Social Connection: Military services weapons Bit of Your Plan for treatment?

A patient, whomI'll call Ashley,was a pleasant,friendly 31-year-old mother of2when shefirst consulted mein 2023 for migrating joint problems.Apreviousproviderhadtold heritwas”probably fibromyalgia.” Not satisfied with what seemed like an off-the-cuff diagnosis, webegan by takinga deepdive into her full history.

It was soon apparent that there was more to her past than “probably fibromyalgia.” Thesymptoms ofpain and tenderness were interwovenwitha history that included trauma, separation, grief,and abandonment. Her current emotional state wasone offeeling isolated and trapped. She had gone to live in the area several years prior, away from her entire support network. Her current relationships were restricted to mothering her2children andbeing marriedto a manshe felt betrayedby, ina stressful,dysfunctional relationship.

She have been referredto meby a nearby acupuncturist, and though the acupuncture was quite effective in reducingher daily pain, the acupuncturist rightly believed that Ashley could use a bit more support.


The drive for social interaction has got the same biological underpinnings as our base drivesofhunger and thirst.1Ifyou experience hunger, you want to satisfy that by eating. If you feel lonely, you want to satisfy that by engaging in social interaction. But what,exactly,is the definition of feeling lonely?

If you ask10people, “What is loneliness?” you will likely get10different answers. In research, that responseis commonly along the lines of, “a negative and unsightly emotional state that is the result of dissatisfaction with the quantity and quality of social resource.”2

When researchersattemptto quantify loneliness, they might make use of a tool like the DeJongGierveld6-Item Scale for Emotional and Social Loneliness.But this is simply a research tool. There is no key quantity of fulfilling social engagements that definitivelydetermines whethersomeone is lonelyor not.A personcould be considered a recluse or the lifetime of the party;ultimately,though,loneliness boils down toa persondesiring more social interaction thanhe or she iscurrently experiencing.


We are a social species,andthusturn toeach otherfor comfort. When that connection is missing, it is perceived neurologically as a insufficient safety,athreat. This creates ahyperviligancein the nervous system,whichcan beassociated with hypertension, elevated cortisol,and elevated inflammatory markers,such as suppressednatural killer cellactivity and elevated antibody titers.3

Pain is closely linked with loneliness.Canaipaet al wrotethe followingin their 2023 article,”Feeling Hurt: Pain sensitivity is correlated with and modulated by social distress”4:

When people experience pain, they can then experience more isolation. Patients with chronic pain are in risk for this snowballing effect of pain and loneliness.

Loneliness is definitely an independent risk factor for back pain.5A 2023 study of 1563 adults found that being in painwasassociated with a 58% increased risk of loneliness over4years.6Pain is another risk factor for loneliness7 -it is a2-way street. We can even see this on a day-to-day basis:Patients with fibromyalgia report increased pain severity onthe samedays they reportfeelings ofloneliness.8

In recent years the UnitedKingdomhas faced this head-on using the creation of a Loneliness Minister and the”Campaign to finish Loneliness.”9Their research foundthe following:

  • Over 9 millionpeople in the UnitedKingdom reportedfeelingalways or often lonely

  • 59% of adults overage52 who reportedpoor healthsaidtheyfeltlonely some of the time or often,ascomparedwith21% whoclaimed to bein excellent health

By viewing loneliness as a public ailment, it may be better screened and addressed. Some liken this to society's management of mental health, that has been historically underrepresented, stigmatized,and undertreated.

ShouldLonelinessBe aNewVitalSign?

Along with tracking patients' blood pressure, heart rate, respirations,and temperature, many primary carephysiciansalso routinely inquire about alcohol consumption andsymptoms ofdepression. But exactly how many doctors routinely ask their sufferers about loneliness?

It is importantyetoften never asked. According to the UK research referenced above, many people are uncomfortable discussing their loneliness,so will not often volunteer these details unless asked.Because the doctor, you might not be comfortable asking since you have no idea how to handle the information. If that's the situation, take a page in the UnitedKingdom's approach,and “prescribe company.” While their campaign arranges for volunteers to visit lonely residents,I think we are able to acquire a similar goalwith some creativity.


