The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature

Abstract

Background: Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex interrelationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies. Methods: We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity. Results: Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression. Conclusions: Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.

Can Social Prescribing Foster Individual and Community Well-Being? A Systematic Review of the Evidence

“…Social isolation, an objective, quantifiable measure of the number and the quality of contacts that one has, is another global issue that influences health and well-being [ 14 ]. While related to loneliness, social isolation is a distinct phenomenon; socially isolated individuals do not necessarily experience loneliness, and lonely individuals do not necessarily have less social contact with others [ 15 ]. Both phenomena are linked to depression, a mental health condition that impacts physical health, well-being, and ways in which one adjusts and recovers from difficult life experiences [ 15 ].…”

A Comparison of Isolation Stress and Unpredictable Chronic Mild Stress for the Establishment of Mouse Models of Depressive Disorder

“…On the other hand, it is well noticed that loneliness from social connectedness leads to stress susceptibility and depressive symptoms, including pessimism, low self-esteem, and anger (Cacioppo et al, 2006 ). Recently, people who live a solitary life are rapidly rising, and it is closely associated with the increased prevalence of depressive disorder (van den Brink et al, 2018 ; Achterbergh et al, 2020 ). To mimic human depression-related disorders, social isolation stress is commonly used (Ieraci et al, 2016 ).…”

Loneliness, Social Isolation and Their Difference: A Cross-Diagnostic Study in Persistent Depressive Disorder and Borderline Personality Disorder

“…Over time, these interpersonal difficulties can elicit rejection from others, ultimately leading to poor-quality relationships and social withdrawal ( 8 ). The strain of PDD and BPD patients' relationships can be assumed to increase the likelihood and severity of experiencing loneliness: caught in this vicious circle of dysfunctional interpersonal transaction, PDD and BPD patients are likely at great risk of experiencing prolonged loneliness ( 9 , 10 ). Loneliness, defined as a perceived mismatch between existing social relationships and subjective social ideals ( 11 ), develops when our needs for social belongingness are not sufficiently met ( 12 ).…”