How Did We Get So Lonely? A Conversation With Surgeon General Dr. Vivek Murthy

The day before I meet with Vivek Murthy, MD, current Surgeon General of the United States, I spend an hour with my therapist working on how to breathe through the unpleasant interpersonal interactions I’ve been having with increasing frequency as of late. For some reason, people seem to have suddenly forgotten what it’s like to treat others with kindness; one complete stranger to whom I’ve shown nothing but respect is so inexplicably rude to me over email that I cry. Is everyone okay, I wonder? 

The answer, according to Dr. Murthy, is not really. Throughout our conversation in which we unpack why Americans are feeling so low, I’m struck by just how kind Dr. Murthy is in comparison to pretty much everyone else I’ve spoken to recently. America’s doctor is likely the busiest—not to mention the most objectively “important”—person I’ve interacted with, and yet he takes time and care to humanize our interaction in a way no other professional contact has as of late. It’s no wonder, I think, he’s become the unofficial czar of connection. In just 30 minutes, he reminds me what it’s like to be rewarded by human interaction, and our conversation feels like a warm hug. 

Dr. Murthy, who is now serving his second term as Surgeon General under President Biden, has made it his mission to reconnect Americans. In April of 2020, at the height of pandemic isolation, he published Together: The Healing Power of Connection in a Sometimes Lonely World, a book that highlights the ways in which the social fabric of our society is unraveling (the causes of which comprised much of our conversation), and describes how the health of both individuals and the collective are suffering as a result of widespread disconnection.

“As a society, we need to put relationships back at the center of our lives and not at the periphery.”

— Surgeon General Vivek Murthy, MD

In 2023, he officially sounded the alarm with an advisory entitled, “Our Epidemic of Loneliness and Isolation¹.” The 82-page report describes the ways in which human health depends upon social connection, the reasons social connection seems to be plummeting in the U.S., and the significant mental and physical health consequences of this mass disconnect (think: increased rates of depression, anxiety, heart disease, type 2 diabetes, and more). With this action, Dr. Murthy took the unusual step of declaring loneliness a public health crisis. 

For Dr. Murthy, this issue is deeply personal. “I struggled a lot with loneliness at various points in my life and never really talked about it until we started working on these issues [professionally],” he says. “I didn’t realize it was so much more than a temporary bad feeling, that it had real implications for my health, and that it was something I should have addressed.” 

This loneliness surfaced for him early on in life. In Together, Dr. Murthy says he first noticed it in grade school where, as a shy child, he felt lonely every single day. I tell Dr. Murthy I can relate, having been a timid gal who changed schools nearly once a year throughout middle school. We shared our mutual regret around living alone for “too many” years in adulthood—a rite of passage that is widely seen as a good thing in the U.S.—because of the subsequent loneliness and depression we experienced. 

“I lived alone for a decade before I got married, and it was only in retrospect that I realized it would have been better for me to be living with other people at the time, even if it was roommates,” Dr. Murthy says. “I thought it was a step up to be able to get my own place to live by myself, and that turned out not quite to be the case.” 

In interviews, Dr. Murthy has also acknowledged that he experienced profound feelings of loneliness after the end of his first term as Surgeon General. He’d been so focused on his job that he’d lost touch with friends and loved ones. “I react to stress by withdrawing and trying to be on my own and figure everything out,” he tells me. He knows it’s not a helpful stress response, but rather one that begets more loneliness (and yes, he’s working on it). After some time and uncomfortable effort, Dr. Murthy managed to rebuild the relationships he’d left untended during his first term, and learned a valuable lesson in the process: “Relationships are a buffer to stress,” he says. 

Despite Dr. Murthy’s own history with social isolation, it’s been the profound loneliness he’s witnessed in others that’s impacted him most. In Together, Dr. Murthy tells the story of his uncle Rajesh, who immigrated to the U.S. ahead of his wife and children when Dr. Murthy was in middle school. Initially, Rajesh lived with Dr. Murthy’s family, and the two would keep each other company for hours after school. Outside of the home, however, Rajesh had trouble connecting with others due to language and cultural barriers. 

