June 11, 2023 • 28 mins
06/11/23
The Healthy Matters Podcast
S02_E13 - Overcoming the Loneliness Epidemic, Together
Solitude is a choice and something that all of us need in our lives at some point or another. Loneliness, on the other hand, is something entirely different and it's become one of the largest present-day issues facing our society. In a recent in-depth report by the Surgeon General of the United States, Dr. Vivek Murthy, he refers to the loneliness issue in the U.S. as an epidemic and something that is affecting 1 in every 2 people at any given moment.
The effects of loneliness have been compared to those of smoking and even obesity, and include severe afflictions, such as heart attack, stroke, dementia, anxiety, depression - the list goes on. But what's causing this? What can we do to help ourselves and our society? Join us for a conversation with the Chair of Psychiatry at Hennepin Healthcare, Dr. Eduardo Colón, as we take a closer look at the Surgeon General's report and discuss the causes and effects of the Loneliness Epidemic. It's something that affects both individuals, as well as our society, so it's safe to say we're all in this together, and that there's something in the episode for everyone.
If you or someone you know are experiencing a mental health crisis, help is available. Please reach out to friends and relatives, contact your healthcare provider, or call the Lifeline by dialing 988.
Got a question for the doc? Or an idea for a show? Contact us!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare
and what matters to you. Andnow here's our host, Dr. David
Hilden .
Speaker 2 (00:21):
Hey everybody. David Hilden here, and welcome to
episode 13 of the podcast wherewe are gonna tackle the subject
of loneliness. It affects allof us introverts, extroverts,
the rich, the poor, thoseliving in cities as well as in
rural communities, the youngand the old. Did you know that
half of the US population isexperiencing symptoms of
(00:42):
loneliness at any given moment?
This is according to Dr. VivekMurphy . He is the Surgeon
General of the United States,and he has just come out with a
really fascinating in-depthlook on the causes of, and the
effects of being disconnectedfrom each other. And he likens
it to something as serious assmoking in terms of how bad it
(01:03):
can be for your health. There'sa risk factor for heart
attacks, strokes, dementia, andthat's not just an individual
thing. Our communities areaffected as well. So it truly
is an epidemic of a healthcarenature. That's what the Surgeon
General has identified. Well,today I'm gonna talk to a
colleague of mine, Dr . EduardoColon , who is the chair of
Psychiatry and HennepinHealthcare here in downtown
(01:24):
Minneapolis. Dr. Co Colon ,welcome to the show.
Speaker 3 (01:26):
Glad to be here.
Thank you. I
Speaker 2 (01:28):
Really appreciate you coming to talk about this
topic. Does it resonate withyou? Does this make sense what
the surgeon talking about?
Speaker 3 (01:34):
Absolutely. The Surgeon General has touched on
a very important point. When wetalked and looked at literature
on depression in the past, weknow that there's been a lot of
awareness of the impact ofdepression and health overall.
And this goes beyond that. Itlooks at the concept of
loneliness , uh, and theepidemiologic consequences of
it. And more importantly, whathe does in this paper is he
(01:55):
looks at a number of surveysand studies and he provides a
number of meta-analysis. That'swhen you put together a number
of similar articles and look ata bigger meaning. So this is a
very well-founded in science,and he provides a lot of the
data. He
Speaker 2 (02:10):
Calls it as bad for you as smoking. That's a pretty
bold statement. Exactly.
Speaker 3 (02:15):
So that really tells you why he's so concerned about
it as an epidemic, as a , as aconcern for public health. So
when you look at markers ofhealth in the community and
what things can lead to illnessand or , uh, difficulties in
living you , we think of anumber of factors like obesity
, uh, smoking, alcohol, etcetera . And a lot of the data
(02:35):
that he produces suggests thatit is as important as some of
these physiologic factors asleading to medical problems.
Speaker 2 (02:41):
Is it getting worse?
Speaker 3 (02:43):
Uh, the survey data suggests that starting with the
pandemic, this got a lot worse.
So there's a lot of data priorto the pandemic, and then the
surveys that have looked sincethen suggest that actually it
has gotten worse. What we don'thave right now is any sense of
whether we're in the road torecovery or not.
Speaker 2 (03:00):
Do you see in your practice people identifying
this as a problem? Or is it, isit not on people's
consciousness? Because I thinkpeople are noticing something's
different, but do they identifyit as I'm lonely?
Speaker 3 (03:12):
I I don't think people publicly have been
addressing this as much as theycould. And by the time I see
this, it really is in thecontext of people who are
struggling with eitherdepression or mental illness
and their substance abuse. Andcertainly, you hear this a lot.
I just recently saw somebodywith a pretty scary suicide
attempt who identified theperiod before starting college
(03:33):
in, in real life. The, theperiod of being on Zoom and how
difficult it , it was, as wellas trying to then get
reintegrated into the , theflow of school and feeling like
a , uh, somebody who's leftover and not feeling like a
part of things.
Speaker 2 (03:48):
We talk about introverts and extroverts and
there's all these jokes flyingaround and there's internet
memes about the pandemic wasjust wonderful for introverts.
But it is true that all peopleneed some kind of social
interaction. What is the, whatdoes the medical science say
about the effects on us when welack human interaction?
Speaker 3 (04:05):
So I, I think what the literature has shown is
that the , uh, the absence ofinteraction not only leads to
that profound sense ofloneliness, sadness, and
withdrawal, it certainly has animpact on your stress response
syndrome. Uh, so you have a lotof the stress hormones , uh,
are altered in terms of theirability to respond at the time
they should, as well as theevidence that people have more
(04:27):
rates of inflammation, as wellas all kinds of other
physiologic consequences. Thishas been , uh, something we've
recognized for a long time, butI think we think about it in
extremes. You know, whensomebody has profound
depression, when they cannotfunction, and there's two ways,
obviously. One is it has animpact on your body. The other
part to it is that then it alsoleads to depression, dysphoria
(04:49):
and or social isolation, whichkind of keeps it going. So you
can end up with this viciouscycle,
Speaker 2 (04:55):
Right, right. Now, who is most at risk in the
past? Um, I think many of uscan think of some groups,
seniors who are maybe living innursing facilities and aren't
getting visitors, you know,people who live alone and don't
get out much. Yeah , I think wecan think of that, but it seems
to be many more people are atrisk now.
Speaker 3 (05:12):
Correct. I think the data does corroborate the , uh,
vulnerability of the seniorpopulation. It also
underscores, to my surprise ,the high rate in young adults
anywhere from adolescent up toage 20 or so. And actually the
, uh, the report from thesurgeon general suggests that
this is a particularly affectedgroup.
Speaker 2 (05:31):
I read that , uh, I read that about teenagers.
Mm-hmm . arefeeling less connected to their
peers than almost ever before,and yet they're so connected,
at least electronically.
Comment on that if you could.
