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Imagine if we were struck with the disease affecting up to 80% of the entire U.S. adult population.

A disease with symptoms that can include stroke, diabetes, depression, suicide, dementia and an early death.

Well, we've got one, and it's called loneliness.

Tonight, we discuss a silent epidemic that affects millions.

And our Steve Higgins with a look at a unique cultural phenomenon we live with here in the Pacific Northwest that certainly isn't helping.

Loneliness is the discussion on this special Mind Matters edition of Northwest now.

Welcome to This Mind Matters edition of Northwest now.

We've got several of these shows planned in the coming months, all focusing on mental health.

Some studies indicate loneliness is an issue with 80% of the U.S. population.

A land where we have a thousand friends on our phones but have never even spoken with our neighbors.

It cuts across all age groups and has a particular impact on minorities.

The low income, the LGBTQ community and the young.

Loneliness or social isolation impacts productivity at work, increases health care costs because it's estimated to be the equivalent of smoking a pack of cigarets a day.

And it has proven to be the primary issue reported in a study of mass shooters thinking about the Seattle area specifically.

Seasonal Affective Disorder is part of this.

And as Steve Kitchens tells us, there's a contributing local phenomena that we've actually given a name to.

Seattle is America's fastest growing big cities.

300,000 have joined since 2010.

That's according to the census.

And if you're one of those newcomers, you've probably noticed it's a bit difficult to form strong relationships or meet new people.

Thanks to the Seattle Freeze, I'd be tough to figure out if Seattleites like you.

If you move here, you got to be prepared for the Depression for the first two years.

I just want the concerts by myself.

Winter is quickly approaching.

The dark gray clouds soak up the sun.

Daylight hours are getting shorter.

Inviting Seasonal Affective Disorder to settle in.

Depression is more than our emotions and also can affect the body.

It can affect our energy, our motivation, our sleep.

Dr. Patrick Rowley, professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington, focuses mostly on older generations, he says are more likely to try shrugging off the blues on their own.

We've been working on the issue of social isolation and loneliness in older adults, in particular, those folks who are 60 or 65 and older.

For those who do seek out help finding psychiatrists, accepting new patients can be hard.

That's why Dr. Rowley and colleagues launched an evidence based program called Do More Feel Better?

They teach volunteers at senior centers, observation and planning skills to boost older adults moods and energy by recognizing patterns of avoidance, withdrawal and depression.

Hope to kind of offer this program nationwide a way for senior center administrators or leadership to kind of pick up this program and to deliver the program and offer it themselves.

And it's not just our older neighbors who are down in the dumps.

The US surgeon general says half of all Americans report measurable levels of loneliness.

The Seattle freeze doesn't help the people that are rude.

And don't look at me from here.

Maybe because they're uncomfortable.

Yeah, they're scared of me.

The weather, I think, also plays plays a partial role.

The surgeon general says Americans should work toward strengthening social connections, reevaluate how we interact with technology in social media, and cultivate a culture of community.

Plus, some Northwest newcomers insist breaking through Seattle's icy facade is not impossible.

If you get hobbies, you can meet people through those things, and that's your best way.

Building connections, meeting people, getting different jobs.

You run into more people and eventually I just met the right kind of people.

Somebody gives you the Seattle freeze, you got to shake it out of them.

You know.

In Seattle, Steve Kitchens Northwest now.

Joining us now are Dr. Whitney Carlson, clinical associate professor at the University of Washington, and Elizabeth Allen, the behavioral health promotion and policy coordinator at Tacoma, Pierce County Health.

Thank you both for coming to Northwest now.

Great to have a conversation about a topic I've been wanting to do for a while on loneliness and it's such a huge problem.

As it turns out.

We set that a little bit coming up into the segment, but I also have a sneaking suspicion maybe and I'm going to get your feedback on this, that it's underline dying and sitting behind a lot of the things that we think are kind of common.

The first one of those, Dr. Carlson, 15% of this country is on mental health medication.

And a new study shows that Seattle's number six nationally is just a huge issue.

So many people with anxiety and depression and problems.

