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One of the biggest misconceptions about loneliness is that people who are "isolated" according to some objective measure (for example, they live alone) must also be lonely. The converse produces its own common misunderstanding - that if you are connected to others in some objective way (for example, you are married and live with your spouse), then you are probably not lonely.

Statistically, we can show that isolation and loneliness are not perfectly correlated. A pair of researchers from Wales went far beyond that. In 1979, they recruited 500 people from rural Wales who were at least 65 years old and followed them for the next 20 years. They interviewed them in their homes every four years, asking standard questions about isolation and loneliness, as well as other open-ended questions about their lives.

By 1999, there were only 47 people who were still alive and not living in an institution, so that small sample size needs to be kept in mind.

To be considered socially isolated, more than one of the following had to apply:

Lives alone

Never goes out of the house

Has no close relatives

Never visits anyone

Has no contact with neighbors

Is alone for more than 9 hours a day

Has no telephone

Nearest neighbor is more than 50 yards away (out of earshot)

To determine loneliness, the researchers used these criteria:

Feels lonely much of the time

Wishes for more friends

Does not see enough of friends and relatives

Has no confidant

Has no real friends living nearby

Does not meet enough people

Has no one of whom to ask favors

Spent the previous Christmas alone and lonely

Let's consider the people who were classified objectively as isolated, but who were not lonely. What were they like?
Isolated but Not Lonely

They are people who enjoy their own company. They tend to be quiet or reserved.

Either they have satisfying relationships with friends or neighbors, or they have always stayed to themselves

In this sample, they were all people who did not have children

They have self-sufficient personalities

They spent the previous Christmas alone by choice

Some people were isolated or lonely early in the study but overcame their loneliness later on. Typically, these were people who had made lifestyle changes. For example, one person, at the outset of the study, had been recently widowed. Twelve years later, though, she had made several good friends and also had good relationships with neighbors; she was no longer lonely. Another example involved a widowed farmer who was initially very isolated and lonely. After suffering a heart attack, he cut down on the number of livestock he maintained, and spent more time chatting with neighbors and hanging out at the pub. He wasn't lonely any more, either.

Now let's look at the people who did not qualify as isolated but did score as lonely.
Not Isolated but Lonely

They are caring for a dependent spouse and have little help

They are living with an adult child who is working full time

They have experienced the death of their spouse or friends

They moved during the study

Their health is deteriorating

No one visits them

They don't ask for help

I expected this category to include people who were living with another person and not getting along very well with that person. However, there was no mention of that.

After presenting their findings, the authors shared their thoughts about possible policy changes or interventions. The last few sentences of the article were these:

"...it would be wrong to assume that solitude should always be a target for intervention and change. Solitude may be associated with a greater risk of undiscovered emergencies, but it is probably the risk that should be reduced and not the solitude itself, which may be cherished."

Reference: Wenger, G. C., & Burholt, V. (2004). Changes in levels of social isolation and loneliness among older people in a rural area: A twenty-year longitudinal study. Canadian Journal on Aging, 23, 115-127.

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When Isolated People Are Not Lonely and Connected People Are

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A 20-year study that followed people into old age found that some who were objectively isolated were not at all lonely, and others who were not at all isolated were lonely. Who were these people? What were their lives like?

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Whether they're excluded or confined by others, or simply choose their own isolation, some people have spent vast amounts of time alone. Be they reluctant prisoners, mystical hermit types, or reclusive eccentrics, their stories are sometimes tragic and always compelling.

10John Bigg

In 1649, at the end of the English Civil War, Oliver Cromwell's puritanical Roundheads took control of England's Parliament and hurried to put the reigning monarch, Charles I, on trial for treason. Simon Mayne, an English magistrate and Member of Parliament at the time, became one of the judges at Charles' trial. Mayne's clerk, a Mr. John Bigg, was rumored to be one of the hooded executioners at the king's subsequent beheading.

Charles' impromptu trial and execution caused widespread disapproval. The Roundheads had to get rid of half of all England's parliamentarians before they could even bring it about. Thomas Hoyle, a retained member of "the Rump Parliament" that remained, committed suicide on the first anniversary of Charles' death. Royalists later claimed he'd been haunted by headless phantoms. Another judge, Rowland Wilson, was said to have died of melancholy and guilt the same year.

John Bigg-whether he was one of Charles' executioners or not-succumbed to a metaphorical death soon afterwards too. When the monarchy was restored in 1660, Bigg's boss, Mayne, was put on trial, found guilty of regicide, and died in the Tower of London before his appeal could be heard. Perhaps out of fear or guilt, Bigg took up residence in an underground cave at Mayne's home, Dinton Hall, and lived there alone for the rest of his days. He was last seen in an 18th century illustration, oddly resembling an Ewok.

Despite his name and oversized shoes -one of which can still be seen, though hopefully not sniffed, at the Ashmolean Museum-Bigg was not a giant man. When his clothes wore out he simply nailed another leather strap over the old, worn-out ones, which led to his peculiar, bulky appearance.

9Dorothy Paget

The eccentric racehorse owner Dorothy Paget had been an accomplished rider in her youth, but over the years she grew obese. Weighing in at 127 kilograms (280 lbs) and smoking 100 cigarettes a day, Paget eventually came to look twice her age. She might have slimmed down a bit by dating, since the company of men, with the exception of a few racetrack cronies, was said to make her actually vomit. Understandably, she remained single throughout her life. When she congratulated her Grand National and Cheltenham Gold Cup winning racehorse, Golden Miller, people unkindly joked that it was the only male she'd ever kissed. Some other great wit immediately pointed out that this was only possible because the horse was a gelding.

Although she could be domineering, intimidating, and rude, Paget also suffered from debilitating shyness. At the racetrack she insulated herself from others with a herd of protective female secretaries and her signature uniform-a speckled blue tweed coat, which resembled a tent, and a beret. She sometimes locked herself in the toilets until the crowds had gone home, and when traveling by train she would hire an entire carriage in order to ensure her privacy. She predominately communicated with her staff by leaving them notes, and preferred to address them via a color-code system rather than calling them by name. Besides horses, it seems only one other creature received the fullness of Paget's affections-Olga de Munn, niece of Princess Meshchersky. Meshchersky, a Russian immigrant, had run the Parisian establishment in which the spoilt and unruly Paget had been forced to complete her formal education after having been expelled from no less than six other schools.

By age 54, Paget was living as a recluse at her home in Chalfont Saint Giles. Now she insulated herself with stacks of yellowing copies of the Sporting Life, and placed her bets over the phone. She was such a recluse that bookmakers would allow her to place bets long after races had finished, so confident were they that she could not have known the results due to her isolation. She slept through the day and worked at night, telephoning her trainers at inconsiderate hours. She was found dead early one morning, presumably by one of her color-coded staff, slumped over a race calendar. The newspapers ran acidic articles reviewing her life, which prompted Olga de Munn to make a public defense of her unfortunate friend.

8Kevin Tust

Kevin Tust is a lonely hunter-although not in the usual sense. He's spent decades alone for months on end, freezing his knees off in the Fiordland wilderness on the west coast of New Zealand trying to photograph Canadian moose.

The first attempt to introduce moose into New Zealand took place in 1900. There were only four-10 of their companions had died during the rough ocean voyage from Canada. By the time they arrived the four survivors were described as being as tame as pet ponies. During the course of their epic journey they also seem to have become addicted to biscuits. Only three of them ventured off when eventually released. One stayed close to the settlement of Koiterangi for years, probably in the hopes of finding a Biscuit Addicts Anonymous group. Or more biscuits.

The next batch of moose were released at Supper Cove in Dusky Sound, Fiordland, in 1910. There were 10 altogether-four males and six females. These seem to have had a more successful introduction, despite one of the females breaking her shoulder on the day of release, and another being shot within a week. Free of the ravages of biscuit-addiction, these moose soon adapted to their new environment. Their descendants were infrequently sighted up until 1953.

As time went on, practically everyone believed moose had died out in Fiordland due to competition for food with growing numbers of imported red deer. However, Tust, a biologist, became convinced a small herd of moose had survived. He's been living mostly alone in the Fiordland wilds in order to find proof of remaining moose ever since. His long, solitary periods in the wilderness were somewhat validated back in 2005 when DNA analysis of some animal hairs found in Fiordland confirmed that they could only have come from the descendant of a Canadian moose. Tust's search continues.

7Blanche Monnier

She spent 25 years locked in a completely dark room, half starved, naked, and lying on a mattress covered in lice and her own excrement. Her only companions were the rats she shared crusts of bread with. By that stage she had aged and understandably lost her wits. Her crime? Loving someone beneath her family's social status-or maybe sheer stubbornness, depending how you look at it. No matter the conclusion, it seems fair to say that Blanche Monnier was the victim of a terrible injustice, and that love, despite the popular aphorism, doesn't always conquer.

Discovered by French police in the well-to-do town of Poitiers after an anonymous tip-off, Mademoiselle Monnier was rushed into care in 1901. It was first thought that she wouldn't survive, and though she later recovered physically, her sanity was never fully restored. Meanwhile, the world was shocked to learn that the woman who later came to be known as "The Sequestered of Poitiers" had been locked in the room by members of her own family after refusing to renounce her love for an unsuccessful local lawyer.

