The friend effect: why the secret of health and happiness is surprisingly simple: A study has found that regularly eating meals alone is the biggest single factor for unhappiness, besides existing mental illness. Why is hanging out with friends so helpful?
For some, eating alone can be a joyous thing: forking mouthfuls of pasta straight from the pan, peanut butter licked off a spoon, the unbridled pleasure of walking home from the chippie alone on a cold night. But regularly eating meals in isolation is a different story. This one factor is more strongly associated with unhappiness than any other apart from (unsurprisingly) having a mental illness. This is according to a new study by Oxford Economics that found, in a survey of 8,250 British adults, that people who always eat alone score 7.9 points lower, in terms of happiness, than the national average.
This research is far from the first to suggest a link between eating with others and happiness. Researchers at the University of Oxford last year found that the more that people eat with others, the more likely they are to feel happy and satisfied with their lives. The study also found that people who eat socially are more likely to feel better about themselves and have wider social and emotional support networks.
Robin Dunbar, a professor of psychology, worked on the Oxford University study. He says that “we simply don’t know” why people who eat together are happier. But it is clear that this is a regular social ritual, a moment of union and communion in our often chaotic lives. It can be a place of conversation, storytelling and closeness.
“At a psychological level, having friends just makes you happier,” says Dunbar. “The kinds of things that you do around the table with other people are very good at triggering the endorphin system, which is part of the brain’s pain-management system. Endorphins are opioids, they are chemically related to morphine – they are produced by the brain and give you an opiate high. That’s what you get when you do all this social stuff, including patting, cuddling and stroking. It is central to the way primates in general bond in their social groups and relationships.”
Our face-to-face relationships are, quite literally, a matter of life or death. “One of the biggest predictors of physical and mental health problems is loneliness,” says Dr Nick Lake, joint director for psychology and psychological therapy at Sussex Partnership NHS Foundation Trust. “That makes sense to people when they think of mental health. But the evidence is also clear that if you are someone who is lonely and isolated, your chance of suffering a major long-term condition such as coronary heart disease or cancer is also significantly increased, to the extent that it is almost as big a risk factor as smoking.”
One of the most striking pieces of evidence for this, says Dunbar, is a meta-analysis of 148 epidemiological studies that looked for the best predictors that patients would survive for 12 months after a heart attack. “The best two predictors, by a long way, are the number and quality of friends you have and giving up smoking,” he says. “You can eat as much as you like, you can slob about, you can drink as much alcohol as you like – the effect is very modest compared with these other two factors.”
Human beings are biologically engineered for human interaction – and particularly face-to-face interaction. One study from the University of Michigan found that replacing face-to-face contact with friends and family with messages on social media, emails or text messages could double our risk of depression. The study also found that those who made social contact with family and friends at least three times a week had the lowest level of depressive symptoms.
“We are the most social of all the animals,” says Prof Paul Gilbert, a psychologist and the founder of compassion-focused therapy. “Our brains and our bodies are built to be regulated through interactions with others from the day that we are born.” This is not the case with many creatures, such as turtles and fish, that procreate in vast numbers. “They don’t need looking after,” says Gilbert. “Many of them will die before they reach reproductive age. The caring behaviour [associated] with mammals is a major evolutionary adaptation – it changes the brain and the physiology of the body so that a parent is interested in staying close to an infant. One of the most important things is the human capacity for soothing and engaging. So, when a mother smiles at a baby and makes eye contact, that positive emotion in the face and the voice of the mother is stimulating positivity in the child. You can see why it’s called mirroring, the baby smiles back.
“The ability to stimulate positive emotions, which is linked to happiness, begins in interactions with others who are having positive emotions about you. So, when we see our friends and they say, ‘Good to see you’ – it’s important.”
But there are many factors that might prevent us from seeing friends and family: mental ill health, immobility, a lack of money. Alison Harris is a consultant clinical psychologist and professional lead for psychological services in Salford. “Austerity has a huge influence on the loss of happiness and wellbeing,” she says. “Homelessness and unemployment in particular takes us out of contact with others. In addition to the obvious harms of homelessness, it does massively increase social isolation and anxiety. To take that even further, many people are in exile from their communities. In mental health services, we see an enormous amount of grief, depression and anxiety in people who are asylum seekers and refugees and much of that is not just due to trauma or torture or detention or fleeing from their country, but from the severe rupture of being cut off from their families and communities of origin.”
When we are around others, it has an effect on our body. Some forms of friendship – going to parties, getting married, having positive interactions with others – stimulate our sympathetic nervous system. Gilbert says that the parasympathetic nervous system (otherwise known as the “rest and digest” system) “is stimulated through the verbal and voice tone of relations with each other. As far as we know, it’s not that stimulated through texts. Generally speaking, you’re designed to respond to voice tone and expression, and stroking. We are physiologically designed for face-to-face interaction.”
