Loneliness - definition and symptoms

Loneliness - definition and symptoms

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Loneliness - an epidemic

Those who are lonely are more likely to suffer from heart attacks, strokes, depression and cancer. Loneliness spreads like an epidemic - the psychiatrist does not mean that metaphorically. He defines the disease as experiencing social isolation, which has its own dynamic and becomes a vicious cycle.

"A lot of the people in the developed western The world is increasingly suffering from loneliness. (…) We educate our children to a lesser extent than before, but train them to be overly self-centered. ”Brain researcher Manfred Spitzer, known as a critic of digitization (“ cyber sick ”), sees loneliness not only as a symptom, but as his own Illness, even an illness that is contagious and "classified as one of the leading causes of death in the civilized world."

Soul medicine has mostly understood that obedience is a symptom of other mental disorders. However, it is a matter of its own, a disease of its own.

The single society

The number of single-person households is continuously increasing. At a young age, people might appreciate this as an expression of freedom, but with age it becomes a problem. High demands and the idea that "something better" is coming, prevent a fulfilled partnership. Also, more and more people would leave long-term partnerships and live alone. The hope for freedom is now becoming loneliness.

Social isolation is objective, loneliness is subjective

It distinguishes objective social isolation from the subjective feeling of loneliness. The two were related: the greater the social isolation, the greater the feeling of loneliness. People with few friends would become lonely over time.

Humans are the most social mammals?

According to Spitzer, humans of all mammals are particularly geared towards community life. According to Daniel Kahneman, Israeli-American psychologist and Nobel laureate, people spend around 80% of their waking hours with other people.

Spitzer sees this as a contradiction to today's trend towards “single life”. The trend towards being alone is a megatrend, in fact in the vast majority of countries. Everywhere there is an increase in individualism, in practice as well as in values.

Spitzer writes: “Even the largest number of hermits or narcissists is not a community. From the perspective of every functioning community, everything that promotes cooperation and cooperation between people is therefore of existential importance. ”(P.45)

Loneliness is contagious

"If one understands loneliness (...) the experience of social isolation (and not the social isolation itself ...), it is quite possible without contradiction that this social experience can be transferred to others through social interaction." (P.71)

Spitzer considers alcoholism and obesity to be contagious, as is loneliness. The closer we live to a lonely, the more likely we would feel lonely. Affects and emotions could be infectious, and this includes loneliness. Such an emotional contagion is well known in medicine, and has now also been proven by brain research, because people approach other people emotionally by automatically imitating their language, gestures and facial expressions and synchronizing them with the other person. According to Spitzer, this also applies to loneliness.

Pain, illness, death

Spitzer divides his book into ten chapters, in which he quotes extensively from studies that are all supposed to demonstrate how harmful loneliness is based on different aspects. This ranges from “loneliness triggers stress” to “loneliness hurts” and “loneliness as a risk of illness” to “number one cause of death”. It's always about feeling loneliness.

"The Internet makes you lonely"

"A cause for concern (...) scientific studies that show that modern information technology replaces real social contacts, especially in children and adolescents, to an unprecedented extent." (P.122)
Spitzer sees today's trends such as personal relationships, social media, laptop, smartphone and Facebook as risky. According to him, social media cause loneliness, fear and depression. This is frightening because “they fill up a significant part of everyday life in young people”. This is bad for social health.

"Social media are not social"

Why do social media lead to loneliness? Spitzer does not consider them social, on the contrary. Social relationships were characterized by their immediacy. We look into the eyes of others and perceive their speech melody, their expression, facial expressions and gestures. The screen in between abolishes this immediacy. That leads to loneliness.

The increasing leisure time on the computer diminished empathy and nothing could replace direct social contacts; Meta-analyzes showed a clear connection between the benefits of digital media on the one hand and less well-being and depression on the other. (P.122)

He writes: “The first Facebook users were socially particularly active people who used the new online offer to manage their many contacts even better. In the meantime, almost every young person uses Facebook or similar online social media to an extent that has a measurable and significant impact on their social life. ”(P.127)

Even more. Participants in a study felt worse after using Facebook and felt that they had wasted their time senselessly, but continued to use Facebook, Spitzer said, because before the FB benefit, they believed that they would be better off afterwards. (P.130).

Language development is social development

According to the author, there is nothing more interesting for young children than other people. The mother tongue cannot be learned on the screen and speakers. Children watch the mouths of their parents, who are holding them in their arms, so that they can better distinguish the speech sounds, and empathy can only be learned through dialogue with one another, says Spitzer. The television hinders children's language development, even if it is running in the background. Compassion is learned in dialogue, language development is always social development and both are demonstrably disturbed by the media.

Social and physical pain

Research showed a connection between social and physical pain. According to Spitzer, they have a common neurobiological basis. Like physical pain, loneliness is a warning signal, an appeal by the organism to maintain social relationships in order to survive. Loneliness triggers stress, the body's reaction to danger. However, while stress is essential for survival in acute situations, chronic stress makes people sick. The consequence of this is permanently high blood pressure, suppression of digestion etc. and corresponding secondary diseases.

