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Depression is a Disease of Loneliness


A lack of friends can suck someone into solitude – sharing the language of affection could help to ease the pain.

Hans Thoma, Loneliness, 1880.

Hans Thoma, Loneliness, 1880.

“Naked and alone we came into exile,” wrote the American novelist Thomas Wolfe in his 1929 novel Look Homeward, Angel. “In her dark womb we did not know our mother’s face; from the prison of her flesh we come into the unspeakable and incommunicable prison of this earth … Which of us is not forever a stranger and alone?”

A study published by the relationship charity Relate would suggest that Wolfe was on to something. One in 10 people in the UK said they had no friends and one in five reported feeling unloved in the fortnight preceding the survey.

Those who have friends frequently go through life unaware that others do not, because those others are so isolated as to be socially invisible. Because I have written about depression, some such people have reached out to me for advice, describing its universal bleakness and the bleaker reality of suffering without the cushion of love. “I was extremely unhappy and I didn’t feel I could tell anyone,” a woman named Claudia Weaver told me. “I avoided the world.”

In an era in which Facebook has made “friend” into a verb, we often confuse the ambient intimacy of websites with the authentic intimacy that comes with sharing your life’s challenges with someone who cares – who will be sad because you are sad, happy because you feel joy, worried if you are unwell, reassuring if you are hopeless. We are imprisoned even in crowded cities and at noisy parties.

Prof Simon Wessely, the incoming president of the Royal College of Psychiatrists, has indicated that only one-third of people with mental health issues in the UK are receiving treatment of any kind, which means that the number receiving effective treatment must be much smaller. It has been suggested that treating mentally ill people is expensive, and that in the current economic climate, funds cannot readily be found for such treatment. But not treating the depressed is ultimately more expensive than treating them. People who cannot function end up on the dole; parents may not be able to take care of their children; men and women too depressed to sustain their physical health could develop serious conditions that cost the NHS a great deal. Such neglect would never be tolerated in response to a physical illness.

Depression is a disease of loneliness. Many untreated depressives lack friends because it saps the vitality that friendship requires and immures its victims in an impenetrable sheath, making it hard for them to speak or hear words of comfort. Worldly success does little to assuage that agony, as Robin Williams’ suicide this week makes clear. Love – both expressed and received – is helpful, not because it ameliorates the symptoms of depression (it does not), but because it gives people evidence that life may be worth living if they can only get better. It gives them a place to admit to their illness, and admitting it is the first step toward resolving it.

It would be arrogant for people with friends to pity those without. Some friendless people may be close to their parents or children rather than to extrafamilial friends, or they may be more interested in things or ideas than in other people. The Relate research suggests that married people are mostly happier than the unmarried, but marriage is not right for everyone. Creating a social system that shoehorns people into relationships or friendships they don’t want– as the Victorians sometimes tried to do in the name of good fellowship, or the Soviets in the name of communism – is not likely to solve the ever-widening depression crisis. Insisting to people who don’t want companionship that they’d be happier if they were less lonely is not a useful intervention.

Many people, however, are desperate for love, but don’t know how to go about finding it, disabled by depression’s tidal pull toward seclusion. Loneliness will not be fixed by medication, though pills may instigate the stability to open up to friendship’s liabilities: potential rejection, exhausting demands, the need for self-sacrifice.

For some, friendship has become a vocabulary as obscure as Sanskrit. Lack of emotional fluency may cause depression; it may exacerbate it; it may cast a shadow over recovery. But there are ways to help people who want friendships to learn the language of affection. Parents and schools can teach children productive ways to engage.

Literature, film, poetry, music and art can show what relatedness looks like. For those who are too far along for such high-minded modelling, psychotherapy can help translate the methods of friendship’s alarming, vanished language. Over and over again I have heard tones of astonishment as social relations are built – often starting with a therapist. Many of us are more alone than we need to be, living in gratuitous exile. Friendship is an impulse encoded deep within us, but it is also a skill, and skills can be both taught and learned.