Passion Struck with John R. Miles - Dr. Julianne Holt-Lunstad on Navigating Isolation, Loneliness, and Health EP 282

Episode Date: April 20, 2023

Isolation and loneliness are often interchangeable, but is one more important than the other? My guest today, Dr. Julianne Holt-Lunstad, reveals that both are essential to our health and well-being and can increase the risk of premature mortality. But what happens when one is surrounded by others and still feels lonely? Or are isolated but don't feel lonely? Join us as we explore the complexities between psychological and social well-being and physical well-being. The answers may surprise you and leave you with more questions... Julianne Holt-Lunstad Joins Me to Discuss How to Navigate Isolation, Loneliness, and its Impact on Health In the podcast, Julianne Holt-Lunstad distinguishes between isolation and loneliness by emphasizing the distinction between objective physical separation and subjective emotional experiences. She points out that a person might be physically isolated but not feel lonely, or vice versa. Both conditions can significantly impact one's health, and understanding the difference can aid in developing effective strategies to alleviate their consequences. Full show notes and resources can be found here: https://passionstruck.com/julianne-holt-lunstad-isolation-loneliness/  Brought to you by Green Chef. Use code passionstruck60 to get $60 off, plus free shipping!” Brought to you by Indeed. Head to https://www.indeed.com/passionstruck, where you can receive a $75 credit to attract, interview, and hire in one place. --► For information about advertisers and promo codes, go to: https://passionstruck.com/deals/  Like this show? Please leave us a review here -- even one sentence helps! Consider including your Twitter or Instagram handle so we can thank you personally! --► Prefer to watch this interview: https://youtu.be/Y7XOi_Ns634  --► Subscribe to Our YouTube Channel Here: https://www.youtube.com/c/JohnRMiles  Want to find your purpose in life? I provide my six simple steps to achieving it - passionstruck.com/5-simple-steps-to-find-your-passion-in-life/ Catch my interview with Lori Gottlieb on the importance of embracing self-compassion: https://passionstruck.com/lori-gottlieb-on-embracing-self-compassion/  Watch the solo episode I did on the topic of Chronic Loneliness: https://youtu.be/aFDRk0kcM40  Want to hear my best interviews from 2022? Check out episode 233 on intentional greatness and episode 234 on intentional behavior change. ===== FOLLOW ON THE SOCIALS ===== * Instagram: https://www.instagram.com/passion_struck_podcast * Facebook: https://www.facebook.com/johnrmiles.c0m  Learn more about John: https://johnrmiles.com/  Passion Struck is now on the AMFM247 broadcasting network every Monday and Friday from 5–6 PM. Step 1: Go to TuneIn, Apple Music (or any other app, mobile or computer) Step 2: Search for “AMFM247” Network

Coming up next on passion struck. We often use the terms isolation and loneliness interchangeably. And that's because they often go hand in hand, but not always. The one thing that I want to emphasize that I think is a common misconception is that people assume that one might be more important than the other. And the evidence does not support that they are both Important for our health and well-being and both significantly predict risk for premature mortality And so even if you are surrounded by others and you still feel lonely you're still at risk even if you're isolated

But don't feel lonely you're still at risk Welcome to PassionStruct. Hi, I'm your host, John Armiles, and on the show, we decipher the secrets, tips, and guidance of the world's most inspiring people and turn their wisdom into practical advice for you and those around you. Our mission is to help you unlock the power of intentionality

so that you can become the best version of yourself. If you're new to the show, I offer advice and answer listener questions on Fridays. We have long form interviews, the rest of the week with guest-ranging from astronauts to authors, CEOs, creators, innovators, scientists, military leaders, visionaries, and athletes. Now, let's go out there and become PassionStruck.

Hello, everyone, and welcome back to episode 282 of PassionStruck. Rated by Apple is one of the top 20 health podcasts. And we have some incredible news. We are now on syndicated radio. You can find us money and Friday from 5 to 6 p.m. on the AM, FM, 247 radio. And I'll put links to all the stations you can find us in the show notes.

And you can also find the AM FM 247 broadcast on Tunin or whatever other player that you use. If you're new to the show, thank you so much for joining us. Where you simply want to introduce this to our friend or family, remember, we now have episodes started back, which are collections of our fans' favorite episodes that we organize into convenient topics. If you have any new listener, a great way to get acclimated to everything we do here on the show, either go to Spotify or passionstruck.com slash starter packs to get started.