Loneliness is a risk factor, as is smoking or a lack of exercise, increasing the risk of developing an infection, leading to high blood pressure, psychological complications and a weak immune system.

Social online media: lonely together

According to Spitzer, more digital communication does not go hand in hand with an increase in social connection, on the contrary. The media stand between people, would hinder real contacts and thus create loneliness. This is evidenced by new scientific knowledge. Social online media therefore generate loneliness, fear and depression. The permanent comparison with others, the social orientation "upwards" and self-uncertainty are what make sick in connection with online media.

His point of view is clear: "Social media harm mental health." People would be infected by the mood of others through social media. Mutual trust is waning through online social media, depression is increasing and loneliness is increasing. Instead of joy with friends there would only be hot air, stale taste and emptiness. Real reality is sudden. There are huge differences between media and real contacts. Those who spend their time with online social media instead of real conversations risk their life satisfaction and happiness.
In real dialogues, people acted together. If nobody leads and nobody follows, you can quickly agree and act more effectively.

He writes: "Many small daily encounters with mostly strangers are the glue that not only holds our own lives together, but also our society."

Smartphone crisis of confidence

Trust arises from successful interactions between strangers. That only works if everyone adheres to the rules of the game. Trust is quickly lost and slowly rebuilt. With the Smarthone, however, people-to-people encounters, which keep showing us dependence on others, are diminishing. Online shopping, online banking, GPS orientation, etc. run without contact with people. Chatting, emailing, texting etc. work without direct contact with people. Personal entertainment will be replaced by media entertainment. The social contacts that lead to experiences of belonging in healthy society would thus be reduced. Those who trust others less are more lonely. The smartphone could also lead to more loneliness.

Loneliness as a focus of illness

Diseases that promote loneliness include, according to Spitzer, high blood pressure, metabolic disorders, vascular disorders, sleep disorders, depression, lung diseases and infectious diseases.

According to the author, mental illnesses and loneliness often form a vicious circle of social isolation. One of the most common experiences in psychiatry is not having enough social contacts and experiencing loneliness. Loneliness is a leading symptom of patients with depression, schizophrenia, delusional disorders and addictions. In old age, the decline in mental performance is exacerbated by loneliness.

Cause of death number one

According to Spitzer, both objective social isolation and experiencing loneliness go hand in hand with a higher risk of death. The negative effects of loneliness are greater than those of smoking, obesity, heavy alcohol consumption or poor nutrition. Loneliness and social isolation are just as avoidable risks as the other factors. Risk factors such as smoking, diet or exercise take doctors seriously, but these should be supplemented by social relationships.

Is every relationship better than none?

As a psychiatrist with over 30 years in the job, he knows that relationships can be experienced as "hell", Spitzer writes. However, these are extreme cases. In general, spouses connect more than friends and acquaintances, also in the common activities, and this provides a breeding ground for mutual help as well as for conflicts. The couple relationship is the most important relationship of people. (P.175)
Better quality marriage also goes hand in hand with overall better health and lower mortality. (P.177).

Happiness and community

According to Spitzer, many small actions can weaken the negative circulation. This includes making music, singing and dancing - cultures that do not maintain social activity would not survive. Cooperate, coordinate and cooperate again are the keys. All actions that bring people closer together, according to the author, work against loneliness.

Positive loneliness

According to Spitzer, there is also a positive loneliness. To savor this, you have to go actively into nature. People who do this would develop greater awareness of community and connectedness. In nature we would get a better grip on our emotions and this type of being alone works against loneliness, which is now meant negatively.

Criticism - A little of everything and too little of everything

"Loneliness, the unrecognized illness" is supposed to be an "overdue wake-up call". Spitzer does not present anything new. Whether Kafka, Marcuse, Adorno or Sartre: The fact that modernity, with greater individual freedom of man also brought greater uncertainty and the loss of old social ties, has accompanied the literature of this modern age from its beginnings. The question is, who does Spitzer want to reach, and what should his book be?

Is it the popular form of new scientific knowledge about a disease called loneliness, as the many studies cited suggest? Then the question arises, why does it mainly refer to American studies? They cannot simply be transferred to Europe or Germany - moreover, they are not even empirically viable. Sometimes it seems as if his opinion precedes the study he is quoting and the question remains whether the studies could not be assessed in reverse. His omissions are not scientifically valid.

The way Spitzer deals with studies in order to underpin his pointed theses sometimes seems dubious. For example, he quotes a study according to which the word "I" appears more frequently in American books than 50 years ago and less often the word "we". This counts as proof of what he knows anyway: people have become more and more narcissistic.

Studies and facts are obviously only interesting for him to use as a splash of color in his crisp statements such as "The life risk number one" or "Cause of death number one". This has little to do with science, but a lot with market yelling to sell books, which he does well.

Help for those affected?

Should the book help to fight loneliness actively? Those affected are of little help with the extensive citation of, especially American, studies. Even the tips according to the motto "join a singing choir or a dance group" seem strangely helpless if someone has a problem as serious as the "cause of death number one".

Social criticism?