Blanche Monnier had been an attractive, bright-eyed brunette, reportedly desired by several men in the town. But much to her upper-class family's dismay, her heart was set on the lawyer. The Monniers, believing their reputation would be ruined if the union were allowed to go ahead, decided to prevent the marriage by confining the young woman. It was her brother, a local government official, who trapped her-but the plan was hatched by their mother, who was convinced the girl would soon relent. But Blanche never did.

The lawyer died 16 years before Blanche was rescued. When the shocking crime was discovered, Blanche's mother was locked away in prison, dying of heart failure soon after realizing the true horror of her crime.

In an interesting postscript, the so-called life of "The Sequestered of Poitiers" is believed by some to have haunted the French philosopher Michel Foucault, who grew up in the same town and regularly passed the Monniers' home. A BBC documentary suggested that the philosopher's obsession with madness and confinement may well have been inspired, at least to some extent, by the horrifying story, which he must surely have heard as a child, and which he seems to have never forgotten.

6The 5th Duke Of Portland

Although the 5th Duke of Portland has been mentioned in a previous list of British eccentrics, the true extent of the mystery surrounding his seclusion remains to be told. Back in the Victorian era it was claimed that the Duke-who stayed shut away in his room on his private estate, Welbeck Abbey-was a real-life Jekyll and Hyde. His extensive network of underground rooms and passageways may perhaps have been constructed in order to assist him in leading a double life.

The story could have come straight out of a Victorian novel. In fact, some have suggested it was the inspiration for Charles Dickens' final, unfinished work, "The Mystery of Edwin Drood." A widow named Anna Maria Druce insisted for decades that her father-in-law, Baker Street textile shop owner Thomas Charles Druce, had been none other than the Duke of Portland himself. Though Thomas Druce had died in 1864, a full 15 years before the Duke, Anna claimed the entire funeral had been a hoax. She asked that the coffin be exhumed and opened, certain it would either be empty or filled with lead weights. Thomas Druce, she claimed, had staged his own death in order to fully resume his life as the Duke.

Anna never recanted her seemingly outrageous story and went as far as to contest the inheritance of the Portland estates. She was finally committed to an asylum in 1903 due to the "stress of litigation." Other members of the Druce family pursued the matter after her, though the evidence some of them gave was found to be false and several main witnesses were given heavy sentences for perjury. When the coffin of Thomas Druce was finally opened in 1907 and found to contain a body, the case was dismissed as " frivolous and vexatious." However, Anna Marie Druce's claims could well have been rooted in some long-obscured truth.

Consider the reported evidence. On the extremely rare occasions when the solitary Duke made an appearance, he was buried under three overcoats and a ridiculously oversized top hat, and hid behind a huge umbrella. He mostly gave his orders through written notes. When traveling, his stage coach always had the curtains drawn, and it was loaded onto the London-bound train, presumably with him inside. He kept apartments in London that were said to be linked to Baker Street by a secret tunnel, discovered by workmen years later.

Due to his isolation, no one really knew whether the Duke was in his room at Welbeck Abbey or not. Food was delivered, but nobody ever saw him collect or eat it. Even when sick, the Duke would shout his symptoms through a slot in the door and his doctor would shout back a diagnosis. Likewise, Thomas Druce was said to have kept his Baker Street office behind some red velvet curtains. When the curtains were drawn, employees were told to stay clear and not to bother Druce. When the Duke's whereabouts were known, Druce's became mysterious, and vice versa. After the funeral of Thomas Druce, the Duke was known to have resided permanently at Welbeck Abbey.

5John Slater

John Slater, a former Royal Marine commando, is a notable English eccentric with a penchant for long-distance walking and lonely coastlines. After leaving the military because: "There came a time when I lost interest in learning how to kill a man using only my thumbs," Slater went on a mission of self-discovery, spending months living among the homeless on the streets of London. After that he became unsettled, working dozens of jobs and wrecking a number of relationships. At one point, he volunteered to be a human exhibit in a London zoo for six months in order to raise money for giant pandas. His offer was turned down.

Later he went on to gain the world record for walking barefoot the entire length of Great Britain, from Land's End to John O'Groats. He completed the walk dressed in brightly striped pajamas, while his accompanying border collie wore suede booties. To raise money for charity he also walked the entire coastline of Scotland in just four months. Later, he built a working automobile out of "bits of old cars, washing machines, ironing boards, and Coke bottles" that people had thrown away.

Whatever Slater's hang-up was, he finally seemed to resolve it by growing an Old Testament beard and going to live in a remote oceanfront cave on the west coast of Scotland, where he regularly stayed for up to four months at a time for at least 10 years. Twice a day he was forced to gather his stuff and run to the back of the cave as the tide came in. At night the cave apparently became infested with rats, which would crawl over him as he slept. Unsurprisingly, his wife refused to join him, and they later divorced. As extreme as this may sound, Slater seemed to settle into it.

"There is also a cathedral-like silence which helps me think," he once told The Herald newspaper. "I'm addicted to harmony . . . restfulness. You realize the planet's breathing, that the same energy moving these stones is moving your heart." Slater also admitted plans to one day unleash his mystical insights and deep, cave-born wisdom on the world with the help of a large hand puppet he'd created called Muddy the Frog.

4Mary Molesworth

After her debut in the Dublin theater, Mary Molesworth's talent and beauty was praised throughout Ireland. Unfortunately this attracted the attention of one Colonel Rochfort, a man known for his terrible temper. Mary didn't want to marry him, but her father insisted. Rochfort had by that stage become the 1st Earl of Belvedere and he could offer Mary land and a title. So, against her wishes, Mary Molesworth became Lady Belevedere in 1736, bearing the Earl several children. Neglected and alone on the Earl's estate at Gaulstown, she began spending time with the Earl's brother, Arthur, and his wife, Sarah.

At some point the Earl received a parcel of letters that implicated Mary in an adulterous affair. The poisonous suggestion was that she'd been sleeping with his brother during his frequent absences. The Earl wigged out and threatened to shoot Arthur on sight, forcing him to flee the country. Meanwhile he confined Mary to Gaulstown. She was kept under close guard and escaped only once, returning to seek her father's protection in Dublin. But her father refused to speak to her, handing her back to the Earl's men as soon as they came looking for her.

Sixteen years passed with Mary locked away at Gaulstown. People had apparently mostly forgotten about her by that stage, and were only reminded when Arthur returned from overseas. A trial followed and Arthur was found guilty and ordered to pay £20,000 damages for wrecking the Earl's marriage. When he couldn't pay, he was sent to prison.

Mary remained a prisoner at Gaulstown for another 16 years, finally being set free by her son upon the Earl's death in 1774. After her release, someone who met her wrote: "Who would believe she was the woman of the beauty of which we had heard so much? She is a wreck, weak and haggard! Her hair is white as snow, and in her eyes there is a wild, scared look, as of one who has received some terrible shock, the memory of which is ever with her. She speaks in a trembling voice which hardly rises above a whisper, and the dresses she wears are of a fashion in vogue over 30 years ago!"

Even on her death bed, Mary continued to protest her innocence-as did Arthur Rochfort, who died in his jail cell. Their tragic story became one of the greatest scandals of 18th century Ireland.

3Christopher Knight

Christopher Knight was described by high school classmates as quiet, intelligent, and nerdy. Graduating in 1984, Knight showed a brief interest in computers before walking off into the Maine woods and never looking back. In the following 27 years, he reportedly had just one human encounter -passing a hiker in the woods. Knight spoke a greeting and kept on walking.

Locals guessed there was someone hiding out somewhere nearby because their homes were frequently burgled. Knight committed hundreds of break-ins over decades. He stole sleeping bags, clothing, propane canisters, batteries for his radio, and an untold amount of food and alcohol. He was finally caught after tripping a motion sensor while raiding a camp for special needs children. When arrested, Knight claimed that his glasses were the only things he owned that were originally his-he'd stolen everything else. The police filled two pickup trucks when clearing his camp.

Knight had apparently spent his time in the woods playing his Nintendo Gameboy, meditating on an overturned bucket, watching TV, enduring the freezing winters, reading whatever books and magazines he could pilfer, getting drunk, and listening to talk radio. On his arrest, he suddenly found himself sharing a six person cell and at the center of a global media storm. He became almost legendary overnight, with people writing songs and poems about him, offering to pay his bail, and even proposing marriage.

Knight refused all interviews and offers of help. His lawyer put public donations into a fund to compensate victims of the hermit's multiple robberies. Knight served several months in jail before confessing to an alcohol problem and being admitted into a three-year program designed to help him reintegrate into society. He was ordered to attend counseling and check in with authorities on a weekly basis. However, he was not found to be mentally ill-he simply wanted to be alone.

2William Beckford

Beckford was the only legitimate son of an enormously wealthy sugar merchant. After he inherited everything in 1770, Lord Byron is said to have referred to him as " England's wealthiest son." Byron and several other influential writers also acknowledged Beckford as a genius. So why did someone with so much talent and money end up a social outcast, living alone in a tower? And how did he manage to squander his fortune?

Beckford was the archetypal romantic, using his apparently limitless money to indulge his own fantasies. He never stopped collecting rare books, items of furniture, and works of art. At first, this hardly affected the steady annual income from his plantations in the West Indies. But as the slave trade was abolished, things began to change in the sugar industry and his income declined. On top of that, Beckford poured good money after bad into his notorious architectural project, Fonthill Abbey.