Yeah,
Speaker 3 (05:43):
That's an interesting observation. So
paradox, right? And he really ,um, goes out of his way to try
and explain this is hard to, tograb at times the notion that
you might be spending more timeonline. And yet a lot of the
interactions are not meaningfulas well as the, the , uh,
exposure that many youngstersare really exposed to perceived
rejection or to a lot ofbullying. Um, it is a lot
(06:06):
easier for people to be mean orto dismiss you when you're
online rather than when they'resitting with you in person. So
it takes up a lot of time andyou have a lot of flittering
around with superficialawareness of data numbers or
chats or games, but not anykind of fulfilling
interpersonal exchange.
Speaker 2 (06:25):
Do you think we're getting to a place that where
kids growing up are gonna havefewer social skills because of
that?
Speaker 3 (06:33):
That's certainly been the concern. And I'm , I'm
curious about what mycolleagues and child
psychiatrists say, but I thinkit's gonna create a big
challenge. Certainly thepandemic did in , in the way
that we've seen having toreturn to school and get used
to this. I have a relativewho's a school psychologist who
was telling me how a lot of thechildren are being either
tagged as having attentionproblems or behavioral
(06:54):
problems. And in essence, hersuggestion is that these
children who are strugglingneed to be socialized. They
need to get used to dealingwith other children, not just
their relatives, and begin tohave time to spend on doing
very basic social events thatwe just take for granted. And
Speaker 2 (07:10):
I'm not saying that all adults have are great
social skills. There's plentyof people in their older years
who aren't great at socialskills, but it seems
particularly , um, scary, ifyou will, in adolescents and
children growing up who mightlack just the daily
interactions with other people,and then can therefore feel
lonely even though they'reconnected to people. That
that's a little bitdisconcerting. And , and
Speaker 3 (07:31):
I believe he talks on the report on this concept
that this has been going onbefore the pandemic. Clearly
that pandemic worsened it, andcertainly the social media has
made it more challenging attimes, but prior to that, our
social structures have changedso that kids are not as
embedded in neighborhoods andcommunities. Parents are not
involved in a lot of theactivities that used to bring
(07:53):
people together to socializeand to have that kind of social
exchange. So it's almost likeyou have to think about it,
program it, and make it a partof, of what you're thinking
about in terms of your kids'development.
Speaker 2 (08:03):
So Eduardo , does the problem get compounded?
Like once you're kind of in alittle, you're a bit more
socially isolated, maybe it'scuz of the pandemic or you're
working from home or whatever,and, and you're not getting out
as much, and then it getsharder to get out and the
problem sort of just builds ,uh, and , and compounds itself.
Speaker 3 (08:21):
That , that certainly can be the case. So
if you think about it in termsof , um, either the loss of
comfort or loss of skill, andall of a sudden you're back in
an environment where you'refeeling uncomfortable. So
again, it depends on how bad itgot, what your previous
capacity for engaging and whathappens in the future. So you
think about a lot of people notcoming back to the office, and
(08:42):
all of a sudden theinteractions that we have at
work, which is a big source ofcontact satisfaction , um,
sharing a particular task or agoal, and all of a sudden
you're doing that onlinethrough a distance without a
lot of human contact. We needto be mindful and keep track
of, to what extent does thatreally satisfy your need for
(09:02):
social contact and to whatextent it doesn't and how you
need to deal with that.
Speaker 2 (09:07):
Now, maybe I'm asking you to speculate here ,
um, but I read a commentary insome newspaper recently about
American cities and theirdowntowns, how they're becoming
ghost cities. We have all thesebuildings and they're never
gonna fill up again withworkers. Um, so get over it.
And this particular commentarywas making this out to be a
very positive thing. They weresaying people can be from home
(09:28):
and they're just as productive,so get over it. The downtowns
are never coming back. Andthat's a good thing. But is
that true? Is it, what are yourthoughts on our role as adults
in the workplace? You know,when some folks are saying it
is better that we're all at ourhomes and relatively isolated
and others are saying we needto be back in the office. And I
(09:48):
think there's a lot of peoplethinking, I don't wanna go back
to my office, I'm doing justfine. How do you respond to
that?
Speaker 3 (09:53):
Well, I think like with everything , uh, you can
find both sides, right? And itdepends on your personal
situation. But when you look at, uh, the Surgeon General's
report on, on loneliness, theargument that even just having
, um, so-called superficial ortrivial exchanges with people
at work provides you with acertain amount of social
(10:14):
interaction. People get tochat, talk about their kids,
talk about their families, orabout what troubles them . A as
well as I'm sure we'll talkabout this later on, the notion
that when you're in a socialsetting like that, people can
have a sense of whether you'redoing well or not. You might
have the opportunity to , um,share your concerns or get some
support, which may take a lotmore effort if you're sitting
(10:36):
at home and you have to pick upthe phone and call somebody or
let them know I'm not doingwell
Speaker 2 (10:40):
Completely. I've seen you in the hall, and you
might say, I'm kind of jokinghere. You might say most of our
interactions are worthless andsuperficial. But I think that
just seeing each other in thehallways, I can tell when my
colleagues are feeling a littledifferent or even just saying,
hello. Um, it was a greatweekend. Uh , what'd you do
this weekend? Seems to be to bevaluable. Yeah .
Speaker 3 (10:59):
Look at when you think about patients who come
to see us and say at times, youknow, just walking in the
building. And that person whogreeted me said, good morning.
How are you doing? Uh , youlook so good today. It's nice
outside. Just made me gratefulto be here. Very small things.
And we know that from ourclinic, how many times our
patients talk about theirinteraction with our staff in
(11:19):
the front line , how much thateither makes or breaks their
visit in terms of your sense ofaccomplishment and pleasure.
And it makes you feelrecognized, it makes you feel
special, and, and it kind ofgives you a sense of
satisfaction. And we all needthat.
Speaker 2 (11:32):
We are gonna take a short break. We've been talking
about loneliness with Dr.
Eduardo Colon and about whatthe surgeon General of the
United States has called anepidemic of loneliness that has
health consequences. We aregonna talk about those health
consequences and what you mightdo about it after this short
break. We'll be right back.
Speaker 1 (11:50):
You are listening to the Healthy Matters podcast
with Dr . David Hilden . Got aquestion or comment for the
doc, email us at HealthyMatters hc m e d.org or give us
a call at six one two eightseven three talk. That's 6 1 2
8 7 3 8 2 5 5. And now let'sget back to more healthy
(12:11):
conversation.
Speaker 2 (12:12):
And we're back talking to Dr. Eduardo Cologne
about the epidemic ofloneliness. Eduardo, I I wanna
shift gears just a little bitand talk about specific health
conditions and why mightloneliness lead to worsening
health conditions. So let'sstart out with the ones , uh,
of what you're a specialist inmental health conditions. How
does being lonely eitherexacerbate or lead to things
(12:34):
like depression and, and eventaking that further leading to
risk of dying by say, suicide?
Well,
Speaker 3 (12:40):
I, I think that people who get depressed
clearly will become a lot morelonely and distance themselves.
