in other countries too, that parents have really powerful voices.

And when they're used to, whether it's to shape policy in schools or at a state or federal level, it can have a really powerful impact. I mean, I know that when we were dealing with a high number of car accident related deaths in the 1980s in the United States, it was the voices of mothers actually

that ended up being really powerful in changing laws and fundamentally making the roads and cars safer. But I do wanna underscore what you said in the beginning here, which is that parents themselves are struggling. One of the things that people don't appreciate as much is that the rates of depression and anxiety among parents are actually pretty similar to what they are among kids.

And we're all aware that there's a youth mental health crisis that's sweeping across many countries in the world. There's also a parents mental health crisis as well. And so we've got to support and help parents and make this easier for parents, which is why I think some of these policy changes to make social media safer are critical and urgent. But it's also why my hope is that while we're working on that, that parents can find some solace and support in one another. And if we can have more conversations and broker

more dialogue among the parents to help build a community that can support one another in making these kinds of decisions around tech, I think it would do a world of good for parents who are feeling actually quite isolated and lonely now and feeling that there's more than ever that's been placed on their shoulders. I mean, we talk about the impact that social media has on children. And of course, as adults, our brains are much more developed than children, but it has a pretty toxic effect on us as well. We all fall victim to comparison when we go online. And I've said it a million times, but I'll reiterate because it's so important. Your conscious brain may know logically that what you're seeing from other

people is perfectionist presentation. It's the best parts of their lives, but your subconscious brain is constantly picking up the idea for most of us, not all of us, for most of us, that everyone else's lives are better than our own. Yes. And so for me, it's like, of course, kids are struggling. We're struggling as adults. So, you know, I think it's just important to put that piece out there. And it's not because we're failures either. These products, these applications are designed that way. And I know personally for me, although I do spend time on social media and I do a lot of my public health advocacy through social media, I also take four to six weeks off social media and I do a lot of my public health advocacy through social media.

I also take four to six weeks off social media every summer where I delete all the apps and I go off completely. And it's probably my happiest six weeks of the year, honestly. Really? Yeah, I do. I do that every summer. So I intentionally take time off from social media during the summer and the kids are off on holiday and it's just more presence and mindfulness and all that kind of stuff. But yeah, so it's, again, I say that acknowledging that I'm lucky with my career, with the autonomy I have in my life, which many people don't have, I can make these decisions, but most people can't. So actually, can we dig into this? Because I think this is very interesting and I actually think could be accessible to a lot of make these decisions, but most people can't. So actually, can we dig into this? Yeah, please.

Because I think this is very interesting and I actually think could be accessible to a lot of people. Look, there are some people whose livelihood is dependent on being on social media, but for most people, it's something they do in addition to whatever their normal source of livelihood is, right? Yeah. So the notion of taking a break,

potentially from social media may actually be feasible just from an economic perspective for people. So one thing I'm curious about is if you reflect on your experience, when you take these breaks, like one, I'm curious, did you start with a four to six week break or did you start initially with a shorter break? And I'm curious sort of how, how did you actually put that into practice? Like how did you deal with the fact that the first couple of days maybe you were craving going back on and how did you resist the temptation to go back on? So talk to us a little bit about the break. Yeah, so this is built up over a number of years.

Okay, so first of all, I recognize that my position may not be the same as everyone else's. I have, you know, in the UK I'm a public figure. So I share a lot of information online. So you could say for my work or a part of my work, I go on social media. But I recognize that the more time I spent on social media, just the less content I generally felt. And so it started off as one week a few years ago, it progressed to two weeks, to three weeks. And I found, you know, I think on that three week break that at the end of it, I didn't really want to go back on. And so I think last year it may have been maybe five or

even six weeks last summer. Right. Don't get me wrong, I enjoy social media as well. I do enjoy using it and connecting with people or whatever form of connection that is. I do like interacting with people. But at the same time, I realized I was calmer. I was more present. I felt better about myself. I think there's a wider point here, Vivek. I know I've heard you talk before about the fact that when we are lonely we become hyper vigilant yeah yeah and that's kind of what loneliness is meant to do there's an evolutionary case for that but I don't think many of us realize how it alters the way we see the world. So when I spend a prolonged period of time off social media, the world seems brighter

because all your interactions then are real in-life interactions. You're not skewed by this, what I call these one or two-dimensional interactions online where we don't get body language and tone of voice and what the eyes are doing and what the facial expressions are doing. So, so much of our human connection is on those non-verbal cues. And of course, those non-verbal cues disappear online. is on those non-verbal cues. And of course those non-verbal cues disappear online.

