Melanie Cole. MS (Host): The Surgeon General of the United States has issued a public health advisory on loneliness. A Surgeon General's advisory is a public statement that calls the American people's attention to an urgent public health issue and provides recommendations for how it should be addressed. Advisories are reserved for significant public health challenges that require the nation's immediate awareness and action.

This is It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and joining me we have fan favorite Karen Warmack. She's the Program Director of the Behavioral Health Unit at Henry Mayo Newhall Hospital. Karen, I'm so glad to have you with us. As I said in the intro about the Surgeon General, issuing a public health advisory on loneliness.

This is shocking in a way. And so I'm just surprised by this topic that we're talking about today, that it's really a public health awareness and advisory. Can you tell us why this happened? Why loneliness is so harmful to us?

Karen Warmack, RN: Oh, Melanie, I would love to tell people about that. Just to tell you that statistically, over a half of adults in the United States of America have experienced feeling of loneliness on a daily basis. So I can see why it's such an alert for us as for the public. And so I can tell you that feeling alone and being alone or loneliness, you know, they're two different things and I really want to take a time to separate the two because loneliness is not just being alone. So let's start with being alone being just that. You are physically by yourself and sometimes it's by a choice and sometimes it's not.

But feeling alone is an emotional state, Melanie. It is feeling disconnected and isolated from others. And the biggest take away that I want the public to understand, this is a normal human experience and feeling. And later as we continue to talk, I can tell you that that feeling of loneliness can eke into depression and other areas.

But the biggest, I think, health concern or awareness is that it is something that everyone experiences at one time or another in their life.

Host: I guess you are right. And we don't tend to think of it as something that is clinical in nature that needs to be addressed. We just think, Oh, well, you know, that, that seems like a lonely person or that person doesn't have a big family, but it really is something that makes me even sad to talk about now.

How do we differentiate loneliness from depression? Because that is a clinical situation. Tell us what's the difference.

Karen Warmack, RN: So as I said, we know loneliness is, I'm going to say, a state of mind, but it is an emotional feeling and it can cause people to feel empty. It causes people to feel isolated. And here's something you can be with groups of people and still feel loneliness or feel alone. And so it really is a state of mind.

And there's so many causes, for that, that will cause people to feel lonely. And part of it is life. Some of it is our life changes. A lot of times we do social isolation if we've moved to a different area, or if we're grieving someone's death, or we're grieving a loss, and that loss can be with friendship, it can be with family, and then those symptoms can actually do lead to depression, Melanie.

You know, there's more studies saying that loneliness is as harmful to our health as if we were smoking 15 cigarettes a day. Isn't that crazy?

Host: That's crazy. Wow. What a statistic, Karen. So you said that it's possible to have a job, be in school, be in a relationship and still feel alone and have people around you, but still feel lonely, which to me is an even more difficult situation to wrap around when you're surrounded by people, but I do understand it. So what advice do you have for someone who's feeling that way, who's feeling alone, who's feeling just by themselves without that support.

Karen Warmack, RN: So I want to also make the biggest pieces I want everyone to hear me say that it is not abnormal. It is a normal human feeling. But what can we do with that, when we feel loneliness? Well, number one, Melanie, it starts with acknowledging those feelings. We have this term in psychiatry that says sit with that feeling, feel it, experience it.

But I say, label that feeling and emotion, because sometimes the loneliness is connected to anger, it can be connected to failure or disappointment or frustration. And so, it is so important to recognize, acknowledge that you're feeling these feelings of loneliness and label that emotion. Because there's a saying that the moment you label it, it knocks the energy, the negative energy out of it.

We recognize it. I'm feeling lonely because I feel that my family has rejected me. I'm feeling lonely because, someone said something to me the other day and it really hurt my feelings. So loneliness is an emotional state, and so acknowledge the emotion. That's number one. And then once we acknowledge that emotion, let's create a plan.

And I think sometimes we hear that word create a plan, it's just too much. So I want to say, I would want you to consider these things. That the moment we do feel loneliness, there are things that we can do that are healthy for us. We can start connecting with people. We can do things that bring us a level of comfort.

