Making connections good for the heart and soul

Loneliness takes a toll on the heart; building a social network can strengthen it.

The heart is not, as Scottish poet William Sharp called it, a lonely hunter "" at least not by nature. Loneliness actually stresses the heart and the entire cardiovascular system, and may harm them as much as high blood pressure or high cholesterol. What helps the heart and blood vessels thrive are social connections, intimacy, and love.

Many of us don't get enough of these. The average American has just one or two people he or she can talk with about important subjects, and a whopping one-quarter have no one, according to a nationwide survey published in the June 2006 American Sociological Review. As many as 20% Americans classify themselves as lonely.

Since the mid-1990s, there has been growing interest in, and evidence about, how loneliness and social connections affect health. Researchers have linked isolation with physical problems ranging from diminished immune system activity to shortened life span. A fair amount of this work has focused on the cardiovascular system. Consider these findings:

• Heart attack survivors scoring high on tests of social isolation and stress were four times more likely to die during the three years after their attacks than those with dense social networks and little stress.

• Older people with little or no emotional support who were hospitalized with heart failure had triple the risk of having a heart attack or dying in the next year as those with good support. The impact of loneliness was stronger in women than men.

• In a survey of 229 Chicagoans, blood pressure averaged 30 points higher among lonely people than among those who weren't lonely.

• Swedish men preparing for bypass surgery who agreed with the statement "I am lonely" were twice as likely to have died within five years of surgery as those who weren't lonely.

Loneliness, like beauty, is in the eye of the beholder. It is highly subjective "" wanting more or different social interactions, feeling isolated or disconnected, not fitting in. Loneliness doesn't necessarily equate with living alone. Some people who live by themselves and see family and friends every now and then feel perfectly connected and supported. Some who are surrounded by family and friends feel lonely.

Exactly how loneliness harms the circulatory system, or how good relationships nurture it, remains a mystery. The leading contender is that social connectedness somehow influences brain regions that calm the body or put it on high alert for danger. The resulting cascade of hormones can affect blood pressure, the flexibility of arteries, and inflammation, a key underlying cause of heart disease.

Make one connection

Although anyone can be lonely, it is especially common among older people. Americans' relentless mobility whisks children and friends to other parts of the country, or the world, while the Grim Reaper prunes their social networks in a more permanent way.

As lonely people know all too well, making new connections isn't easy. A few can muster their courage and plunge into a more sociable life by joining a club, taking a class, or getting involved at church. For many lonely people, though, doing these things can be as hard as climbing Everest. For them, the solution may start with understanding the roots of their loneliness. It could be a problem with energy or mood. Anxiety can make social situations seem overwhelming. Or for whatever reason they never developed a talent for making or keeping relationships.

Many lonely people need heart-opening surgery, the kind practiced by professionals who wield the scalpel of talk therapy. If loneliness has been a life-long problem, talking with a counselor, therapist, psychologist, or other mental health professional may help you understand what has gotten in the way of making relationships and teach you new skills for starting and developing friendships. If there is an underlying problem with anxiety or depression, a medication may help ease that burden.

If you are determined to pull yourself up by your bootstraps, altruism is a good first step. Take something you know "" mathematics or coping with heart disease "" and help someone else. Schools across the country welcome tutors to help children improve their math, reading, and other academic skills. Groups like Mended Hearts, a national support group for people with heart disease, offer outlets for making connections while helping others.

Devoting time and energy to relationships pays off at least as fully as taking care of high blood pressure or adopting a more healthful diet. People with rich social networks generally live longer, recover faster from heart attacks and other health setbacks, and have more joyful lives. Weaving yours a link at a time is good for you, and, if one of those links is with a lonely person, it's good for him or her, too.