Dads Making Waves: Former U.S. Surgeon General Talks Loneliness

'In the US, more adults struggle with loneliness than have diabetes or smoke'

By Joyce Shulman June 2, 2020

We normally feature amazing moms in this space and are excited to feature a dad in June -- the month we celebrate fathers. Chief Macaroni Kid Mom Joyce Shulman was thrilled to speak with Dr. Vivek Murthy, who served as the 19th Surgeon General of the United States from 2013 to 2017, and is the author of the just-released book "Together: The Healing Power of Human Connection in a Sometimes Lonely World," a groundbreaking book that makes a case for loneliness as a public health concern.

What's it like for you being a dad? 

I love being a dad. It's perhaps the best thing ever (right next to being a husband, son, and brother!). I have a 3-year-old son named Teyjas and a 2-year-old daughter named Shanthi.

My favorite moments are seeing them laugh and jump up and down with glee when something excites them — finding a ripe mango on the tree, getting an unexpected piece of chocolate from their aunt, running in the rain, and splashing in puddles.

I also treasure those moments before bedtime when they say, 'I love you' and give my wife and me a big 'squeezy' hug. Through them, I sometimes feel I'm seeing the world with new eyes and experiencing joy in new ways.

Parenthood is the hardest thing I've ever done with many moments of doubt, exhaustion, and anxiety. But it's the greatest blessing to be a dad to these two wonderful kids.  

Did becoming a dad alter your view of the world?

A friend once told me that being a parent was like living life in high def — everything looks different. I find myself thinking about what I choose to do in terms of work through the lens of what is going to make the world better, safer, and more hospitable for my children (and all children). 

I feel pressure, in a good way, to put the values I hold into practice because I’m setting an example for my children and because how I live my life has an effect on their lives. I decided to focus my work on the issue of loneliness and social connection because I realized that our connection with each other is the foundation on which we build better health, better performance, and stronger community.  

That's the world I want my children to inherit — a world powered by love, fueled by human connection, and grounded in compassion. 

When did you begin to recognize loneliness as something that contributes to many of our most pressing health issues?

It was the conversations I had during my tenure as Surgeon General that helped me recognize loneliness as a serious public health concern. I began my time in office with a listening tour to big cities and small towns across America. Everywhere we went, we asked a simple question: How can we help? 

The answers in some cases confirmed what I suspected were major pain points: the opioid epidemic and rising rates of obesity, diabetes, and heart disease, to name a few. 

But one recurring topic was different. It wasn’t a frontline complaint. It wasn’t even identified directly as a health ailment. Loneliness ran like a dark thread through many of the more obvious issues that people brought to my attention, like addiction, violence, anxiety, and depression. The teachers and school administrators and many parents I encountered, for example, voiced a growing concern that our children were becoming isolated — even, or perhaps especially, those who spent much of their time in front of their digital devices and on social media. Loneliness also was magnifying the pain for families whose loved ones were struggling with addiction to opioids.

One of the first times I recognized this connection was a chilly morning in Oklahoma City when I met a couple named Sam and Sheila, who had tragically lost their son Jason to an opioid overdose. We met at their local treatment facility more than a year after Jason’s death. The pain that both carried was visible in their exhausted faces. Once they started talking about their son, it didn’t take long for their eyes to well up. Their wounds were still raw. Losing Jason had been unimaginably painful. But what made it even worse was that, at their hour of greatest need, they found themselves without the people they’d counted on for years. 

“When bad things happened to our family before,” Sheila said, “our neighbors would show up to help or express their support. But when our son died, no one came by. They thought we might be embarrassed that he died of a disease they believed was shameful. We felt so alone.” 

Sam and Sheila were far from alone in their loneliness. In Phoenix, Anchorage, Baltimore, and many other cities, I listened to men and women who told me that the hardest part of addiction to alcohol and drugs was the profound loneliness they experienced when they felt like their family and friends had given up on them. This loneliness, in turn, made it harder for them to stay on the path of treatment and recovery. It’s not easy handling a substance use disorder, they would tell me. “Everyone needs some support.” 

In some cases, loneliness was driving health problems. In others, it was a consequence of the illness and hardships that people were experiencing. It wasn’t always easy to tease out cause and effect, but clearly there was something about our disconnection from one another that was making people’s lives worse than they had to be. 

In your brilliant book you talk about three different types of human connection that we all crave, can you describe them? 

I find these three types of loneliness are helpful to think about because they help us make sense of why somebody may be in a fulfilling marriage but still feel lonely. Or somebody may have a lot of friends that they spend time with on weekends and on vacations but still feel lonely. There are three types of loneliness:

Intimate loneliness is what you feel when you lack very close relationships with people who know you truly for who you are and with whom you can fully be yourself. That can be a spouse or best friend.

Relational loneliness is when we lack good friends — the kind of friends you would spend time with during weekends, have over to a dinner party, or go on vacation with. 