But by the same token, we knowthat loneliness is a risk
factor for development ofdepression and other
psychiatric conditions. Whenyou think about it, depression
is , uh, accompanied by asignificant sense of negative
self-esteem, negative talk,negative cognition, which are
(13:03):
part of what some people dealwith in providing therapy. So
when there isn't areinforcement, the sense that
I'm worthwhile, that I do well, uh, the repeated sense of
failure are not beingrecognized, not being
acknowledged. We all need tohave a sense of attachment.
That's the primary need that weall have since our birth. And
when that's not present, webegin to then , uh, really kind
(13:25):
of wilt away or become a lotmore despondent.
Speaker 2 (13:28):
Why do you think then loneliness can lead to
heart disease or stroke?
Speaker 3 (13:33):
Well, the , the most obvious and superficial way
would be actually because ofthe impact on activity, the
impact on your self care . Soif I'm lonely, if I'm
depressed, I'm less likely toexercise, I'm less likely to
pay attention to my diet. Idon't care as much if I'm
gaining weight or not, and I'mmore likely to engage in other
high risk behaviors likesmoking, drinking, and or doing
(13:56):
things in excess or not doingenough. There's also a lot of
information about the directphysiologic links between these
conditions and your health. Sopeople who are depressed, for
example, don't have the samedegree of heart rate
variability. So your heart rateis not going at the same time
constantly. It goes up and downand it measures to a certain
extent the capacity of yourcardiovascular system to
(14:17):
respond to stress. Uh, we alsoknow that, as I mentioned
earlier, your flow of hormonesthrough the course of the day
gets altered so that you mayhave either a chronic release
of stress hormones and thatthat happens frequently. You
have a blunting of response. SoI think what happens with
chronic stress, where a lot ofpeople is not that they
necessarily are in high gearall the time, but their system,
(14:39):
if I can use the metaphorsexhausted and you cannot
respond when you need to andslow down when you should to
allow your body for recovery.
It's a lot of things thathappen in our body which happen
acutely, and they're meant tobe timed. They're meant to end
shortly thereafter, and thenyour body gets to recover. And
if you have that going on thewhole time, your, your system
(15:00):
just does not have theopportunity to do so.
Speaker 2 (15:02):
That makes sense. I , is it a global phenomenon or
is this something that indeveloped countries we're
experiencing marketing ? Uh , I
Speaker 3 (15:09):
Think it's, it's probably true of human beings
anywhere, but the question ofto what extent that happens in
places where I think we becomea lot more industrialized and
isolated, the initial conceptis that as human beings, as ,
uh, human animals initially, weall have the need to gather.
Because if you're hunting andgathering, if you work in
groups, it's a lot moreefficient. You're more likely
(15:30):
to survive. So we seem to havean inbuilt need to belong to a
social structure. So whatevercountry, town or location where
the social structure begins toget challenged , it's probably
gonna have to face the samesense of isolation and, and
loss of continuity. The
Speaker 2 (15:48):
Surgeon General talks about three
interventions, and I'd like youto comment on whether a , you
think these are gonna beeffective and how they're gonna
affect both individuals andcommunities. And the first one
of the surgeon general'srecommendations are to
strengthen our socialinfrastructure. I take it that
means schools and workplaces.
Do you think that that's aneffective strategy and how
(16:08):
might it be?
Speaker 3 (16:09):
Absolutely. The question is how to get there
mm-hmm . . Soright . When you think of the
basic places where peoplegather, the basic place where
people relate to each other ,uh, have people lost their
sense of community? Have theylost their sense of belonging
to a particular group ororganization? Either places of
worship where people used togather or social structures of
(16:29):
any other kind, clubs, classes,groups that really gather and
bring people together so youdon't feel alone even, you
know, I see advertisementsrecently looking at things like
gathering together to pick upgarbage, getting people
together to clean up the river,getting people together to do
stuff. We need, we need to havea conscious return to this kind
(16:50):
of , uh, structure. And I , andI think he's right on the
money.
Speaker 2 (16:52):
Yeah . So it's schools , workplaces, the
communities we live, all ofthose things that we need to
refocus on. I think that thatmakes perfect sense. What about
the surgeon general's secondrecommendation, which is to
what he says, renegotiate arelationship with technology.
What does he mean by that?
Speaker 3 (17:10):
Well, this is kind of what we're talking about,
right? That technology makes iteasier to be in touch with
people, but if used in thecorrect way. So the question is
, to what extent are we usingtechnology to fill ourselves up
with fear negative newscommentaries, where people
begin to, you know, the , theconcept of going down the
rabbit hole and really gettingentangled up in ideologies
(17:33):
rather that isolate people asopposed to being a way of
sharing. So when people gettogether and have a zoom
conversation with familymembers, it's a very positive
experience. And that'sdifferent than bearing your
head in the computer andreading all these positions and
or fears that get promoted alot of times in, in the media.
And the same thing withrelationship with children and
(17:55):
youth. To what extent are theygetting in touch of things that
are more harmful and not ableto talk to parents about it and
or utilizing the anonymity orthe protection of the
technology to be nast or meanto each other and to hurt
people who might already behurting.
Speaker 2 (18:12):
Do you think that leads to polarization in our
society? Because I know that'snot exactly the conversation of
loneliness, but when you justsort of retreat into what your
own bubble, if you will, andthen we don't , uh, we become
more polarized in society aswe're all just kind of more
isolated from people who maybedon't think or look like us.
Speaker 3 (18:31):
Absolutely. Um, and we see it both ways. It leads
to more polarization. The morepolarized we get, the more
isolated we become. So all of asudden we've reached a spot
where essentially you are verynervous about racing certain
topics. So it is the problemwhen we are so polarized around
whatever issue that we cannotrelate to people in a
(18:52):
comfortable, supportivefashion. And Lord, we begin to
exclude a lot of the folksaround us in pretty soon you
find yourself pretty alonebecause you have this seeming
companionship online, and yetit's not the companionship
that's available for you whenyou say, let's go for a walk,
or, do you know what I'mfeeling today?
Speaker 2 (19:10):
That leads to what , uh, you've touched on what the
third recommendation from theSurgeon General is after
strengthening socialinfrastructures and
renegotiating technology, andthat is just taking small steps
in our personal lives toreconnect. Dr. Murth , uh,
talks about just introducingyourself to more people and
saying hello in just smallinteractions. Does that
(19:31):
resonate with you? It ,
Speaker 3 (19:32):
It does resonate with me. And this also talks
about who may be morevulnerable, right? I remember
growing up my, my brother wasvery much an extrovert and I
learned that if we wentanywhere, I could just rely on
him.
Speaker 2 (19:44):
So you're not an extrovert to
Speaker 3 (19:45):
Make the
Speaker 2 (19:46):
Speaker 3 (19:46):
? Actually,
I'm pretty shy. Um , so
Speaker 2 (19:49):
Really, are you kinda shy? It
Speaker 3 (19:50):
Really was something I had, I had to develop later
on mm-hmm . ,because you rely on people
around you who are a lot moreextroverted , uh, being able to
just go out of your comfortzone and say to somebody, how
are you doing? Why you're here?
