Originally posted at Beacon Lens The holidays are upon us, and the irony they bring is the potential for isolation and loneliness. Holidays’ essential identity is getting together with loved ones, but some people do not feel as connected as they would like or expect. In 2020, add COVID-19 and its quarantining dictates, and the potential for such feelings can strengthen. The holidays, therefore, present an excellent time to discuss how we can reinforce connections during a time that requires us to be apart to protect our physical health, a requirement that paradoxically can have a damaging effect on our mental health. We can, however, take charge of improving our mental health.

Loneliness and isolation and our health

What is the difference between loneliness and isolation? “Loneliness is the feeling of being alone, regardless of the amount of social contact,” according to the Centers for Disease Control and Prevention (CDC). Social isolation, on the other hand, is a lack of social connections. Put differently, one can have many social connections but still feel lonely. The physical and mental health risks of loneliness and isolation are significant. They include but are not limited to:

• Social isolation increases the risk of premature death by 29 percent, rivalling smoking, obesity and physical inactivity.
• Social isolation is associated with increasing the risk for dementia by approximately 50 percent.
• Loneliness is connected to higher rates of depression, anxiety and suicide.

A 2020 report by the National Academies of Science, Engineering and Medicine (NASEM) states that more than one-third of adults 45 and older feel lonely, and approximately one-fourth 65 and older are socially isolated. Add the holidays and COVID-19 to an already preexisting condition, and the time is ripe for all of us to take action to protect our mental health.

Simple steps for better mental health during the holidays

Specific to the season and the times, there are common-sense tips that we all can practice to help manage loneliness. For example:

• Talk to someone about your sense of loneliness and isolation. There’s stigma around loneliness so it can be hard to do. However, you may well find that you’re not alone in those feelings, and sharing them can help lessen their effect.
• Manage your holiday/COVID-19 expectations. The holidays can fall short of expectations, but this year it may be worse. Understand that the pandemic won’t last forever, and that we’re all in this together. Indeed, many people’s holiday gatherings will likely be different this year.
• Remember to take care of yourself, now more than ever. Sleep, exercise and good nutrition — with the proper amount of holiday indulgence — go a long way in addressing mental health.
• Avoid social media, such as Facebook or Instagram, especially during the holidays. It’s easy to negatively compare one’s life to the “perfect” lives posted on social media, forgetting that people mostly post only the positive.

Loneliness and isolation as its own pandemic

The holidays don’t last forever, and we will get through the COVID-19 pandemic. However, loneliness and social isolation may persist, which presents a challenge for behavioral health providers. The recent NASEM report explores interventions that the healthcare system can take to address loneliness as a societal condition, such as engagement in support groups, cognitive behavioral therapy and mindfulness, social determinants of health, social prescribing and more. Social prescribing is arguably one of the more interesting interventions in that it puts a clinical lens on non-clinical solutions. While there is no hard-fast definition of social prescribing, it is generally accepted as a way to connect people to non-clinical sources of support, according to the NASEM. Specifically, it is a “non-medical referral, or linking service, to help people identify their social needs and develop wellbeing action plans to promote, establish or reestablish integration and support in their communities, with the aim of improving personal wellbeing.” Examples of secondary services that improve social concerns affecting health include housing and food insecurity services. While known to varying community-based organizations, social prescribing is not common among practitioners, but it’s a common-sense solution. An analysis of one pilot program from the NASEM report — albeit a small one — found that social prescribing reduced inpatient admissions by as much as 21 percent and emergency room visits by 20 percent. A modern world — without COVID-19 — is more connected than ever due to social media and other technology. However, studies have shown we are more lonely now than in any other time in recent history. It’s time to think out of the box as we realize more and more how non-physiological conditions — such as issues ranging from a public health emergency to social media — can affect our health.

We constantly receive messages from family, friends and even physicians implying that there is a correlation between weight and well -being. You will be happy, healthy, and successful if you are skinny. You must lose weight in order to live a good life. If you do not fit this mold, you may feel shame or be stigmatized. Unfortunately, this approach has not been successful. Most people who diet gain the weight back. People resort to sneak eating and are unable to enjoy the foods that they love. They may under-eat or over exercise. Periods of food deprivation only result in the body raising the set point and becoming heavier over time. Weight cycling has been shown to lead to poorer health. BMI has often been used as to assess a person’s health status. However, it has been found that people who fall into the obese category according to their BMI are often physically fit than those who are slimmer. Surprisingly, they have actually been shown to have half the mortality of people who are thin and more sedentary. A much better approach is to focus on wellness, encouraging people of all sizes to respect and take care of themselves. Physical activity could be encouraged for pleasure as well as for health benefits. Eating would be in response to hunger and satiety cues rather than a diet plan. Foods would not be labeled as “good or bad”. This approach would respect people of all sizes. They would not be judged based on their body size but instead encouraged to take care of their physical and emotional needs.

Obesity and inactivity could someday account for more cancer deaths than smoking if current trends continue, a leading cancer expert says.  As the rate of smoking decreases, other unhealthy habits threaten to offset the progress in reducing cancer deaths, says Richard Wender, a physician and chief cancer control officer at the American Cancer Society (ACS). A study in the New England Journal of Medicine last fall found 13 types of cancer were linked to excess body weight.  There's no guarantee that obesity and inactivity will surpass smoking as a cancer cause, Wender says, but the possibility is startling. "Who would’ve thought we’d ever see the day where what you eat (and) exercise, could account for more cancer deaths than smoking?” he asks.  The connections between smoking and too much exposure to the sun and cancer are well known, but the connections between nutrition and exercise and cancer are less known and harder to determine. Calculating cancer's link to obesity is difficult in part because of an overlap in cancer risk factors, says ACS' Rebecca Siegel, strategic director of ACS' surveillance information services.   Siegel comments that 20% of cancers are caused by poor diet, alcohol consumption, a lack of physical activity and/or excess weight.  However, that 20% cannot be combined with the 30% of cancer deaths caused by cigarette smoking since poor people are more likely to be obese and to smoke than those who are more affluent people.  A striking 50% of all cancer deaths could be prevented by following the basics of a healthy lifestyle, says Wender. That includes diet and exercise and having regular cancer screenings and getting the HPV vaccine that helps prevent cervical cancer and likely oral cancer and for Hepatitis B, which can lead to liver cancer.