And so, you know, early this morning at the Happiness Summit, Arthur Brooks was on stage. I think he said that one in six US adults are no longer talking to another member of their family because of opposing political views, which is truly remarkable. Because here's what happens in my view

is when we spend a lot of time online, we become more polarised. We get shocked when people have a different opinion to ours. We take it as a personal insult. Whereas when you actually interact with real people, you realise that, hey, the people I see in the coffee shop every day, you know what? Yeah. One of them votes Labour, one of them votes Conservative. But hey, you know what? They're both really great guys. They just see the world differently. So I don't know if I'm answering your question or not, but

I feel that's what happens when I spend a prolonged time offline. And I also feel more in touch with myself. I start to realize what I actually think, not what the rest of the world thinks. It's like, well, what does Rangan actually think about this? And I think we really underestimate that. So much of who we think we are or our views, I think for a lot of us, they're not our views. They're the views that we have absorbed from these constant streams of information. So we don't actually know what we think anymore. So of course, I want to protect my own kids from that, knowing all this, experiencing that. I'm like, I don't want them to go down that comparison with others' roots. Do you know what I mean?

And I'm super passionate about this because I think it's a massive, massive issue. And I've seen suicidal teenagers before who I've managed to help by getting them off social media. So I'm really, really passionate about this topic. Well, Rangan, I'm so glad that you shared that example. And I mean, I would encourage like everyone who's listening, who's thinking about their own use of social media to consider taking a break

in the way that you did for a week initially or for two weeks. And to recognize that it may not be easy in the beginning. Like you may feel jittery for the first couple of days. You might feel like that itch or twitch. Yeah, I felt sick. Yeah. Every summer I feel it, even now when I go off.

And that's just a normal behavioral thing. But to like make a pact with somebody that you're going to do this, because I think we all like need people sometimes to keep us accountable. When I took a break from social media, I actually had two good friends, my friends, Sonny and Dave,

who I talked to about this and they would check on me to make sure I was sticking to what I said. One of them, my friend Dave actually, when he took a break, he realized that he needed to give his passwords to his wife and have her change the passwords so that he would not be able to log in again

if he was tempted to do so. So whatever we need, it's usually involved getting somebody else involved, but make a pact with a friend. Maybe you can both take like a week off and or two weeks off and to see how you feel. Like what you described, Prangad, in terms of how you felt

when every time you take that break, that is remarkably similar to how college students, university students in the United States tell me they feel when they take a break. They say like tell me they feel when they take a break, they say like to a T that when they take a break, they start to feel better about themselves because they're not comparing themselves all the time to others.

They start to care less about what other people think and are more focused on living their own life because they realize that they've been living life on other people's terms based on what other people think are important or will bring them happiness. And the third thing they say is interesting, which is they say there are fewer people that they are in contact with,

but that smaller circle of people, they have stronger interactions and relationships with them. So the circle is smaller, but it's deeper in terms of their friendships. That actually sounds pretty good, right? And just in terms of like how we'd want to live life. And so that's why I think it's really important

that people consider this because you don't, sometimes I think we assume that because this is the norm, that it always has to be this way. And that is just not the case. And like in the United States, there's actually a movement of university students that's called the Log Off Movement, started and run by a woman named Emma Lemke

and some of her colleagues and peers. But this is a movement that's actually trying to help young people to take steps, to draw boundaries around social media, and in some cases, taking breaks. And I'll share one thing she told me, which I think is actually very insightful. She said to me, she said, sometimes you guys, and when she said you guys, she meant you old people. I was in the old person category for sure.