Fonthill was an amazing work of neo-gothic construction. It took years to complete, but since its design was more concerned with aesthetic beauty than with the practical realities of the physical world, it collapsed within two years of Beckford selling it in 1823. Doubtless distraught at the loss of his monumental erection, Beckford moved to Bath and further indulged his Freudian obsession with raising huge towers. He became a recluse in his less famous Lansdown Tower, an unusual work of neo-classical architecture that stands 37 meters (120 ft) high and remains to this day. He also left behind one of the greatest under-appreciated treasures of gothic literature-his peculiar and highly imaginative novel " Vathek." You can read it for free online.

1"Terrible Tommy" Silverstein

Tommy Silverstein is one of America's most violent criminals, as this previous list illustrates. Jailed for armed robbery in 1977, his sentence was upgraded to life without parole after he murdered two of his fellow inmates. He was placed on "no human contact" status after killing a guard at Marion Prison in 1983. However, the verdict is still out as to whether or not his punishment fits the crime. Some human rights activists claim it breaches the American constitution, which officially outlaws "cruel and unusual punishment."

Silverstein spent time in solitary in Atlanta before being moved and locked away alone in the bowels of Leavenworth Prison for 18 years. Finally he was moved to the ADX Florence, a "supermax" prison in Colarado. A former warden of this institution once described it as a " clean version of Hell." Silverstein is now "entombed" in his cell, behind a sound-proof door for 23 hours a day. He eats alone and gets just one hour of solitary recreation inside a somewhat larger cage. Some say this infernal environment is deliberately designed to drive prisoners mad and render them more compliant. The detrimental psychological effects of solitary confinement have certainly been well documented. Silverstein claims he has experienced depression, hallucinations, disorientation, and memory loss. He says he has gone "beyond the boundaries of what most human beings can psychologically tolerate."

Silverstein has now been in solitary confinement for more than 30 years. Though this is a record for the federal prison system, amazingly some prisoners in Louisiana were stuck in solitary confinement even longer. Herman Wallace spent 41 years in solitary and died just three days after his release at the age of 71.

HTR Williams has been writing in a cupboard under the stairs for the past three years, living off pasta sheets posted under the door twice daily. Read more for free at htrwilliams.com.

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10 Amazing People Who Spent Years In Total Isolation - Listverse

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Whether they're excluded or confined by others, or simply choose their own isolation, some people have spent vast amounts of time alone. Be they reluctant prisoners, mystical hermit types, or reclusive eccentrics, their stories are sometimes tragic and always compelling.

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Loneliness hurts, but social isolation can kill you. That's the conclusion of a study of more than 6,500 people in the U.K.

The study, by a team at University College London, comes after decades of research showing that both loneliness and infrequent contact with friends and family can, independently, shorten a person's life. The scientists expected to find that the combination of these two risk factors would be especially dangerous.

"We were thinking that people who were socially isolated but also felt lonely might be at particularly high risk," says Andrew Steptoe, a professor of psychology at University College London.

To find out, the team studied 6,500 men and women ages 52 and older. All of them had answered a questionnaire back in 2004 or 2005 that assessed both their sense of loneliness and how much contact they had with friends and family. The researchers looked to see what happened to those people over the next seven or eight years.

And Steptoe says he was surprised by the result. "Both social isolation and loneliness appeared initially to be associated with a greater risk of dying," he says. "But it was really the isolation which was more important."

At first, it looked like people who reported greater levels of loneliness were more likely to die, Steptoe says. But closer analysis showed that these people were also more likely to have other risk factors, like being poor and having existing health problems. Once those factors were taken into account, the extra risk associated with loneliness pretty much disappeared, Steptoe says.

But people who spent very little time with friends and family, or at social events, were more likely to die regardless of income or health status, the team reports in the Proceedings of the National Academy of Sciences.

It's not clear why social isolation is linked to mortality. But one possibility is that having other people around has practical benefits as you get older, Steptoe says. For example, they may push you to go see a doctor if you are having symptoms like chest pain, he says. And if you were to lose consciousness, they would call for help.

Other researchers say they are surprised and not necessarily convinced by the new study, even though they say it's large and well-done.

"It doesn't negate the loneliness work that's been done to date," says Bert Uchino, a University of Utah psychology professor. He says this study may have reached a different conclusion than earlier ones because people's definition of loneliness is changing in the Internet age.

"People ... may think that they're connected to other people because they're on Facebook," Uchino says. So they may not report feeling lonely. But that sort of connection, he says, may not have the health benefits of direct contact with other people.

The different result might be because this study looked at people in the U.K., while many earlier studies looked at people in the U.S., says University of Chicago psychologist John Cacioppo. So in the U.K., where the culture values a "stiff upper lip," people who live alone may be "less likely to admit to feeling lonely than are residents of the U.S.," he says.

Whether or not loneliness raises the risk of dying, Cacioppo adds, it certainly reduces a person's quality of life.

And it's easy for people to do things that alleviate both isolation and loneliness, Uchino says. "Have lunch with somebody," he says. "Take a walk. Give them a phone call. I think those are all important ways that we need to stay connected with our relationships. And I think, in the long term, it can help us."

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Maybe Isolation, Not Loneliness, Shortens Life

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Loneliness and isolation often go hand in hand, so teasing out which factor is harder on health isn't easy. But a British study now suggests that, while loneliness may make you unhappy, it's social isolation that could take years off of your life. Discuss (with a friend).

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As we expect more from technology, do we expect less from each other? Sherry Turkle studies how our devices and online personas are redefining human connection and communication -- and asks us to think deeply about the new kinds of connection we want to have.

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You say you want to be alone? Think again. Researchers have found that older people with fewer human contacts are more likely to die-even if they're happy in their solitude-than are people with richer social lives. The study adds to the debate over whether loneliness, social isolation, or some combination of the two leads to higher mortality.

Social isolation is an objective condition in which people have little interaction with others. Loneliness, on the other hand, is an emotional state felt by people who are dissatisfied with their social connections. "Someone who's socially isolated is likely to be lonely, and vice versa, but that's not completely the case," says epidemiologist and lead author Andrew Steptoe of University College London.

To tease apart the effects of being alone versus just feeling lonely, Steptoe and his colleagues examined data from 6500 Britons aged 50 and up who had filled out questionnaires assessing their levels of loneliness. The researchers also tabulated the subjects' contacts with friends, family, religious groups, and other organizations to gauge their social connections. Then they counted how many subjects died over a 7-year period.

The most socially isolated subjects had a 26% greater risk of dying, even when sex, age, and other factors linked to survival were accounted for, the researchers report online today in the Proceedings of the National Academy of Sciences. They then tweaked their model to determine whether the connection to death was due to the fact that isolated people are often lonely. It wasn't.

The researchers then explored the connection between loneliness itself and death. Intense loneliness also appeared to raise the risk of death by 26%-until the team took into account a host of other factors linked to survival, including wealth, education, and the presence of health problems. Once their impact had been accounted for, the scientists discovered that loneliness on its own didn't make people more vulnerable to death.

The researchers suspect that older people who have few social ties may not be getting the care they need. No one is urging them to eat right or take their medicine, and in a crisis no one is there to help.

"There are plenty of people who are socially isolated but who are perfectly happy with that," Steptoe says. "But even then we should be trying to make sure there's enough contacts with them so that if something does go wrong ... they're going to be advised and supported." Even those who are content to be alone, he says, should have some regular contact with other people who can encourage and check on them.

Other researchers praise the new work as rigorous and well-controlled. But they say it's far from clear that social isolation, not loneliness, is always the real culprit when it comes to increased mortality.

Other studies, including an analysis of older Americans led by John Cacioppo, a psychology professor at the University of Chicago in Illinois, have shown a link between loneliness and a higher death rate. Cacioppo suspects that the discrepancy between his study and the new research could lie with cultural differences between Steptoe's British subjects and Americans. "The culture of the stiff upper lip may mean people are answering somewhat differently ... than they do in America," he says, adding that Britons and Americans may define friends differently, too.

Health psychologist Bert Uchino of the University of Utah in Salt Lake City lauds the new study for its large sample size and its direct comparison of social isolation and loneliness, but he says that researchers are still far from understanding how those two factors affect one another and other health-related behaviors. "They've done a really good study here," Uchino says. "I just don't think it's going to be the final word on the issue."

*This story provided by Science NOW, the daily online news service of the journal *Science.

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You say you want to be alone? Think again. Researchers have found that older people with fewer human contacts are more likely to die-even if they're happy in their solitude-than are people with richer social lives. The study adds to the debate over whether loneliness, social isolation, or some combination of the two leads to higher mortality.

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Sarah Shourd's mind began to slip after about two months into her incarceration. She heard phantom footsteps and flashing lights, and spent most of her day crouched on all fours, listening through a gap in the door.

That summer, the 32-year-old had been hiking with two friends in the mountains of Iraqi Kurdistan when they were arrested by Iranian troops after straying onto the border with Iran. Accused of spying, they were kept in solitary confinement in Evin prison in Tehran, each in their own tiny cell. She endured almost 10,000 hours with little human contact before she was freed. One of the most disturbing effects was the hallucinations.

"In the periphery of my vision, I began to see flashing lights, only to jerk my head around to find that nothing was there," she wrote in the New York Times in 2011. "At one point, I heard someone screaming, and it wasn't until I felt the hands of one of the friendlier guards on my face, trying to revive me, that I realised the screams were my own."