As opposed to the notion ofmind your own business. It
doesn't matter.
Speaker 2 (20:06):
So let's talk about what we can do about the
loneliness epidemic, both inour communal lives and
individually. So I'm gonna askyour thoughts for our
listeners. How does someoneidentify another person in your
family or your social circlesor in the community as being
affected by loneliness? Youknow, what, what warning signs
(20:28):
or , or ways can we use to, toeven identify that the people
that we are living among mightbe lonely?
Speaker 3 (20:35):
I , I think if you're watchful and attentive,
there's a lot of non-clear cuesthat you have that something is
different. But in general, whenpeople disappear, they're not
present in as many of thethings we're used to see them
at . You don't hear from themas often, and they seem to have
just kind of distancethemselves. It's a good
opportunity to wonder what'sgoing on, and not necessarily
(20:56):
to , um, intrude, but to reallyreach out and say, haven't seen
you. What's going on? How areyou doing? I think it's also
clear when people are becomingless reactive to their
environment. When people beginto get more withdrawn, they
don't seem to have the same joythat they expressed before. Uh,
irritability is a good sign formany of us, certainly , uh, for
me personally, of when you'vekind of reached that level
(21:19):
where you want to just withdrawand get away and have and be
quiet. And by the way, thatjust reminds me to make a very
important distinction there .
There's a big distinction to bemade between solitude and
loneliness. And solitude issomething that I think most of
us need and cherish. That is bychoice. Finding yourself in a
situation where you're byyourself and you can find some
(21:41):
peace with whatever it is.
Whether you just like to watchthe river, whether you
meditate, whether you pray,whether you just like to walk
around. It's a refreshing , uh,moment of quieting down in a
very positive way. And that'sdifferent from loneliness when
you really feel that nobodylikes you, that nobody's around
you or that you're missing.
Speaker 2 (22:01):
So what about self-care? How do you identify
when you yourself could use ahand?
Speaker 3 (22:07):
Well, you know, it takes a certain amount of, of
honesty, right? And, and whenyou start to feel depleted is
the word I like to think of.
When you feel like you don'thave a lot, you're tired all
the time, nothing excites you ,um, you don't feel like going
out to things that normallywould be exciting to you, I
think is a , is a moment tobegin to think about. And , and
(22:29):
as we talk about loneliness,and we've talked about all the
other things that can go alongwith loneliness, obviously one
of the complications ofloneliness is the spectrum from
loneliness to depression, noenergy, poor focus,
concentration, troublesleeping, sleeping too much
negative thoughts , um,inability to respond to your
environment, which is what Ilike to ask most of my patients
(22:50):
is, when good things happen,how do you feel? Are you able
to modulate really? Because weall have moments when you feel
down, but if you bump intosomebody you know and miss all
a sudden you go, I'm capableof, of smiling, of enjoying
their presence. And I lookforward to things when people
get depressed, they're nolonger looking forward to
anything. And if it gets to thepoint where people begin to
(23:11):
either challenge their worth orthink that life is too much,
it's way past time to go getsome help.
Speaker 2 (23:17):
So do you suggest they call their doctor their
friend or a hotline? What are ,what are some good steps for a
person to do in that situation?
Speaker 3 (23:25):
And any or all of those? Right now we have
hotlines where anybody can dialthe number and get help. We
also know that reaching out toa friend is always important.
And more importantly, I thinkbeing comfortable with letting
your healthcare provider knowthat you're struggling. We're
teaching physicians, and you dothis all the time to recognize
signs and symptoms ofdepression. We give patients
(23:46):
questionnaires to ask ifthey're having symptoms of
depression. And the reason todo that is to try to identify
it before it becomes a problemwhere people have retreated
into themselves and get into ,into significant danger. So as
a friend or a colleague, thenit's our opportunity to see how
people's behaviors suggest thatsomehow they're distancing
themselves. And to just offer ahelping hand. I always tell
(24:11):
this anecdote of a day when Iwas really particularly
overwhelmed, some difficultcases, and one after another
now is walking down the hallwayand somebody walked by me and
said, out of the blue, and whotakes care of Dr. Colon ? Oh ,
Speaker 2 (24:22):
To you? They said that to you? Yes , your doctor.
Speaker 3 (24:25):
And it just woke me up. I'm m down the stairs
going, what a kind thing forsomeone to do. And I realized
that I was lost in my own self.
Mm-hmm . ,clearly I was not depressed or
depleted, but it was a nicewake up call and more
importantly, reminded me of howimportant just somebody
reaching out and sayingsomething kind can be for some
(24:47):
folks.
Speaker 2 (24:48):
So listeners, if you are experiencing , uh, um,
pervasive symptoms ofdepression or you just simply
need to talk to a mental healthprofessional, please do call
the national hotline. Thenumber is easy. It's 9 88, 9 88
if you need to speak to amental health professional 24
hours a day, seven days a week,9 88. So Dr. Colon , this has
(25:11):
been a great topic. It's a lotto digest and I think it really
is going to resonate with allof our listeners because it's
something that affects all ofus from all walks of life. And
so I think it's been just anincredibly important topic. Dr.
Cologne , I'd like to give youthe last word. What, what would
you like to leave our listenerswith about the topic?
Speaker 3 (25:30):
I I think that the most important part is to
recognize that loneliness is asignificant problem. That if
you , um, notice that someonearound you may be experiencing
loneliness or you begin torecognize it in yourself ,
there are things you can andyou should do. You can reach
out to people, you can justbegin very consistently saying,
hello, how was your day? Andpeople say, that's an empty
(25:53):
question. And it could be, butpay attention. The second part
is, I , I think Dr. Murphy isvery clear about suggesting
that people volunteer. And itis an incredibly powerful way
to get someone who isstruggling with how to get into
the community, how to feel asense of productivity and or
company to figure out where youcan offer some volunteer work
and see if that is gratifying.
(26:15):
People also turn to , um, othergroups or clubs or your , uh,
your minister, your priest ,your rabbi or or anybody in
your faith community forsupport. Uh , but the important
theme is be attentive. Be awareof it around you and in you.
And if you notice it, begin todo something about it. It can
be starting with very shortstepss. We all go through
(26:37):
lonely moments and we just needto be aware that either , uh,
we're coming out of it or we'redoing something to help
ourselves or people around
Speaker 2 (26:45):
Us. We've been talking to Dr. Eduardo Colon
about loneliness. He is thechair of psychiatry at Hennepin
Healthcare and a friend and acolleague of mine here in
downtown Minneapolis. This hasbeen a great topic and in like
so many other large issues inhealthcare , the first step is
often to identify the problem.
And that's what you have donefor us today. Thank you so much
for being with us Erra .
Speaker 3 (27:05):
Thank you. My pleasure.
Speaker 2 (27:06):
It's been a great show and I hope you will join
us for our next episode when wewill tackle the subject of
autism with another one of mycolleagues, Dr. Krishnan
Subramanian. And in themeantime, take care of
yourselves, keep an eye out forothers, and be healthy and be
well.
