Loneliness
Loneliness is the subjective experience of unwanted social isolation — the gap between desired and actual social connection. Persistent loneliness is associated with substantial mental-health and physical-health consequences and is increasingly recognized as a public-health concern.
Overview
Loneliness is the subjective experience of unwanted social isolation — the painful awareness of a gap between desired and actual social connection. It is distinct from objective social isolation (which can be desired or undesired) and from solitude (chosen aloneness). Loneliness can be experienced in the absence of others (no companions when wanted) or in their presence (feeling unseen, unknown, or disconnected even when surrounded by people).
Loneliness is not a DSM-5-TR diagnosis but is a clinically significant phenomenon associated with substantial mental-health and physical-health consequences. Recent research and public-health attention has identified loneliness as a major contributor to depression, anxiety, suicide risk, cardiovascular disease, dementia, and mortality. The U.S. Surgeon General (2023) and the WHO (2023) have declared loneliness a global public-health priority comparable to smoking or obesity.
Population data: approximately 25-30% of Canadian adults report feeling lonely “often” or “always.” Rates are particularly high in young adults (18-25) and older adults (75+). Loneliness has increased over the past decade, accelerated by the COVID-19 pandemic, with effects persisting beyond the acute pandemic period.
Loneliness exists on a continuum from situational (acute episodes related to specific circumstances) to chronic (persistent across years). Chronic loneliness is associated with the most substantial health consequences and warrants clinical attention. Subtypes include emotional loneliness (lack of close confiding relationships), social loneliness (lack of broader social network), and existential loneliness (sense of fundamental aloneness in the world).
Treatment is effective. Clinical and community interventions including individual therapy, group therapy, social-skills training, attachment-based work, behavioural activation, mindfulness-based approaches, and structural community-building programs all produce meaningful improvement. Treatment outcomes are typically gradual rather than rapid; sustained engagement supports lasting change.
Signs and symptoms
- Persistent feeling of being alone — Subjective experience of being alone, disconnected, or apart from others — often persistent across contexts.
- Sense of being unknown or unseen — Feeling that no one truly knows or understands you, even in the company of others.
- Difficulty initiating or sustaining connection — Social skills, attachment patterns, or anxiety preventing the formation or maintenance of close relationships.
- Withdrawal and avoidance — Avoidance of social opportunities; declining invitations; reducing contact with existing connections.
- Negative interpretation of social cues — Hypervigilance to rejection cues; interpreting ambiguous social signals as negative; assuming others do not want connection.
- Comorbid depression and anxiety — Loneliness frequently co-occurs with major depressive disorder, generalized anxiety, and social anxiety disorder.
- Sleep disturbance — Loneliness is associated with poorer sleep quality and increased nighttime wakefulness.
- Increased substance use — Alcohol, cannabis, or other substance use to cope with loneliness or social anxiety.
- Health behaviors and physical health impacts — Loneliness is associated with poorer self-care, reduced exercise, more inflammation, elevated cardiovascular risk, and earlier mortality.
- Suicide risk — Loneliness is a robust predictor of suicidal ideation and attempts; one of the strongest individual risk factors.
Causes and risk factors
Loneliness develops through interaction of individual, relational, and contextual factors:
Life-stage factors: certain life transitions — leaving home, starting university, moving to a new city, losing a partner, retirement, becoming a caregiver, aging — predictably elevate loneliness risk.
Attachment factors: insecure attachment styles (anxious, avoidant, fearful) elevate risk for chronic loneliness. Early attachment disruption shapes adult relational capacity.
Mental-health factors: depression, social anxiety, autism spectrum, ADHD, BPD, schizophrenia spectrum, and substance use disorders all elevate loneliness risk and complicate connection.
Social skills: some loneliness reflects skill gaps in initiating, maintaining, or deepening connection. Skills can be learned.
Trauma and adverse experiences: bullying, peer rejection, betrayal, and trauma exposure can produce protective withdrawal that becomes chronic loneliness.
Health and disability factors: chronic illness, disability, mobility limitations, hearing loss, and other health conditions can constrain social participation.
Demographic factors: men, low-income individuals, immigrants, LGBTQ+ individuals (particularly older adults), and members of marginalized groups have elevated risk.
Social and structural factors: community decline, social-media displacement of in-person connection, working-from-home, urban planning that reduces casual encounter, and broader cultural shifts toward individualism all contribute.
COVID-era effects: pandemic-era isolation produced lasting changes in social patterns, particularly in younger and older adults; some patterns have persisted post-pandemic.