We all want to be alone from time to time, to escape the demands of our colleagues or the hassle of crowds. But not alone alone. For most people, prolonged social isolation is all bad, particularly mentally. We know this not only from reports by people like Shourd who have experienced it first-hand, but also from psychological experiments on the effects of isolation and sensory deprivation, some of which had to be called off due to the extreme and bizarre reactions of those involved. Why does the mind unravel so spectacularly when we're truly on our own, and is there any way to stop it?

We've known for a while that isolation is physically bad for us. Chronically lonely people have higher blood pressure, are more vulnerable to infection, and are also more likely to develop Alzheimer's disease and dementia. Loneliness also interferes with a whole range of everyday functioning, such as sleep patterns, attention and logical and verbal reasoning. The mechanisms behind these effects are still unclear, though what is known is that social isolation unleashes an extreme immune response - a cascade of stress hormones and inflammation. This may have been appropriate in our early ancestors, when being isolated from the group carried big physical risks, but for us the outcome is mostly harmful.

Yet some of the most profound effects of loneliness are on the mind. For starters, isolation messes with our sense of time. One of the strangest effects is the 'time-shifting' reported by those who have spent long periods living underground without daylight. In 1961, French geologist Michel Siffre led a two-week expedition to study an underground glacier beneath the French Alps and ended up staying two months, fascinated by how the darkness affected human biology. He decided to abandon his watch and "live like an animal". While conducting tests with his team on the surface, they discovered it took him five minutes to count to what he thought was 120 seconds.
A similar pattern of 'slowing time' was reported by Maurizio Montalbini, a sociologist and caving enthusiast. In 1993, Montalbini spent 366 days in an underground cavern near Pesaro in Italy that had been designed with Nasa to simulate space missions, breaking his own world record for time spent underground. When he emerged, he was convinced only 219 days had passed. His sleep-wake cycles had almost doubled in length. Since then, researchers have found that in darkness most people eventually adjust to a 48-hour cycle: 36 hours of activity followed by 12 hours of sleep. The reasons are still unclear.

As well as their time-shifts, Siffre and Montalbini reported periods of mental instability too. But these experiences were nothing compared with the extreme reactions seen in notorious sensory deprivation experiments in the mid-20th Century.

In the 1950s and 1960s, China was rumoured to be using solitary confinement to "brainwash" American prisoners captured during the Korean War, and the US and Canadian governments were all too keen to try it out. Their defence departments funded a series of research programmes that might be considered ethically dubious today.

The most extensive took place at McGill University Medical Center in Montreal, led by the psychologist Donald Hebb. The McGill researchers invited paid volunteers - mainly college students - to spend days or weeks by themselves in sound-proof cubicles, deprived of meaningful human contact. Their aim was to reduce perceptual stimulation to a minimum, to see how their subjects would behave when almost nothing was happening. They minimised what they could feel, see, hear and touch, fitting them with translucent visors, cotton gloves and cardboard cuffs extending beyond the fingertips. As Scientific American magazine reported at the time, they had them lie on U-shaped foam pillows to restrict noise, and set up a continuous hum of air-conditioning units to mask small sounds.

After only a few hours, the students became acutely restless. They started to crave stimulation, talking, singing or reciting poetry to themselves to break the monotony. Later, many of them became anxious or highly emotional. Their mental performance suffered too, struggling with arithmetic and word association tests.

But the most alarming effects were the hallucinations. They would start with points of light, lines or shapes, eventually evolving into bizarre scenes, such as squirrels marching with sacks over their shoulders or processions of eyeglasses filing down a street. They had no control over what they saw: one man saw only dogs; another, babies.

Some of them experienced sound hallucinations as well: a music box or a choir, for instance. Others imagined sensations of touch: one man had the sense he had been hit in the arm by pellets fired from guns. Another, reaching out to touch a doorknob, felt an electric shock.

When they emerged from the experiment they found it hard to shake this altered sense of reality, convinced that the whole room was in motion, or that objects were constantly changing shape and size.
Distressing end
The researchers had hoped to observe their subjects over several weeks, but the trial was cut short because they became too distressed to carry on. Few lasted beyond two days, and none as long as a week. Afterwards, Hebb wrote in the journal American Psychologist that the results were "very unsettling to us... It is one thing to hear that the Chinese are brainwashing their prisoners on the other side of the world; it is another to find, in your own laboratory, that merely taking away the usual sights, sounds, and bodily contacts from a healthy university student for a few days can shake him, right down to the base."

In 2008, clinical psychologist Ian Robbins recreated Hebb's experiment in collaboration with the BBC, isolating six volunteers for 48 hours in sound-proofed rooms in a former nuclear bunker. The results were similar. The volunteers suffered anxiety, extreme emotions, paranoia and significant deterioration in their mental functioning. They also hallucinated: a heap of 5,000 empty oyster shells; a snake; zebras; tiny cars; the room taking off; mosquitoes; fighter planes buzzing around.
A clip from BBC Horizon's Total Isolation experiment - read more information about the programme here.
Why does the perceptually deprived brain play such tricks? Cognitive psychologists believe that the part of the brain that deals with ongoing tasks, such as sensory perception, is accustomed to dealing with a large quantity of information, such as visual, auditory and other environmental cues. But when there is a dearth of information, says Robbins, "the various nerve systems feeding in to the brain's central processor are still firing off, but in a way that doesn't make sense. So after a while the brain starts to make sense of them, to make them into a pattern." It creates whole images out of partial ones. In other words, it tries to construct a reality from the scant signals available to it, yet it ends up building a fantasy world.

Such mental failures should perhaps not surprise us. For one thing, we know that other primates do not fare well in isolation. One of the most graphic examples is psychologist Harry Harlow's experiments on rhesus macaque monkeys at the University of Wisconsin-Madison during the 1960s, in which he deprived them of social contact after birth for months or years. They became, he observed, "enormously disturbed" even after 30 days, and after a year were "obliterated" socially, incapable of interaction of any kind. (A comparable social fracturing has been observed in humans: consider the children rescued from Romanian orphanages in the early 1990s, who after being almost entirely deprived of close social contact since birth grew up with serious behavioural and attachment issues.)

Secondly, we derive meaning from our emotional states largely through contact with others. Biologists believe that human emotions evolved because they aided co-operation among our early ancestors who benefited from living in groups. Their primary function is social. With no one to mediate our feelings of fear, anger, anxiety and sadness and help us determine their appropriateness, before long they deliver us a distorted sense of self, a perceptual fracturing or a profound irrationality. It seems that left too much to ourselves, the very system that regulates our social living can overwhelm us.

Take the 25,000 inmates held in "super-maximum security" prisons in the US today. Without social interaction, supermax prisoners have no way to test the appropriateness of their emotions or their fantastical thinking, says Terry Kupers, a forensic psychiatrist at the Wright Institute in Berkeley, California, who has interviewed thousands of supermax prisoners. This is one of the reasons many suffer anxiety, paranoia and obsessive thoughts. Craig Haney, a psychologist at the University of California, Santa Cruz, and a leading authority on the mental health of inmates in the US, believes that some of them purposefully initiate brutal confrontations with prison staff just to reaffirm their own existence - to remember who they are.
Coping strategy
Social isolation is not always debilitating, however. Are some better than others at coping? And can you train yourself to resist the worst effects? Here scientists have fewer hard answers, but we can at least look to the lessons of individuals who thrived - or floundered - under isolation.

When Shourd was imprisoned in Iran, she was arguably among the least-equipped people to cope, because her incarceration came out of the blue. People in her circumstances have their world suddenly inverted, and there is nothing in the manner of their taking - no narrative of sacrifice, or enduring for a greater good - to help them derive meaning from it. They must somehow find meaning in their predicament - or mentally detach themselves from their day-to-day reality, which is a monumental task when alone.

Hussain Al-Shahristani managed it. He was Saddam Hussein's chief nuclear adviser before he was tortured and shut away in Abu Ghraib prison near Baghdad after refusing on moral grounds to cooperate on the development of an atomic weapon. He kept his sanity during 10 years of solitary confinement by taking refuge in a world of abstractions, making up mathematical problems which he then tried to solve. He is now deputy energy minister of Iraq. Edith Bone, a medical academic and translator, followed a similar strategy during the seven years she spent imprisoned by the Hungarian communist government after World War Two, constructing an abacus out of stale bread and counting out an inventory of her vocabulary in the six languages she spoke fluently.

Such experiences may be easier to take if you belong to a military organisation. Keron Fletcher, a consultant psychiatrist who has helped debrief and treat hostages, says mock detention and interrogation exercises of the kind he himself underwent while serving with the Royal Air Force are a good preparation for the shock of capture. "They teach you the basics of coping," he says. "Also, you know your buddies will be busting a gut to get you back in one piece. I think the military are less likely to feel helpless or hopeless. Hopelessness and helplessness are horrible things to live with and they erode morale and coping ability."

