The Loneliness Epidemic Is a Health Emergency, Not a Feeling
Day 2 of the 30-day Relationships Series.
In May 2023, the U.S. Surgeon General published an advisory titled "Our Epidemic of Loneliness and Isolation." It was one of the most striking documents to come out of federal public health in the last decade — because it framed loneliness not as a mood, not as a personality problem, and not as a soft cultural concern, but as a health emergency comparable to smoking, obesity, and physical inactivity.
This piece is here to make sure that message reaches the people in Utah who most need to hear it.
If you are lonely, you are not failing at life. You are experiencing a physiological signal from your body that the amount of human connection it is receiving is not enough for you to thrive. That signal deserves the same seriousness a persistent cough or a rising blood pressure would.
What the Advisory Actually Said
The Surgeon General's 2023 report drew from decades of research to make a set of very direct claims.
About half of American adults report meaningful loneliness.
Chronic loneliness carries an all-cause mortality risk roughly comparable to smoking 15 cigarettes a day.
Chronic loneliness is associated with a 29% increased risk of heart disease, a 32% increased risk of stroke, and roughly a 50% increased risk of dementia in older adults.
Isolation increases the risk of depression, anxiety, and suicide.
In children and adolescents, loneliness increases the risk of school failure, substance use, and self-harm.
The average amount of time Americans spend in-person with friends dropped by about 20 hours per month between 2003 and 2020. For young adults, the drop was closer to 70%.
Read that list again slowly. Each line is a health outcome that we would take seriously if it came from any other cause. Loneliness deserves the same seriousness.
Two Kinds of Loneliness
Researchers who study loneliness typically divide it into two categories, because they respond to different kinds of interventions.
Emotional loneliness — the absence of a deep, close bond with someone who knows you well. The person you would call in a crisis. This kind of loneliness is not solved by adding more casual acquaintances. It is solved by deepening or forming a small number of close bonds.
Social loneliness — the absence of a wider network of people you see regularly. The neighbors, the class, the volunteer group, the weekly community. This kind of loneliness is not solved by having one deep friend. It is solved by building a repeating context.
Most adults who describe themselves as lonely have some of both. But the fix is different for each. Naming which one is running larger in your life is a useful starting point.
Why This Is Happening Now
The rise in loneliness has real, structural causes. It is not a moral failing of any generation.
Remote work removed one of the largest daily sources of casual adult contact.
Neighborhoods thinned out as social hubs. People know their neighbors less well than they did in every prior decade of the twentieth century.
Religious and community organization attendance dropped sharply, especially post-2020.
Marriage and cohabitation are happening later and less often. Household sizes are smaller.
The phone in your pocket has delivered a shallower substitute for connection that partially quiets the hunger without actually feeding it.
Rising rates of anxiety, depression, and complex trauma in young adults make forming new bonds harder even when opportunities exist.
You are not lonely because you are broken. You are lonely because the water you are swimming in has changed.
The Body's Signal
Loneliness has a specific physiology. When your nervous system detects that social connection is insufficient, it produces a low-grade chronic stress response — elevated cortisol, elevated inflammation, disrupted sleep, and impaired immune function. It is essentially a biological alarm designed to push you back toward the group.
In the short term, this alarm is protective. In the long term, if the signal cannot be answered, it becomes the disease itself. This is why chronic loneliness produces cardiovascular disease, dementia risk, and premature death. The alarm was never meant to keep ringing for years.
When you feel it — restlessness, sadness, a low-grade sense of not being seen — that is the alarm doing its job. Do not medicate it into silence. Answer it.
What Answering the Alarm Looks Like
One weekly rhythm with one person. A call, a walk, a meal, a video visit. Same time each week. Frequency matters more than novelty.
One repeating context. A class, a group, a volunteer shift, a faith community. Somewhere the same faces appear on the same day of the week.
Cutting solo screen evenings by even one night. What replaces the screen matters — a walk, a call, a real conversation.
Naming loneliness out loud to one safe person. Loneliness metabolizes when it is witnessed. Silence deepens it.
For older adults, community programs, senior centers, and intergenerational volunteering are underused resources. In Utah, look into local senior centers, church programs, and community education programs at nearby colleges.
For young adults, in-person clubs, run groups, hobby communities, and religious or philosophical communities are far more effective than dating apps at rebuilding a bonded life.
When Loneliness Has Become Something More
If loneliness has moved into persistent depression, hopelessness, changes in sleep or appetite, or thoughts of self-harm, please treat it as clinical. This is not weakness. It is what a chronic biological alarm does to a body over time.
If you are having thoughts of suicide or self-harm, please call or text 988 (Suicide and Crisis Lifeline) any time. It is free, confidential, and available 24/7.
Whole-Person Steps
Take the alarm seriously. It is not a mood. It is a physiological signal deserving the same attention as any other vital sign.
Name which kind you have more of — emotional or social — and choose interventions accordingly.
Commit to one weekly rhythm and one repeating context this month.
Rule out the biology of low mood — thyroid, iron, hormones, sleep, depression, anxiety. See Day 5.
If the loneliness has become depression, get help. It is treatable. You are not meant to carry this alone.
If You Are in Utah
At Integrative Mind Body Psychiatry, I treat the whole picture — the biology of low mood, the mental health, and the relational life that has to be rebuilt around it. Telehealth for adults, adolescents, and women in hormonal transitions across Utah. Insurance accepted through Headway (headway.co/providers/beth-makar).
Tomorrow: Day 3 — The Nervous System Learns to Love. Attachment styles for adults who did not grow up hearing the term.
This post is educational and is not a substitute for individualized medical or mental-health care.
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