When Dr. Vivek Murthy was surgeon general of the United States during the Obama administration, he went on a listening tour of America: He wanted to hear firsthand about people's health concerns.

That meant addressing opioid addiction, diabetes and heart disease. And one more thing — something he wasn't really prepared for — the number of Americans suffering from a lack of human connection. Loneliness, he learned, was impacting them not only mentally but also physically.

"I found that people who struggle with loneliness, that that's associated with an increased risk of heart disease, dementia, depression, anxiety, sleep disturbances and even premature death," he told NPR.

It's a subject he writes about in his new book, Together: The Healing Power of Human Connection in a Sometimes Lonely World.

Interview Highlights

On finding that loneliness is at the root of so much emotional and physical pain

I heard many familiar stories about substance use and addiction, stories about depression and anxiety. But what I didn't expect was that behind so many of their stories were threads of loneliness. And people wouldn't say to me, "I'm lonely," but they would say things like this: "I feel like I have to shoulder all of these burdens by myself"; "I feel if I disappear tomorrow, no one would even notice." And I heard this time and time again. It was like a lightbulb went off. And I saw in the research that loneliness was far more common than I had thought, affecting 22% of adults in America. And it was deeply consequential.

On the word "shame"

There's a tremendous sense of shame that people who are lonely feel. I say that as someone who felt ashamed of being lonely as a child and even at points during adulthood. I think part of the reason is that saying you're lonely feels like saying you're not likeable, you're not lovable — that somehow you're socially deficient in some way. The reality is that loneliness is a natural signal that our body gives us, similar to hunger, thirst. And that's how important human connection is. Thousands of years ago, our ancestors knew this. They knew there was safety in numbers. And when we were separated from each other, it places our survival at risk. And it puts us in a physiologic stress state, which, when it's short, when it's acute, it can lead us to seek out connection. But when it's prolonged, then it can become a chronic state of stress, which leads to inflammation in our body, damages tissues in blood vessels and, ultimately, damages our physical, as well as our emotional, health.

On measuring loneliness

I do think that we can impact how people feel about themselves and others. And more importantly, I think each of us as individuals can take certain steps in our own life — our connection to other people really begins with our connection to ourself. If we approach other people understanding our own value, being confident in who we are, being centered and grounded, it's actually easier for us to connect with them because we can listen more deeply and we can express ourselves more authentically without fear of being judged or not being enough.

On the long-term effects of our self-isolation at this moment

I think this could take us down one of two paths. One path is the worrisome one, marked by greater loneliness as we spend more and more time physically separated from one another. But the other path is the path of social revival, if we recommitted to people and to relationships. We have the opportunity to use this moment to recenter our lives on people. And if we do that, then I believe we can come out of this pandemic more connected, more fulfilled and more resilient than before the pandemic began.

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