In case you missed it, earlier in the week, I interviewed New York Times number one best-selling author, Brechen Ruben, about her new book, Life in 5 Senses. It is an incredible interview, please go check it out. And if you like that one or today's interview, please share it with those that you love and give us a 5-star rating interview, which will go such a long way to improving our popularity,

but more importantly, bringing more people into the passion-strike community, where we can bring hope, meaning, connection, and inspiration. And I know our guests love hearing from you as well. Now, let's talk about today's episode. You've probably met folks who outwardly seem like they have a large social circle, but when pressed and fessed, that nobody really knows them,

or they don't really feel close to many people. If you are in Mars and had the best telescope, one that could look through walls, you could locate every isolated person on Earth, but you couldn't locate the lonely people. According to social psychologists, loneliness is the discrepancy between the social relationships you believe that you have and the ones that you would like to have.

Loneliness is not one size fits all. The majority of people associate the sensation with interpersonal or psychological loneliness. Questions like, do I have a friend? Do I have someone to whom I can express my concerns? However, there is also existential loneliness. Do I belong in the world? Does my life have significance, meaning, or purpose? As our guest, Dr. Julian Holt Lundstad will discuss today, this epidemic of loneliness is impacting billions of people worldwide. You heard that right, billions. And the overwhelming health implications of loneliness have become clearer and clearer over time as we will discuss. With the

greatest evidence linking physical and cognitive health outcomes, who a higher chance of premature mortality. Dr. Julianne Holtlunstead is a professor of psychology and neuroscience at Brigham Young University, where she was recently named the Martin B. Hickman Outstanding Scholar and is also director of the Neuroscience Lab. Dr. Holtlunstead's research is focused on the long-term health effects of social connection and her work has been seminal in the recognition of social isolation and loneliness as risk factors of burly mortality. Thank you for choosing PassionStruck and choosing me to be your hosting guide on your journey to creating an intentional life. Now let that journey begin.

I am so excited today to welcome Dr. Julianne Holdlunstedt, passion star. Welcome, Julianne. Thank you. Well, I always like to give the audience an introduction to the guest. And for someone who has studied social connection for much of their adult life, what led you have the passion for that and examining the long-term effects that result from it? Like most things in life, I think it was a bit of a journey. I didn't go straight there.

I started looking at just the connection between our psychological and social well-being and our physical well-being. And that really started from the framework of stress. And so I was really focused initially on this association between stress and health. And it became really clear just how powerful our relationships are when it comes to that, whether it's coping with stress or relationships being

sources of stress, but then starting to recognize that our relationships are so important for health, even beyond the context of stress. So it didn't take a direct pathway there, but it's evolved over time. Well, I recently interviewed Dr. Robert Waldinger, Harvard professor who leads a Harvard study of adult development, which I'm sure you're aware of.

If the audience doesn't know what we're talking about, it had a study of over 700 men for over 70 years, and then they studied the 2000 offspring of the children and it's still ongoing. What did that study determine about social connection? Well, they like many others that have been done since then and others that are still ongoing have shown that being socially connected is critically important to both our well-being,

but also our health and ultimately our longevity. In fact, I did a meta-analysis combining studies like Bubs, and I mean, his is pretty remarkable in the sense that they've been able to follow the same people in the offspring, but other studies have followed people maybe for shorter times, maybe not quite so long. For example, one of my men and analyses looked at 148 studies, and they followed people for an average of seven and a half years. And what we found was that people who are more socially connected had a 50% increase of the survival. And so that goes across age, across countries, across gender. And so we have pretty good data that this is something that is well established and well replicated.

And I should mention that even after I published my met analysis of 148 studies. Others have been published. The last review I saw included 276 studies, and I know that there's been some sense that. So very well established finding. Well, what really shocked me about that study and some of the others I've read is it doesn't depend on what your economic situation is. It doesn't depend on how famous you are, how successful someone is. It really came down to how much being socially connected factored in their lives, which was just overwhelming to me how much a profound impact it made.