His uncle’s struggles intensified after moving out of the Murthy home and were further compounded by a stressful job loss. Eventually, he died by suicide. After his uncle’s death, Dr. Murthy recalls looking upon the time he’d spent with Rajesh in a new light; he realized their togetherness had likely meant more to his lonely uncle than he, himself, could have imagined. The tragic experience highlighted a new truth for Dr. Murthy: You can’t always tell from the outside how much pain someone may be feeling on the inside.

Later on in life, while working as a Massachusetts-based internal medicine doctor and then as Surgeon General, Dr. Murthy would witness the devastating effects of loneliness on a much larger scale. In researching the issue, he discovered that loneliness can have profound, measurable effects on not only your emotional health, but on your physical health too. 

To this end, Dr. Murthy’s 2023 advisory includes a number of alarming statistics. For example, studies show² that poor social relationships are associated with a 29 percent increase in the risk of heart disease and a 32 percent increase in the risk of stroke. Rates of hypertension³ and type 2 diabetes⁴ have also been shown to increase, along with your risk of developing the common cold⁵. Another study⁶ found that chronic loneliness and social isolation can also increase the risk of developing dementia by 50 percent in older adults.

In terms of the emotional impacts of loneliness, a systematic review⁷ of multiple studies found that the odds of developing depression in adults is more than double among those who report often feeling lonely. Loneliness and low social support are also associated with increased risk of self-harm. One study⁸ of 500,000 middle-aged adults found the probability of dying by suicide was more than double among men who lived alone. Ultimately, research⁹ suggests that loneliness poses health risks as deadly as smoking 15 cigarettes a day—just in case you needed something more tangible in your mind.

These stats aren’t exactly uplifting. Like, “Hey, being lonely sucks, but did you know it’s also literally killing you?” And trust me; I get it. As the last single and childless person in my social circle, loneliness sent me into a deep depression that lasted half a decade, and at the time, I felt powerless to remedy the situation. Of course, I’m far from the only person who can relate to this experience. Dr. Murthy says more than one in two Americans have reported feeling lonely, underscoring the irony of this epidemic: We’re all in it together. 

But what’s so different about modern society that’s making us feel lonelier than our grandparents, who, you know, didn’t even have the internet or cell phones? According to Dr. Murthy, quite a bit. This current “inflection point,” as he calls it, is the result of our uniquely American ethos—which reveres individualism—coupled with a slow snowballing of cultural shifts, technological advances, and an overall devaluing of community and human connection. 

“

When you connect with someone, you remind yourself that you have value to give to the world.”

On a micro level, the reasons are myriad (as is evident by the thousands of TED Talks and textbooks that exist on “the current state of society”). Still, some glaring trends stand out, like the fact that traditional support structures have been steadily disappearing since our grandparents were kids. Not only have family size and marriage rates been declining for decades, but real-life “third places,” like service clubs, recreational leagues, and faith organizations, have all but vanished in many communities.

Technology has also replaced opportunities for us to run into each other organically throughout the day. “We used to encounter one another in settings like post offices, grocery stores, retail stores, and walking on the streets, but these days, you can get so much delivered to your home that you don't need to go out,” says Dr. Murthy. “It has led to less human interaction in our life overall.” 

All of this has landed us where we are today: less socially connected, less involved with our communities¹⁰, and more, well, on our own¹¹. Interestingly, though, many of us may not even realize that we’re feeling lonely. Social isolation can be hard to recognize in today’s digital age, when our phones can be flooded with texts, DMs, and notifications at any given time. 

But, according to Dr. Murthy, online interactions are not an adequate substitute for IRL interaction—at least, not to our brains. “We’ve evolved over thousands of years to have in-person interaction, to interpret not just the content of what somebody is saying, but the tone of their voice, their facial expressions, their body language,” he says. “All of these things matter when we’re building a connection with someone, and we lose a lot of that when we’re solely online.” 

Unfortunately, many of us are also out of practice when it comes to in-person interaction, thanks to pandemic isolation and an increased reliance on digital spaces. “I think about our social comfort very much as a muscle,” says Dr. Murthy, “and our social muscle, like any other muscle, is one that can get weaker over time if we don't use it.” This increased social anxiety has prevented many people from attempting to make new connections, he says, thereby increasing feelings of loneliness.

