Difficult social circumstances

Human beings are social creatures, and positive relationships are essential to our mental health. Social isolation and loneliness can therefore have a severe detrimental effect on us. Singleton, N., Bumpstead, R., O’Brien, M., Lee, A., Meltzer, H. (2001). ‘Psychiatric morbidity among adults living in private households, 2000′. International Review of Psychiatry, 15(1/2): pp. 65–73. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12745312 [accessed 9 Aug. 2017]. NHS. (1999). ‘National service framework for mental health’. [online] London: NHS, p. 46. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/198051/National_Service_Framework_for_Mental_Health.pdf [accessed 14 Aug. 2017]. Halliwell, E., Main, L., Richardson, C. (2007). ‘The fundamental facts’. [online] London: Mental Health Foundation. Available at: https://www.mentalhealth.org.uk/sites/default/files/fundamental_facts_2007.pdf [accessed 9 Aug. 2017]. Cacioppo, J., Hughes, M., Waite, L., Hawkley, L.,Thisted, R. (2006). ‘Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses’. Psychology and Aging, 21(1). Available at: https://www.ncbi.nlm.nih.gov/pubmed/16594799 [accessed 9 Aug. 2017]. Wilson, R., Krueger, K., Arnold, S., Schneider, J., Kelly, J., Barnes, L., Tang, Y., Bennett, D. (2007). ‘Loneliness and risk of Alzheimer’s disease’. Archives of General Psychiatry, [online] 64(2). Available at: https://www.ncbi.nlm.nih.gov/pubmed/17283291 [accessed 9 Aug. 2017].

• 20% of people with common mental health issues live alone, compared with 16% of the overall population
• One in four people using mental health services has no contact with their family, and one in three has no contact with their friends
• People with religious beliefs who belong to a community of like-minded and supportive individuals are more likely to recover from depression
• People with common mental health problems are twice as likely to be separated or divorced
• People with common mental health problems are more than twice as likely to be single parents
• Loneliness is strongly linked to cognitive decline and dementia: the risk of Alzheimer’s disease more than doubles in older people experiencing loneliness
• Lonely individuals are also more prone to depression
  • There is a ‘vicious circle’ here: loneliness leads to increased depressive symptoms, because the brains of lonely people are more wary of social threats and focused on self-preservation, meaning that lonely people can become less attentive to others and more likely to perceive social interactions as negative

Damaging and negative relationships can be very detrimental to mental health. They are characterised by any one or more of the following:

• Unkindness
• Lack of support
• Feeling stifled and trapped
• Constant tension
• Unhealthy personal and emotional boundaries
• Consistent pain and suffering
• Abuse (sexual, emotional, physical)

Relationship difficulties, in particular, are a significant source of stress, because we perceive the potential loss of a relationship (even when it’s unhealthy) as a threat to our sense of stability.

As we grow up, get married, and have children, relationships become essential to our sense of identity. Relationship difficulties then have a greater impact on our sense of self-esteem, purpose, and grounding. If one partner assumes a ‘carer’ role, for instance, the ‘looked-after’ partner may come to feel helpless or lack a sense of purpose. And if a relationship breaks down, it can greatly affect our sense of identity and self esteem.

Romantic relationships involve the close proximity of partners (cohabitation, marriage, work, and so on). If a relationship is going through a difficult period but both partners are forced to be together constantly, their stress levels may remain high and lead to constant anxiety.

Relationship difficulties can result in the following mental health symptoms:

• Poor concentration and attention
• Poor memory
• Poor sleep
• Depression
• Anxiety
• Irritability
• Mood swings

Relationship difficulties can also cause low self esteem and social isolation.

The negative feelings caused by relationship difficulties can exacerbate any existing mental health issues, and adversely affect our biochemistry, causing:

• Hormonal imbalances
  • The stress generated by negative relationships can cause chronically high Stress hormone imbalances, which can then reduce sex hormones and thyroid hormones, and disrupt our HPA axis (our bodies’ central stress-response system)
• Neurotransmitter imbalances
  • The same stress can also cause cognitive decline, and a decrease in key brain chemicals such as endorphins, serotonin, dopamine, and BDNF (brain-derived neurotrophic factor)
• Gut issues
  • Finally, this stress can cause gut issues, such as leaky gut and gut dysbiosis

Belonging to a community and having good relationships is essential to mental wellbeing. Communities and a network of positive relationships can be very helpful in making us feel supported, giving us a sense of belonging, and having a network that we can rely on in case of need. Not belonging to a supportive community can be a tremendous source of stress and hardship, and can negatively affect our mental health.