So, being socially connected depends on a number of factors. What are some of the most important ones? Yeah, one of the things that becomes a little bit tricky is, of course, our social lives are really rich and really complex. And similarly, the way in which they're studied and measured are similarly very complex and has been measured in very diverse ways. So social connection has become somewhat of a umbrella term that encompasses all of these different ways in which we connect to other people. ways in which we connect to other people. And so I can give you the three main categories that these tend to fall under. And the first is the structure of our relationships. And this is really getting at some of the objective aspects of our

relationships that are more quantifiable. So things like the size of our social network, how frequently you interact with others. It'll also, these kinds of measures also get at things like your living situation, whether you're living alone or living with others or living with partner. And so in essence, this structure aspect really gets at the extent to which we, there is the presence or absence of others in our life. The second component really gets at the functions of our relationships. So it's not that we just that we have people in our lives, but what kinds of functions do they serve? Can we rely on people for emotional support?

Someone to give us advice or lend us a hand or do a favor when we need it? Or a sense of belonging. The next kind of component is really the extent to which we have others, the functions that these relationships serve in our life and the extent to which they meet our needs. And then the last element of social connection is the quality of our relationships. And we all know that not all relationships are entirely positive. As much as our relationships can be sources of joy and satisfaction and nurturance,

and they can also be really frustrating at times insensitive or unreliable. And so the positive and negative aspects of our relationships also come into play. Even though these are somewhat distinct components of social connection, all of them are really important for our health and well-being and all of them have been linked to chronic illness as well as mortality risk. They're somewhat on a continuum so that when we're high in these things, there's more protection and when we're low in each of these elements, there tends to be associated with more risk.

Yes, well it's interesting. I recently released a solo episode that I did on the topic of knowing when to quit and when people hear that most of the time, they think about a job, but I took it much broader than that into it could be a sport that you're doing that's causing you adverse health impacts. It could be an intimate relationship you're in. It could be a toxic friendship. So I just wanted to say that given what you just brought up. I also recently interviewed Dr. Marissa Franco who is a professor at the University of Maryland and recently wrote a New York Times bestselling book called Platonic. And in that book she talks about platonic relationships,

but she discusses attachment styles and their impact on our relationships. And so what I wanted to ask you is, how do our intimate relationships and our attachment styles within them shape our ultimate social connections? Well, attachment styles have been studied for decades, dates back to John Bolby and some of his work, but also others, Ainsworth and others.

And so this has been studied for a long time. And in essence, what we're striving for is that secure attachment. And there's also the anxious attachment and avoidance attachment. The idea that our earliest attachment figure, our caregiver, often our mother, can shape the way in which we view future relationships, and that can influence adult attachments. It's something that has been looked at not only

from a childhood attachment and to what extent these early relationships inform later relationships. And I will say that when it comes to health, we're also seeing that very early childhood experiences, whether that be positive experiences or even adverse childhood experiences, whether that be positive experiences, or even adverse childhood experiences, have lasting effects not only on their relationships, but that can predict risk for various chronic illnesses

in later adulthood. So these have been looked at interestingly, in some of my own research, there are some standardized survey tools for attachment styles. And interestingly, none of my studies showed any kind of significant effects, meaning that in the confined context in which we were studying it, so oftentimes looking at things like our physiological responses to various situations. So looking at more biological effects and health effects, we found that things like relationship quality impacted these health

outcomes regardless of one's attachment style. On the one hand, they can be really important, but on the other hand, if, for instance, your relationship that you're currently in is strained, regardless of your attachment style, that's going to have an effect. Whereas if you had more supportive relationships, you had better kinds of outcomes. And so there's a lot of complexity there in terms of trying to understand and link these two things together. I think one thing that we really need to recognize is that these early experiences can shape and have in lasting influences because many of the kinds of efforts that people are considering

now, especially when it comes to issues like isolation and loneliness, many of them are focused on older adults and starting so late. We really need to start much, much earlier. Well, it's interesting, as I was prepping for today's interview, I happened to come across a great Harvard Business Review article that you were featured in, and I loved one of the quotes from one of your peers in there that they said, if you are in Mars and

you had the most advanced telescope on the planet, something that could see through walls and buildings, and you pointed it at Earth, you'd be able to see everyone on Earth who was socially isolated, but you wouldn't be able to tell those who were lonely. And I use that to open up this question because I think it's an important one for the audience because there's a huge difference between choosing to be socially isolated and being lonely. And I was hoping that you could discuss both and why there's such a big difference. Yeah, yeah. So we often use the terms isolation and loneliness interchangeably. And that's because they often go hand in hand, but not always. So isolation really refers to objectively either being alone or having few or infrequent social contact.