I realize because I was cursed with taking statistics in in graduate school that you'd have to do a real study to tease out those variables and come up with that.

So I'm asking you more about your gut and the quality of part of this.

What's your suspicion about the role loneliness plays?

And what we know is sitting out there is a big use of antidepressants and anti-anxiety medication.

Yeah, but I mean, it's complicated when people have mental health problems in general.

There's usually many reasons for it.

Antidepressants are prescribed not only by mental health, but also primary care.

And as probably most people know, who've been to a primary care doctor lately, they don't have a lot of time.

And so I think that's the easiest thing for people to do, is to prescribe a medication and even the mental health, we do that too.

So I think I think there's a fair amount of loneliness.

There's a lot of evidence that a lot of primary care visits are actually related to loneliness.

It's it's their way of getting some kind of connection with someone.

And so I suspect it's behind that quite, quite a lot actually.

Yeah.

And that and that inability and that lack of connectedness with, with either social circles or families or wherever it may be, it's certainly, I think it'd be safe to say it certainly can't help depression, right.

Yeah.

Yeah.

Most of us are quite a ways from from our families and we have a good friendship circle.

Or if you're new to the area, it's hard.

It's hard to make connections.

I think as someone from the Midwest originally, I think it was really hard to move to the Northwest and we were talking a little bit about the Seattle Freeze idea, and I think it is hard to break into to relationships with people in a big city in particular.

So Elizabeth Pierce County did a huge mental health study, lots of factors, lots of many different categories of data involved in this.

And I don't know if it's addressed specifically, but when it comes to mental health, same question for you.

Is there what's your gut say about what kind of a component loneliness may be in feeding a lot of these other mental health related problems that we are more familiar with?

absolutely.

And, you know, we see that connection of loneliness play out and even a bigger field.

When we look at public health, it's not only about that individual, but how does that impact of loneliness and then have on our communities, our community resilience?

How are people thriving in communities if they're lonely, if they don't have those social connections?

So we're really looking at how does this impact physical health as well as mental health with that component of loneliness, how we need social connections.

I would say one of the most difficult challenges that we've had is we have technology, so we think we're having social connections when we are on social media, even when we're talking to somebody maybe on face time.

But what we're seeing, especially with the Surgeon General's advisory, is that is not enough.

We also had a pandemic where we were told to stay at home.

We were told to isolate.

And coming out of that has been a real challenge for everybody.

So being able to address this and look at that as a major component to people not being able to get up and go to work in the morning, people not being able to do their daily activities.

If you look back at that core issue and a lot of it does stem from loneliness.

Yeah.

Yeah.

You know, Dr. Carlson, there's another term that we've been talking about in this country that circles directly back to what Elizabeth was was talking about there.

We've we've heard this term before and we're pretty used to it.

Deaths of despair.

You know, happiness is kind of this difference between your expectations and your reality.

And a lot of folks with COVID and economic disappointment, a lot of things are that deaths of despair shows up in alcoholism and it shows up in drugs and it shows up in mental health needs and those things.

How do you think loneliness fits into that despair issue?

Is there is there a piece of of despair, if you will, that loneliness also feeds into?

yeah, for sure.

I think I agree.

I think I agree with everything Elizabeth said.

And I think the other piece that we don't recognize is people are quite lonely even when they're with people.

So even when you're around people, if you don't feel you have a good quality of relationship with people, whether it's at work or at home or in the community, you don't feel like you have anyone to count on or that you can talk about your deepest problems, your deepest fears.

And that's what makes people feel very lonely.

And they and that's what leads to people feeling particularly isolated and then coping in unhealthy ways, like, you know, drinking and using drugs and isolating.

Elizabeth talked about this and I wanted to give you a chance as well when it comes to social media, which is just been shown to have this plethora of problems that that come along with it.

You know, my social media says I have 4000 friends.

Do I?

I think you have 4000 people that you have a superficial relationship with.

Probably.

I think what's mostly missing in social media, it's so important with the pandemic because we had need some way to stay connected.

But I think what's really missing is actual in-person, you know, face to face contact where you can pick up on nonverbal cues.

You can look people in the eye, you can shake people's hand, you can hug people that kind of connection with people is really what leads to people feeling very seen and known.

And there's this You can't do that on social media very well.

So yeah, the piece, the term reporter Steve Kitchens did for us leading into this was about seasonal affective disorder and the Seattle Freeze.

You mentioned that spontaneously on your own in your first question, but I also wanted to give you a chance with that.

Elizabeth.

Again, things that we know about, we knew about the Seattle freeze.

We know about seasonal affective disorder.

Well, here's the loneliness sitting under those two possibly to do they have a compounding effect or what's your take on that?

absolutely.

And, you know, looking at looking at how we go about our business, go about our daily lives, we we tend to focus in on what's important.

And when we have things like computers again and that technology right there in our face, we tend to forget about some of the other some of those other valued points in our life, such as our neighbors, such as our friends, such as getting together and talking, sharing a hobby together.

So those those components definitely rise up.

When you think about overall mental well-being, how are we interacting with strangers on the street?

How are we interacting with even extended family?

A lot of rage out there.

A lot of is that a problem?

We seems we are we too pissed off to have friends?

I mean, seriously, I think there is a certain apprehension about interacting with people you don't know in the community because you don't you don't know how they're going to react.

And then of course, with substances and things like that, that that makes people kind of afraid.

I was I was actually thinking I was walking my dog recently and I was thinking, well, you know, really good for me to start talking with more people when I'm out and about.

And but half of the people at least have AirPods in or headphones or they're looking down at their phone as they're walking.

So it's almost even impossible to start a conversation to make a friendship, let alone be afraid of what the reaction is going to be If you interact their podcast.

So I mean, yeah, I mean, I think it's hard it's hard to know how to predict what people are going to.

And here's the problem with social media again, Elizabeth.

It used to be that if I were to meet you, I wouldn't express every political thought I had ever religious thought.

I have spew all my venom about this or that or my road rage or whatever it is.

I'd be a little careful.

We'd get to know each other, we'd talk about the weather, we'd have a nice time.

I would connect with you and realize, you know, Elizabeth's a real nice gal before I started dropping my politics on you, after we had established relationship and I asked if we're all too pissed off because you get it's a it's a firehose of people's opinions and garbage on social media.

And you walk out of the house.

If you take a walk, you're not ready to meet somebody.

You're you're like, I need to get the hell away from all these people, not make friends with them.

The other the other issue with that scenario that you said is how much you knew about me before you connected with me face to face.

And that element right there is anxiety.

We have now increased our anxiety because we have found maybe some superficial information about somebody before we even got to know them face to face or in person.

She's a cat.

She likes cats.

Forget it.

Right?

So let's increase our anxiety by having, you know, having this component before we even get to know somebody around anxiety.

And we all know that anxiety has increased quite a bit and that just adds to it.

And I also want to say to that here we are talking about the downside of social media, but yet we all need it.

A lot more people are working remotely.

Are doctors offices are asking us to have apps on our phone to, you know, check our outcomes maybe on, you know, sometimes your your doctor doesn't want to talk to either.

So yeah.

So there's this very, very difficult double edged sword, if you will, on here we are You're saying you've got to get out and you've got to connect with people, put the phone down.

And we probably need that phone just to connect with you, to let you know that, you know, I'm coming to see you or, you know, I'll be there in a couple of minutes.

So it's really quite challenging.

This is something new that our generations are facing and making a friend is a skill, is it not?

I mean, and it's a perishable skill like most other skills.

Build on Elizabeth's comments a little bit there, Doctor.

I mean, do we even have that skill anymore or is it or is it pretty much flushed out of us by the time we're kids because kids are doing this now.

I was having this discussion with somebody today.

They're not out in the neighborhoods playing football and riding bikes and doing all the things we did come back.

We know when when the streetlights come on, you had to be back.

That's not how it is anymore.

They're doing this.

Yeah, I do think it's true.

I was actually just reading a little bit about this and, you know, social media and kids and how that connects to loneliness.

But it it depends on the kid.

