Welcome to April’s #FacetsOfME where we will focus on loneliness and how this illness affects our need for connection and relationships. Loneliness can be difficult to discuss as contemplating our own loneliness and need for connection can make us feel very vulnerable. Loneliness is certainly not unique to ME but we will try to examine how our illness contributes to loneliness. The symptoms of post-exertional malaise, cognitive dysfunction, sensory sensitivity, etc. contribute to challenges with connecting.
I do not have numbers on how many people with ME experience loneliness on a regular basis, but from what I see in our support groups and on social media, it is common. We do know that in the United States, 40 percent of people who say that they have a debilitating disability or chronic disease report experiencing loneliness and social isolation. Perhaps this could be helpful to some of our fellow spoonies as well. This one might be difficult to dive into but hopefully doing it together will ease the discomfort and I think we might come out better for it on the other side. Are you ready? Get comfortable and take all the breaks you need. If at any point you need to reach out to speak with someone, please see these crisis resources.
What is Loneliness?
When it comes to discussing loneliness, I think it is important to start with making sure we have a shared understanding of the language around loneliness and connection.
“Loneliness is the state of distress or discomfort that results when one perceives a gap between one’s desires for social connection and actual experiences of it.” Feeling lonely is not always about being alone. We can feel alone in a crowded room but in the case of our illness, being forced into spending a lot of time alone is certainly a part of our loneliness. As humans, we have a need for connection. When we are not able to fulfill that need, we feel the loss. We feel lonely.
Loneliness is universal, so let’s first make sure we learn from what is known and then apply that to our specific circumstance of loneliness in relation to a chronic illness that makes visiting, conversations, and common social interactions anywhere from difficult to impossible.
Researchers have identified 3 dimensions of loneliness as described in the research article ”Loneliness: Clinical Import and Interventions”:
- “Intimate loneliness, or… emotional loneliness, refers to the perceived absence of a significant someone (e.g., a spouse), that is, a person one can rely on for emotional support during crises, who provides mutual assistance, and who affirms one’s value as a person.” It can be a small core group or one person.
- “Relational loneliness, or… social loneliness. It refers to the perceived presence/absence of quality friendships or family connections, that is, connections from the “sympathy group”…the “sympathy group” can include among 15 and 50 people and comprises core social partners whom we see regularly and from whom we can obtain high-cost instrumental support.”
- “Collective loneliness… refers to a person’s valued social identities or ‘active network’ (e.g., group, school, team, or national identity).”
The United States Surgeon General, Dr. Vivek Murthy, in his recent book Together describes the three dimensions this way: “Intimate or emotional loneliness is the longing for a close confidant or intimate partner, someone with whom you share a deep mutual bond of affection and trust. Relational or social loneliness is the yearning for quality friendships, and social companionship and support. Collective loneliness is the hunger for a network or a community of people who share your sense of purpose and interests. These three dimensions together reflect the full range of high-quality social connections that humans need in order to thrive.“
The idea that a deficiency or “perceived deficiency” in any one of these can cause you to be lonely. Now that we know the dimensions of loneliness, we can identify which dimensions are affected by this illness. Let’s look back and see…
Intimate loneliness? Check.
Relational loneliness? Check.
And finally, collective loneliness? Check.
All of them.
All three dimensions are affected by living with ME. Yay, us! (Read in sarcastic tone.)
Let’s start with intimate loneliness. Finding a partner in life is a challenge in general. Let’s add possibly being unable to leave your home or carry on long conversations, and well…it’s not easy. (I am not at all trying to make light of this but I do want us to be able to speak plainly here amongst ourselves). It is deeply personal and there is so much understandable grief in our community about it. It is not just about finding a partner either. It is maintaining and nourishing that type of relationship under trying conditions. Some of us had a life partner and then got ill. This has meant that some lost that relationship totally or are now having to adjust to a very changed version of the relationship. It has also allowed some to have a very deep satisfying relationship from two people deeply committed to each other, and to working things out. Not everyone can do that.
One very important note here is that it can also be another hindrance to leaving an abusive relationship. The dependence on a partner for the very basic activities for daily living can be a situation ripe for abuse.
If you are experiencing domestic abuse, please click below for resources.
Let’s move on to the next dimension of loneliness: relational (or social) loneliness—the need for friends and true companionship. I believe this is a loneliness that cuts deep in our community. Complex, misunderstood chronic illness can be hard on a friendship.
For friendships already in existence, once this illness enters the picture both people in the friendship have to drastically adjust expectations. The once easy habits that kept you close are now drastically different. It takes time, work, and open communication to navigate and sometimes that is not always possible.
For friendships yet to develop, you face difficulties meeting new people and reaching out in those first baby steps toward a deeper friendship—the spontaneous “I am about to go grab a coffee, want to join me?” Or the running into others at functions for like-minded individuals. Maybe for you this was work, school, clubs, churches, your child’s school, etc. Now showing up in person is drastically reduced if not totally impossible.