US senator John McCain is a good example of how a military mindset bestows psychological advantages. His five-and-a-half years as a prisoner of war in Vietnam, during which he refused to yield to his interrogators, actually seemed to strengthen him. Though note what he had to say about the two years he spent in isolation: "It's an awful thing, solitary. It crushes your spirit and weakens your resistance more effectively than any other form of mistreatment... The onset of despair is immediate, and it is a formidable foe."
Extreme reality
Psychologists who study how people cope with isolation have learnt much from solo explorers and mountaineers. For many adventurers deprived of human company - albeit voluntarily - the landscape itself can serve as an effective surrogate, drawing them out of themselves into the beauty or grandeur of their surroundings. Norwegian psychologist Gro Sandal at the University of Bergen in Norway, who has interviewed many adventurers about how they cope in extreme environments, says that transcending the reality of their situation in this way is a common coping mechanism. "It makes them feel safer. It makes them feel less alone."

A similar psychological mechanism could explain why shipwrecked mariners marooned on islands have been known to anthropomorphise inanimate objects, in some cases creating a cabal of imaginary companions with whom to share the solitude. It sounds like madness but is likely a foil against it. Take the way sailor Ellen MacArthur nicknamed her trimaran "Mobi", during her record-breaking solo circumnavigation of the globe in 2005. During the voyage she signed emails to her support team "love e and mobi", and in her published account uses "we" rather than "I".

There is no more poignant illustration of the power of solitude to sink one person while lifting up another than the stories of Bernard Moitessier and Donald Crowhurst, two of the competitors in the 1968 Sunday Times Golden Globe round-the-world yacht race. The trophy, offered to the first sailor to complete a solo non-stop circumnavigation of the globe, was won in 313 days by Robin Knox-Johnston, the only one out of nine starters to finish. He seemed to relish being alone with his boat, but not as much as Moitessier, an ascetic Frenchman who practised yoga on deck and fed cheese to the shearwater birds that shadowed him. Moitessier found the experience so fulfilling, and the idea of returning to civilisation so distasteful, that he abandoned the race despite a good chance of victory and just kept on sailing, eventually landing in Tahiti after travelling more than halfway round the world again. "I continue non-stop because I am happy at sea," he declared, "and perhaps because I want to save my soul."

Crowhurst, meanwhile, was in trouble from the start. He left England ill-prepared and sent fake reports about his supposed progress through the southern seas while never actually leaving the Atlantic. Drifting aimlessly for months off the coast of South America, he became increasingly depressed and lonely, eventually retreating to his cabin and consolidating his fantasies in a rambling 25,000-word philosophical treatise before jumping overboard. His body was never found.

What message can we take from these stories of endurance and despair? The obvious one is that we are, as a rule, considerably diminished when disengaged from others. Isolation may very often be the "sum total of wretchedness", as the writer Thomas Carlyle put it. However, a more upbeat assessment seems equally valid: it is possible to connect, to find solace beyond ourselves, even when we are alone. It helps to be prepared, and to be mentally resilient. But we shouldn't underestimate the power of our imagination to knock over prison walls, penetrate icy caves or provide make-believe companions to walk with us.
This article is based on the book If you would like to comment on this, or anything else you have seen on Future, head over to our or page, or message us on . The Power of Others by Michael Bond (Oneworld Publications).

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Sarah Shourd's mind began to slip after about two months into her incarceration. She heard phantom footsteps and flashing lights, and spent most of her day crouched on all fours, listening through a gap in the door.

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Into The Wild Documentary | Return to the Wild: The Chris McCandless Story english subtitl - BC FİLM

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Loneliness has been linked to everything from heart disease to Alzheimer's disease. Depression is common among the lonely. Cancers tear through their bodies more rapidly, and viruses hit them harder and more frequently. In the short term, it feels like the loneliness will kill you. A study suggests that's because the pain of loneliness activates the immune pattern of a primordial response commonly known as fight or flight.

For decades, researchers have been seeing signs that the immune systems of lonely people are working differently. Lonely people's white blood cells seem to be more active in a way that increases inflammation, a natural immune response to wounding and bacterial infection. On top of that, they seem to have lower levels of antiviral compounds known as interferons.

That seemed to provide a link to a lot of the poor health outcomes associated with loneliness, since chronic inflammation has been linked to everything from cancer to depression. The human body isn't built to hold a high level of inflammation for years. "That explains very clearly why lonely people fall at increased risk for cancer, neurodegenerative disease and viral infections as well," says Steve Cole, a genomics researcher at the University of California, Los Angeles, and lead author on the study published in the Proceedings of the National Academy of Sciences on Monday.

But it still doesn't explain how or why loneliness could change our bodies. To find that out, Cole and his collaborators tracked 141 people over five years. Every year, the researchers measured how lonely the participants felt and took blood samples to track the activity of genes involved with immunity and inflammation. They also tracked concentrations of the hormone norepinephrine, one of the two main signals during the flight-or-fight response.

Cole noticed that when people felt lonesome, they had significantly higher levels of norepinephrine coursing through their blood. That could explain all the other immune changes that happen when people suffer from social isolation.

In a life-threatening situation, norepinephrine cascades through the body and starts shutting down immune functions like viral defense, while ramping up the production of white blood cells called monocytes. "It's this surge in these pro-inflammatory white blood cells that are highly adapted to defend against wounds, but at the expense of our defenses against viral diseases that come from close social contact with other people," Cole says.

At the same time, lonely people seem to be shutting down genes that would make their bodies sensitive to cortisol, which lowers inflammation. That ramps up the defensive inflammation response, Cole says.

Loneliness would hit the switch on a defense plan our bodies initiate in the face of mortal danger, Cole thinks, if isolation is somehow truly lethal. "At this point, my best guess was that loneliness really is one of the most threatening experiences we can have," he says. "Though I didn't think of loneliness as being that awful. It's not pleasant, but not something my body should be getting all up in arms about."

In the world of cubicles and studio apartments, loneliness is everywhere. We find it in both crowds and empty rooms. We change cities and lose friends. Even in marriage, people can be strangers to one another. But things were very different for our ancestors. When humans were evolving in a prehistoric environment, they banded together for food and for protection.

To be ostracized from your tribe was a death sentence, says Charles Raison, a psychiatrist at the University of Wisconsin, Madison who did not work on the study. "Literally they would die. There was no human way to live in isolation," he says.

Being alone in the wild meant you could be mauled by animals or even other human beings. Then your body would need extra defenses against wounds and infection, but less protection against viruses you get from other people, like the flu. In that case, the stressful response to loneliness would simply be the body's way of trying to survive exile.

But this fight-or-flight immune response is really nonspecific, says Turhan Canli, a neuroscientist at Stony Brook University in New York who was not involved with the study. Loneliness might not necessarily have to do with ancient survival, he says. Our bodies basically have one panic button, and any kind of adverse condition can trigger this response. "I think loneliness is a kind of psychological stress," he says. "The change in the immune response is part of biological changes that come with a stress condition."

What Canli finds really interesting about Cole's results is that people who felt lonely one year had increased gene activity around inflammation and norepinephrine later on. And people who had increased inflammation felt lonelier the next year. "It's a two-way street," he said. "Loneliness predicted biological changes, and biological changes predicted changes in loneliness."

So the shock of social isolation could fuel inflammation in the body. And the immune system may affect a region of the brain processing fear and anxiety. "Inflammation can change people's experiences of the social world and what they're thinking," says Naomi Eisenberger, a neuroscientist at the University of California, Los Angeles, who was not involved with the study. That could make us more apprehensive about social interaction and lead to more isolation.

If the cycle continues, that could explain chronic isolation and the subsequent depression and illnesses plaguing the lonely. "There are things we can do to get out of a depressed or lonely state, but they're not easy," Cole says. "Part of the reason is because these negative psychological states develop some kind of molecular momentum."

But that doesn't mean the loop is permanent. "Inflammatory biology is one thing, but it's not the only thing," he says. All it does is push our proclivity for social activity one way or another. But loneliness is deep. It's encoded in our genetics, and it's not easy to shake.

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Loneliness May Warp Our Genes, And Our Immune Systems

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Loneliness has been linked to everything from heart disease to Alzheimer's disease. Depression is common among the lonely. Cancers tear through their bodies more rapidly, and viruses hit them harder and more frequently. In the short term, it feels like the loneliness will kill you.

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NEAL CONAN, HOST:

This is TALK OF THE NATION. I'm Neal Conan, in Washington. Many older people prefer to live alone. Others like to get out of the house, to work or meet up with friends and family. A new study from University College London followed thousands of people over the age of 52 for seven or eight years. The idea was to assess the effect of loneliness and isolation.

It turns out both may actually shorten people's lives, isolation even more so. But those are averages. Individuals vary, and again, some prefer life alone, and do not report that they're lonely. If you're in this age group - over 60, let's say - what's your story, and what has the effect of your choice been on your life? 800-989-8255 is our phone number. Email us: talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.

Later in the program: lint alive, the bacteria of the belly button. But first, Andrew Steptoe is professor of epidemiology and public health at University College London, one of the authors of a new study "Social Isolation, Loneliness and All-Cause Mortality in Older Men and Women." He joins us from BBC Studios in London. And it's good of you to be with us today.

ANDREW STEPTOE: Not at all.

CONAN: And I know you started with 6,500 people age 52 and older, and I have to begin by saying a whole lot of us would say 52, that's not so old.

STEPTOE: Exactly. But this study is one that we've been running for a number of years, where we're interested in what happens as people grow older, as they move towards retirement, and then through retirement into old age. So we started with a sample of people aged from 52 right up to 100, actually, and then followed them up over time.

CONAN: And for the purposes of this study, how did you define isolation and - even more difficult, I suspect - loneliness?