Speaker 1 (27:22):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy Matters hc m ed.org or call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. And finally, if you
(27:45):
enjoy the show, please leave usa review and share the show
with others. The HealthyMatters Podcast is made
possible by Hennepin Healthcarein Minneapolis, Minnesota, and
engineered and produced by JohnLucas At Highball Executive
producers are Jonathan Comitoand Christine Hill. Please
remember, we can only givegeneral medical advice during
this program, and every case isunique. We urge you to consult
(28:06):
with your physician if you havea more serious or pressing
health concern. Until nexttime, be healthy and be well.
Welcome to the Healthy Matters podcast with
Dr. David Hilden , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare
and what matters to you. Andnow here's our host, Dr. David
Hilden .
Speaker 2 (00:21):
Hey everybody. David Hilden here, and welcome to
episode 13 of the podcast wherewe are gonna tackle the subject
of loneliness. It affects allof us introverts, extroverts,
the rich, the poor, thoseliving in cities as well as in
rural communities, the youngand the old. Did you know that
half of the US population isexperiencing symptoms of
(00:42):
loneliness at any given moment?
This is according to Dr. VivekMurphy . He is the Surgeon
General of the United States,and he has just come out with a
really fascinating in-depthlook on the causes of, and the
effects of being disconnectedfrom each other. And he likens
it to something as serious assmoking in terms of how bad it
(01:03):
can be for your health. There'sa risk factor for heart
attacks, strokes, dementia, andthat's not just an individual
thing. Our communities areaffected as well. So it truly
is an epidemic of a healthcarenature. That's what the Surgeon
General has identified. Well,today I'm gonna talk to a
colleague of mine, Dr . EduardoColon , who is the chair of
Psychiatry and HennepinHealthcare here in downtown
(01:24):
Minneapolis. Dr. Co Colon ,welcome to the show.
Speaker 3 (01:26):
Glad to be here.
Thank you. I
Speaker 2 (01:28):
Really appreciate you coming to talk about this
topic. Does it resonate withyou? Does this make sense what
the surgeon talking about?
Speaker 3 (01:34):
Absolutely. The Surgeon General has touched on
a very important point. When wetalked and looked at literature
on depression in the past, weknow that there's been a lot of
awareness of the impact ofdepression and health overall.
And this goes beyond that. Itlooks at the concept of
loneliness , uh, and theepidemiologic consequences of
it. And more importantly, whathe does in this paper is he
(01:55):
looks at a number of surveysand studies and he provides a
number of meta-analysis. That'swhen you put together a number
of similar articles and look ata bigger meaning. So this is a
very well-founded in science,and he provides a lot of the
data. He
Speaker 2 (02:10):
Calls it as bad for you as smoking. That's a pretty
bold statement. Exactly.
Speaker 3 (02:15):
So that really tells you why he's so concerned about
it as an epidemic, as a , as aconcern for public health. So
when you look at markers ofhealth in the community and
what things can lead to illnessand or , uh, difficulties in
living you , we think of anumber of factors like obesity
, uh, smoking, alcohol, etcetera . And a lot of the data
(02:35):
that he produces suggests thatit is as important as some of
these physiologic factors asleading to medical problems.
Speaker 2 (02:41):
Is it getting worse?
Speaker 3 (02:43):
Uh, the survey data suggests that starting with the
pandemic, this got a lot worse.
So there's a lot of data priorto the pandemic, and then the
surveys that have looked sincethen suggest that actually it
has gotten worse. What we don'thave right now is any sense of
whether we're in the road torecovery or not.
Speaker 2 (03:00):
Do you see in your practice people identifying
this as a problem? Or is it, isit not on people's
consciousness? Because I thinkpeople are noticing something's
different, but do they identifyit as I'm lonely?
Speaker 3 (03:12):
I I don't think people publicly have been
addressing this as much as theycould. And by the time I see
this, it really is in thecontext of people who are
struggling with eitherdepression or mental illness
and their substance abuse. Andcertainly, you hear this a lot.
I just recently saw somebodywith a pretty scary suicide
attempt who identified theperiod before starting college
(03:33):
in, in real life. The, theperiod of being on Zoom and how
difficult it , it was, as wellas trying to then get
reintegrated into the , theflow of school and feeling like
a , uh, somebody who's leftover and not feeling like a
part of things.
Speaker 2 (03:48):
We talk about introverts and extroverts and
there's all these jokes flyingaround and there's internet
memes about the pandemic wasjust wonderful for introverts.
But it is true that all peopleneed some kind of social
interaction. What is the, whatdoes the medical science say
about the effects on us when welack human interaction?
Speaker 3 (04:05):
So I, I think what the literature has shown is
that the , uh, the absence ofinteraction not only leads to
that profound sense ofloneliness, sadness, and
withdrawal, it certainly has animpact on your stress response
syndrome. Uh, so you have a lotof the stress hormones , uh,
are altered in terms of theirability to respond at the time
they should, as well as theevidence that people have more
(04:27):
rates of inflammation, as wellas all kinds of other
physiologic consequences. Thishas been , uh, something we've
recognized for a long time, butI think we think about it in
extremes. You know, whensomebody has profound
depression, when they cannotfunction, and there's two ways,
obviously. One is it has animpact on your body. The other
part to it is that then it alsoleads to depression, dysphoria
(04:49):
and or social isolation, whichkind of keeps it going. So you
can end up with this viciouscycle,
Speaker 2 (04:55):
Right, right. Now, who is most at risk in the
past? Um, I think many of uscan think of some groups,
seniors who are maybe living innursing facilities and aren't
getting visitors, you know,people who live alone and don't
get out much. Yeah , I think wecan think of that, but it seems
to be many more people are atrisk now.
Speaker 3 (05:12):
Correct. I think the data does corroborate the , uh,
vulnerability of the seniorpopulation. It also
underscores, to my surprise ,the high rate in young adults
anywhere from adolescent up toage 20 or so. And actually the
, uh, the report from thesurgeon general suggests that
this is a particularly affectedgroup.
Speaker 2 (05:31):
I read that , uh, I read that about teenagers.
Mm-hmm .
peers than almost ever before,and yet they're so connected,
at least electronically.
Comment on that if you could.
Yeah,
Speaker 3 (05:43):
That's an interesting observation. So
paradox, right? And he really ,um, goes out of his way to try
and explain this is hard to, tograb at times the notion that
you might be spending more timeonline. And yet a lot of the
interactions are not meaningfulas well as the, the , uh,
exposure that many youngstersare really exposed to perceived
rejection or to a lot ofbullying. Um, it is a lot
(06:06):
easier for people to be mean orto dismiss you when you're
online rather than when they'resitting with you in person. So
it takes up a lot of time andyou have a lot of flittering
around with superficialawareness of data numbers or
chats or games, but not anykind of fulfilling
interpersonal exchange.
