Anxiety and loneliness

20 August 2019

Interview with 

Sarah Garfinkel, University of Sussex and BSMS

MENTAL HEALTH

MENTAL HEALTH

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What can the anxious and depressed brain tell us about loneliness? Katie Haylor spoke to psychiatry professor Sarah Garfinkel from the University of Sussex and Brighton and Sussex Medical School...

Sarah - The data on loneliness and anxiety is the only data that's ever made me cry, because the correlation between people's loneliness scores and their anxiety scores were so tightly coupled, it was almost a straight line. And in clinical research we're used to seeing really really varied and messy data. So to see such a tight correlation I think tells you something really profound about the way that anxiety and loneliness and depression are interwoven together.

Katie - What key areas of the brain do we know are involved in anxiety and depression? And does that give us any inkling of what a lonely brain might look like?

Sarah - You see I think it might do. We see areas that are involved in emotion and bodily processing, so these are limbic areas or the insula which is currently my favorite brain area, which is an area involved when your brain reads out bodily signals, like the pounding of your heart or hyper activation to do with anxiety of the body will be represented in this area. And you see these emotion bodily areas are more active and anxiety and depression. And then conversely you see reduced activation especially in anxiety in areas that are involved in emotion regulation, and regulation in general like the prefrontal cortex.

Katie - Does this say anything about the vicious cycle it can be difficult to sidestep when you're lonely? Because it seems like being lonely can actually make it more difficult to make friends which makes you feel more lonely!

Sarah - You're completely right about this vicious vicious cycle. People can then be anxious and worried about social interactions and then also withdrawal is something that's very known to happen in people who are anxious and depressed.

So I think it tells you something about how feelings of loneliness can be perpetuated. It also tells us something about potentially how loneliness and anxiety and depression can be targeted by activities which maybe target social interaction and helping people feel more included. It can also help us understand the conflicting results at the moment about how loneliness is presented and manifests in the brain. And at the moment there is not a strong consensus on how this looks, but maybe tying it more to anxiety and depressive symptomatology would give us a more solid grounding about how we really know brain changes occur and showing effects have been replicated many times.

Katie - Do you think we're getting lonelier? I'm conscious that loneliness isn't just a problem for the elderly.

Sarah - I think we are. Some of my other work is looking at dynamic physiological responding between individuals. So that is shared emotion in brain and body. And when we're with people and we can see them closely and they're sad, then they will have different signatures of the sadness, for example their peoples will get smaller. And then if we look at them and we empathize with them then our pupils get smaller too. We also have body language that mirrors the emotions of others and this can really help us to feel connected to people and actually maybe we need to be close to people in order to have these dynamic physiological changes to ours to share emotions. And if we're sharing emotions then we're less lonely. We're not just having them ourselves.

And then in the rise of social media and technologies that make us more far apart like us texting and other things over the computer, we're potentially not able to share these physiological signals that allow us to share emotions. And that's actually creating an emotional divide between people.

Katie - Of course some of these technologies are advantageous from the perspective of being able to communicate in a way that you might otherwise not be able to do. Say if you've moved halfway across the world or something.

Sarah - I think it's great to use these technologies and I think that actually it’s something just to be aware of to inform the technology, that maybe we need to make sure that we can see clearly people's pupils if we're communicating with them, see their body language and allow these different technologies to facilitate these sharing signals as the technologies get more advanced.

Katie - One thing I wanted to put to you is I guess the other side of the coin. Some people really like their own company. Is there anything that we understand about any sort of neurological differences or I guess is there any sort of biological component to that. See if you just prefer being on your own?

Sarah - There's some interesting work that's been done in mind wondering. This is something that you can do when you're on your own. And they were looking at the relationship between mind wandering and feelings of loneliness and they found it's what people think about when they're on their own which was indicative of loneliness. So it wasn't time spent alone, it was whether they, when they do daydream, do they think about people who are close to them or do they think about people who are not close to them. You can be alone but still have in mind people you care about. So that's one thing. But you're right. Loneliness questionnaires ask how lonely people feel. They're not looking at objective amount of time people spend alone, because it’s a very very subjective thing. And some people do like solitude and that's absolutely fine. And that's why loneliness probably is best got at by these subjective measures because it's a subjectively felt thing that doesn't necessarily correspond to any absolute index.

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