The Loneliness Epidemic

Are we truly connecting?

October 2024 | August Joaquim

KEY POINTS

  • Despite our digital connections, many people feel lonelier due to the superficial nature of social media interactions.

  • Loneliness can be emotional, lacking close relationships, or social, from feeling insufficiently connected. Both types can harm mental health.

  • Build meaningful connections, join community activities, volunteer, seek professional help, and practice self-compassion to combat loneliness.

In today’s hyper-connected world, where social media and instant messaging keep us in touch with friends and family, it might seem strange to feel lonely. Yet, loneliness remains a pervasive issue for many people. Even as we become more digitally connected, the fundamental human experience of loneliness intensifies. But why is this the case? And how can we address it? Let’s explore the why and what we can do about it, drawing on insights from various studies and reports.

The Irony of Social Media

It’s ironic, isn’t it? Despite being better connected, many of us feel more isolated. Virtual interactions, while convenient, can sometimes lead to surface-level connections rather than deep, fulfilling bonds. The study by Brian A. Primack, published in the American Journal of Preventive Medicine (2017), found a troubling link between social media use and perceived social isolation among young adults. The more time individuals spend on social media, the more likely they feel socially secluded. While technology can keep us in touch, it doesn't necessarily foster meaningful relationships. This suggests that while digital platforms offer a facade of connectivity, they can sometimes exacerbate feelings of loneliness rather than alleviate them.

The Many Faces of Loneliness

What does loneliness really look like?

Understanding these distinctions can help in addressing loneliness more effectively. It's not just about having people around us but having the right kind of connections. The BMC Psychiatry study by Manfred E. Beutel (2017) highlights that loneliness can significantly impact mental health, contributing to conditions such as depression and anxiety. Understanding these categories helps in addressing loneliness effectively and can guide interventions and personal strategies.

The Psychological Impact

Loneliness is more than just a passing feeling; it has tangible effects on our mental and physical health. Steven W. Cole and his team, in their research published in PNAS (2015), found that loneliness can influence our immune system at a cellular level, potentially impacting our overall health. Prolonged loneliness can increase stress levels, impair cognitive function, and even lead to physical health issues such as cardiovascular diseases. The psychological impact can be profound, leading to decreased self-esteem and heightened feelings of depression and anxiety.

The Public Health Perspective

Loneliness is increasingly recognized as a major public health issue. The U.S. Surgeon General's Advisory on the Healing Effects of Social Connection and Community (2023) emphasizes that loneliness and isolation are significant health risks. The advisory underscores the importance of fostering social connections as a crucial component of public health strategies.

According to The Economist and Kaiser Family Foundation (2018), loneliness is now considered a serious public health problem, comparable to other major health issues like obesity and smoking. This recognition calls for a collective effort to address and mitigate loneliness through community-building and supportive interventions.

Here are some strategies to consider:

How Can We Combat Loneliness?

Loneliness is a multifaceted issue that affects many people, even in our highly connected world. By understanding its causes and recognizing its impact, we can take meaningful steps towards overcoming it. Building deeper connections, engaging in community activities, and practicing self-compassion are all vital parts of this journey. Remember, reaching out for help and making small changes in how we connect with others can make a significant difference. Let’s strive to turn our moments of loneliness into opportunities for growth and connection.

Contact us today if you’d like to become a new patient.

References

Brian A. Primack, Ariel Shensa, Jaime E. Sidani, Erin O. Whaite, Liu yi Lin, Daniel Rosen, Jason B. Colditz, Ana Radovic, Elizabeth Miller. Social Media Use and Perceived Social Isolation Among Young Adults in the U.S. Americal Journal of Preventative Medicine (2017) 53:1, pages 1-8, DOI:10.1016/j.amepre.2017.01.010

Gillian A. Matthews, Edward H. Nieh, Caitlin M. Vander Weele, Sarah A. Halbert, Roma V. Pradhan, Ariella S. Yosafat, Gordon F. Glober, Ehsan M. Izadmehr, Rain E. Thomas, Gabrielle D. Lacy, Craig P. Wildes, Mark A. Ungless, Kay M. Tye. Dorsal Raphe Dopamine Neurons Represent the Experience of Social Isolation. Cell (2016) 164:4, Pages 617-631, ISSN 0092-8674, http://dx.doi.org/10.1016/j.cell.2015.12.040.

Manfred E. Beutel, Eva M. Klein, Elmar Brähler, Iris Reiner, Claus Jünger, Matthias Michal, Jörg Wiltink, Philipp S. Wild, Thomas Münzel, Karl J. Lackner, and Ana N. Tibubos. Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry (2017) 17:97.

Our Epidemic of Loneliness and Isolation. The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community 2023.