Speaker 2 (06:25):
Do you think we're getting to a place that where
kids growing up are gonna havefewer social skills because of
that?
Speaker 3 (06:33):
That's certainly been the concern. And I'm , I'm
curious about what mycolleagues and child
psychiatrists say, but I thinkit's gonna create a big
challenge. Certainly thepandemic did in , in the way
that we've seen having toreturn to school and get used
to this. I have a relativewho's a school psychologist who
was telling me how a lot of thechildren are being either
tagged as having attentionproblems or behavioral
(06:54):
problems. And in essence, hersuggestion is that these
children who are strugglingneed to be socialized. They
need to get used to dealingwith other children, not just
their relatives, and begin tohave time to spend on doing
very basic social events thatwe just take for granted. And
Speaker 2 (07:10):
I'm not saying that all adults have are great
social skills. There's plentyof people in their older years
who aren't great at socialskills, but it seems
particularly , um, scary, ifyou will, in adolescents and
children growing up who mightlack just the daily
interactions with other people,and then can therefore feel
lonely even though they'reconnected to people. That
that's a little bitdisconcerting. And , and
Speaker 3 (07:31):
I believe he talks on the report on this concept
that this has been going onbefore the pandemic. Clearly
that pandemic worsened it, andcertainly the social media has
made it more challenging attimes, but prior to that, our
social structures have changedso that kids are not as
embedded in neighborhoods andcommunities. Parents are not
involved in a lot of theactivities that used to bring
(07:53):
people together to socializeand to have that kind of social
exchange. So it's almost likeyou have to think about it,
program it, and make it a partof, of what you're thinking
about in terms of your kids'development.
Speaker 2 (08:03):
So Eduardo , does the problem get compounded?
Like once you're kind of in alittle, you're a bit more
socially isolated, maybe it'scuz of the pandemic or you're
working from home or whatever,and, and you're not getting out
as much, and then it getsharder to get out and the
problem sort of just builds ,uh, and , and compounds itself.
Speaker 3 (08:21):
That , that certainly can be the case. So
if you think about it in termsof , um, either the loss of
comfort or loss of skill, andall of a sudden you're back in
an environment where you'refeeling uncomfortable. So
again, it depends on how bad itgot, what your previous
capacity for engaging and whathappens in the future. So you
think about a lot of people notcoming back to the office, and
(08:42):
all of a sudden theinteractions that we have at
work, which is a big source ofcontact satisfaction , um,
sharing a particular task or agoal, and all of a sudden
you're doing that onlinethrough a distance without a
lot of human contact. We needto be mindful and keep track
of, to what extent does thatreally satisfy your need for
(09:02):
social contact and to whatextent it doesn't and how you
need to deal with that.
Speaker 2 (09:07):
Now, maybe I'm asking you to speculate here ,
um, but I read a commentary insome newspaper recently about
American cities and theirdowntowns, how they're becoming
ghost cities. We have all thesebuildings and they're never
gonna fill up again withworkers. Um, so get over it.
And this particular commentarywas making this out to be a
very positive thing. They weresaying people can be from home
(09:28):
and they're just as productive,so get over it. The downtowns
are never coming back. Andthat's a good thing. But is
that true? Is it, what are yourthoughts on our role as adults
in the workplace? You know,when some folks are saying it
is better that we're all at ourhomes and relatively isolated
and others are saying we needto be back in the office. And I
(09:48):
think there's a lot of peoplethinking, I don't wanna go back
to my office, I'm doing justfine. How do you respond to
that?
Speaker 3 (09:53):
Well, I think like with everything , uh, you can
find both sides, right? And itdepends on your personal
situation. But when you look at, uh, the Surgeon General's
report on, on loneliness, theargument that even just having
, um, so-called superficial ortrivial exchanges with people
at work provides you with acertain amount of social
(10:14):
interaction. People get tochat, talk about their kids,
talk about their families, orabout what troubles them . A as
well as I'm sure we'll talkabout this later on, the notion
that when you're in a socialsetting like that, people can
have a sense of whether you'redoing well or not. You might
have the opportunity to , um,share your concerns or get some
support, which may take a lotmore effort if you're sitting
(10:36):
at home and you have to pick upthe phone and call somebody or
let them know I'm not doingwell
Speaker 2 (10:40):
Completely. I've seen you in the hall, and you
might say, I'm kind of jokinghere. You might say most of our
interactions are worthless andsuperficial. But I think that
just seeing each other in thehallways, I can tell when my
colleagues are feeling a littledifferent or even just saying,
hello. Um, it was a greatweekend. Uh , what'd you do
this weekend? Seems to be to bevaluable. Yeah .
Speaker 3 (10:59):
Look at when you think about patients who come
to see us and say at times, youknow, just walking in the
building. And that person whogreeted me said, good morning.
How are you doing? Uh , youlook so good today. It's nice
outside. Just made me gratefulto be here. Very small things.
And we know that from ourclinic, how many times our
patients talk about theirinteraction with our staff in
(11:19):
the front line , how much thateither makes or breaks their
visit in terms of your sense ofaccomplishment and pleasure.
And it makes you feelrecognized, it makes you feel
special, and, and it kind ofgives you a sense of
satisfaction. And we all needthat.
Speaker 2 (11:32):
We are gonna take a short break. We've been talking
about loneliness with Dr.
Eduardo Colon and about whatthe surgeon General of the
United States has called anepidemic of loneliness that has
health consequences. We aregonna talk about those health
consequences and what you mightdo about it after this short
break. We'll be right back.
Speaker 1 (11:50):
You are listening to the Healthy Matters podcast
with Dr . David Hilden . Got aquestion or comment for the
doc, email us at HealthyMatters hc m e d.org or give us
a call at six one two eightseven three talk. That's 6 1 2
8 7 3 8 2 5 5. And now let'sget back to more healthy
(12:11):
conversation.
Speaker 2 (12:12):
And we're back talking to Dr. Eduardo Cologne
about the epidemic ofloneliness. Eduardo, I I wanna
shift gears just a little bitand talk about specific health
conditions and why mightloneliness lead to worsening
health conditions. So let'sstart out with the ones , uh,
of what you're a specialist inmental health conditions. How
does being lonely eitherexacerbate or lead to things
(12:34):
like depression and, and eventaking that further leading to
risk of dying by say, suicide?
Well,
Speaker 3 (12:40):
I, I think that people who get depressed
clearly will become a lot morelonely and distance themselves.
But by the same token, we knowthat loneliness is a risk
factor for development ofdepression and other
psychiatric conditions. Whenyou think about it, depression
is , uh, accompanied by asignificant sense of negative
self-esteem, negative talk,negative cognition, which are
(13:03):
part of what some people dealwith in providing therapy. So
when there isn't areinforcement, the sense that
I'm worthwhile, that I do well, uh, the repeated sense of
failure are not beingrecognized, not being
acknowledged. We all need tohave a sense of attachment.
That's the primary need that weall have since our birth. And
when that's not present, webegin to then , uh, really kind
(13:25):
of wilt away or become a lotmore despondent.