It could be crocheting, it could be knitting. It could be gardening, it could be painting. This weekend I went to the beach and walked on the beach. So there are things that we can do that are healthy coping skills alone. If we want to get connected with people, then there are things like, number one, joining a group, joining a social group, asking for help.

But the biggest thing, too, I want to share, Melanie, is creating healthy boundaries. Do you know sometimes a lot of that loneliness, that emotional state, it can be connected to people or things. And so, sometimes those people or things trigger us. So, building healthy boundaries for ourself is not being around the people that are going to continue to create negative energy around you that now makes you feel lonely.

Because again, it's an emotional state. So how do you do that? You just create the boundaries that are healthy for yourself. You maintain a place of positivity. You center yourself in the here and now. Because what I found that when I start feeling lonely, I begin to have this negative narrative in my mind.

Well, you know, I'm always lonely during this time. Why am I alone? Why don't I have friends? And then we begin to self negative talk ourselves.

Host: Boy, ain't that the truth.

Karen Warmack, RN: So it is really begin to center ourselves. And get grounded. And what does that mean? Karen, what do you mean get grounded? It's the things that you and I've talked about, Melanie, in the past. It's relaxation. It's breathing. It's meditation. And mindfulness. And just centering the here and now. And connecting with ourself. And really begin to get rid of that negative self talk. And begin to say, beautiful things to ourselves. And I know that sounds silly, but I have affirmations sometimes put up when I'm feeling sad and lonely and isolated.

You can do this, Karen. You're beautiful. It's going to be okay. There are so many things that we can do, Melanie, to create healthy coping skills when we have a feeling of loneliness.

Host: Wow, Karen, you're really choking me up here because it's so true. And we have to stop all that negative self talk and you're right. It does build on itself. If we're feeling that way, then we look around at the other people and anger and resentment can even build and say, well, they have so many friends and I don't know what's going on with me these days. You're right. It can take us to these darker places. Now, you've given us some of the best advice that we get on any of our shows right there in this last couple of minutes there. And listeners, play it again, because everything she just said is what we have to do for ourselves.

But if we know someone that we feel is suffering from loneliness, just showing up isn't necessarily the answer, right? Because you said the person has to set boundaries and they have to have their own way of coping and acceptance. But how can we help them without also feeling like we are hovering or trying not to make them feel lonely.

Karen Warmack, RN: Correct. I say that if the loneliness is a continual state, it does touch in the areas of depression. It can create cognitive decline. That could be anxiety, panic attacks. So, you know, Melanie, we have SAMHSA. They're part of the Department of Human Services, a wonderful organization, an agency that helps with mental health issues, substance abuse issues.

We can call. They have a hotline. They even have resources and referrals to communities. And again, it's asking for help. But I wanted to say this as we close, this is going to just make people feel so good. Do you know that acts of kindness, doing something for others randomly, it stimulates and releases three feel good chemicals in our brain.

It's dopamine, it's serotonin and oxytocin. We call those the feel good brain chemicals. Do you know that they have found that that counteracts cortisol? Cortisol is when we're stressful and we're sad and all that. But if you do random acts of kindness, it stimulates those feel good brain chemicals, and it gives us areas of euphoria, and it will shift those feelings and mood of sadness, loneliness, depression.

But again, if it's continual, I don't want to make a mess to anyone. If you're feeling like this and it's been continually, please seek out help for support. But just for all us that just have those moments of loneliness, there's so many things that we can do, but I encourage everyone that's listening, start doing some random acts of kindness. You'll be surprised how you will start feeling.

Host: Thank you so much, Karen. What a great guest you are. So soothing and comforting and knowledgeable. Thank you again for joining us. And your compassion really comes through in these podcasts. So thank you again. And for tips on staying healthy, mentally and physically, you can visit Henry Mayo Newhall Hospital online Health Library. You know where it is. I've told you before. You can find it@library.henrymayo.com. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please always remember to subscribe, rate, and review this podcast and all the other Henry Mayo Newhall Hospital podcasts. And I'd like to encourage you to share these shows with your friends and your family on your social channels, because we are learning from the experts at Henry Mayo New Hall Hospital together. I'm Melanie Cole. Thanks so much for tuning in today.