But she said, sometimes you guys think that this can all be solved with just small incremental changes. She's like, but you don't understand that a lot of us are so deeply sucked in to these platforms and addicted to social media that sometimes we just need a clean break. And we need, and that can help jolt us back to a very different feeling and weighing of being and living. And once we experienced that,

it changes our view of what's possible. And I think that's actually a very good point. And that's, again, not to say that's right for everyone, but if you're someone out there who's thinking that, hey, I'm maybe not, I'm having some challenges with how I manage social media in my life. I wish it would be a little different.

I don't love how I feel sometimes when I'm on it. I'm using it more than I want to. I think this idea of taking a one to two week break and making a pact with a friend to do that and seeing how you feel could be really powerful, I think, in a lot of people's lives. Let's move on to practical solutions. That's obviously something practical that people can do

if they feel they have a problematic relationship. And even if you don't, I would encourage people just to experiment and just see how you might feel. And if it works, great. If it doesn you don't, I would encourage people to just experiment and just see how you might feel. And you know, if it works great, if it doesn't, okay, cool. But at least experience that for yourself. We've talked about the fact that loneliness is a real problem now all across the world. You mentioned before some of the practical things that people can do. Let's just double down on those so that we're not just presenting a problem to people. We're

actually giving them some practical things that they can do. Of course, we've acknowledged there needs to be policy change in a whole variety of different areas. We'd like to see certain schools have certain policies in place over technology, over phones, what they encourage at school, how they communicate with the kids and all that kind of stuff. But on an individual level, let's just go through what someone who feels, yeah, you know what? I think I'm a little bit lonely. What can I actually do? Let's just go through that right at the end day, if that's okay. Sure. Let's do that. So, you know, I'd say like drawing from our original, I'd say, look, number one is regularity of interaction matters.

And so finding 10 to 15 minutes a day to reach out to someone you care about, phoning them, visiting them in person, stopping by to see them at the end of the day. These 10 to 15 minutes make a big difference. And it doesn't have to be complicated. You just call, I could call you and say, hey, I just wanted to see what's going on. How are you? How's your mom? How are your kids? How's your wife? That it's not about what you talk about. It's about just having a genuine, authentic interaction

with someone you care about. So can I say on that then, that's quite similar to the, we might encourage people to get 30 to 40 minutes of movement a day. So go for a walk. So I think the public can choose to understand, yeah, I should move my body every day. If I can get a 30 minute walk in every day,

that will be good for my health. You're almost putting that in the same category saying, yeah, okay, get your 30 minute walk in. Also try and get 15 minutes of connection with someone. And I think you say that that should be with someone outside your household, right? I think ideally, yeah. Ideally that's not like,

if you're living with your wife and your kids, your husband, your kids, like somebody outside your household. It could be a friend, could be an external family member, could be a work colleague. And there are ways to combine these. You could take a short walk with a friend and you get your exercise and your social interaction in. But that point is that 10 to 15 minutes is where you're exercising your social muscle. And that builds, you know, like over time. The second thing that you can do is you can be,

you can make the time that you have with people really count by putting away technology when you're interacting with others. That could be when you're having a meal with friends. It could be during that 10 to 15 minutes. And look, if you're calling somebody on the phone, just to be really practical about this, you might say, hey, I've got my device.

So aren't I using it to make a phone call? That's fine. But sometimes when we're making a phone call, we're also checking our email and looking at the scores, you know, for the game and, and, you know, just Googling random things. We get distracted, right? So make it a point to single task when you're actually with someone for those 10 or 15 minutes, you'll make that time stretch and count. And then the third thing is I would find one thing you can do each day to be of service to someone. And that could be something really small, like

helping someone who's having a hard time, greeting someone who you run into, like in the grocery store or elsewhere, or checking on a colleague, you know, who might be having a hard time. Just a couple of minutes to help someone like in your life, that will make you feel more connected. There's a lot more we can do, but if you think about these three simple things of 10 to 15 minutes a day of being fully present, of looking for one small way to help somebody each day, these help form the glue that over time can build

like a strong connection in our life to other people and make us feel like we're part of a social web. Yeah, no, I love that. Very, very practical. And of course, if someone's struggling with 15 minutes, okay, don't let that put you off. Do 10 minutes, even five minutes, right? That will make a difference.