Steven W. Cole, John P. Capitanio, Katie Chun, Jesusa M. G. Arevalo, Jeffrey Ma, and John T. Cacioppo. Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation. PNAS, Volume 112, Issue 49, December 2015, pages 15142–15147. https://www.pnas.org/doi/pdf/10.1073/pnas.1514249112

The Economist and Kaiser Family Foundation (2018). Loneliness is a serious public health problem. Available URL: https://www.economist.com/international/2018/09/01/loneliness-is-a-serious-public-health-problem

The Brains Behind The Alphabet

September 2024 | August Joaquim

The psychological devastations that follow familial rejection towards LGBTQ+ individuals.

KEY POINTS

  • Familial rejection profoundly affects LGBTQ+ individuals, causing intense emotional pain, including betrayal, loneliness, and internalized shame.

  • Transgender people face unique psychological challenges due to family rejection, including worsened gender dysphoria and increased risk of mental health issues such as depression and suicidal ideation.

  • Research shows that familial rejection significantly heightens the risk of severe outcomes like homelessness, unemployment, and substance abuse, emphasizing the need for familial support and acceptance.

Gender Nonconforming

What does it mean to be gender nonconfirming?

Familial rejection can be a painful experience for anyone, but for members of the LGBTQ+ community, it can carry unique psychological burdens. When family members reject their loved ones based on their sexual orientation or gender identity, the impact can be profound and multifaceted. We are going to explore the psychological effects of familial rejection on LGBTQ+ individuals, with a focus on transgender and gender nonconforming (GNC) people, and offer insights into coping mechanisms and paths to healing.

1. The Emotional Impact of Rejection

The word ‘family’ is usually associated with unconditional love and support. When this fundamental support system is compromised, LGBTQ+ individuals can experience a range of intense emotions:

Rejection

What is the emotional impact?

2. Psychological Effects on Transgender Individuals

Transgender or GNC individuals face unique challenges when rejected by family, as their identity often requires more significant personal and social adjustments, such as undergoing name changes or medical transition. Without familial support, these changes that are integral to their mental well-being can create strife when faced with choosing one's true self above the comfort and safety of a family.

Gender Dysphoria

What does it mean?

Identity Invalidations:

When a transgender person is dismissed by their family, it can feel like an invalidation of their very identity. This rejection can exacerbate feelings of gender dysphoria and undermine their efforts to live authentically. Those who make the choice to change their name, pronouns, and physical appearance also take on the responsibility of re-introducing themselves to their loved ones, and their social circles. This step in their transition is integral to attempts to alleviate the dysphoria caused by misgendering and dead-naming.

My family’s initial reaction was to isolate me from any positive outside influence. ...They isolated me and then ignored my identity, leaving me to attempt to secretly socially transition within my inner circles.
— Community Member

Increased Risk of Mental Health Issues:

Studies have shown that family rejection is associated with higher rates of depression, anxiety, and suicidal ideation among transgender people. In 2018, one in four LGBTQ+ individuals in Charleston (and the surrounding counties) reported suicidal ideation, which is five times the national average. Additionally, the Center for American Progress reported in 2020 that 62% of transgender individuals experienced discrimination within the past year, further compounding these mental health issues.

Research consistently shows that family rejection significantly increases the risk of mental health issues among LGBTQ+ individuals. According to PubMed, LGBTQ+ youth who experience high levels of family rejection are:

Family Rejection

Increases the Risks

Building Support Networks:

Connecting with LGBTQ+ communities, friends, or support groups can provide a sense of belonging and affirmation. There are certain networks out there that can offer you support.

Resources

Take note of these community resources

Barrier to Affirmation:

Family support is often crucial for affirming one's gender identity. Without it, transgender and GNC individuals might struggle to access necessary resources or support systems, increasing feelings of isolation and vulnerability.

The U.S. Transgender Survey Findings:

The 2015 U.S. Transgender Survey (USTS), conducted by the National Center for Transgender Equality, provides one of the most comprehensive insights into the lived experiences of transgender individuals in the United States. With nearly 28,000 respondents, this landmark survey sheds light on the profound challenges faced by transgender people, especially those who experience family rejection.

The survey revealed that transgender individuals who faced rejection from their families were significantly more likely to encounter a range of negative outcomes across various aspects of their lives:

  • Homelessness: Family rejection was strongly associated with a higher likelihood of experiencing homelessness. 30% of respondents who experienced family rejection had experienced homelessness at some point in their lives, compared to 11% of those who had supportive families.

  • Unemployment: Family rejection is also correlated with higher unemployment rates. The survey showed that respondents who experienced rejection from their families were more likely to be unemployed, with 27% of those who faced rejection being unemployed at the time of the survey.