STEPTOE: Well, isolation is a kind of objective indicator of the sorts of social contacts people have. So what we do is to ask people about the amount of contact they have with their families, with friends, with relatives and whether that's maybe daily or weekly, or possibly once a month or less than that.

And we also people if they were involved with organizations such as social clubs or churches or other groups of that sort. And so through using those different kind of measures, putting them together, we get an indicator of social isolation.

But loneliness, as you say, is more complicated. It's really a subjective experience. It's a feeling of being - of lacking companionship, possibly lacking intimate feelings with other people. And that's much more subjective. And so we use a pretty well-established scale, which actually was developed in California for this purpose, and classified people on that.

CONAN: And your findings - and when you say all-cause mortality, I assume that's death from any reason whatsoever.

STEPTOE: That's right. I mean, the - during this follow-up period of over 6,500 people, just over 900 people died, and they died of, you know, the causes you would expect. You know, quite a number of people died from heart disease, some from cancer, some from respiratory complaints, and so forth. And that's why we talk about all-cause mortality, because we're grouping those all together.

CONAN: And yet there was a - if someone was defined as more isolated, it seemed that they may have died earlier.

STEPTOE: That's right. I mean, we found both isolation and loneliness actually predicted a shorter life. But one has to think carefully about the sorts of people who might be prone to dying. For example, age is an obvious factor. Someone who entered the study at age 90 would be much more likely to have died over this follow-up period than someone age 55. So we have to take that into account.

And we also have to take into account their baseline state of health, you know, what sort of illnesses they had right at the beginning, as well.

CONAN: I was wondering, in terms of isolation, some people - would people living as a couple, but not seeing a lot of other people, would that count?

STEPTOE: Yes, it could do. It's - being a couple is obviously a very good thing as far as isolation is concerned, probably for loneliness, as well. But even among married couples - and we had quite a lot in our study - the other indicators might not have been so good, so that the couple might be quite sort of isolated, if you like, as a couple and not having much contact with other people.

CONAN: And as these studies have - they're continuing?

STEPTOE: Yes, this is part of a large study, which goes on and continues through time.

CONAN: And are there measurable health benefits to having lots of friends?

STEPTOE: Well, it does seem like that - not only from this study, but also from other research carried out in the U.S. and in this country - that people who have more contacts, both with relatives, friends and others, seem to be in better health. It's always a difficult issue teasing out the chicken and egg here, you know, whether someone is unwell, and so they withdraw, maybe, socially.

But even when we take account of the initial state of health of people in this study, we have found that over the following years, the more isolated people were more likely to die.

CONAN: And do you find that people living in isolation, or relative isolation, is that a choice, or is that a circumstance?

STEPTOE: Well, that's difficult. I mean, as you said in your introduction, some people are quite self-sufficient, and so don't necessarily want a whole range of social contacts, whereas other people are very gregarious and have many types of contacts. So there's going to be, in part, a kind of preference about these things.

But also, as we know, when people get older, their social networks tend to diminish, either because children move away, or the contemporaries of the individual pass away. And so social networks tend to become reduced as people get older.

CONAN: Here's an email we have from Ruth in Wyoming: I am 59 years old and live in a town of 5,000 in Wyoming. I've lived here for 11 years. My husband works on the north slope of Alaska and is gone 16 days every month. I have tried volunteering, taking classes at the junior college, etc., and have not found a lasting support group of any kind. I really don't like this isolation, and my drinking has increased over time.

And you would think that, at least statistically, Ruth is not alone. Alcohol may prove to be more of a problem for those who are isolated or lonely.

STEPTOE: Yes. I mean, Ruth is doing all the right things there, by trying to make the social contacts, by, you know, trying to go out and about and use what resources there are. But clearly, in a small town like that, there are limited possibilities, and I guess you might soon run through those.

And, of course, people do turn to alcohol and maybe to overeating when they're trying to cope with these sort of situations. So that's very distressing.

CONAN: Let's see if we can get a caller in on the conversation. And, again, we want to hear from those of you, let's say over 60, and talking about isolation and loneliness, your lifestyle, how does that affect your life? And give us a call: 800-989-8255. Email: talk@npr.org. Paul's with us from Spokane in Washington.

PAUL: Hi. How are you?

CONAN: Good, thanks.

PAUL: I retired in December of 2011, and I was 65, and I worked in a warehouse for 41 years with about seven to 800 people. And before I retired, I thought about just what you're talking about. I'm going to be - I lived out in the country, so I'm going to be basically isolated, because my wife is still working. And what can I do?

And so a neighbor said, hey, we need to walk every day. And so we do that. And then in the summertime and spring, I go golfing and stuff like that. But it's not like interacting with the people I did at work, which is a little tough, but, you know, just trying to figure out what to do after you retire, because when you work with that many people, it's, you know, kind of tough just waking up in the morning and there's nobody around.

(LAUGHTER)

CONAN: It's a lot of stimulation, and all of a sudden, there's a lot less.

PAUL: Right.

CONAN: And I wonder, Andrew Steptoe, if that proves out in your studies.

STEPTOE: Yes. I mean, I think that's a big problem. When people retire, they have a - many people have quite an elaborate social network at work, even if they don't like everyone at work. They still have a lot of companionship of various levels, and suddenly, that is taken away.

On the other hand, your caller is, again, doing the right things, because he's not only trying to make contact with people, but also doing some healthful things at the same time. And that's one way that social connections work. They work not only to give us companionship, but maybe to help us keep our habits good and, you know, things like physical activity are very good.

And social contacts can also help us, for example, in advising us about whether we should go to the doctor with a symptom or something like that, which you might not do if you're on your own.

CONAN: Paul, you still see your friends regularly, though.

PAUL: Yes, I do. I go out to work and go out to lunch with people at work, oh, maybe once every three weeks or so. And I supervised a bunch of mechanics in a truck shop, and, you know, they're emailing me all the time. So I keep in contact. But, you know, I do miss the day-to-day interaction with the people at work.

CONAN: I can understand your situation. Paul, thanks very much. Good luck.

PAUL: OK.

CONAN: And the other question, Andrew Steptoe, is: Are we - and obviously, you're studying people there in Britain, but I suspect it's not so different. Are we living more in isolation than we used to?

STEPTOE: Yes, I think there's good evidence for that. The most striking facts about that are to do with the proportion of people who are living alone, which has really increased a lot in the U.S. and in Europe over the last couple of decades. And I think the most recent figures from the U.S. show that in people over 65, 37 percent, that's more than one in three women are living on their own, and about 19, 20 percent of men are living on their own. And that is a big increase from earlier times.

CONAN: And does that increase with age?

STEPTOE: Yes, it does. The most obvious reason, of course, is that people who've been married become widowed, and so they tend to end up living on their own, and so that does increase, I must say.

CONAN: Here's an email we have from George in St. Louis: Arthritis somewhat limits my mobility, but I maintain daily Internet contacts and interaction with interesting people in show business, music, theater and films, as well as friends. In a physical sense, some say I may be a bit reclusive, but I feel that I have a full and satisfying social life. Am I fooling myself?

And that's been a change, even over the period of your measurements, Andrew Steptoe: the social media.

STEPTOE: Yes, it has, indeed, and it's a very interesting change that we don't really understand very well. There's clearly a great deal more electronic communication. It used to be the telephone, but now it's email. And then we also have social networks and social networking sites. And we don't really know very much about how that operates as far as these sort of social connections are concerned, whether it's as good as face-to-face or telephone contact, or whether it's not quite so good.

And that's really - it's quite difficult, actually, to assess these things, particularly among older people. But it's something that we and others in the U.S. are determined to do to try to find out whether people are compensating for, you know, living on their own with these kind of means of communicating.

CONAN: Well, it's evening there in London. We thank you for your time. We know you've got elsewhere to be. Appreciate it.

STEPTOE: Not at all. Thanks very much.

CONAN: Andrew Steptoe is a professor of epidemiology and public health at the University College London, one of the authors of the study "Social Isolation, Loneliness and All-Cause Mortality in Older Men and Women," with us from the BBC Studios there in London. After a short break, NPR's Jon Hamilton will join us to talk more about this research and others. Stay with us. This is NPR News.

(SOUNDBITE OF MUSIC)

CONAN: This is TALK OF THE NATION, from NPR News. I'm Neal Conan. If you're just joining us, we're talking about a recent study by a team at University College London in which they studied the effects of loneliness and isolation on mortality. It's not the first attempt to draw links between socializing and longevity.

For example, last June, a study published in the Archives of Internal Medicine made another important distinction: While well-being has long been connected to friendships, it focused specifically on older people who said they were lonely, no matter how well-connected they might be socially.

If you're getting on in years - let's say 60-plus - do you go solo, or prefer the company of others? And what's the effect of your choice on your life? 800-989-8255. Email us: talk@npr.org. You can find us on Twitter @totn. And death - here to tell us some more about research on isolation, loneliness and death is Jon Hamilton - I didn't mean to draw that immediate distinction there - correspondent for NPR's science desk. He did a report last week on the UCL isolation study for MORNING EDITION. He's here with us in Studio 3A. Nice to have you with us, Jon.

JON HAMILTON, BYLINE: Great to be here.

CONAN: And what does being socially isolated have to do with dying sooner? Is there cause and effect?