So some some kids are more vulnerable to that, where they use that entirely for their social connections.

Some can use it, just like you're saying, to get together with people and then they do go ride your bike.

It's like my my son will go out and say, okay, I'm going to go paddleboarding.

I'm meeting up with, you know, my friend and I'll be home later.

So it kind of depends on on the situation.

I think it's I think inherent on schools and also parents for sure or other close people in and kids lives to teach them that that's not the only way to connect with people and take a time out from it.

Because a lot of times we're we're in the on our own house with our own family members and everyone's on their own little it's not communication, Right?

Right.

I mean, you can teach that at home a little bit, too.

The surgeon general talked about fostering a culture of connection.

But when we look at what we call kind of the American culture, the American dream, the American way, it is very much there's it's very much a dichotomy.

There's this whole kind of John Wayne, pull yourself up by your own bootstraps and go riding off into the sunset on a horse by yourself because you're a lone, dangerous guy.

But there's also a great history in this country of of cooperatives for everything from electric electricity to farming to agriculture and raising barns.

We needed each other.

We're not seeming to get it right, though.

Elizabeth, What do we have a need to have in our mind about what it means to be an American and this whole friend making peace?

Right.

Right.

And it was touched on here with, you know, that communication with friends.

We need to develop new skill sets.

We have this new, you know, this newer piece of information technology.

We need to build different skill sets.

We talked a little bit here about coping skills.

Every individual wants to try to take care of themselves when they're not feeling well, and we know that that leads to a lot more mental health challenges.

But we need to develop a new set of skills around how to balance having those times alone with technology or being alone.

Because now I'm working remotely and balancing that with finding other other people to connect with thinking about our own interests and how probably somebody else in our community has those interests as well, whether it's a hobby, whether it's getting together for a meal.

But at this point we really need to be intentional about those types of relationships and getting back to those social connections, force yourself sometimes to go to the model train group or or to whatever it may be.

An affinity affinity is really seemed, you know, car guys sewing, whatever it may be, whatever hobbies really seem to be a real pathway into that too, if people can access it.

I don't want to make it sound like, you know, little, little Joey's lonely and that's an isolated problem.

And this has some huge societal health consequences and financial consequences.

Doctor, can you talk a little bit about either, you know, that's dealer's choice there.

Whatever you want to talk about.

Well, there's there's actually studies that show that people who have very small social circles or lonely are at 50% risk of of dying from that as an independent risk factor for death.

That's I mean, it by itself can kill you.

Yeah.

And it's just as risky as smoking.

So 15 cigarets a day and more more risky than alcoholism or lack of physical activity.

I don't think people realize.

No, it's huge.

It's there's a huge study that was done and it's it was pretty shocking when I heard the numbers, too.

I was like, wow, that's from a public health perspective.

You can't hear that and see those studies and say, yeah, but we're going to focus on, you know, the normal public health things, right?

I mean, this has to you have to swing your gun around and really look at this.

I would think don't let me put words in your mouth.

What is from a public health perspective, how how how can this be dealt with?

Exactly.

And and just to bring up the point, you know, 20 years ago, we would have been talking about loneliness.

We've really shifted from that viewpoint of looking just at physical health and now looking at mental health and saying mental health is just as important, if not more important, than your physical health here as it flows into so many other flows.

So we look at loneliness can increase your risk of stroke even when you are not well, when you're not physically well, you you can't thrive.

You're not able to have your best life possible and not only for yourself, but possibly for your family too.

You know, that is our goal in public health.

Everybody's living their best lives possible.

Yeah, we don't want people to be suffering from stroke or even possibly dementia dimensions.

Another one that's increased with loneliness.

We want everybody to be healthy and have and make those healthy choices.

And this isn't just any age group.

I mean, this is kids and suicidal ideation and folks in there, you know, who have younger and older generations on both sides.

And the older generation, too.

Absolutely.

Yeah, Absolutely.

Yeah.

It's a danger for everyone.

I'm wondering to a little bit your thoughts on this, too, Doctor, about, you know, we didn't talk about it directly.

We talked about the mental health piece.

But I mean, there are costs associated with this, too.