  • Discrimination in Public Spaces: Transgender individuals who experienced family rejection were also more vulnerable to discrimination in public spaces. More than half of those who faced family rejection reported being verbally harassed in public, and 29% reported being denied equal treatment, compared to 36% and 19%, respectively, among those with supportive families.

For instance, according to the American Progress, 50% of LGBTQ+ individuals have encountered discrimination in public places. This environment of intolerance often leads to significant changes in behavior; in fact, two out of three transgender individuals report altering the way they dress and their mannerisms to avoid such discrimination. Notably, more than two-thirds of transgender people report experiencing significant psychological harm due to discrimination.

  • Mental Health Impact: The mental health consequences of family rejection were particularly alarming. The survey found that 54% of respondents who experienced familial rejection had attempted suicide at some point in their lives, compared to 37% of those who had supportive families. Additionally, 70% of those who faced rejection reported experiencing severe psychological distress in the month before taking the survey, compared to 42% of those with supportive families.

  • Substance Use: Family rejection was also linked to higher rates of substance abuse. 35% of those who experienced familial rejection had engaged in drug or alcohol use to cope with mistreatment based on their gender identity, compared to 22% of those whose families accepted them.

These statistics from the USTS underscore the severe impact that familial rejection can have on transgender individuals. The survey’s findings highlight the critical need for families to provide acceptance and support, as doing so can dramatically reduce the risks of homelessness, unemployment, discrimination, and mental health crises among transgender people.

The Role of Internalized Rejection

Internalized rejection is when individuals begin to internalize negative messages or attitudes they’ve received from their families. This can manifest in several ways:

The Role of Internalized Rejection

“....when I brought up the desire for transition, I was met with such fear and disgust that I

even questioned my own needs for living as my true authentic self.”

- Community Member

4. Coping Strategies and Pathways to Healing

While the pain of family rejection is profound, there are strategies and pathways that can aid in healing:

Coping Strategies

Pathways to Healing

*Centerway Psychiatry focuses on medication management, but we can recommend local therapy practices.

5. Why Family Acceptance Matters

Family acceptance doesn't just reduce the risk of mental health issues—it can be life-saving. When LGBTQ+ individuals feel supported by their families, they are more likely to thrive, both mentally and emotionally. They can navigate the challenges of living in a world that often marginalizes them with the assurance that they have a safe and loving environment to fall back on.

Anti-Trans Bills

For parents, guardians, siblings, and extended family members, understanding the importance of acceptance can make a world of difference. Simple acts of kindness, such as using the correct pronouns, advocating for your LGBTQ+ loved one, or simply listening without judgment, can foster a sense of belonging and self-worth.

My mother sometimes refers to me in a non-gendered way and I love that. Those small
moments bring me such joy.
— Community Member

6. Moving Forward: Finding Peace and Acceptance

Acceptance from family may not always be attainable, but finding peace and self-acceptance is a crucial goal. Embracing one’s identity, regardless of external validation, and focusing on personal growth and happiness can lead to a fulfilling and authentic life.

Familial rejection is a deeply painful experience, particularly for LGBTQ+ individuals who rely on family support for validation and stability. Understanding the psychological impact and exploring coping strategies can help individuals navigate this challenging terrain.

Through support networks, therapy, and self-affirmation, LGBTQ+ individuals can find ways to heal and build a fulfilling life, even in the face of familial rejection.

Breaking the Cycle of Rejection

It's crucial to recognize that change is possible. Families who have initially rejected their LGBTQ+ members can work towards healing and acceptance. Educational resources, support groups, and counseling can help families understand the importance of acceptance and learn how to provide the love and support that their LGBTQ+ loved ones need.

For those who may not have the immediate support of their family, it's important to seek out alternative sources of support—whether it’s through friends, chosen family, or LGBTQ+ community organizations. No one should have to face the challenges of being LGBTQ+ alone, and there are countless resources available to provide the love and acceptance that everyone deserves.

Family isn’t stitched to biology, as we’ve learned, biology isn’t the end all be all. Family

can be found in friends, mentors, and those who nourish you. Chosen family is just as

powerful.
— Community Member

Family rejection is a silent epidemic that deeply affects the mental health and well-being of LGBTQ+ individuals. The statistics are clear: rejection leads to a higher risk of depression, anxiety, and suicidal ideation. However, the power to change these outcomes lies within families. By embracing love, acceptance, and understanding, families can become the safe havens that every LGBTQ+ person needs and deserves.

If you or someone you know is struggling with family rejection, remember that help is available. Reach out to local LGBTQ+ organizations, find supportive communities, and never underestimate the impact that acceptance can have on someone’s life. If you need assistance with med management, please contact us to schedule a consultation.

