Column: U.S. Surgeon General: Loneliness Is at Heart of Growing Mental Health Crisis

U Magazine Spring 2023
Vivek H. Murthy, MD, MBA - U Magazine Spring 2023
U.S. Surgeon General Dr. Vivek H. Murthy spoke in May at UCLA’s annual WOW (Wisdom of Wellness) Mental Health Summit. (Photo by Nick Carranza)

By Vivek H. Murthy, MD, MBA

Mental health is the defining public health crisis of our time, and for many Americans, loneliness is at the heart of that crisis. At any given moment, about one out of every two of our fellow citizens is experiencing measurable levels of loneliness. It is not something we talk about or easily see: Loneliness is a condition that is hidden in the shadows.

More than just a bad feeling, loneliness is a corrosive condition with grave consequences. Social disconnection puts us at increased risk for depression, anxiety and suicide, as well as heightening our risk for stress-related physical ailments like heart disease, stroke and dementia. Its impact on our risk of premature death is on par with smoking 15 cigarettes daily.

Why is this so? It is because we evolved to live in community. As hunter-gatherers, we found safety in togetherness. Being isolated from the group put the individual at elevated risk — from predators, from starvation, from exposure — and that created stress. Our survival depended on being a part of something larger than just ourselves.

As much as our circumstances are very different today than they were in our hunter-gatherer days, that basic truth remains: We are hardwired to live in community. Connection is the essential glue of our lives. It is what brings us happiness and fulfillment. We need social connection for our survival and collective well-being.

This epidemic of loneliness has been building over many years. The pandemic made it worse, to be sure, but it is a crisis that has been evolving for a half-century or more. During that time, there has been declining participation in communal life. Fewer people belong to churches or synagogues or other religious institutions or are engaged with civic organizations. We, as a society, move around more. We change jobs more frequently. We don’t put down roots in the same ways as our parents and grandparents.

Too often, we imagine loneliness as a condition of the elderly living in isolation with no one to support them. While that can be true, loneliness in the United States is not limited to older Americans. There are people in marriages who are lonely, CEOs of major companies who are lonely, seemingly happy people posting pictures of their fabulous vacations on social media who are lonely. And far too many young people who are lonely. From the outside, everything looks fine. But inside, they are struggling.

Addressing this national crisis is a profound challenge. We all want to be seen and understood. Sometimes all we need is acknowledgment of our worth and value. This is something we can do for each other — and for ourselves. Taking just 15 minutes a day to reach out to someone you care about can make a huge difference in how connected we feel.

There is nothing more fundamental to the health and well-being of people in our country than ensuring that we are building a moral and spiritual foundation that guides how we interact with each other. Toward that goal, service is one of the greatest antidotes to loneliness. When we help somebody else, two things happen. One is we forge a connection with them. The second is that we remind ourselves that we have value, and that can help us in times of our own loneliness. The less worthy we feel, the harder it is to reach out to other people.

I know this from my own experience. When my first stint as Surgeon General ended abruptly in 2017, I felt profoundly lonely. During my time as Surgeon General, I threw myself into the job at the expense of my friendships. When the job ended, I was left without those relationships that had sustained me before. I was lonely, and also ashamed. I believed it was my fault because I had neglected those relationships. It was a choice I had made, and I felt embarrassed to call my friends and say, “Hey, I’m sorry I wasn’t there for you for the last two-and-a-half years.” It took the urging of my wife, who recognized what was happening to me and that I was withdrawing more and more, to reach out to reconnect.

One of the best definitions of a friend that I ever heard was when I was in college: A friend is somebody who reminds you of who you are when you forget. And we all do forget from time to time. We all go through periods in our life when we feel unworthy or that we fall short. That is when we need our friends to step in. That is why I think that at a time such as we are now experiencing, when as a community we are struggling so much with our mental health, we need these connections in our lives.

Yes, we do need more psychiatrists and better access to psychiatric care to address the mental health crisis that confronts our country. Yes, we do need more psychologists. Yes, we need the technology to bring the care that is needed to people in their homes.

But we also need each other. We need to turn our attention to reinforcing the caring, supportive institutions, communities and relationships that give our lives purpose and meaning. We need to come up with ways to tip the balance toward love and away from fear, to rebuild the public square so that we can once again speak rationally with each other. To address this crisis of loneliness, we need to return to the core values of kindness, generosity and friendship that are so essential to the social fabric of our communities.

Ultimately, it comes down to one thing: Embrace love. It has the extraordinary capacity to heal and is the force we need to reach for each and every day in our lives. Love is our oldest medicine.

Dr. Vivek H. Murthy is Surgeon General of the United States. He is currently serving as the 21st Surgeon General under President Joe Biden, and he also served as the 19th Surgeon General under President Barack Obama. This column is adapted from a conversation Dr. Murthy had with Oprah Winfrey at UCLA’s Royce Hall in May during the 2023 WOW (Wisdom of Wellness) Mental Health Summit to benefit the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA and the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA.