Study explores loneliness among men in the COVID-19 pandemic

A recent study from the University of York, UK, has taken on an underexplored area regarding the prevalence, and associated factors of loneliness, among men in the context of the coronavirus disease 2019 (COVID-19) pandemic.

The preliminary findings of the study have been made available as a preprint on the medRxiv* server, while the article undergoes peer review.

The study’s findings not only open a window onto this experience, including the long-term ramifications of this type of loneliness after the pandemic restrictions are completely removed, but could also help understand how to deal with such ill-foreseen consequences of severe social restrictions in the future.

Background

Loneliness is thought of to be the perception that one lacks or has lost meaningful social relationships and is associated with poor health. In contrast, social isolation refers to the actual measurable loss of social contact.

Loneliness may exist without social isolation and vice versa. If social support is strong, the latter scenario is more probable.

The COVID-19 pandemic brought in an era of restrictions on normal social interactions, such that ‘social distancing’ became a well-known term even in non-English-speaking countries and communities. While this was widely seen to be necessary to help curtail the spread of the virus, it did increase loneliness, which had necessary adverse impacts on health in other ways, both mental and physical.

Women living alone are more likely to feel lonely, with men often being inhibited by their self-perceived need to appear strong from reaching out for help with this problem. However, there is little research in this area.

The current study was built around themes such as seeing and doing new things or meeting new people; a rethinking of the truly important things in life; loneliness as deliberate in a pandemic situation vs. loneliness as the normal (perhaps undesirable) condition of life in the present situation; the anxiety associated with reduced social interactions as well as the fear of social contact spreading the virus; and the recognition of the distinct differences between people with respect to the degree and type of loneliness felt during these restrictions.

How was the study carried out?

The researchers conducted this study during the second lockdown shortly after Christmas 2020 in the UK, which was introduced in the face of increasing cases and hospitalizations. They asked questions to men about their experience of loneliness and how this would affect their lives post-pandemic, as well as their views about relaxing restrictions and dealing with future outbreaks of infectious disease.

The participants were aged 21 to 70 years, with or without a history of loneliness. Many were living alone, while others lived with their families, parents or in one case, with housemates.

Change in routine

Many men said the restrictions had disrupted their normal routines and social interactions and joked about substituting activities for these, such as cleaning the house or do-it-yourself hobbies. Typically, these were minimized but were nonetheless important in building a sense of unity and social support.

Others looked for new activities and routines, and these were methodically built up, especially if they were incorporated into a routine. Many said remote interactions were inferior to direct socializing but were nonetheless worthwhile.

Conversely, some said remote interaction had widened their opportunities to socialize, especially if they were physically disabled and thus had limited chances to interact with the outside world pre-pandemic.

Public- or private-facing?

If a man had primarily public interactions rather than those with family and neighbors as their priority social sphere, he was likely to feel lonelier. Again, this was more of a problem with those who were interested in dating or sex.

In contrast, many actually came to see the restrictions as a blessing in disguise, as they saw their relationships with their significant others in a new light and focused on building them up. Some also saw that their neighborhoods became their public sphere of social support and connection, but raised questions as to whether this would survive once the pandemic faded.

Social responsibility

Many men appreciated the need for the restrictions that brought about their loneliness and felt that in this way, they were contributing to the common good, thus reducing the pain to some extent. Others, who were less concerned with the purpose of the lockdown or other restrictions compared to their personal needs, felt lonelier.

Some men found, rather to their surprise, and perhaps guilt, that being alone did not really make them feel bad. This emphasizes that there may be a collective expectation that loneliness is expected during the pandemic, as a normal state, compared to the unacceptable loneliness seen to be mildly pathological before COVID-19 appeared on the scene.

Anxiety

When anxiety was discussed, two contrasting themes came to the forefront. One was that in-person social interactions left them unable to enjoy it due to the fear of infection. The other was that they might enjoy the group so much that they did things that were unacceptable under lockdown regulations. One man also noted his fear that he would forget how to behave around people once lockdowns were removed.

Among Black and minority ethnic communities, social interactions were richer because of multi-generational families sharing the same dwelling place. However, the communities where they lived were less supportive, with more violence and criminal behavior. Pandemic-related assistance was also less likely in this setting.

What are the implications?

The study reiterates that while loneliness is an experience that affects public health in its consequences, it is often more important for one sex. In particular, the current pandemic engendered loneliness on a vast scale due to public health policies. Loneliness among men has been little studied so far.

In the current paper, the authors demonstrate that the abrupt loss of routines along with a sharp reduction in direct personal interactions led to increased loneliness, most distinctly among men living alone. They also show that men may enjoy and benefit from remote interactions when carried out on schedule and in smaller groups, while offering the chance for each man to speak.

Moreover, the loneliness was both caused and affected by the anxiety related to the risk of contracting the virus, as well as the mechanisms constructed to limit viral transmission.

Narrowed social spheres may result in smaller, but closer, social networks for years, particularly if people are more anxious of social settings and/or have lost social skills.”

The understanding of loneliness as a need during such times may help to deal with it, though as vaccination rates rise and case rates fall, and as people become more tired of the restrictions, this may fall. People who lack an adequate sense of social responsibility may find this harder to achieve.

Existing social networks are often more helpful in mitigating loneliness than making new friends. Outdoor activities provide both physical exercise and a change from the ‘cooped up at home’ feeling that could be especially welcome. Remote interactions may contribute to lockdown fatigue over the long term.

The study obviously cannot classify the negative effect of loneliness as a rational or pathological response, nor does it purport to guide measures to balance social needs vs. blocking transmission. However, it does suggest that while returning to pre-pandemic life, newly developed social interactions and anxieties must be accounted for, even while allowing some leeway for the inevitable loss of social skills.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.