March 28, 2018
Feeling lonely and unloved are bad for your heart, and not just in the figurative sense. In fact, studies show that loneliness, marital distress, and lack of social support are linked with a host of negative health outcomes, including cardiovascular illness, obesity and its related complications, and even increased rates of morbidity. Our emotional states are inextricably linked with our physical health, so why don’t we pay as much attention to stress and loneliness as we do to physical symptoms like chest pain?
In a recent issue of Policy Insights from the Behavioral and Brain Sciences, Lisa Jaremka and Naoyuki Sunami make the case that we need to pay more attention to the causes and consequences of stress and loneliness. After reviewing studies on several forms of social isolation and distress and finding common patterns of illness, the authors conclude that we should categorize loneliness, marital distress, and lack of social support under one umbrella that they call threats to belonging. That categorization could prove useful to clinicians and policymakers for the purposes of identifying, preventing, and treating some common health concerns.
Threats to belonging seem to impact health through at least two pathways. The first is dysregulation of immune functioning. If it seems like you always get sick after a big deadline or when you’re experiencing family stress, there’s a reason for that. It has long been documented that stress dampens the immune system, making it harder to fight off infections. Jaremka and Sunami’s review finds that threats to belonging also depress immune functioning. For example, divorced women tend to have higher recurrence of dormant viruses in the bloodstream, like herpesvirus, and lonely people have shown heightened inflammation relative to people who don’t feel lonely. As if those findings weren’t alarming enough, the authors write that “a provocative study demonstrated that a marital conflict discussion caused slower wound healing…than a socially supportive discussion.” Healing was particularly slow when couples displayed hostility toward one another – a rather poetic illustration of the pain associated with relationship strife.
A second, less researched pathway appears to be appetite dysregulation. It turns out there is some basis for the rom-com trope of spurned lovers eating pints of ice cream and bags of chips in their PJ’s. Of course, the comfort foods we crave when we’re feeling low or stressed tend to be high in sugar, salt, and fat and are therefore detrimental to cardiovascular health and other outcomes. But there also seems to be a relationship between threats to belonging and hormones that modulate our eating. One study found that reports of interpersonal stress were related to altered levels of appetite-regulating hormones (increased levels of an appetite-stimulating hormone and decreased levels of an appetite-inhibiting hormone), while reports of other kinds of stress were not. Another study found that, after an incident of marital discord, research participants had increased levels of the appetite-stimulant, even after they had already eaten. (This only occurred in non-obese participants, likely because obese people tend to be resistant or desensitized to these hormones.)
The authors hope that grouping loneliness, marital distress, and lack of social support together can help researchers and policymakers identify and deploy intervention strategies that will effectively reduce the threats to belonging and improve physical health. They cite the well-documented success of cognitive behavioral therapy and behavioral marital therapy in addressing loneliness, stress, and a range of mental health conditions, and suggest that these approaches could be examined as part of efforts to improve physical health as well. The authors call on policymakers and insurers to cover such techniques in health insurance and community programming. They also recommend that public health efforts educate both individuals and physicians about the risks of strife-filled relationships and other threats to belonging.
Drawn from “Threats to Belonging Threaten Health: Policy Implications for Improving Physical Well-Being” by Lisa M. Jaremka and Naoyuki Sunami in Policy Insights from the Behavioral and Brain Sciences.