Speaker 2 (13:28):
Why do you think then loneliness can lead to
heart disease or stroke?
Speaker 3 (13:33):
Well, the , the most obvious and superficial way
would be actually because ofthe impact on activity, the
impact on your self care . Soif I'm lonely, if I'm
depressed, I'm less likely toexercise, I'm less likely to
pay attention to my diet. Idon't care as much if I'm
gaining weight or not, and I'mmore likely to engage in other
high risk behaviors likesmoking, drinking, and or doing
(13:56):
things in excess or not doingenough. There's also a lot of
information about the directphysiologic links between these
conditions and your health. Sopeople who are depressed, for
example, don't have the samedegree of heart rate
variability. So your heart rateis not going at the same time
constantly. It goes up and downand it measures to a certain
extent the capacity of yourcardiovascular system to
(14:17):
respond to stress. Uh, we alsoknow that, as I mentioned
earlier, your flow of hormonesthrough the course of the day
gets altered so that you mayhave either a chronic release
of stress hormones and thatthat happens frequently. You
have a blunting of response. SoI think what happens with
chronic stress, where a lot ofpeople is not that they
necessarily are in high gearall the time, but their system,
(14:39):
if I can use the metaphorsexhausted and you cannot
respond when you need to andslow down when you should to
allow your body for recovery.
It's a lot of things thathappen in our body which happen
acutely, and they're meant tobe timed. They're meant to end
shortly thereafter, and thenyour body gets to recover. And
if you have that going on thewhole time, your, your system
(15:00):
just does not have theopportunity to do so.
Speaker 2 (15:02):
That makes sense. I , is it a global phenomenon or
is this something that indeveloped countries we're
experiencing marketing ? Uh , I
Speaker 3 (15:09):
Think it's, it's probably true of human beings
anywhere, but the question ofto what extent that happens in
places where I think we becomea lot more industrialized and
isolated, the initial conceptis that as human beings, as ,
uh, human animals initially, weall have the need to gather.
Because if you're hunting andgathering, if you work in
groups, it's a lot moreefficient. You're more likely
(15:30):
to survive. So we seem to havean inbuilt need to belong to a
social structure. So whatevercountry, town or location where
the social structure begins toget challenged , it's probably
gonna have to face the samesense of isolation and, and
loss of continuity. The
Speaker 2 (15:48):
Surgeon General talks about three
interventions, and I'd like youto comment on whether a , you
think these are gonna beeffective and how they're gonna
affect both individuals andcommunities. And the first one
of the surgeon general'srecommendations are to
strengthen our socialinfrastructure. I take it that
means schools and workplaces.
Do you think that that's aneffective strategy and how
(16:08):
might it be?
Speaker 3 (16:09):
Absolutely. The question is how to get there
mm-hmm .
basic places where peoplegather, the basic place where
people relate to each other ,uh, have people lost their
sense of community? Have theylost their sense of belonging
to a particular group ororganization? Either places of
worship where people used togather or social structures of
(16:29):
any other kind, clubs, classes,groups that really gather and
bring people together so youdon't feel alone even, you
know, I see advertisementsrecently looking at things like
gathering together to pick upgarbage, getting people
together to clean up the river,getting people together to do
stuff. We need, we need to havea conscious return to this kind
(16:50):
of , uh, structure. And I , andI think he's right on the
money.
Speaker 2 (16:52):
Yeah . So it's schools , workplaces, the
communities we live, all ofthose things that we need to
refocus on. I think that thatmakes perfect sense. What about
the surgeon general's secondrecommendation, which is to
what he says, renegotiate arelationship with technology.
What does he mean by that?
Speaker 3 (17:10):
Well, this is kind of what we're talking about,
right? That technology makes iteasier to be in touch with
people, but if used in thecorrect way. So the question is
, to what extent are we usingtechnology to fill ourselves up
with fear negative newscommentaries, where people
begin to, you know, the , theconcept of going down the
rabbit hole and really gettingentangled up in ideologies
(17:33):
rather that isolate people asopposed to being a way of
sharing. So when people gettogether and have a zoom
conversation with familymembers, it's a very positive
experience. And that'sdifferent than bearing your
head in the computer andreading all these positions and
or fears that get promoted alot of times in, in the media.
And the same thing withrelationship with children and
(17:55):
youth. To what extent are theygetting in touch of things that
are more harmful and not ableto talk to parents about it and
or utilizing the anonymity orthe protection of the
technology to be nast or meanto each other and to hurt
people who might already behurting.
Speaker 2 (18:12):
Do you think that leads to polarization in our
society? Because I know that'snot exactly the conversation of
loneliness, but when you justsort of retreat into what your
own bubble, if you will, andthen we don't , uh, we become
more polarized in society aswe're all just kind of more
isolated from people who maybedon't think or look like us.
Speaker 3 (18:31):
Absolutely. Um, and we see it both ways. It leads
to more polarization. The morepolarized we get, the more
isolated we become. So all of asudden we've reached a spot
where essentially you are verynervous about racing certain
topics. So it is the problemwhen we are so polarized around
whatever issue that we cannotrelate to people in a
(18:52):
comfortable, supportivefashion. And Lord, we begin to
exclude a lot of the folksaround us in pretty soon you
find yourself pretty alonebecause you have this seeming
companionship online, and yetit's not the companionship
that's available for you whenyou say, let's go for a walk,
or, do you know what I'mfeeling today?
Speaker 2 (19:10):
That leads to what , uh, you've touched on what the
third recommendation from theSurgeon General is after
strengthening socialinfrastructures and
renegotiating technology, andthat is just taking small steps
in our personal lives toreconnect. Dr. Murth , uh,
talks about just introducingyourself to more people and
saying hello in just smallinteractions. Does that
(19:31):
resonate with you? It ,
Speaker 3 (19:32):
It does resonate with me. And this also talks
about who may be morevulnerable, right? I remember
growing up my, my brother wasvery much an extrovert and I
learned that if we wentanywhere, I could just rely on
him.
Speaker 2 (19:44):
So you're not an extrovert to
Speaker 3 (19:45):
Make the
Speaker 2 (19:46):
Speaker 3 (19:46):
Speaker 2 (19:49):
Really, are you kinda shy? It
Speaker 3 (19:50):
Really was something I had, I had to develop later
on mm-hmm .
around you who are a lot moreextroverted , uh, being able to
just go out of your comfortzone and say to somebody, how
are you doing? Why you're here?
As opposed to the notion ofmind your own business. It
doesn't matter.
Speaker 2 (20:06):
So let's talk about what we can do about the
loneliness epidemic, both inour communal lives and
individually. So I'm gonna askyour thoughts for our
listeners. How does someoneidentify another person in your
family or your social circlesor in the community as being
affected by loneliness? Youknow, what, what warning signs
(20:28):
or , or ways can we use to, toeven identify that the people
that we are living among mightbe lonely?