If you are in need of assistance, please see below for a list of national and Charleston-specific organizations:

GLAAD Resource List https://glaad.org/resourcelist/

The Trevor Project https://www.thetrevorproject.org/resources/

Lowcountry Pride https://www.lowcountrypride.org/

References

2024 Anti-Trans Bills: Trans legislation tracker. 2024 Anti-Trans Bills: Trans Legislation Tracker. (n.d.). https://translegislation.com/

Alliance For Full Acceptance. (2019). Tri-County Area LGBTQ Community Needs Assessment Report. AFFA-SC. https://www.affa-sc.org/wp-content/uploads/AFFA_AssessmentReport_2019_Singles.pdf.

The state of the LGBTQ community in 2020. Center for American Progress. Retrieved February 2, 2023, from https://www.americanprogress.org/article/state-lgbtq-community-2020/

Direct online and phone support services for LGBTQ+ Youth. HRC. (n.d.). https://www.hrc.org/resources/direct-online-and-phone-support-services-for-lgbtq-youth

Fact sheet: Transgender & gender nonconforming youth in school. SRLP (Sylvia Rivera Law Project). (2012, August 20). https://srlp.org/resources/fact-sheet-transgender-gender-nonconforming-youth-school/#:~:text=“Gender%20nonconforming”%20refers%20to%20people,they%20were%20assigned%20at%20birth

Family. US Trans Survey. (2024, August 13). https://ustranssurvey.org/report/family/

Family Acceptance and LGBTQ+ Youth. The Trevor Project. (2023). www.thetrevorproject.org/resources/family-acceptance.

Free stock photos, royalty free stock images & Copyright Free Pictures · Pexels. (n.d.). https://www.pexels.com/

The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality. James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016).

Marquez-Velarde, G., Miller, G. H., Shircliff, J. E., & Suárez, M. I. (2023). The impact of family support and rejection on suicide ideation and attempt among transgender adults in the U.S. LGBTQ+ Family: An Interdisciplinary Journal, 19(4), 275–287. https://doi.org/10.1080/27703371.2023.2192177

Research. Research | Family Acceptance Project ®. (n.d.). https://familyproject.sfsu.edu/research

Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino Lesbian, gay, and bisexual young adults. Pediatrics, 123(1), 346–352. https://doi.org/10.1542/peds.2007-3524

Trevorspace .The Trevor Project. (2024, August 15). http://www.thetrevorproject.org/pages/safe-community

Understanding LGBTQ+ Rejection and Mental Health. GLAAD. (2024). www.glaad.org/resources/LGBTQ+-rejection-mental-health.

US Trans Survey. (2017, October). Florida State Report - National Center for Transgender. Equality. 2015 U.S. Transgender Survey: Florida State Report. Retrieved February 3, 2023, from https://transequality.org/sites/default/files/docs/usts/USTSFLStateReport(1017).pdf

What is gender dysphoria? Psychiatry.org - What is Gender Dysphoria? (2022). https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-genderdysphoria

The Mental Health Pandemic: Covid-19 - Depression and Anxiety

Although in the United States, we are finally at a point when it appears there is a life-saving solution to covid-19. The impact the global pandemic has had on minds around the world is irrefutable. Whether or not individuals have contracted Covid-19, there has been a noteworthy increase in cases of anxiety, depression, and stress-related illnesses.

People are universally concerned about restoring their pre-Covid existence and it can be stressful, along with dealing with new realities relating to work, travel and leisure. The propensity for experiencing anxiety and depression over the past two years has been high for these and many other reasons and at Centerway Behavioral Health, we’d like to make sure we’re participating in the awareness and treatment of these cases.

The Physical and Mental Impacts of Covid-19

Although people may have recovered from the physical effects of Covid-19, research is beginning to assess the lingering effects of the disease on mental health. Approximately one out of every three people who have had Covid-19 are diagnosed with a form of mental illness within six months from infection, with nearly 20% of people diagnosed within three months.

Among people who recover from the physical symptoms from Covid-19, anxiety and mood disorders have become very prevalent. “Mask anxiety” still affects many people who have already been completely vaccinated. The cloak of restricted living that accompanied life with Covid-19 continues to affect many people who are finding it difficult to get back to their pre-pandemic routines.

Difficulty Returning to Normal After the Pandemic

pexels-tim-douglas-6567667.jpg

Having to fulfill responsibilities now that many restrictions are being lifted can produce anxiety. While many people feel liberated by declining case and death rates, others find it difficult returning to normal. For some, this can even manifest as Covid-19 anxiety syndrome.

There are some physical symptoms of Covid-19 overlap with some symptoms depression, including insomnia, difficulty concentrating and poor appetite. If you suspect that you or a loved one may be depressed or anxious after your experience with Covid-19, it is important to seek out a qualified mental health practitioner.

Centerway Behavioral Health is here to support anyone who feels their mental health has been negatively impacted by Covid-19.