Whereas loneliness is the subjective of feeling alone or the discrepancy between one's desired and actual level of social connection. So of course, objectively being alone increases your risk of feeling alone. And so that's where they often go hand in hand. However, like I said, not always. You can be isolated and content, maybe not feel lonely. You might take pleasure in that solitude.

And conversely, you can be not isolated, you can be surrounded by other people and still so lonely. The one thing that I want to emphasize that I think is a common misconception is that people assume that one might be more important than the other. The evidence does not support that. They are both important for our health and well-being

and both significantly predict risk for premature mortality. And so even if you are surrounded by others and you still feel lonely, you're still at risk. Even if you're isolated but don't feel lonely, you're still at risk. And if you're isolated, but don't feel lonely, you're still at risk. And so granted, much of the research has studied them separately,

meaning that we have a ton of studies that look just at isolation and a ton of studies that look just at loneliness and fewer studies that look at them both in the same group to determine who's isolated but not lonely, who's lonely but not isolated, who's both and who's neither, right? And presumably there may be added effects of being both isolated and lonely, but we definitely need more evidence when it comes to that. I will say, however, that they're among the few

studies that have looked at that, there is some evidence, at least when it comes to mortality, there was a very large study done in the UK that found that even when they controlled for loneliness, those who were isolated still were at significantly increased risk for mortality, whereas those that were lonely when they controlled for isolation, that effect went away. So really what I think is critically important to recognize is that we really need to pay attention to both and we shouldn't provide or put too much emphasis

on one versus the other, but we do need to recognize that they are different experiences. And so how we go about helping someone, the way we go about that might be very different. So for example, someone who's isolated but not lonely, right? Or who's isolated, joining a group might really help them, right? Getting out and spending more time with others. But someone who's already spending lots of time with other people but still feels lonely,

they're going to need a different approach. And so we need to be really careful about not assuming that everyone's experience is the same as also. Yeah, well, that's really interesting. And one of the major reasons, if not the most major reason I started this podcast is because as I started looking at this and not only the epidemic of loneliness, but also the epidemic of hopelessness that's going on. So many people right now are just lacking meaning, human connection, and above all hope. just lacking meaning, human connection, and above all, hope. And I was hoping just so you could paint how large an issue this is, that you could go through some of the statistics

of how prevalent this is, meaning loneliness and social isolation, both in the US, but also around the world. I can tell you, it's a large portion of the population. When it comes to giving you exact numbers, that's a little bit trickier, just given that not all of the studies use the exact same survey. And so when you're not using the same measurement tool, you can get different kinds of findings. But roughly, when we look at varying estimates, first of all, some report it in terms of some degree of loneliness, others report it in terms of moderate to severe loneliness. And roughly, we see that when you look more broadly at any level of loneliness, those tend to be quite high. I've seen estimates ranging over 50% to as high as 75%.

To more severe types of moderate to severe types of loneliness. And those estimates range anywhere from about 20% to 30%. And so it varies depending on that measurement, but even by conservative estimates, that's quite high. And we did an international study during the pandemic where we surveyed 101 countries in 10 different languages. And we wanted to better understand who is lonely, who is more likely to be lonely, right? Because to some extent, we were all relatively more isolated. But again, that varies depending on people's situations.

But who is faring better during those circumstances and who was more at risk. And what we found was that people who are already suffering from some kind of mental or physical health issue reported more severe loneliness, those who had poor economic situations also reported greater severity of loneliness and those that were living alone also reported greater severity of loneliness. So one thing I should note is that any one of us, because we're human, will feel loneliness from time to time. And so that's a very normal human experience. It's like feeling hungry or thirsty. It's a biological drive that we all feel from time to time.