Just like all other facet of our treatment approach, a recommendation of social connection should be individualized toeachpatient. Not everybody may benefit from more friends, more outings,or a puppy. It comes down to a discussion about the ways in which they're lonely, learning each patient's background,andthen making respectful and useful recommendations.Whenpossible, I like to combine a “social prescription” with another aspect of my plan for treatment, like a group fitness class for a patient who's looking to get more active.


  • Volunteering:In a local school, church, political group -whatever interests the patient. In case your patients need inspiration, have them visitVolunteerMatch, a sizable website that suits volunteers with organizations.10
  • Group classes:Fitness, dance, yoga, Taichi,orQiGongare all recommendations Ioftenmake. I encourage my patients to test new things and getina little exercise at the same time.
  • Hobby groups:Knitting, crafting,and painting are a few ideas
  • Learning new skills:Examples area cooking or language class at the neighborhood center
  • Outdooractivitygroups:Examples includewalking, hiking,or birdwatching. When my patients say, “I'm uninterested in anything,” then 1) I believe there's a larger disconnect issue at hand,but 2) for the moment,I tell them to look at theMeetUpwebsite for local group event ideas.
  • Message boards and social networking groups:These exist forall conceivable interests, but Iconsider thema lower priority than in-person connections

CrossFit, arockclimbinggym,or a whitewater rafting groupcanall be amazing sources of social connection.However,since I'm often discussing thisissuewith older adults orindividualscoming out of periods of inactivity, we usually start with smaller steps into an active life.

Back towards the Patient

My initial discussion with Ashley didn't include my usual recommendations of vitamins, herbs,andthe ordering oflabtests. Typically, we simply talked. It had been obvious to bothof usthat she was struggling with deficiencies in support network. After our first visit, she playing suggestions for rekindling lost relationships remotely,as well as the recommendation to look into local groups that interested her. After discussing her interests,we thought a “moms of toddlers”-type group may well be a good fit;but it was up to her to determine and try them out.

Though we planned to follow in a couple weeks, I lost contact with her for a few months and feared the worst. Did she think I had been too pushy and nosy? Was she disappointedthatI didn't just recommend an adrenal supplement? I was surprised when she turned up on my schedule nearly3months after our first visit.

During thissecondvisit withAshley, itwas like meeting a completely new person;her whole demeanorwas different. She had been friendly before, but now she was exuberant. She had a brand new air of vibrancy and positivity. She overflowed with happy news, which included getting a stroller-walking group along with other moms. She was connectingandgetting out walking,and her pain was at an all-time low.

With her new-found support, she felt she was in a good starting point marriage counseling in order tofigure outwhether she wanted to stay married. When she'd raised her marriage difficulties on the first visit, she had been fearful of what her spouse would do or think,andhehad expressed no regard on her own feelings and wishes.

Our subsequent work revolved around othernaturopathic foundations,focusing on energy, sleep,and thyroid function. What Ashleyneededfirst, and what a lot of patients need, was a secure social networking. With that as the foundation, we could then work on accumulating her health inside a truly comprehensive way.


This topic of the importance of social connection was unforeseeably timely when I originally wrote this short article in February of this year. The Covid-19 pandemic was at full swing at that time and social distancing guidelines were gradually, then quickly, instituted in many states.Within the months since, we have seen social isolation across all aspects of our society, including shifts from the workplace to working at home, cancellation of group and public events, and inability of family and friends to meet in person for weeks, or perhaps months, at any given time.Seniors in lots of long-term care facilities happen to be confined to their bedrooms and barred visitors, and young adults whose schools have closed down have been denied crucial contacts using their peers. For a lot of, coping with this pandemic has created new and worsening mental health challenges related to these potentially isolating changes.In times past, we may have attributed “suffering from loneliness” simply to those people who are house-bound because of advanced age or poor health.Our current events show us that nobody is immune to the actual psychosocial effects of loneliness induced by social separation.

Obviously, the social distancing recommendations as a result of the pandemic have placed inherent limits on some traditional group activities. However, the creativity of people forced to self-isolate during this period has additionally opened the door to innumerable methods to still socially connect without having to be shoulder to shoulder.Hopefully these additional ways of connecting will stay long after social restrictions have recently been lifted. In the meantime, however, our support is needed more than ever before.