Speaker 3 (20:35):
I , I think if you're watchful and attentive,
there's a lot of non-clear cuesthat you have that something is
different. But in general, whenpeople disappear, they're not
present in as many of thethings we're used to see them
at . You don't hear from themas often, and they seem to have
just kind of distancethemselves. It's a good
opportunity to wonder what'sgoing on, and not necessarily
(20:56):
to , um, intrude, but to reallyreach out and say, haven't seen
you. What's going on? How areyou doing? I think it's also
clear when people are becomingless reactive to their
environment. When people beginto get more withdrawn, they
don't seem to have the same joythat they expressed before. Uh,
irritability is a good sign formany of us, certainly , uh, for
me personally, of when you'vekind of reached that level
(21:19):
where you want to just withdrawand get away and have and be
quiet. And by the way, thatjust reminds me to make a very
important distinction there .
There's a big distinction to bemade between solitude and
loneliness. And solitude issomething that I think most of
us need and cherish. That is bychoice. Finding yourself in a
situation where you're byyourself and you can find some
(21:41):
peace with whatever it is.
Whether you just like to watchthe river, whether you
meditate, whether you pray,whether you just like to walk
around. It's a refreshing , uh,moment of quieting down in a
very positive way. And that'sdifferent from loneliness when
you really feel that nobodylikes you, that nobody's around
you or that you're missing.
Speaker 2 (22:01):
So what about self-care? How do you identify
when you yourself could use ahand?
Speaker 3 (22:07):
Well, you know, it takes a certain amount of, of
honesty, right? And, and whenyou start to feel depleted is
the word I like to think of.
When you feel like you don'thave a lot, you're tired all
the time, nothing excites you ,um, you don't feel like going
out to things that normallywould be exciting to you, I
think is a , is a moment tobegin to think about. And , and
(22:29):
as we talk about loneliness,and we've talked about all the
other things that can go alongwith loneliness, obviously one
of the complications ofloneliness is the spectrum from
loneliness to depression, noenergy, poor focus,
concentration, troublesleeping, sleeping too much
negative thoughts , um,inability to respond to your
environment, which is what Ilike to ask most of my patients
(22:50):
is, when good things happen,how do you feel? Are you able
to modulate really? Because weall have moments when you feel
down, but if you bump intosomebody you know and miss all
a sudden you go, I'm capableof, of smiling, of enjoying
their presence. And I lookforward to things when people
get depressed, they're nolonger looking forward to
anything. And if it gets to thepoint where people begin to
(23:11):
either challenge their worth orthink that life is too much,
it's way past time to go getsome help.
Speaker 2 (23:17):
So do you suggest they call their doctor their
friend or a hotline? What are ,what are some good steps for a
person to do in that situation?
Speaker 3 (23:25):
And any or all of those? Right now we have
hotlines where anybody can dialthe number and get help. We
also know that reaching out toa friend is always important.
And more importantly, I thinkbeing comfortable with letting
your healthcare provider knowthat you're struggling. We're
teaching physicians, and you dothis all the time to recognize
signs and symptoms ofdepression. We give patients
(23:46):
questionnaires to ask ifthey're having symptoms of
depression. And the reason todo that is to try to identify
it before it becomes a problemwhere people have retreated
into themselves and get into ,into significant danger. So as
a friend or a colleague, thenit's our opportunity to see how
people's behaviors suggest thatsomehow they're distancing
themselves. And to just offer ahelping hand. I always tell
(24:11):
this anecdote of a day when Iwas really particularly
overwhelmed, some difficultcases, and one after another
now is walking down the hallwayand somebody walked by me and
said, out of the blue, and whotakes care of Dr. Colon ? Oh ,
Speaker 2 (24:22):
To you? They said that to you? Yes , your doctor.
Speaker 3 (24:25):
And it just woke me up. I'm m down the stairs
going, what a kind thing forsomeone to do. And I realized
that I was lost in my own self.
Mm-hmm .
depleted, but it was a nicewake up call and more
importantly, reminded me of howimportant just somebody
reaching out and sayingsomething kind can be for some
(24:47):
folks.
Speaker 2 (24:48):
So listeners, if you are experiencing , uh, um,
pervasive symptoms ofdepression or you just simply
need to talk to a mental healthprofessional, please do call
the national hotline. Thenumber is easy. It's 9 88, 9 88
if you need to speak to amental health professional 24
hours a day, seven days a week,9 88. So Dr. Colon , this has
(25:11):
been a great topic. It's a lotto digest and I think it really
is going to resonate with allof our listeners because it's
something that affects all ofus from all walks of life. And
so I think it's been just anincredibly important topic. Dr.
Cologne , I'd like to give youthe last word. What, what would
you like to leave our listenerswith about the topic?
Speaker 3 (25:30):
I I think that the most important part is to
recognize that loneliness is asignificant problem. That if
you , um, notice that someonearound you may be experiencing
loneliness or you begin torecognize it in yourself ,
there are things you can andyou should do. You can reach
out to people, you can justbegin very consistently saying,
hello, how was your day? Andpeople say, that's an empty
(25:53):
question. And it could be, butpay attention. The second part
is, I , I think Dr. Murphy isvery clear about suggesting
that people volunteer. And itis an incredibly powerful way
to get someone who isstruggling with how to get into
the community, how to feel asense of productivity and or
company to figure out where youcan offer some volunteer work
and see if that is gratifying.
(26:15):
People also turn to , um, othergroups or clubs or your , uh,
your minister, your priest ,your rabbi or or anybody in
your faith community forsupport. Uh , but the important
theme is be attentive. Be awareof it around you and in you.
And if you notice it, begin todo something about it. It can
be starting with very shortstepss. We all go through
(26:37):
lonely moments and we just needto be aware that either , uh,
we're coming out of it or we'redoing something to help
ourselves or people around
Speaker 2 (26:45):
Us. We've been talking to Dr. Eduardo Colon
about loneliness. He is thechair of psychiatry at Hennepin
Healthcare and a friend and acolleague of mine here in
downtown Minneapolis. This hasbeen a great topic and in like
so many other large issues inhealthcare , the first step is
often to identify the problem.
And that's what you have donefor us today. Thank you so much
for being with us Erra .
Speaker 3 (27:05):
Thank you. My pleasure.
Speaker 2 (27:06):
It's been a great show and I hope you will join
us for our next episode when wewill tackle the subject of
autism with another one of mycolleagues, Dr. Krishnan
Subramanian. And in themeantime, take care of
yourselves, keep an eye out forothers, and be healthy and be
well.
Speaker 1 (27:22):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy Matters hc m ed.org or call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. And finally, if you
(27:45):
enjoy the show, please leave usa review and share the show
with others. The HealthyMatters Podcast is made
possible by Hennepin Healthcarein Minneapolis, Minnesota, and
engineered and produced by JohnLucas At Highball Executive
producers are Jonathan Comitoand Christine Hill. Please
remember, we can only givegeneral medical advice during
this program, and every case isunique. We urge you to consult
(28:06):
with your physician if you havea more serious or pressing
health concern. Until nexttime, be healthy and be well.
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