Collective loneliness is when we lack a community with which we feel connected based on a shared mission or common identity. This could be a community of parents who come together based on their kids going to the same school. It could be a group that comes to feel close to each other because they are part of the same volunteer network, faith organization, or workplace. Shared identity alone doesn’t create community — we need opportunities for dialogue and then take action together based on common concerns and shared passions. When we do so, we feel part of something bigger than ourselves.  

These different bonds all help sustain us in their own way. If we have intimate ties in our life, that’s deeply fulfilling. But if we don’t have friendships with people who can help extend those ties or with whom we can spend time, or if we don’t have a community that we feel a part of and identify with, then we can experience loneliness even though we’re in a fulfilling marriage or even though we have a best friend.

There is rampant loneliness among moms, especially those with young kids. I wonder if that's something you've observed as well?

Loneliness is incredibly common in society at large. In the US, more adults struggle with loneliness than have diabetes or smoke.

But loneliness among parents is a particularly common phenomenon that isn’t much recognized or talked about. As blessed as parenthood is, it is not easy. It often involves changing our social patterns and turning our lives upside down in a way that can dramatically alter our social ties. I experienced this as well and found it challenging to figure out how to build and rebuild connection to others while all of my time was going to work and raising the kids. 

Talk to us about tangible, potential health consequences of loneliness — it goes far beyond just feeling sad, right?

Loneliness is more than a bad feeling. It has consequences for our physical and mental health. It also affects our performance in school and the workplace. It even affects our ability to dialogue with one another and contributes to the polarization we are experiencing in the world today. When it comes to health, we know that loneliness is associated with an increased risk of heart disease, dementia, premature death, depression, anxiety, and sleep disturbances, to name a few conditions. The mortality impact associated with loneliness appears to be similar to that associated with smoking 15 cigarettes a day, and greater than that associated with obesity and sedentary living. 

Wow. So then the big question is: If someone is wrestling with loneliness, what are some steps they can take to begin to create connections?

Especially in the time of COVID-19, when we’re being asked to physically distance ourselves from others, it’s essential that we recognize simple but powerful steps we can take to build greater connections in our lives. 

First, we can make it a point to spend at least 15 minutes with someone we care about. That could be video conferencing with them or calling them on the phone. Even though this is a short amount of time, it makes us feel good in the moment, and when done consistently over time, it can serve as a lifeline to the outside world. 

The second thing we can do is to increase the quality of time we spend with others by eliminating distraction during our conversations. It is so easy to multitask when we are catching up with friends, but as human beings, we are not good at multitasking even though we think we might be. If you’ve ever had the experience of talking to someone when they were fully present and listening deeply, you know how powerful that experience can be. Even if we don’t spend a single additional minute with others, we can make it a priority to give them the gift of our full attention. 

The third thing we can do is to look for opportunities to serve. I was struck during my research to find that service is one of the most powerful antidotes for loneliness. When we serve others, we shift the focus from ourselves to them in the context of a positive interaction and we also remind ourselves that we have value to bring to the world. If we look around, we will find there are many opportunities for us to serve. Checking on a neighbor who may be having a hard time, having food delivered to a friend who may be worried about going out to get groceries because of the risk of infection, offering to virtually babysit for 10 minutes for a fellow parent who may be struggling to telework and homeschool their kids — these are all small but powerful acts of service that can deepen how connected we feel to others. 

Finally, protecting a few minutes each day for solitude is a counterintuitive, but essential strategy for building a more connected life. Moments of solitude are when we re-center and re-ground ourselves. It’s when we let the noise around us settle and when we reflect on our lives. When we approach others from a place of being grounded and calm, we are often better able to focus on conversation, to listen deeply, and to show up more fully as ourselves. Solitude can just be a few minutes that we spend walking in nature, meditating, praying, or remembering three things you’re grateful for. It doesn’t have to take long, but solitude helps strengthen our foundation for connecting with ourselves and others. 

In your book, you talk pretty openly about feelings of loneliness you've experienced and I suspect that you, like everyone, sometimes has "those days." What's your recipe for pushing through challenging days?

I’ve experienced periods of loneliness throughout my life from when I was in elementary school to my time during and after serving as Surgeon General. It was painful and associated with a great deal of shame. I’ve seen firsthand how loneliness begets more loneliness as you feel like withdrawing further and feel your sense of self and your confidence erode. During these times, I’ve found a few things help: 

  • Pushing myself to pick up the phone to call a close friend. And pushing myself to be open with them about my feeling disconnected. Vulnerability feels risky, but it’s liberating and almost always worth it. 
  • Looking for ways to serve others — helping a friend, listening to a colleague who is having a hard time, even smiling and being kind to strangers. All of these lift my mood and remind me of how good it feels to connect. 
  • Reaching for sources of inspiration — usually books, poems, or sports movies, in my case. They raise my energy level, often making it easier for me to go out and engage with the world. 
  • Similarly, working out and walking in nature energize me and make it easier to overcome the energy barrier to going out and interacting with the world. 
  • Meditating helps calm the noise around me including the internal dialogue that can sometimes fuel my loneliness. 

Dr. Vivek Murthy's new book "Together: The Healing Power of Human Connection in a Sometimes Lonely World," can be found on Amazon.