Of course, for those struggling with depression, the idea of physical contact can be impossible to fathom. At those moments, the capacity to lift up a mobile phone and type out a text is an enormous mark of progress. It may not be the ideal form of interaction, but it’s a vast improvement on staring at a wall.
Dragging ourselves out of low energy states – be that by trying to cultivate compassionate voices internally or having compassionate relationships with others – is key to Gilbert’s work. “If you ask someone, ‘What is your internal critic most frightened of?’ [you will find] it’s frightened of rejection, of being seen as no good. Of being unlovable, of not being wanted. All the raging that goes on beneath us, the thing that we fear most is shame – not being good enough or wanted. We are frightened of being revealed to be not so nice.”
He says that what has happened in the past decade, with the rise of social media, “is that it has become a very plastic society. We are all living like theatrical actors, presenting ourselves as our best. That can’t be real, and so we have many people who feel like failures or useless. They say: ‘I’m not as attractive as that, I’m overweight, I’m not kind or compassionate to others.’”
As Gilbert says, the best relationships are the ones where people love us for our perceived dark sides and flaws. “People forget that love is about loving you for the difficult things, not the easy things,” he says. It is those who know us intimately who can provide that, and they do it through their physical presence, through touch, and through eating, drinking and sharing with us. Spending time together is social nourishment. So, instead of texting a friend or messaging them on social media, why not knock on their door, look them in the eye and make yourselves both feel better?
This article was amended on 23 May 2018. Dr Alison Harris works for the Greater Manchester Mental Health NHS foundation trust, and not Salford Royal NHS foundation trust, as an earlier version said.
Lonely millennials found to be more likely to have mental health problems and be out of work
Lonely millennials are more likely to have mental health problems, be out of work and feel pessimistic about their ability to succeed in life than their peers who feel connected to others, regardless of gender or wealth, research has revealed.
Loneliness should be taken seriously as a potential marker for other problems, the team behind the study say, though it is not clear whether loneliness is behind the other problems or instead caused by them.
“If somebody discloses to their friends or family, or a GP, that they feel lonely a lot of the time, that could be a warning sign that they are struggling in other areas of life,” said Dr Timothy Matthews, co-author of the study from King’s College London.
Discussion about loneliness has mostly focused on the elderly, but a recent study by the Office for National Statistics found that young people aged 16-24 felt lonely more often than any other age group of adults.
The health impacts of loneliness have also been under scrutiny – studies have shown that people who are lonely are 50% more likely to die before their time, with research suggesting loneliness is as dangerous to health as smoking 15 cigarettes a day and more hazardous than being obese.
The latest research, published in the journal Psychological Medicine, is based on a large-scale study known as the Environmental Risk Longitudinal Twin Study, which assessed same-sex twins, born in 1994-1995, at various stages of their life. The new research draws on surveys conducted when the participants reached 18 years of age, and involved 2,066 participants.
Participants were asked whether they often, sometimes or hardly ever experienced various aspects of loneliness as well as being quizzed on factors including their mental health, physical health, life satisfaction and relationship with technology. The researchers also looked back at the participants’ family environments and mental health, as well as other data collected in previous years.
“What we wanted to do was … a study that gives a snapshot of the lives of young people in the UK who are suffering from loneliness,” said Matthews.
The results reveal that up to 7% of participants said they often had feelings of loneliness, with 23-31% of participants saying they experienced feeling left out, alone, isolated or lacking in companionship some of the time. The results held regardless of gender or socioeconomic status.
The researchers then pooled the responses to give an overall measure of loneliness. After taking into account gender and socioeconomic status, they found that for every two-point increase on an eight-point loneliness scale, the odds of experiencing depression, anxiety or attempting suicide all more than doubled, while the odds of being unemployed rose by 38% .
Among other findings loneliness was also linked to smoking, being less physically active, compulsive use of digital technology, having low qualifications and being less likely to talk about problems with others – although it was not related to job hunting efforts.
The team notes that the study has some limitations, including that all participants had at least one sibling, and that loneliness was only measured once for 18-year-olds. But, they add, the study suggests increasing contact between individuals might not be enough to tackle loneliness and that approaches should include addressing bullying, isolation and mental health in children, since these were found to be linked to greater loneliness at 18.
Anne Rogers, professor of health systems implementation at the University of Southampton, who was not involved in the study, said that while the research raises questions about whether lonely children go on to become lonely adults, it is important to consider that loneliness can also be down to social situations, such as the death of friends or health crises, or even belonging to a group that is marginalised.
“Whilst calls for early intervention might be one way of addressing [loneliness], we need to look at developing and evaluating interventions that might connect people to social opportunities and networks of support in everyday settings – ie doing something which makes a difference to loneliness,” she said.
Stephen Buckley of the mental health charity Mind added: “Feeling lonely isn’t in itself a mental health problem, but the two are strongly connected.
“Being sociable and connecting with other people is rewarding in its own right and can help significantly improve your mental wellbeing, especially if you’re not feeling so good.”
- In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at befrienders.org.