HAMILTON: Well, you know, it's interesting, because there have been sort of two strands of research that have happened. People have been studying loneliness and its connection with health problems and mortality. But they've also been studying isolation. And I was particularly interested in this study from a few days ago, because it was trying to break down those two things and look specifically at isolation and say: Is the problem the isolation? Or is the problem the loneliness? And this study concluded, of course, that it was the isolation.

CONAN: Ah. So loneliness, as Andrew Steptoe told us, a more difficult, subjective measurement.

HAMILTON: It's tricky, and, of course, isolation and loneliness often go together. So teasing them apart is not the easiest thing. But he tried to do that in his study. And when I talked to other researchers about what he'd found, they were all very interested in it. He's highly respected, and they thought it was a good study. However, the people who had done the loneliness studies - and there are a number of them - say they still think that loneliness by itself is also a health risk factor and also contributes to earlier death.

CONAN: And does anybody say why? Is it a kind of stress? Is it, well, you're not there to tell somebody, you know, I've got a twinge, maybe I should go to the doctor?

HAMILTON: Well, I mean, obviously, isolation is easier to talk about, because you can think about things like that. You don't have somebody to tell you that you need to see the doctor or lose weight or stop drinking or stop smoking. And if you happen to collapse, say, you don't have somebody there to call and get you some help.

So, isolation you can kind of connect to obvious things. It's much less obvious with loneliness. And the kind of things people talk about are you can see some subtle changes in the immune system. You see some changes in brain function. But there isn't - it's not like there is one single thing that kills people who are lonely. They talk about increase in heart disease and stress and all of these things, and together, they seem to affect your chance of dying.

CONAN: And, again, we are talking about averages. Individuals vary. Some people prefer to live alone. Some people make other choices. It's not something we're prescribing that covers everybody. But let's get some callers in on the conversation. We'll go to - this is Judy. Judy's on the line with us from San Antonio.

JUDY: Hi. How are you?

CONAN: Good, thanks.

JUDY: I live alone and pretty much isolated, and I'm 71 years old. And I'm the last of my family to survive. And I do have my days of loneliness, but as far as the isolation goes, I like it in that I'm a farmer now, and I came from a farming family, and it's very rewarding for me. And when I found myself getting lonely - and I do have days that way - I found that getting involved in the farm, and I decided to go back to college, I went back to college for another degree, and I'm about to graduate in another two semesters. And it didn't take away the loneliness, but it gave me options, because my children tended to want to run my life. Because you seem to get at a certain age, and suddenly, society and your children and your family seems to know what you need most.

CONAN: Yeah, they - it's called infantilization.

JUDY: Exactly. And so I found, as strong-willed as I am, that I was going to have to take some risks if I wanted to live my life out the way I wanted to live it, or I was going to have to do like - and I think I came to this realization. As a nurse, I saw so many people in the nursing home who looked like they had - that could have had a life, but had no life and gave up.

And I decided I was not going to go out of this world without having a life. Good or bad, I was going to live it to the very fullest. And it has its bad side, and it has its good. But if I had to say would I prefer to be alone, yeah, I guess I would.

CONAN: That's interesting, and it sounds like you're a determined person.

JUDY: Very.

CONAN: And you graduate, what you're new degree going to be in?

JUDY: It's - I'll be an RN instead of an LBN.

CONAN: And are you going to be pursuing work in that field?

JUDY: Yes, I - well, my goal is, and I've wanted to for a long time, and I've got held back because some of the colleges - or not some, but one in particular - didn't like older students being there. But I wanted to go to work with Doctors Without Borders. I like the - I'm a very - what's the word? I can't think of the word right now, senior moment. But I like to do things beyond the norm. You know what I'm saying? Go places where somebody else may not want to go.

CONAN: That's an interesting - and by the way, what are you farming?

JUDY: I have cattle, and I have horses. I used to have goats, and I cut down on that. With the drought, it has been so hard to make it. It's been really a struggle. We got our first great rain last night, and I am thanking Jesus, because everything was just dried up. But I've got some rain now. My tanks are full again, and I have some horses, and just the routine things of a farm. I plow the field, and I bring in the hay. I do what I have to do.

CONAN: If you've got animals, you've got to do it.

JUDY: Well, you know what? Believe it or not, and some people find this hard to believe, but your animals can be some of the greatest friends you've ever had. I can go to a sale to buy some more cattle, and because of my ability to deal with animals, I can get a whole lot more done with my stock than people there that are having to hire people to handle their stock. I mean, it's just - I guess it's just part of the life. But I love it. I do.

CONAN: Well, Judy, it sounds like you've got that full life. Good luck.

JUDY: Thank you so much.

CONAN: Appreciate the phone call. Here's an email. This is from Patsy(ph) in Rochester, New York: I am 62. I live a very small life working at home and with my husband. He's gone all day. I rarely talk to anyone, yet, of course, I am friendly when I encounter people. I talk to my family and children every now and then. I try not to let anyone know that I spend so much time alone, as people tend to wonder about stuff like that.

Truly, I do not wish to be out in the world much, as I don't want to have to interact much. Life has just gotten too difficult and hurtful, and I do know there are a lot of us like this. Thank you for your show. And she adds: I will miss you a lot. I will miss you, too. Thank you very much for the kind words.

And Jon Hamilton, there are a lot of people like that who prefer to live a quiet life, not like Judy, who's going off with Doctors Without Borders, but...

HAMILTON: Right. I mean, and it's one of the interesting things in the research on this, is you really have to distinguish people who are alone and people who are lonely, because they are not necessarily the same thing. You have a lot of people like your caller who choose to be alone and are quite happy with that situation.

And you have other people who, like your previous caller, who was not so happy with it, but did the things that put you in touch with other people: You go back to school. You get involved in organizations. And so each of them seems to have found a great accommodation for that they want to do.

CONAN: Let's go next to Susan, Susan with us from Santa Rosa, California.

SUSAN: Hi. Thank you. Well, I'm 71, and to follow up what Judy was saying, you know, connecting with nature is really very gratifying for me. I live alone in the country, and there's a lot you can get from gardening, I get, and nature. So, for me, I'm - living alone is somewhat of a challenge, because I'm naturally introverted, and I have to force myself to get out and connect, which I need to do so I don't feel lonely.

But I feel it's also a privilege, and I think my - because of the independence. And I think my health has improved, because I just have to take care of myself. And I can go where I want, when I want, and rest when I want and so forth. And also it's, you know, you can just - my creativity is even higher, because I don't have to answer to anybody. Nobody's here to criticize, and so forth. So I feel, on balance, it's been good for me.

CONAN: And gardening, do you feel like you're eating better?

SUSAN: Oh, yeah. Well, I've always been a kind of a health nut. But yes, gardening is the answer. It's wonderful.

CONAN: The truth, the light and the way.

SUSAN: Yes.

CONAN: All right, thanks very much for the call, Susan. Good luck.

SUSAN: Thank you.

CONAN: Appreciate it. Here's another email, and this one we have from Donald in Hayward, California: I'm only 46, but my wife passed away last year. I live alone and work from home. This morning, I verbally commented as a reaction to something and startled myself. I realized it was the first time I'd heard my own voice in a day and a half. I have a plethora of feelings. Loneliness is one. I just assume it is a process.

And that was one of the things, Jon Hamilton, that Andrew Steptoe was talking about. People, as they get older, even as young as 46, if you lose your spouse and the circle of friends tends to contract.

HAMILTON: Yeah, and especially in a time where people tend to have smaller families. So if you lose a spouse, the chance that you'll have many children - we're a more mobile society. People often have children who have moved away. So, yeah, social connections can be a real problem.

CONAN: Let's go next to - this is Fran, Fran with us from Francis(ph), Michigan.

FRAN: Hello.

CONAN: Hi. You're on the air.

FRAN: Hey, Neal. No, it's Fran from Birmingham, Alabama.

CONAN: Birmingham, Alabama. I apologize.

(LAUGHTER)

FRAN: That's quite a ride, and I enjoy your show tremendously.

CONAN: Thank you.

FRAN: And in listening to the past couple of ladies speaking, they sound like they've got it all together, ladies in their - both 70, and just seem to have found happiness and a contentment, noted in their voices, of nature and of animals. And, yes, that is part of where I find contentment. I was blessed to have been able to retire early at 62, and I thought to myself, well, what am I going to do? You know, when you've worked for 40 years, you wonder.

What you do is you find new routines, and you keep active, and you stay - if you stay on routine, it seems to help, and I find the day just flies by. I am married. Actually, we got married, it will be two years ago. He was a widower and I was divorced. And it's just like - we call it a new chapter in life. I do find great satisfaction in the friendships I found in church, community and physical activity and nature and pets.

CONAN: Hmm, nature and pets.

FRAN: Animals can bring such - a pet can bring so much love and contentment and help even lower blood pressure, they have said. So - and not everybody who lives alone is lonely, as witnessed by your past couple of ladies. They just sound perfectly content.

CONAN: And you said you were blessed to retire early at the age of 62. You were...

FRAN: Yes.

CONAN: ...working in the salt mines there in Alabama?

FRAN: No. No.

(LAUGHTER)

FRAN: No, I was working in an office atmosphere and - but - and corporate. And after many years - it's quite a difference. It's a slower pace, but it's - you find your - you have to find your tick. You have to find your rhythm in a different mindset. And - but waking up and being grateful to be alive and being thankful for what you have and acting grateful and smiling and just reaching out to others.