But really where there is concern is when it becomes chronic, just like hunger or thirst. If you're not meeting that need and it becomes chronic, that's when it becomes worrisome. Those are the kinds of prevalence that we're looking at is those that are feeling this more on a chronic basis, not just the momentary or transitory feelings of loneliness, that is just a normal part of human experience. Yeah, and as you and I were coordinating our interview, I actually did a solo

episode on loneliness where I did a bunch of research on this and I found a chart by Statistica that said what is the most lonely country on the planet and it really shocked me based on their data it was Brazil and they showed that 56% of the population was lonely. I don't know what criteria they used but then I found another study that had examined chronic loneliness over a period of 20 years, and they had done it in 113 countries and territories, and it found 33%, which if you look at that across the globe, I mean, we're talking 2 plus billion people, if not more, which is just mind blowing how many people this is affecting. And one of the things that I found is that when you're talking about mental health, people

oftentimes don't want to lean into that and admit it's going on. I think it's even worse for someone who has an addiction issue, but it seems like people are open to talking about loneliness or at least admitting that they feel it. I've had a ton of psychologists on this show, and the one thing that has become evident across the board is that mental disorders themselves are increasing at just a drastic pace. And the thing that's scary to me is that the one that's increasing faster than any of them is depression.

And the fastest category in which it's growing is in adolescence. And a lot of those you can't even measure because most of the studies have to start at 18. But when you start talking to people who are doing this clinically, they will tell you it's growing in kids. And I wanted to ask you, I personally think that technology has a major link to this. I myself am not a psychologist, I haven't studied this,

but I was hoping that you could talk about the impact, that technology overall, but more importantly, social media is having an isolation and creating this toxic environment that is making people, especially younger people feel lonely. Yeah, I should note that several surveys now are consistently showing the highest prevalence rates of

loneliness are in youth as well. So these trends and patterns that you're mentioning in terms of depression are also seen in terms of loneliness. And so our youth really have been perhaps under appreciated. That's not the right word. But often our focus has been focused at least when it are youth really have been perhaps underappreciated, that's not the right word,

but often our focus has been focused, at least when it comes to loneliness, has assumed that this is more of an older adult issue. And yes, it's important in older adults, but the issue in youth has not received the same level of attention and attention that it deserves. One of the explanations for this has been social media and technology.

It's probably not the only explanation. There are probably multiple things going on that I can circle back to if you'd like, but to more directly answer your question about social media and technology, I can tell you that there's a lot of evidence, but it's very complex. So I'm trying to be very cautious because I think on the one hand, we still need to know more and learn more, but it's not that there aren't studies out there. There are a ton of studies out

there. It's just incredibly complex. And I'll tell you why. As you can imagine, there are so many different types of tools and apps out there. And the way in which you use them also can vary drastically. So for instance, even if we narrow it down to just social media, there are different kinds of apps that can be used very differently, but there are both potential strengths and harms associated with it depending on how of the harms tend to be associated with younger users, particularly adolescent girls. There is some evidence to suggest that loneliness is linked to social media. However, a lot of that evidence is correlational. And so what I mean by that is that they're associated, but it doesn't tell us much about

the direction. So for instance, it could be that social media is making us more lonely or that those who are lonely are more likely to use social media. And it could be both, right? But I think the key here is that there's also research that has looked at time use and to what extent it's taking time away from other kinds of activities, like interacting with others in person,

the social comparison element, and of course online bullying, some of these kinds of negative aspects. But it also should be noted that for those who may be struggling with some issue like for instance their sexual orientation or identity that may not be able to find the support they need locally that there are many online support groups that people are able to find that they may not be able to get that support where they're at. I hate to say it's all good or all bad because

there are elements of both, but I think we need to be incredibly careful because there is enough evidence of potential harms that we need to really be serious about this, but it's also something that's not going away. And so what we really need to do is to ensure that we understand the harms and understand where the benefits are so that we can maximize the benefits, minimize the harms. And I know that's really tough because there are lots and lots of barriers to doing that. But it's something that I think is going to be really imperative in the future, given how widespread it is throughout society that we need to understand its potential harms, just like we would want to know the harms of a medication or the harms of some gadget you buy.

When it comes to public health and safety, we need to understand those sorts of things and so that we can deal appropriately with them. Okay, and then I guess as a follow on to that, more broadly than technology, what do you think are some of the other factors that are causing the increase in loneliness? Right, yeah.