Of course, modern society—and all of its resulting isolation—isn’t disappearing anytime soon. Instead, these cultural shifts and trends are becoming more and more entrenched, says Dr. Murthy, which means the stakes are even higher in terms of our mental and physical health. After all, loneliness is not “just a bad feeling,” but rather a force that exerts negative effects on our biology, psychology, and behavior.

The good news is that as a society, we're far from a lost cause, despite how deflating the current statistics can sound. Dr. Murthy not only has a detailed plan for combatting the loneliness crisis, but he also says the health consequences of loneliness are reversible, and that it's never too late to enjoy the benefits of human connection.

According to his published advisory, connecting with others can increase your overall odds of survival by 50 percent¹², and is also associated¹³ with a 36 percent lowered risk of developing high blood pressure. Having the support of family members has also been shown¹⁴ to improve the health of people with type 1 and type 2 diabetes, while having a more robust and diverse friend group could significantly decrease your risk⁵ of developing a cold. 

Psychologically, the benefits of connection are often more obvious and immediate, especially in our general mood and overall well-being. “Anyone who’s ever had the experience of getting a call from a good friend, even if it’s just for a couple of minutes, knows they feel better and more peaceful afterward,” says Dr. Murthy.

Connections can also offer us some perspective and ground us in the present. “The longer we struggle with loneliness, the more we start to believe we’re lonely because we’re not likable; our self-esteem gets eroded,” Dr. Murthy says. “When you connect with someone, you remind yourself that you have value to give to the world.” 

More than anything, Dr. Murthy wants to help us get better at seeking out and fostering the connections that will make us well. He’s not just ruminating on loneliness; he’s actively trying to enact solutions. To this end, Dr. Murthy says raising awareness is a key action item for his team, because individuals can actually exert a significant amount of influence over their own levels of social connection. “It's the small decisions we make,” he says. “[For example], making sure we put in one call to someone we care about each day, or making sure that the time we spend with others is high-quality time, meaning that we're not distracted by our devices when we're with our family and friends.” 

Dr. Murthy acknowledges, however, that the onus is not entirely on individual Americans, and that policies need to be designed specifically to foster connection in our fraying society. His advisory lays out the framework in A National Strategy to Advance Social Connection, which includes six pillars of action, ranging from strengthening the infrastructure in local communities (like volunteer organizations, public transportation, housing, libraries, and playgrounds) to reforming digital spaces to reduce harm and better facilitate quality connection.

None of this will happen overnight, and neither will the dramatic cultural shift Dr. Murthy says also needs to take place if this issue is to be remedied. “As a society, we need to put relationships back at the center of our lives and not at the periphery,” he says. And part of that includes reframing the way we view prosperity and winning.

“We have to rethink how we define success so that it’s not about how much money we can make, how much fame we can achieve, or how many promotions we can get,” says Dr. Murthy. “Success should also be seen as building healthy relationships, investing in your children, and taking time to care for your aging parents.” After all, these things will ultimately have a much greater impact on your mental and physical health than, say, a new Ferrari.

This shift is part of the legacy Dr. Murthy endeavors to leave behind. “I hope people will remember that our relationships are one of the greatest gifts we have in our lives,” he says. “When the patients I’ve had the chance to sit with at the end of their lives reflected on what really mattered to them, it wasn’t how much money was in their bank account or how many followers they had on social media. It was their relationships.” 

With this final word, our time is up, and yet Dr. Murthy decides to take one last opportunity to connect with me, despite the fact that it will make him late for his next appointment. I’d mentioned at the top of our interview that I’m currently pregnant, and he concludes our conversation by asking for my due date. “July 10,” I tell him, to which he responds gleefully that the date is actually his birthday. “Well,” I say, “I guess I’ve found my baby name!” 

Despite the little time we had together, I felt buoyed by our conversation. Its surprise earnestness and vulnerability cut through the growing loneliness I had been feeling, and for that, I felt grateful. Dr. Murthy was right—the benefits of connection really are immediate.