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Introduction

Loneliness signals the need for human connection. It is often defined as a “distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships” (Cacioppo and Cacioppo, 2018). The experience of loneliness is an innate response that can be sometimes paired with feelings of anxiety, fear, depression, and shame (Campaign, 2020). Scholars have also argued that an individual may appear to be very social and outgoing but can nevertheless feel lonely in the presence of others (Hawkley and Cacioppo, 2010). It is a complex concept and feeling that is mirrored in the many different disciplines and lenses applied to its understanding.

It is worth noting that there is no strong evidence that indicates mean-levels of loneliness have increased or decreased globally during the COVID-19 pandemic; though certain groups (e.g. vulnerable populations) are more likely to experience loneliness than others (Killam, 2020). Why? Some researchers posit a “sense of solidarity” and our innate urge to connect with others to have mitigated some of the effects of being unable to come together physically (Silberner, 2020). Other potential reasons may include the ways in which people have created moments of interaction (e.g. virtual happy hours and birthday parties); a shift in populations reporting being newly lonely; and/or likely discrepancies in the methodologies used (e.g. timeframes, location).

What we know of loneliness continues to evolve. Research over the past decade has highlighted numerous corollaries associated with specific population groups, socio-economic conditions, interpersonal relationships, and physical and mental comorbidities. As we have written previously, loneliness does not discriminate and can affect people of different ages, conditions, professions, and places. While there may not be one single cause that influences loneliness, our recent analysis suggests that a greater focus is needed towards uncovering the structural factors that perpetuate systematic discrimination for communities that are more likely to experience loneliness. The question of “whose loneliness matters” insists that we come to understand if and how our systems, digital or not, prioritize access to tools that could help individuals navigate the experience successfully.

In the context of India, recent demographic (e.g., young people between 18 and 25) and socio-economic transitions (e.g., rapid industrialization and deterioration in social capital) have affected the overall wellbeing and sense of loneliness among several segments of the Indian population (Tiwari, 2013). A meta-analysis on studies concerning the prevalence and correlates of loneliness in India found that the burden of loneliness was higher among the elderly compared to younger generations (Anil et al., 2016; Grover et al., 2018; Hossain et al., 2020), as is also the case in Western cultures. Researchers also found factors associated with loneliness to include aging, family structure, marital status, religious practices, and more (Hossain et al., 2020). Studies also reported that pre-existing non-communicable diseases, such as diabetes and anxiety, were associated with loneliness (Grover et al., 2018). While chronic loneliness is often treated as a symptom of mental health problems, the evolving conditions listed above call for a re-evaluation of loneliness “not just as a situation or a symptom of a disease or [a mere] social concept but as a disease in itself” (Tiwari, 2013).

We begin with a brief history of mental health in India and the various policies that have shaped its public mental health system. Additionally, we bring attention to traditions of the region, as manifested in its religion and language. This is necessary in order to situate the current stigmatization and cultural norms around mental health issues, in general, and the seeming absence of the concept of “loneliness” more specifically. As Mishra and others note (2018), “knowing the history of psychiatry with an Indian perspective becomes pertinent in conceptualizing major issues in phenomenology and management specific to the Indian context.”

 
 
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