So an interesting study looked, asked older adults that were reporting currently that they were feeling chronic loneliness and asked them when the loneliness time was and they reported adolescents. And so this adolescent time and young adulthood time seems to also be a critical period for a number of other reasons.

And part of it is that it's a major life transition. So many surveys, as I mentioned, show young adults 18 to 24, sometimes 18 to 28, reporting greatest rates of loneliness. And that's a time of transition where for many you're leaving your home of origin and are perhaps on your own for the first time in your life maybe going off to college or moving out and living independently. So there's a major transition there. It's also a time when it's expected that your social circles are expanding. Remember the definition of loneliness is that discrepancy between one's desired level of social connection and one's actual level of connection. So if those expectations are very high that I should

be living it up and having the best time of my life right now and I don't have any plans it's Friday and I have no plans. you might start feeling really dissatisfied and of course social media if you see others with all sorts of what appear to be exciting social plans that can exacerbate that just given that's a time of when it's expected to be the norm is for those to be growing that that might exacerbate that but But a big issue because of course our life transitions in older adulthood as well. I mean retirement. A huge one. But there's some research to suggest that actually as we age there comes wisdom. And in fact wisdom has been linked to as a protective factor or loneliness. And so it may be that in our youth,

that we may have fewer coping skills and resources to deal with those kinds of issues when we're young compared to when we're older. And so that's another factor that may be coming into play is that younger adults simply haven't acquired the life's coping skills yet. And then also in that age range, this might be a time when many kinds of, whether it be mental health condition might emerge or when there may be emerging identity issues to deal with, that that might be a time when there may be multiple

things going on all at once and a developing brain on top of it. And so you've got a lot going on at that critical developmental period that may make that time period quite vulnerable. Okay, well, we've talked now a lot about what loneliness is, what's causing it. I know a lot of your specialty has been researching. How does it impact us both mentally and physically? And according to the 2022 annual research, a public health document, they found that anywhere from 40% to more than 80% of health and wellness can be directly or indirectly attributed to social factors.

What are some of the things that this can cause? And why should people be aware? In my own research, I did one meta analysis looking at isolation loneliness and living alone on risk for premature mortality. And we had data worldwide from over 3.4 million participants. And we found that loneliness increased earlier death by 26 percent, isolation by 29 percent, and living alone by 32 percent. So these increase our risk for earlier death. Each of these have also been

linked to chronic health conditions. Both isolation and loneliness have been linked to heart disease, cardiovascular diseases and stroke. In fact, just this year, a few months ago, the American Heart Association published a statement on isolation and loneliness as respectors for cardiovascular disease. It's also been linked to type two diabetes. There are other studies that have linked to other kinds of outcomes like cancer, probably the most studies are in cardiovascular disease, but other diseases as well. It's been linked to cognitive health issues as well. So, for instance, isolation and loneliness increased risk for mild cognitive impairment, dementia, and Alzheimer's disease. And then, of course, mental health. It's been linked to depression and anxiety. And one thing that's really interesting, because that might sound like

laundry list of like, oh, is it just related to everything? And I'll mention that there have been several biological and behavioral factors that have been identified as possible pathways or causal mechanisms that may explain these associations. And one, I'll share with you is chronic inflammation. So loneliness has been linked to chronic inflammation. And inflammation has been linked to all of those things. It's been linked to increasing risk for cardiovascular disease, for depression, for dementia. That may be one common pathway that explains what might otherwise be viewed as very diverse kinds of outcomes, and yet that pathway might explain those.

It's interesting. Yesterday, I interviewed a couple of gentlemen who wrote a book on mastering diabetes and in that book. Their research and personal experience because they both are type one diabetics has been that your diet plays such a huge role. yet diet isn't overly emphasized or really talked about when you speak to most of the medical community because when they're going through their training, they get tens and thousands of hours on many things, but maybe 50 hours on diet. And I believe the same may be true when it comes to loneliness because what I want to ask is, why has this evidence, if it's all out there, been under recognized and neglected within medicine and public health?

So, I can only offer my guesses why it's been ignored, because we certainly have robust evidence. And I think part of that is due to the perception that these are personal issues, right? And that this is about our personal lives, our personal relationships. And so in essence, they shouldn't get involved. That might be one explanation. But of course, like you mentioned, there are things that physicians ask patients about that are quite highly personal and sensitive already. I don't think that on adequate explanation.