CONAN: Well, Fran...

FRAN: So there's just many ways and many different personalities and - but, yes, loneliness, it's been there, here and there, but you keep moving on, keep moving forward.

CONAN: Fran, thank you very much. We appreciate it.

FRAN: Thank you so much, Neal. Bye.

CONAN: And here's another email. This is from Marcia(ph): I am 63 years old. I live alone and have for many years. Generally, I've been pretty content. This past year, however, I had a detached retina and needed to find rides to numerous medical appointments, as well as assistance at home. This turned out to be a real challenge. The importance of a broader social network was made clear to me. I do feel lonely at times, but it's been very difficult to forge new friendships.

You're listening to TALK OF THE NATION from NPR News.

And, Jon Hamilton, interesting remark in Marcia's email: difficult to forge new friendships a lot of people find as they get older. Nice to have that caller who connected with somebody else and got remarried after she and her husband - her new husband both lost their spouses. But a lot of people find it hard to make new friends.

HAMILTON: Yeah. And, I mean, if you think about the pattern of our lives, we make so many friends, you know, early on in life and in college, and then we make friends through our work environment. But if you retire and you're alone for that reason, or if you lose a spouse you're alone for that reason, the means to make friends is not necessarily there, which, again, gets back to why, for some people, joining groups or becoming involved in organizations and obviously the church - all of these things are ways that people can connect.

CONAN: Let's go next to Richard, Richard on the line with us from Nashville.

RICHARD: Good afternoon, gentlemen. How are you?

CONAN: Good. Thanks.

RICHARD: On topic of growing older and loneliness, I'm speaking from a child's perspective on my father. He retired at 49. And over the years - he's now 70 - over the years he has - chose to isolate himself more and more and more, to the point where my siblings and I feel that he's almost lost touch with reality. He no longer has accountability in his life, meaning when he was working, he had a boss he had to answer to.

But he is - it's disturbing to see the choice that he has made, that he would rather be on the farm, around his animals, than to spend time socializing and interacting with his children and his grandchildren. My parents are still married. Just a very sad progression in life that we've all witnessed in. I wanted to stay on topic. I hope I'm not getting off the topic, but the isolation, I think, has driven him to become less social and unhappy generally.

CONAN: And that can happen, Jon Hamilton, at least as we look at the statistics.

HAMILTON: Yeah. In fact, the researchers often talk about a phenomena where being alone and isolated will lead to changes in the brain, things like changes in the reward circuit where we don't get the same kind of pleasure out of things, including being with people that we used to. So people get depressed. They become less social. And it's a self-perpetuating problem, right? And sometimes you wonder whether it wouldn't be a good idea to help break somebody out of that particular cycle.

CONAN: Intervention, almost.

HAMILTON: Yes.

CONAN: Have you thought about that, Richard?

RICHARD: Yes, we have. We've tried to speak with him. We've tried many tactics, from casual conversations to the tough love approach. And there seems to be not teaching an old dog new tricks, so to say. He's very set in his ways and says he's happy to be alone, out on the farm working with his animals, yet it doesn't reflect in his attitude when you see him. He's very unhappy, very disgruntled. In fact, once again, has lost touch with reality and I think it's because of the lack of interaction with people and accountability.

CONAN: Well, Richard, we're sorry to hear about that and hope maybe there could be a change before it's too late.

RICHARD: Thank you very much. Gentlemen, have a nice day.

CONAN: And thanks very much for the phone call, we appreciate it. We're talking about social isolation and loneliness. Statistically, they could lead to shorter lives, at least that's what we're learning. Of course, those are averages. Everybody, individually is different. Some prefer to live alone, everybody has their own reasons. Jon Hamilton, thanks very much for being with us today.

HAMILTON: It's been a pleasure.

CONAN: Jon Hamilton, correspondent for NPR science desk. He focuses on neuroscience, health risks and extreme weather. Here's a job description for you. When we come back, we're going to talk about strategies to help elderly people with isolation and feelings of loneliness. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

(SOUNDBITE OF MUSIC)

CONAN: Today, we're talking about connection between social isolation, loneliness and mortality. Joining us now is Mary "Yogi" Wess, the executive director of Little Brothers - Friends of the Elderly in Cincinnati. Little Brothers is a national network of volunteer organizations that tries to relieve isolation and loneliness amongst the elderly. She joins us from her office in Cincinnati. Nice to have you on the program with us today.

MARY YOGI WESS: Oh. Hi, Neal. Thank you. It's very nice to be on your program and thank you for bringing the attention to this topic and also thank you for all of your years of interesting topics, and you will be missed.

CONAN: Well, thank you very much. Thanks for the kind words. Your slogan: Flowers before bread - tell us what that means.

WESS: That means that we believe in honoring the elderly with dignity and respect, and it also means that we believe in providing the nice things in life. Like when we host a party, we always serve meals on china. We always have flowers on the tables. We use tablecloth. We always remember our elderly on their birthday, not the day before or the day after but on their birthday. And we do those things to, again, honor the elderly and provide some of the things that they might not be able to afford or not be able to get to, let's say, a special event that's going on in the community. So it is traced back to our founder - was a wealthy Frenchman, and Little Brothers was founded in Paris in 1946, and he believed in always honoring the elderly. And that's what we do in all of the programs that we offer to our elderly friends.

CONAN: And I assume most of your workers are volunteers.

WESS: Yes. We have in Cincinnati wonderful volunteers. We have about 350 that are the heart and soul of what we do. They provide a lot of the direct service to the elderly. We have visiting volunteer program where they're matched one on one with the elderly and they provide friendship and a lot of other direct service that the elderly person may have difficulty in getting, you know, on their own.

CONAN: Medical appointments, that's what I think. But I wonder whether a lot of those volunteers aren't older people themselves.

WESS: We do. We do have a lot of older volunteers. I'd say every day just probably, you know, mid-50s but we do have a lot of younger volunteers also. We have a lot of families that do volunteer with us that involve, you know, entire families that, well, volunteer with us on major holidays, and it kind of becomes a tradition in the volunteer family to be involved with us on a ongoing basis on all the major holidays.

CONAN: And I understand that your services are provided to people 65 and older, but I gather you get requests form people younger than that.

WESS: Yes, we do. We do get a lot of calls from people like in that 55 to early 60 range that, you know, slips through the cracks because there aren't a lot of services available for people in that age range, and we lately even getting a lot of calls, especially from like Vietnam veterans that fall into that early 60 age range.

CONAN: And as you look at the kinds of services you provide, is the demand increasing? As we're told, more and more people live alone.

WESS: You know, we get referrals constantly, and it's interesting that the more we get there is the more of a recognition of the isolation of people, that people that, you know, don't have anybody, that don't have any immediate family in the area, that don't have a social network that they can rely on. So, yeah. We do continue to get referrals of people that are, you know, living, you know, without a lot of support.

CONAN: Thanks very much for being with us today. It's an organization I had not heard of before. We did some research on this program and obviously, service is greatly needed, appreciate it.

WESS: Well, thank you very much and come and visit us any time and you can volunteer with us.

CONAN: All right. Thanks very much.

WESS: Thank you, Neal.

CONAN: Let see if we can get one more call on this subject. This is Kirsten(ph), Kirsten with us from Naples, Florida.

KIRSTEN: Hi. Thanks for having me on the show. I...

CONAN: Thanks for calling.

KIRSTEN: It's been a good and informative show.

CONAN: What's your situation? What are your choices?

KIRSTEN: I had - have sort of a different background from many of your callers. But I seem to be sharing the component of being 71 and a woman, living alone. But my professional life was very isolated. I was a wildlife biologist. I work primarily in national forests and state forests. So I was alone, and from many, many years. And now I'm retired to Naples, Florida which is a pretty much retirement everywhere. You know, there's many different types of communities, and there - my greatest comfort and solace is being in the wilderness and being out of doors and hiking, and the Everglades don't really provide that kind of experience. And there aren't many outdoor places that they were in California where I could experience the kind of isolation that is coming for me now.

CONAN: I understand. But surely, there's a lot of social groups there.

KIRSTEN: The social groups are - and I attended them and gone to meetings and done a bit of volunteer work. But I have to say that I have never seen a community that is so oriented towards promoting couples and the lifestyle of tennis and golf, and with each other. You know, that kind of - put together, a different category, I think.

CONAN: Then why did you decide to go to Naples as suppose to some place that spoke more to your soul?

KIRSTEN: That's a wonderful question, part of it was economics and part of it was I have family here. I have also family that lived in the North, and I just wasn't ready to face winters again.

CONAN: No, I can understand that. I could understand that. Well, I'm sorry there's no - not much in the way of elevation and not what's in the way of the - the Everglades doesn't answer your particular needs.

KIRSTEN: But that's the challenge. So I will find the answer somewhere.

CONAN: Good luck. Thank you so much for the call.

KIRSTEN: Thank you. Bye-bye.

CONAN: And thanks to everybody who called and wrote. We're sorry we couldn't get to your calls, but the life of the belly button coming up. Stay with us.

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# data[].attributes.attachment_link.title
Isolation V. Loneliness: The Difference And Why It Matters

# data[].attributes.attachment_link.description
Researchers from University College London followed thousands of people over the age of 52 for seven to eight years to assess the effect of loneliness and isolation. Isolation, not loneliness, may actually shorten people's lives regardless of health or income.

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