The final dimension is collective loneliness—that need to belong to a group—the feeling of being on the same team as others. Many of us might lose this as we cannot keep up with sports, schooling, work, previous volunteer efforts, clubs, etc. The things we identified as part of us. Something we showed up for regularly sometimes in our matching shirts as we all worked together for the common good. Except when we stop being able to show up, we stop feeling part of the team.
Need a break?
I knew to truly pull this facet of ME together, the one that our community needs, one that is worthy of this beautiful group of people— that I would need to be open and vulnerable. And moreover, those who shared their lived experiences would possibly need to approach from a place of vulnerability. One could say this is true of sharing any aspect of ME, anything personal but I think it is especially true when discussing loneliness. You came through, of course. You shared personal experiences and thoughts so that we could all learn and provide support and assistance to one another around a very troubling aspect of living with this complex chronic disease. We will get to that in just a bit.
Here is what you shared:
Now that we understand the issues, let’s get into some strategies to help minimize loneliness. To begin, we need to be clear that these strategies are not for all people and they are certainly not the full spectrum of what is available. Your friendships and social life will look very different from your pre-illness life. That is a tough adjustment. Mourn when you need to and allow yourself that time to grieve. It is not a one-and-done thing. As different situations arise, you might feel fresh grief. Know that you have a world of people sitting with you in your grief. You might need to work through this with a therapist. Thankfully, online therapy is more available than ever before. Take a look at these resources to get started.
Some of these options will be better for those who are experiencing mild and moderate levels of illness. We will try and cover some options for the severe but it is a harsh reality that for the most severe, there is not as much available. We must hold them so close in our hearts and keep working to find a treatment and ultimately a cure, so that the most severe can be with us again.
Find your group for social interaction and friendships
First I want to emphasize the power and importance of quality support groups. These can be helpful for relational/social loneliness. Here at #MEAction, we have some truly amazing groups that come together and offer support, friendship, and practical help. I cannot describe what a help these groups have been and how much good happens regularly in these spaces. You also might meet people within these groups and build relationships that lead to deeper friendships.
You can find our full list of our support groups, state and local groups, and affinity groups to find others with a similar interest, identity, or ideology here.
We also have monthly support calls. These are led by volunteers and happen on a local basis or for certain groups such as caregivers. Those can be found here.
We have had a few community events that provide a chance to get to know one another socially. Make sure you are signed up for emails so you will be notified when those happen.
Perhaps you are not interested in a group but want to connect on social media platforms? Use and search hashtags for certain communities and interests. As you start to follow people with similar interests and they follow you, you can build up connections.
Want another way to gather virtually?
- Watch a movie together using something like Teleparty.
- Each of you buy a painting kit and FaceTime while you give it a try. (This can work for any kind of crafting or beauty item, etc.)
- Get a coloring book and color together while you chat.
- Watch a game together – you can keep phone on or just text back and forth.
Find your place for collective purpose
We also have many ways to help with collective loneliness. #MillionsMissing has been a wonderful way to organize around our common cause. Activism works best amongst a community that is supportive of one another. While solving collective loneliness was not the goal of #MillionsMissing, it has been a wonderful by-product. Join us this year.
#MEAction has many other ways to get involved as well. We try to work with your needs and how you can best contribute.
Are you an artist? Check out our artists salons, including the one coming up on May 16th.
Are you a writer? We have a writing group that meets every Thursday where you can show up when able for whatever amount of time you are able. It is a powerfully supportive environment.
Interested in federal or state-level advocacy? More into activism? Want to offer support and participate as a moderator? We have so many ways for you to be part of a collective group. Sign up here.
We know there are many other wonderful organizations and individuals doing good work in this space as well. Take a look online. The internet has opened up options we did not have previously. Enjoy knitting? I bet there is a group for that. Free or low costs webinars and courses are available so you can attend with no pressure. Want to get out the vote? There are ways to help from home.
Something simple like playing the Wordle of the day and sharing on your social media can help you feel a bit more connected to the outside world.
The pandemic has opened up online interaction in ways that those of us who have been ill for many years could hardly have imagined. Online interaction is not perfect and does not satisfy all connection needs but it is a good place to start.
In person interaction
We will start from the position of you having someone you want to interact with in person, whether it is an old friend you want to reconnect with or a new friend you found online or through a mutual connection. Perhaps it is a relative or spouse or even a date.
How can you set this up to be as successful as possible? I am going to share tips as if we were not in a pandemic but PLEASE look into how to gather safely or if it is possible.
Be clear about your needs. You can determine to what level you will explain your needs or the reasons behind them but do be open about what works for you. For example, they might want to go for a hike and you might need to explain that it is not feasible for you. Your experience at getting together will be so much better if you set it up for success from the start.
Choose somewhere quiet where you can sit comfortably. It might need to be at a home so the environment can be controlled. A movie night on the couch together can be fun. A visit on a backyard patio or front porch is great. Perhaps a small coffee shop or restaurant would work for you. Maybe a park with a picnic area or other seating. Think about your mobility and sensory needs.