I think a lot of it is, there may be two key things. One is there may be lack of awareness because it has not been adequately taught in medical schools. So there may be the perception that it's associated with mental health but maybe not physical health. So lack of awareness, but I think that is certainly changing

and that there is greater awareness of that. What I think is a major barrier currently is that many healthcare providers may recognize that it's important but may feel like they lack the resources of what to do about it. So I find out my patients lonely, what am I supposed to do? They may feel that they have been, they don't have adequate training or resources to help

their patients. That may be another major barrier for that. However, we are working towards changing that and certainly the pandemic has one silver lining of that is that it has certainly raised awareness of this issue. Again, there still tends to be a high percentage that still perceive this is primarily a mental health issue rather than a physical health issue. For instance, I've been working with the gravity project to get isolation, loneliness, and social support included in the electronic health record. This was previously recommended by the Institute of Medicine as of 2014. And reiterated again by the National Academy of Sciences in their report in 2020. And now we've gone through that process, it's gotten approval, and so it's now just needs to get implemented.

So we're making strides, but of course there's still a ways to go with that. Yeah, and I just wanted to point out there because I don't think you said it when you were talking about the impacts that this has on your physical health that you've been famously quoted, that your research has found that loneliness

has the same effect as smoking 15 cigarettes per day, which is a very good way for people to think about the health consequence. Yeah, let me explain that a little bit because I think that statistic gets repeated a lot. And I think some either it might be shocking in terms of wow I had no idea that this issue was so important to my health and others might be very skeptical like yeah where did that come from? And so I think it's helpful

to really put it into context. So let me explain that benchmark comparison with smoking 15 cigarettes per day came initially from my Met Analysis that was published in 2010, where we looked at across measures of social connection and risk for premature mortality. We found that those who are more socially connected had a 50% increase odds of survival. We knew that the general public would not really understand what that meant.

We hear all sorts of things that are good for us or bad for us. But how seriously do we take it? One week we're hearing the eggs are good for us and the next we're hearing their bad for us. How do we sift through all of this information about what's good for us and what's bad for us? And so we started to find other large synthesis of evidence on other factors that we take very seriously for our health, like smoking, like alcohol consumption, like exercise, like getting a vaccine. We had a whole list of factors. When we benchmarked that, the one that seemed to stick out in people's minds was the comparison with smoking up to 15 cigarettes per day. I should clarify though that comparison is averaged across these indicators of social

connection. So lacking social connection, what we found was that is comparable, that risk is comparable to smoking up to 15 cigarettes per day. But when we look specifically at measurements of loneliness, loneliness is just one of those measures, right? When we look specifically at loneliness, it doesn't quite reach that level, but it is still greater than the risk of obesity, physical and activity, and air pollution. Again, all factors that we take very seriously for our health. And so the bottom line is that these are really

critically important for us, and that's not to, in any any way diminish these other factors. Of course, we still need to take smoking very seriously. But what it suggests that we need to be taking our relationships far more seriously for our health as well as in public health because these other factors have received far more attention and resources. And we need to have just as much effort when it comes to our social lives as well. Well, I just wanted to point this out over the past year. I've been lucky to interview kind of the cream of the crop when it comes to behavioral scientists from Haiti Milkman and Jonah Berger at U Penn, Michelle Seager and Ethan Cross at the University of Michigan,

Michelle Seager and Ethan Cross at the University of Michigan, Harvard professors, Max Bezerman and Joshua Green, Cassie Holmes, and many more. And what all of them consistently come back with is that it is the microchoises that you make every single day that make the most profound impact. And I believe when it comes to these microchoises, just as we need to make a conscious effort or choice, to set aside time for exercise, we need to do the same for social fitness. Do you agree with that? And if so, can you explain why that's the case? Absolutely. I say it all the time. It is these daily choices, right? It's the small things that become our patterns over time. The choices and patterns that become consistent over time have these lasting kinds of

effects. Like you said, just as we need to make time for physical activity, we need to make time and prioritize social activity and our social lives. And it's really in some ways very comparable. We can't exercise just one day and say, okay, we're good. It can't be one and done kind of effort. And it needs to be part of our everyday life in order for it to have these kinds of lasting effects. It really needs to become a priority.

