Does one disease produce another?

The loneliness epidemic …

Loneliness is grief, distended. People are primates, and even more sociable than chimpanzees. We hunger for intimacy. We wither without it. And yet, long before the present pandemic, with its forced isolation and social distancing, humans had begun building their own monkey houses.

You can live alone without being lonely, and you can be lonely without living alone, but the two are closely tied together, which makes lockdowns, sheltering in place, that much harder to bear. Loneliness, it seems unnecessary to say, is terrible for your health. In 2017 and 2018, the former U.S. Surgeon General Vivek H. Murthy declared an “epidemic of loneliness,” and the U.K. appointed a Minister of Loneliness. To diagnose this condition, doctors at U.C.L.A. devised a Loneliness Scale. Do you often, sometimes, rarely, or never feel these ways?

I am unhappy doing so many things alone.
I have nobody to talk to.
I cannot tolerate being so alone.
I feel as if nobody really understands me.
I am no longer close to anyone.
There is no one I can turn to.
I feel isolated from others.

In the age of quarantine, does one disease produce another?

“Loneliness” is a vogue term, and like all vogue terms it’s a cover for all sorts of things most people would rather not name and have no idea how to fix. Plenty of people like to be alone. I myself love to be alone. But solitude and seclusion, which are the things I love, are different from loneliness, which is a thing I hate. Loneliness is a state of profound distress. Neuroscientists identify loneliness as a state of hypervigilance whose origins lie among our primate ancestors and in our own hunter-gatherer past.

In the new book “Together: The Healing Power of Human Connection in a Sometimes Lonely World” (Harper Wave), Murthy explains how Cacioppo’s evolutionary theory of loneliness has been tested by anthropologists at the University of Oxford, who have traced its origins back fifty-two million years, to the very first primates. Primates need to belong to an intimate social group, a family or a band, in order to survive; this is especially true for humans (humans you don’t know might very well kill you, which is a problem not shared by most other primates).

The loneliness epidemic, in this sense, is rather like the obesity epidemic. Evolutionarily speaking, panicking while being alone, like finding high-calorie foods irresistible, is highly adaptive, but, more recently, in a world where laws (mostly) prevent us from killing one another, we need to work with strangers every day, and the problem is more likely to be too much high-calorie food rather than too little. These drives backfire.

Loneliness, Murthy argues, lies behind a host of problems—anxiety, violence, trauma, crime, suicide, depression, political apathy, and even political polarization. Murthy writes with compassion, but his everything-can-be-reduced-to-loneliness argument is hard to swallow, not least because much of what he has to say about loneliness was said about homelessness in the nineteen-eighties, when “homelessness” was the vogue term—a word somehow easier to say than “poverty”—and saying it didn’t help.

In “A Biography of Loneliness: The History of an Emotion” (Oxford), the British historian Fay Bound Alberti defines loneliness as “a conscious, cognitive feeling of estrangement or social separation from meaningful others,” and she objects to the idea that it’s universal, transhistorical, and the source of all that ails us. She argues that the condition really didn’t exist before the nineteenth century, at least not in a chronic form. It’s not that people—widows and widowers, in particular, and the very poor, the sick, and the outcast—weren’t lonely; it’s that, since it wasn’t possible to survive without living among other people, and without being bonded to other people, by ties of affection and loyalty and obligation, loneliness was a passing experience. Monarchs probably were lonely, chronically. (Hey, it’s lonely at the top!) But, for most ordinary people, daily living involved such intricate webs of dependence and exchange—and shared shelter—that to be chronically or desperately lonely was to be dying. The word “loneliness” very seldom appears in English before about 1800. Robinson Crusoe was alone, but never lonely. One exception is “Hamlet”: Ophelia suffers from “loneliness”; then she drowns herself.

Modern loneliness, in Alberti’s view, is the child of capitalism and secularism. “Many of the divisions and hierarchies that have developed since the eighteenth century—between self and world, individual and community, public and private—have been naturalized through the politics and philosophy of individualism,” she writes. “Is it any coincidence that a language of loneliness emerged at the same time?” It is not a coincidence. The rise of privacy, itself a product of market capitalism—privacy being something that you buy—is a driver of loneliness. So is individualism, which you also have to pay for.

Alberti’s book is a cultural history (she offers an anodyne reading of “Wuthering Heights,” for instance, and another of the letters of Sylvia Plath). But the social history is more interesting, and there the scholarship demonstrates that whatever epidemic of loneliness can be said to exist is very closely associated with living alone. Whether living alone makes people lonely or whether people live alone because they’re lonely might seem to be harder to say, but the preponderance of the evidence supports the former: it is the force of history, not the exertion of choice, that leads people to live alone. This is a problem for people trying to fight an epidemic of loneliness, because the force of history is relentless.

Before the twentieth century, according to the best longitudinal demographic studies, about five per cent of all households (or about one per cent of the world population) consisted of just one person. That figure began rising around 1910, driven by urbanization, the decline of live-in servants, a declining birth rate, and the replacement of the traditional, multigenerational family with the nuclear family. By the time David Riesman published “The Lonely Crowd,” in 1950, nine per cent of all households consisted of a single person. In 1959, psychiatry discovered loneliness, in a subtle essay by the German analyst Frieda Fromm-Reichmann. “Loneliness seems to be such a painful, frightening experience that people will do practically everything to avoid it,” she wrote. She, too, shrank in horror from its contemplation. “The longing for interpersonal intimacy stays with every human being from infancy through life,” she wrote, “and there is no human being who is not threatened by its loss.” People who are not lonely are so terrified of loneliness that they shun the lonely, afraid that the condition might be contagious. And people who are lonely are themselves so horrified by what they are experiencing that they become secretive and self-obsessed—“it produces the sad conviction that nobody else has experienced or ever will sense what they are experiencing or have experienced,” Fromm-Reichmann wrote. One tragedy of loneliness is that lonely people can’t see that lots of people feel the same way they do.

Putnam’s influential book about the decline of American community ties, “Bowling Alone,” came out in 2000, four years before the launch of Facebook, which monetized loneliness. Some people say that the success of social media was a product of an epidemic of loneliness; some people say it was a contributor to it; some people say it’s the only remedy for it. Connect! Disconnect! The Economist declared loneliness to be “the leprosy of the 21st century.” The epidemic only grew.

Living alone, while common in the United States, is more common in many other parts of the world, including Scandinavia, Japan, Germany, France, the Netherlands, the U.K., Australia, and Canada, and it’s on the rise in China, India, and Brazil. Living alone works best in nations with strong social supports. It works worst in places like the United States. It is best to have not only an Internet but a social safety net.

Then the great, global confinement began: enforced isolation, social distancing, shutdowns, lockdowns, a human but inhuman zoological garden. Zoom is better than nothing. But for how long? And what about the moment your connection crashes: the panic, the last tie severed? It is a terrible, frightful experiment, a test of the human capacity to bear loneliness. Do you pull out your hair? Do you dash yourself against the walls of your cage? Do you, locked inside, thrash and cry and moan? Sometimes, rarely, or never? More today than yesterday?

Adapted from Jill Lepore’s The Isolation Ward.

This will be in April 6, 2020 issue of The New Yorker.