If you have a time of day that you generally function a little better, then plan for that time. Schedule a time when you can rest before and after. Then set an end time ahead of the visit. It can be so tempting to extend it in the moment and suffer for it later when the PEM hits hard. Plus cognitive dysfunction might start to worsen or pain heighten and communication will get harder. It is hard to have those limits but in most cases you will be thankful for them later.
We covered that we are assuming you have the person you want to spend time with for these tips. But it is worth a reminder to choose people worthy of your precious time and energy. It can be hard to feel worthy but you are. You are worth friendship and love and comfort and fun. Do not tolerate less. Think about the number of people as well. A gathering with many people might be overwhelming and harder to control sensory needs. At least try to keep larger gatherings for special occasions.
If you use a wheelchair, you might check that the place is wheelchair accessible. If it will be loud where you are, you might use ear plugs- the kind you can hear with but that dampens the surrounding noise. If you have orthostatic intolerance and need electrolytes or to elevate your feet, then try to keep those in mind. Bring your drink with you or drink ahead of going. Don’t be shy about pulling up a chair and elevating your feet. Wear your sunglasses if it is bright. Use your disabled parking permit if you have one. Use whatever helps you access this time with a friend.
I am sure you can add some wonderful ideas. I hope these help get you started!
Too severe for the above strategies
Loneliness is hard when you are not only forced to be alone in person but you cannot access technology to help you connect regularly either. Often, when you are this sick, there is little you can do to pass the time. The tips in this section assume that you can spend a small amount of time online alone or with the help of a caregiver. I recognize there are those for whom this is not possible and all I know to do is hold them close in our hearts and work hard to affect change on their behalf.
Here is where I get vulnerable along with everyone sharing their lived experience. About the only thing I could do to pass the time when I was at my most severe was to make up stories in my mind. When you can only lie in the dark with no noise and no people, there is really only your mind to keep you occupied. I would have conversations in my head with others. I might imagine what I would tell a therapist were I well enough to actually see one. It helped me think things through and occupy my brain. Thankfully, I could watch tv, read with certain parameters, and have short text conversations in my better moments during the more severe years. But those were not possible at my worst. Being online was something I had to limit. It was just too much. Twenty minutes a week was the norm before the advent of quality smartphones. I found I could handle a small device better. Even then, it is hard to explain how short the interactions have to be.
These tips assume the ability for very limited online interaction.
- Start with finding one or maybe two groups that you get the most benefit from and check in on those once a week. Or check on one group early in the week and another one later in the week. It’s amazing how we start getting to know people that way.
- See if anyone wants to chat by text or messenger apps. You can always leave your response to their message when you are feeling up to it. It is a lot less exertion than a conversation where you are speaking.
- To help with the collective loneliness, see if there is a very simple action you can take—maybe something where you sign a petition or share a photo. Slowly write a tweet length message to share during #MillionsMissing or other ME events. Your participation is valuable.
- Some have found certain apps are more bearable for them. Maybe you need something that has less photos or less videos. One that focuses only on messaging and nothing else. Start with what suits your accessibility needs now.
Loneliness within your family
I am not sure that feeling left out in your own family can ever entirely go away but I do think we can make it better. We often are left at home so the family can get out and about. We do not wish them to not do what they enjoy. We just wish we could join in, too. We are sometimes in a dark room with the door shut, hearing the family going about their day – playing, laughing, living. That is lonely, too.
So what can we do? Remember that you are allowed to take up space. You can demand accommodations. Plans can be altered to include you. Always? Well, no. But way more often than I imagine many of us think to ask. Let’s think through some examples of how you can be more included and I do hope you will continue adding to the list in the comments.
- If you are able to go on an outing, make sure it is wheelchair accessible and use it. Rent one if you need to. Look into purchasing one if you can use it more than a few times a year. Or if not a wheelchair, then a walker or cane or Rollator.
- Plan for when you are most able to participate.
- Pick events that do not add lots of extra sensory exertion. Loud concerts with flashing lights—probably a “no.”
- Bring the coloring or the game onto the bed.
- Family movie night in bed or maybe snuggled up on the couch. Make a big deal of it. Order a special treat to eat ahead of time that fits the theme of the movie. You can always hold it in two parts if a movie is too long. Print out a coloring sheet that goes along with the movie—many free printables are available. It will feel more like an event.
- Play Pretend or 20 Questions or Would You Rather. You can be comfy in bed for lots of games.
- Got a child who likes to type or send gifs and emojis? Set up some sort of messaging with you on their device. Let them send you a message about anything, whenever they want and you will respond whenever you are able.
- If you have a partner, relative, or friend who is taking your children on outings, have them record a video or do a live chat so you can join in in real time. If you are not up to that, have them take pictures and let your child(ren) explain it when they get home.
- Snuggle time knows no age limit. Even if they need to be limited due to pain or sensory needs, some version of a snuggle can be a good thing.
Get creative with staying part of the family. And remember your worth and the quality of your relationship is not based on who spends the most hours with whom. It is hard and yes, this is still a reason why a treatment/cure is needed. But we can do our best to maximize our limited energy and mobility.
I know we did not cover every situation but I hope that something you found here will be helpful. Thank you for joining in #FacetsOfME.