And I think it's often been taken for granted and put on the back burner, but I think the other thing that's incredibly so powerful about this is that not only kind of increase your length of life, but it can increase your quality of life. So there are many medications out there that can extend your life, right? But they often come at costs with all sorts of side effects. And that's not to say that relationships are entirely perfect, but those who are more socially connected

often report more satisfaction with their life, lower depression, and a greater sense of meaning and purpose in their life. And so this is something that can potentially lead to not only better health and longevity, but better well-being. And maybe the most important question would be for a listener who's absorbed everything that we've said today and who's themselves feeling very lonely, what are some of the steps that you would

recommend they take to stop feeling lonely? So first off, for anyone who's listening and is feeling really I want to let you know you're not alone. And that many people are currently feeling this way and or have felt this way at some point. And so it's something that is not anything to be ashamed of, but rather it's part of human experience. If someone has been feeling experience. If someone has been feeling severely lonely for long periods of time, it may require getting some outside help. There is evidence that cognitive behavioral therapy has been effective in reducing that. Perhaps something that hasn't gotten too severe yet, and there are many steps that people can take on their own and that can prevent it from getting worse and potentially to get out of that feeling. There are many steps like mindfulness-based practices have been shown to be effective, gratitude practices, participating in the creative arts. But one thing I want to share with you that I think is related to a study that I did recently that is linked to a wider body of research, and that is we ask people to do small acts

of kindness for others. And what we found is that people who did these just small things like checking in on someone seeing how they're doing, maybe just doing a favor for someone, doing something nice for someone, what something nice for someone. What we found was that was associated with significant reductions in loneliness. And I think that this is incredibly powerful because what it suggests is that one of the best ways to help yourself is to help others. There are so many others that are out there struggling.

And by helping them, you can potentially help yourself. Well, Julian, thank you so much for spending time with us today and covering And by helping them, you can potentially help yourself. Well, Julian, thank you so much for spending time with us today and covering this extremely important topic. I know you have done tons of research. And so if a listener would like to absorb more of that research, get to know more about the work that you've done, what is the best place for them to go? to the work that you've done. What is the best place for them to go? Yeah, so first off, they can visit my website. I periodically post articles on psychology today, but they can also find me on Twitter and on Instagram. And they can also watch my TED Talk. Okay, well Julian, thank you so much for taking your time. It was an honor and privilege to have you on the show. Well, it was such a privilege for me. Thank you so much for taking your time. It was an honor and privilege to have you on the show.

Well, it was such a privilege for me. Thank you so much. That was an incredible interview with Julian Holt Lundsted. And I wanted to thank Julian for the honor and privilege of joining us on the show. All links Julian will be in the show notes at passionstruck.com. Please use the website links that you'll find in the show notes. If you purchase any of the books that you find from the guest on the show. All proceeds go to supporting the show. Videos can be found on YouTube, at either John R. Miles' Our Clips channel at Passion Struck Clips.

Avertise their deals and discount codes are in one convenient place at passionstruck.com slash deals. I'm on LinkedIn and you can also find me, Twitter or Instagram at John R. Miles' where I post daily doses of inspiration. Come and check it out. You're about to hear a preview of the podcast interview that I did with Dory Clark, who is a best-selling author of the book The Long Game, and recognized as the number one communications coach in the world. An interview you don't want to miss.

I think is incumbent upon us as early as we can, as soon as we can, to really ask ourselves, what do I want? What is going to be the way that I want to spend my days? Now, it is true that whatever you come up with may not be possible in the short term, you may have debts, you may have obligations, you may need that lucrative job or that source of revenue, and it's not like everybody can immediately pivot and go become an actor.

But it is true that if we are honest with ourselves about the things that light us up, there are ways, sometimes small ways, but there are ways that we can begin to reorient ourselves so that our life can begin to reflect more and more what we want. The fee for the show is that you share it with family or friends when you find something useful or inspirational. If you know someone who's dealing with loneliness,

then definitely share today's episode with them. The greatest compliment that you can give us is to share the show that those that you love and care about. In the meantime, be your best to apply what you hear on the show so that you can live what you listen. And until next time, live life, Ash and Strut.