Comorbidity: bidirectional with depression, anxiety, and substance use; bidirectional with physical-health conditions through inflammatory, cardiovascular, and lifestyle pathways.
Typical treatments
Effective interventions for loneliness include:
Cognitive behavioural Therapy — particularly addressing maladaptive social cognitions (negative interpretation of social cues, assumed rejection, catastrophizing about social situations). Substantial evidence base; meta-analyses show CBT is the most effective single intervention for chronic loneliness.
Social-skills training — structured skill-building for initiating conversation, maintaining relationships, deepening intimacy.
Attachment-based therapy — addressing early attachment patterns that affect adult relational capacity.
Acceptance and Commitment Therapy — values-clarification, defusion from social-anxiety thoughts, committed action toward connection.
behavioural activation — structured increase in social activities, particularly important when depression is comorbid.
Mindfulness-based approaches — develop capacity to be present in social interaction, reducing anxious self-monitoring.
Group therapy — itself a connection-building intervention; structured groups (interpersonal process groups, social-skills groups, support groups) provide both treatment and direct relationship-building opportunity.
Couples and family therapy — when loneliness involves marital or family disconnection.
Treatment of comorbid conditions — depression, anxiety, substance use, hearing loss, and other contributors.
Pharmacotherapy is not directed at loneliness per se but is appropriate for comorbid depression and anxiety.
Community-based interventions: Men’s Sheds, befriending programs, peer-support groups, intergenerational programs, community-based volunteering, religious or spiritual community involvement, and other structural community-building programs all support loneliness reduction.
Animal companionship: emerging evidence for the role of companion animals in reducing loneliness, particularly in older adults.
When to seek help
Professional support is indicated when:
- Loneliness has persisted for months and is causing significant distress.
- You feel unable to initiate or maintain connections despite wanting them.
- Loneliness is accompanied by depression, anxiety, sleep disturbance, or physical-health changes.
- You are using alcohol, drugs, food, screens, or other behaviors to cope with loneliness.
- Loneliness has emerged in the context of a major life transition (relocation, loss, retirement, illness).
- You have a history of attachment difficulties or relational trauma that may be contributing.
- You are experiencing suicidal thoughts.
If suicidal thoughts are present, free 24-hour support is available across Canada at 9-8-8 (Suicide Crisis Helpline, call or text), 1-833-456-4566 (Talk Suicide Canada), or 811 (Health Link). For Canadians 50+: 1-844-454-3548 (Friendly Voice line). For LGBTQ+ peer support: LGBT Youth Line at 1-800-268-9688. For Indigenous community: 1-855-242-3310 (Hope for Wellness Helpline).
Frequently asked questions
How is loneliness different from being alone?
Is loneliness really bad for my health?
Why is loneliness more common now?
Will adding more activities help?
Can therapy help if I cannot easily make friends?
Are there specific resources for older adults?
References
- U.S. Surgeon General. (2023). Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General's Advisory on the Healing Effects of Social Connection and Community.
- World Health Organization. (2023). Social Connection.
- Cacioppo, J. T., & Cacioppo, S. (2018). The growing problem of loneliness. The Lancet, 391(10119), 426.
- Masi, C. M., et al. (2011). A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review, 15(3), 219–266.
- Holt-Lunstad, J., et al. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237.
Find the pattern behind what's been feeling hard
A few simple questions to help surface the concerns that may fit best.
Find Your PatternFind a Therapist by City
Browse therapy availability by city to see local and virtual options, explore services, and connect with a clinician who can serve your area.
Find a Therapist by Province
Browse therapy options by province to see which clinicians are available to work with clients in your region.
Trusted by Leading Psychology & Mental Health Organizations Across Canada
ShiftGrit Psychology & Counselling is professionally regulated, certified, and recognized by leading psychology and mental-health organizations across Canada. These associations reflect our commitment to ethical practice, clinical standards, and evidence-informed therapy through Identity-Level Therapy and Reconditioning.
Trusted By Alberta’s Leading Psychology & Mental Health Organizations
ShiftGrit Psychology & Counselling is professionally regulated, certified, and recognized by leading psychology and mental-health organizations across Alberta and Canada. These associations reflect our commitment to ethical practice, clinical standards, and evidence-informed therapy through Identity-Level Therapy and Reconditioning.
Regulated and affiliated across Alberta’s leading psychology, counselling, and mental-health organizations.
Regulated and affiliated across Canada’s leading psychology, counselling, and mental-health organizations.