I think that's a really, really important. And when you think about the people also that you reach out, some people might think, well, I'm not really in touch with anybody right now. I'm not really close to anyone. How am I going to find somebody to call or talk to? Well, there I would just offer a piece of advice that was given to me

when I was struggling a lot with loneliness a few years ago. I had served at that time as Surgeon General under President Obama, but then when that time in office ended, I was suddenly without a job, a community at work. And I felt very displaced and I had not stayed in touch with my friends over the, those couple of years in government. And I was really alone. And I had a lunch with a friend one day who I, it was, who happened to be visiting town. And I was just telling her how I was

feeling. She said, Vivek, your problem isn't that you don't have friends. It's that you're not experiencing friendships. There are people, there are people in your life who would be there for you if you reached out, if they knew that you were in need, but you feel like because you've drifted apart from them, maybe they don't care for you anymore, or maybe it's too hard to reconnect with them, or maybe they'll mad at you because you were so bad at staying in touch over the last few years. But she said to me, she's like, Vivek, a lot of people are struggling with this sense of being disconnected from each other.

And if you just reached out to any of them and just said, hey, I just wanna know how you're doing. Odds are that they would welcome the call. And the truth is she was right. And I would just encourage people to think about that. Maybe there's a friend that you had from university or from high grade school, like some years ago that you were close with,

but drifted apart from. Maybe it's a family member that you've just, maybe you had a fight with a couple of years ago, and you just haven't been close since. But reaching out to any of those folks, just to check on them, an old classmate, an old colleague, you may be surprised, quite surprised at how grateful they are to hear from you

and how good you feel at reconnecting with them. That's great advice. It's so amazing to have someone in public office, this passionate about tackling this problem. I think you're doing a phenomenal job going around the world, trying to raise awareness and give people practical solutions. I think right at the a phenomenal job going around the world, trying to raise awareness and give

people practical solutions. I think right at the end of this conversation, one thing I have heard you do before for people who don't know what it feels like to feel that love, to feel that connection. You've got a little exercise, don't you? Where people can put a hand on their hearts. I think it would be a really lovely way to finish off this conversation in person. If you could share that exercise with my audience. Oh, absolutely. Well, thank you, Rangan. That's an unexpected surprise.

It's very short and it's very simple. So for all of those of you who are listening, I would just close your eyes and raise your right hand and I'd put it over your heart. And for the next 30 seconds, just think about the people in your life who have been there for you over the years. People who have showed up during difficult times to support you and to remind you that they believed in you. People have been there with you to celebrate during good times.

The people have been there just to be there, to share conversations or walks or just to check on you from time to time. Just feel their love flowing through you, filling you with peace, filling you with happiness. And just remember that that love is always with you,

even if they're no longer with you, because that love resides in your heart. That love reminds you that you are worthy of being loved. And now open your eyes. And that feeling, that feeling that we get when we think about people who have been there for us over the years, that's a gift that we've been given by others. It's a gift that we can give other people as well. And it's the gift that really matters, like in our life.

I know this is a time where it feels like there's so much pressure to do so much, to achieve so much, acquire so much, experience so much. But I often think that at the end of our lives, when we're considering what really matters, what often bubbles up for people, what the patients that you and I, Rangan, and other doctors have cared for over the years, at the end of their lives often talk about, are people.

The relationships they had, the love that they gave and received. And if we're able to keep that at the center of our lives, if we're able to define success by the richness of the relationships that we build over the years that come, then I suspect that we will be happier, that we'll be more fulfilled. That we'll also set a beautiful example for our children

of what it means to be truly successful, which is to build a life where we can enjoy those relationships and help create them for those around us. That's a beautiful exercise. You're doing phenomenal work. Thank you for coming back on my show. Oh, thank you so much, Rangan.

I love your show. I love what you are doing for the public all around the world. And just grateful for our friendship and for this time together. Thanks so much. Thank you. Really hope you enjoyed that conversation. Do think about one thing that you can take away and apply into your own life. And also have a think about one thing from this conversation that you can teach to somebody else. Remember, when you teach someone, it not only helps them,

it also helps you learn and retain the information. Now, before you go, just wanted to let you know about Friday Five. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I'd be consuming, and quotes that have caused me to stop and reflect. And I have to say, in a world of endless emails, it really is delightful that many of you tell me it is one of the only weekly emails that you actively look forward to receiving. So if that

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