Should it be a "wake-up call" to society? It stops halfway there. Marcuse's "one-dimensional person" or Adorno's "cultural industry" did much more to the problem sketched by Spitzer decades ago. If we understood the "undetected illness" loneliness as a result of alienation in neoliberalism and late capitalism, then a "wake-up call" would mean to expose the misanthropy of neoliberal politics, which denies the social essence of man. Here Spitzer writes around the hot porridge without revealing anything about its smell.

A disease?

Spitzer stumbles when he defines this disease. It seems to be dramatic: Undetected, contagious and deadly - like a previously unknown virus that is spreading epidemically. For such a bad illness, however, he lacks diagnostic categories that would allow the term to be used in a way other than metaphorical. Number one cause of death Spitzer postulates luridly, but then admits himself that the data does not allow such a conclusion.

His own remarks show that loneliness, as he describes it negatively, can hardly be described as an illness with fixed symptoms, but rather as the cause of illnesses. Smoking, too, just to choose a comparison, which Spitzer tries to do, is not the disease itself, but a risk factor, for example, to develop a disease such as lung cancer.

It would be very difficult with his “therapies” if the phenomenon he described were really an illness. In the light of his own dramaturgy of a fatal illness, his suggestions seem silly: Going among people, cultivating social relationships, holding honorary posts, helping and giving ... Isn't the loneliness he describes a vicious cycle, comparable to depression? That means that those affected cannot take the steps suggested by Spitzer without professional help.

This lack of clarity about what this disease is supposed to be is also a shame because there are recognized syndromes that have a lot to do with loneliness, for example the bitterness syndrome. Here people feel betrayed, cheated out of their life's work, and for example "old people eat their anger into themselves" because the grandchildren for whom they think they have done everything no longer care when they end their life need someone who is there for them.


At Spitzer, “contagion” means nothing more than that people adopt the behavior of other people. But this has nothing to do with the infection of a disease transmitted by bacteria, viruses or fungi, but infection is a metaphor here. Laughter is contagious, grief is contagious, film scenes touch us like real events, people can be traumatized if other people only tell them about terrible qualities. Everything is contagious somehow. The medical definition is different.

When Spitzer describes loneliness as experiencing social isolation, he contradicts himself with the term illness. If it were a physically effective disease, organs would have to be affected. If it were a mental illness, there would be hard criteria that distinguish it. Rather, it describes a phenomenon, a sensation.

Are social media bad?

Spitzer loves wraps. But they are not helpful, especially when it comes to the role of social media. Of course, on Facebook, Twitter or Instagram the medium between the immediate encounter is. Here Spitzer does not come up with differentiated studies on the great danger he has conjured up, for example whether and which social relationships Facebook friends cultivate in the real world.

This does not necessarily mean that his criticism is wrong, or at least insufficient. For example, mediated communication helps when I am looking for people who share my political attitude, my interests and my hobbies. And when I find out on Facebook where events are taking place in my hometown, I find it better to meet other people who share my interests in real life than without social media.

Conversely: when I speak directly to people on the street about the topics that I know and get little or no positive feedback, I don't end up feeling more lonely than when I first talk about these interests on social media and then talk to like-minded people meet in the real world? Social media also make it possible to re-establish contact with old friends, stay in touch with acquaintances who have moved to other cities, and so on.

So what Spitzer portrays as almost inevitable isolation through social media would be more of an indication of promoting media literacy.

Longing for the good old days?

Between the lines, "loneliness" unfortunately sometimes seems like a complaint about the "youth of today". It is narcissistic, egomaniacal and without empathy, while "we" at this age were still working together, discussing the nights, helping each other and sharing with others. And that's not a "wake-up call", but a story to fall asleep.

The problems that people suffered and suffer from in the “good old days” or still today in conservative village structures are completely forgotten: peer pressure, social control, marginalization of outsiders, lack of privacy.

If, on the other hand, I live in the trendy district of a big city, I can go to cafes with a hint of loneliness, address strangers on a park bench, go to concerts and in pubs, bars and clubs and meet people there. If loneliness means experiencing social isolation, then the danger is much greater if I live in a village where the locals don't like me and the only meeting point is the petrol station.

What remains?

Spitzer's book is not a "wake-up call", and the studies he quotes are interpreted almost arbitrarily by him on his idea of ​​negative loneliness. Can the book provide new food for thought? Only a little, because it stirs up fear instead of offering perspectives. We learn much more about loneliness from Kant and Kafka, Poe and Nietzsche, Bierce and Goethe than from Spitzer.

The book offers very little for people suffering from loneliness in a negative sense. You would be better served with specific therapy offers and a list of specialists to whom you can turn than with tips that come out as "switch off your smartphone and maintain social contacts".
Those who suffer from loneliness in such a way that they become seriously ill need professional help because they cannot help themselves. If he didn't need it, it wouldn't be a serious illness. Spitzer's all-round stroke does little to help those affected, and practical help for people who are "sick" of solitude is still lacking. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Manfred Spitzer: Loneliness - the Undetected Disease, Droemer Verlag, 4th edition, 2018

Video: 17 Signs That Youre Lonely (August 2022).