Stuart Cosgrove: A loneliness epidemic and the song that speaks to it

This week, I was struck by an auction ­already under way in America in which the private papers of John Steinbeck, a giant of literature, came under the hammer.

Among the sought-after insights into Steinbeck’s private life are his personal notes written in 1948, the novelist’s annus horribilis. His best friend had died in a train crash and escaping from a depressive and demanding home life, his wife left him and took their children with her. He was alone.

“Loneliness is still ice on me,” Steinbeck wrote at the time. “I suppose this will get better … or my life will go out very quickly.” In his private notebooks, he recorded very profound feelings of loneliness, thoughts of suicide and impending death.

Loneliness is a feeling that has never touched me personally, although I know from painful experience of how it reached deep into my family.

My mother’s death certificate medicalised her last few years with declining chest and lung complaints but she told me on several occasions how she felt ­consumed by loneliness in older life. She had lost her husband in a car crash as a young woman and after devoting a life to raising three children, we were all ­scattered to ­various parts of the UK pursuing careers, in touch but at a distance.

I had begun to suspect that my mum’s condition was something more than ­medical. She repeatedly booked appointments at our local doctor more for human contact than for a prescription. The highlight of her week was when a barmaid at Christie’s Bar in Perth’s Kinnoull Street took her to a bar lunch on the house.

Ask any doctor and they will tell you ­anecdotally that they see numerous ­elderly patients who are lonely more than they are ill.

In Scotland, a short-life ­working group has recently addressed the rise in ­prescribing anti-depressants and ­published findings “to support ­healthcare professionals … to facilitate the ­appropriate use of antidepressants”.

In short, it is a complex issue, as ­complicated as mental health provision itself, but what cannot be ruled out is the impact of loneliness and social isolation.

In August this year, the Royal College of General Practitioners (Scotland) defended its membership’s performance against accusations of over-prescription.

“GPs are highly trained to have frank and sensitive conversations with our ­patients, and this includes any potential side effects which may occur from taking antidepressants,” the RCGP said. “Once a prescription has been made, follow-up appointments and ongoing medication reviews can assist GPs to assess whether a patient’s symptoms have improved, any side effects they may have experienced as well and if additional support is needed.”

Quite how we address this ­embedded social problem at a time of growing ­dissatisfaction with the embattled health service, the overstretched appointments system and the post-Covid landscape is far from clear.

The doctor’s surgery has many ­parallels with the way that the police force ­regularly describes being too distracted with crime and investigation to respond to ­incidents where mental health issues are in play.

The statistics for loneliness are overwhelming. In 2022, 49.63% of adults (25.99 million people) in the UK ­reported feeling lonely occasionally, sometimes, ­often or always. Approximately 7.1% of people in the UK (3.83m) ­experience chronic loneliness, meaning they feel ­lonely “often or always”. This has risen from 6% indicating that there has not been a return to pre-pandemic levels.

Figures for Scotland are broadly ­proportionate with a higher ­concentration among rural communities and areas of ­social deprivation. While social ­isolation is a key factor, there are many more ­determinants, most notably poverty, lack of opportunity and poor public transport links.

Scotland is living through an epidemic of loneliness which has ravaged the ­mental health of people from all age groups, but elderly people are among the most ­vulnerable and at-risk social groups.

Yet, even in that generalisation, there is massive differentiation. Poverty is ­profoundly important – older people with a private pension, their own home and an active post-work social life are less likely to be lonely than those on ­benefits or in social housing.

ACCORDING to the UK Government’s Tackling Loneliness strategy review, loneliness does impact the elderly and yet remarkably, it is higher for people who are aged 16-24 years old, are female and, like my own mother, are single or widowed.

This is also borne out by an in-depth European study. Some factors seem common-sense such as that having meaningful relationships is associated with lower loneliness levels, and that the ­frequency of contact also matters. But it also found that those in moments of transition, ­people ­experiencing major life events such as ­separation, job loss or finishing their ­studies are more often lonely too.

Another underlying factor is that higher experiences of loneliness are measurable within the “bed-sit” generation, those ­living in rented accommodation or with one bedroom or less.

It is the reference to widowhood across all the studies that chills me. My mother lost her husband when she was very young, and although she battled to bring us up in an economically poor but emotionally rich household, I have recently wrestled with the very real ­possibility that she was lonely for most of her adult life and only the clamour of a busy house hid the signs.

My mother took some comfort from her Catholicism but even devotion could not hold back the waves of feeling alone. Mother Teresa, the most saintly of traditional faith, summed it up starkly: “The most terrible poverty is loneliness and the feeling of being unloved.”

More and more, I come across ­examples of people who have either deepened their relationship with their faith, seeking ­comfort and companionship in religion, or returned to reassuring rituals to ward off a feeling of insignificance.

I eagerly confess that I am one of those eternally hopeful Scots that ­imagines the world will be better with ­independence, while accepting that there are many ­fundamental human ­conditions that ­cannot be solved by constitutional change, or by a magic wave of the ­self-determination wand.

Yes, we can do more through fairer distributive taxation to tackle ­poverty, ­increase the rate of social housing ­provision and find more solutions to ­public transport in rural areas but ­loneliness is a complex and multi-faceted condition that neither independence nor constitutional change can eradicate.

Loneliness is often a mystery beyond simple diagnosis itself.

As a teenager, I grew up in a lively and emotionally fulfilling home, where ­pocket money was anorexic but love was all around. I never imagined then that ­loneliness would eventually visit my ­family in later life.

I had yet to fully discover books and most of my life lessons about love and ­fidelity came from Tamla Motown songs, the great pop poetry of the 1960s.

I wish now that I had concentrated more fully on the Four Tops song Ask The Lonely, a classic piece of Detroit ­philosophy, sung by the peerless Levi Stubbs. I didn’t know then how much it spoke about my own mother and her loss of love.

“But ask the lonely/ How vainly a heart can yearn/ For losing a love that will ­never return/ Just ask the lonely/ Ask me.”