Social Isolation

“Never expect to outgrow loneliness. Never hope to find people who will understand you, someone to fill that space…If you expect to find people who will understand you, you will grow murderous with disappointment”.-Janet Fitch, White Oleander

Is this true? Is loneliness, indeed, “the human condition”? Modern-day psychiatry says no.  We are meant to be social creatures and to nurture one another.

I have always been an emotional loner.  Throughout my elementary, middle, and high school years, I maintained a tacit distance from my group of friends, whether they were cognizant of it or not.  On the outside, I was funny, friendly and fun.  On the inside, I was shy, insecure, anxious and deeply depressed.  And very, very alone.  My emotions were far too volatile and intense to share or compare with any of my peers.  No one else seemed to be experiencing the same level of extremes in moods or the need for specificity and precision.  There didn’t seem to be a soul about who was harboring similar eccentricities as I.

To cope with my intolerable discomfort, I developed a series of authoritarian “magical mind games” and inflexible rules for myself, which were, of course, shared with no one, as they were quite bizarre and humiliating.  Although objectively arbitrary, they were self-soothing, my sacred gospel.  As time went on, they multiplied taking up more and more of my time.   I found myself wanting to do less “normal” fun stuff and more of the tasks that kept me emotionally isolated, “safely” tucked away from the world, insulated from my discomfiting thoughts and feelings.

I wish someone told me there is no such thing as escaping yourself.

You can’t hide from your feelings.  Depression still finds you.  Mania knows where you are trying to sleep.  Paranoia is knocking down your door.

Living in social isolation provides the ideal environment for psychiatric pathologies to deepen and take hold of their host.  In no time at all, they become the cornerstone of the daily routine, and all semblance of normalcy is soon a distant memory.  In isolated environments, self-worth and self-care precipitously decline. Personal affronts become magnified or even manufactured in an isolated environment.

Those in social isolation are slowly dying of lack of companionship, human touch, life meaning, and, perhaps most importantly, counter-balance of unreasonable ideation.  With outside professional psychological counseling, there is no impartial sounding board to talk us out of issuing snap decisions.  Moreover, there is no logical other to counteract our bouts of paranoia, depression or mania.  Isolation is cognate to the cruelest versions of self-flagellation and self-harm, but in the most excruciatingly passive tense.

Who is at Risk for Social Isolation?        

  • The disabled who are home-bound
  • People with intellectual, physical, or sensory deficits (not home-bound)
  • The ASD community: those on the spectrum, their parents and caregivers
  • Parents of disabled children
  • Parents of children in palliative care
  • Overburdened caretakers or parents, particularly of the “sandwich generation” (caring for children still in the household as well as elderly, dependent parents)
  • People with psychiatric conditions like obsessive-compulsive disorder, major depressive disorder, and social anxiety disorder
  • Those battling addiction
  • People with debilitating perfectionism
  • Persons in nursing facilities or extended living
  • Those dealing with gender and sexual identity issues
  • Dealing with bullying in school or amongst peers (at any age)
  • People with body dysmorphia and/or eating disorders
  • Clinically obese and morbidly obese people
  • People living with diseases attached to a stigma such as HIV, Hepatitis C, infectious diseases and end-stage cancer
  • Alzheimer’s patients

The ASD community and Social Isolation

Autism Spectrum Disorder definitively creates social barriers and fosters alienation for individuals on the spectrum as well as their caretakers.   Because the prognosis of those on the spectrum varies so dramatically, it is unfair to draw sweeping conclusions regarding the social challenges a singular autistic person faces.  Integration into social connections beyond school or work environments (or even within) is a significant hardship.  For those on the spectrum, it may not feel natural, be prioritized, or in about half of the cases, ever be feasible.

Popular media, well-intentioned supporters, even members of the ASD community and their families, are at times guilty of presenting an unclear picture of the bleak reality of a severe autism diagnosis and the innumerable basic life challenges it presents.  In an article from the National Council of Severe Autism, a mother discusses a very common episode of worsening aggressive violent and self-injurious behavior of her autistic son.

Government resources for the autistic community are not only limited but deeply flawed.  As autistic children get older, there is less available for them in terms of social services.  For example, aging stage three autistic children, who are transitioning beyond school age, may not be able to be placed into extended group living facilities. Because of social security and Medicare technicalities, group home definitions are and funding is practically non-existent.  Less than two percent of autism funding is directed toward this transition, so the financial burden falls to the families and friends.  For many families, it is financially unrealistic.

Because a profoundly autistic young adult would be placed so much earlier than, say, an elderly family member in a nursing facility, a cost comparison isn’t quantifiable.  This measure is also disregarding the gross discrepancy in needs-based services.

An older, more profoundly autistic person will be unlikely to obtain work or even perform basic self-care.  About half are unemployed, which, among all disability groups, is at the very bottom.  A recent report states that approximately half of those aging with autism continue to self-injure and aggressively injure others episodically.  Because of the perpetual aggressive, anti-social behavior or inability to obtain (or maintain work), an autistic adult living at home or in extended care is likely to be at risk for social isolation.

Those with high functioning ASD or Aspergers are also at risk for social isolation.  This isolation can either create or magnify preexisting depression and anxiety relating to their condition.  For those anywhere on the spectrum, isolation and lack of human connection will inevitably engender a decline in mental health and symptoms will intensify, regardless of where they fall within the range.

Parents of Disabled children and Social Isolation

It is likely that the most overlooked group of people coping with social isolation is that of the parents and caretakers of disabled children whose duties are all-consuming.  They may not realize they are so far socially removed because they are physically everywhere, all the time, going from school to physical therapy to occupational therapy to speech therapy to the psychiatrist to the specialist the IEP meeting, to the GP, and more.  However, the emotional deterioration happens over the course of time, and if it is not addressed, it could have significant ramifications such as increased risk of social anxiety, low self-esteem, and depression.  It can also accelerate the aging of the brain and heart, increasing the risk of dementia and cardiovascular issues.

 

How To Mitigate Social Isolation For The Vastly Different Groups of People?

  • Make transportation more readily available
  • Promote a sense of purpose
  • Encourage dining with others (primarily seniors living alone)
  • Extend help to a caregiver
  • Foster a positive body image
  • Help those able to adopt a pet
  • Encourage reentry to a former place of worship or meditation
  • Reach out to a mental health services professional

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