You have to be concerned as a health care professional about who's paying for these treatments.

And and some of those kinds of is loneliness a coachable, coachable ailment at this point?

Should it be I mean, how what are the financial aspects of that?

Yeah, that's a good question.

I that's actually not the direction I thought you were going to take with the financial impact.

I thought you were going to talk about the impact of like absenteeism and feel free to make this better.

Yeah, so but, but it's so it's both sides.

It's, you know, if you're lonely and then you're having mental health issues or physical problems because you're not taking care of yourself, then you might miss work more often or you you have to take FMLA and that that affects employers a lot.

I think, you know, in psychiatry we often talk about adjustment disorder as are like, you know, when people are having a hard time with life issues.

And so that is a coachable disorder that you can build for.

I don't know if there's I think there are certain codes that you can add when you're when you're a medical doctor or in mental health, too, that sort of bring to the forefront.

That is an additional problem of focus.

They're called codes in the DSM.

So it usually isn't the primary thing, but it's the thing you add to it to show that it's a complicated system.

So you're not out in the woods.

If with health insurance, if this is a primary driver for you, loneliness.

No, I don't.

Yeah, I think you can get the help that you need.

It's it's it's it's a little bit of finesse, I suppose.

Yeah.

Here's another.

This is a tough one to maybe Elizabeth.

I don't know if you've thought about this directly, but I have.

You know, a lot of people will tell you they're not lonely y because they have their spouse.

The whole thing is invested and, you know, maybe guilty as charged.

The whole shot is invested in the spouse.

And when the spouse goes in, it can happen.

You know, we've all had friends on Facebook and realized that somebody in our circle or the spouse of somebody in their circle has died.

And then, boy, boy, are we too dependent on our spouses?

Do we need to think about this friendship, skill and things that we're supposed to be doing outside of our marriages if we are married?

You know, that's a that's a great question.

I don't ever want to put down any relationship because any relationship is valuable.

Right.

But regardless, if you're married or have a partner, it's not a good idea just to depend on one person.

Yeah.

And the idea of having several people that you can depend on in times of need or for celebration is, you know, very, very important.

Certainly we want everybody to have, you know, good, positive relationships.

Sometimes that doesn't happen at home, though, for whatever reason.

And so we really want people to think about it, think about that community, and then also going back to being invested in your community.

So again, not putting down marriage at all, what healthy relationships there, but thinking, thinking more outside the home in terms of what do you want to see in your neighborhood?

What do you want to see in your community?

And a lot of talk around community resiliency.

And that really means you're stepping out of your home, maybe with your spouse or partner.

Widening those connections are making those networks bigger.

Last 30 seconds, Dr..

If somebody said, hey, I know I have a loneliness problem, what's a and because because it is only 30 seconds, what's a positive step I can take help others.

That's the number one thing I would say, because the more you can get outside yourself and contribute to someone else's well-being, the better you actually feel yourself because you realize there's a lot of people with more problems than you do, or maybe they're even more lonely than you are.

So volunteering in something that really matters a lot to you.

You can also meet other people that that Sheryl like minded passion of yours for volunteering.

And then you meet people as well.

So that would be like the know that's a great thought to end it on.

Thanks both of you for coming to Northwest now.

Thank you.

Thank you.

Loneliness is a public health threat that's hiding in plain sight.

And there's no vaccine or medical treatment that can truly solve the problem.

The bottom line, just be aware of this.

Put down your phone and set a goal to see if there's one thing you can do a day or a week to build a connection, promote peace, and get out of the spin cycle of hate and isolation hardwired into our first culture and now so disastrously amplified by outrage fueled social media.

It's a place to start.

I hope this program got you thinking and talking to watch this program again or to share it with others.

Northwest now can be found on the web at kbtc dot org and be sure to follow us on Facebook and Twitter at Northwest.

Now, a streamable podcast of this program is available under the Northwest.

Now, tab at KBTC dot org and on Apple Podcasts and Spotify.

That is going to do it for this Mind matters edition of Northwest Now until Next Time.

I'm Tom Layson and thanks for watching.