Sarah saw a psychiatrist in her 20s. But she wouldn't learn what was wrong until years later.

Loneliness in Australia is on the rise and it’s not just the elderly who are suffering. But how do we address a problem that few people acknowledge and fewer still want to talk about?

When Sarah* was in her 20s, she saw a psychiatrist. There must be something dreadfully wrong with me, she’d decided. She was stressed out all the time, and she had no friends. Even her family was absent.

The psychiatrist was young and inexperienced. Here’s a script, he said. It wasn’t until years later that she discovered there wasn’t, in fact, anything “wrong” with her.

She was simply a young, single mother living in Melbourne on a low income with no support network. A little boy to care for, not much money, bills to pay, hardly anyone to talk to and few moments of joy.

In reality, Sarah, now 42, was awfully lonely.

“Basically it was just really hard for me to maintain housing and money. I had no other problems. I didn’t have a substance issue or anything like that. I just had an extraordinary amount of stress and anxiety over being alone, essentially,” she says.

We think of the lonely as older, frail people, whose wives or husbands or friends have died, leaving them alone and vulnerable. We are living longer and this is the sad reality for many Australians.

But to be young or middle-aged and lonely is also possible, and increasingly, probable. Researchers point to loneliness as an emerging public health issue, with new research showing more than one quarter of Australians say they feel lonely for at least three days every week.

The statistics are concerning to academics and governments. In the UK, a government inquiry led to the appointment in January of a new minister to lead action on loneliness, while in Victoria the MP Fiona Patten last month called for a Minister for Loneliness to help address the negative physical and mental health effects of loneliness.

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These are positive steps, but loneliness is still not well understood and many find it a source of great shame. It will be difficult to address such a pervasive problem if people cannot talk openly about it or know how to seek help.

Anyone can feel lonely

At its core, loneliness is a normal, human emotion that many of us feel when we’re unsatisfied with the quality of our relationships. We can have friends but still feel we’re not truly connecting to anyone, or we may be living alone and feel isolated. The feeling often settles when we satisfy our need for social connection, but it becomes harder to budge when we can’t, as when a partner dies or family moves away.

Swinburne University loneliness researcher Dr Michelle Lim says the risk factors for loneliness, such as people living alone, are rising. Loneliness can touch anyone, with young people particularly at risk.

“People don’t normally think of young people as a lonely cohort. But we do know, especially from 15 years old to 25 there’s a peak period of loneliness there,” Lim says.

Sarah was only 18 when she gave birth and first experienced isolation. She was already reserved and shy, but having a baby meant her friendship group shrunk further.

“And even then they continued on to uni and that type of thing and I was at home with a baby. Gradually those friends sort of fizzled out as well and I guess my shyness took over a fair bit,” she says. With no formal training, Sarah worked part-time in low-paid jobs alongside people with whom she had nothing in common.

“I just kind of entered into jobs that were sort of bottom-of-the-barrel type occupations that were full of people I couldn’t really relate to, who had lots of issues, like factories and stuff like that,” she says.

Splintered lives

Suzanne Leckie, a psychologist with mental health charity SANE, believes loneliness is becoming more common, with people who telephone their help centre or visit their online forum leading profoundly isolated lives.

“I think we live in communities and families that have become splintered. Marriages are breaking down, communities are becoming much more anonymous where you don’t necessarily know your neighbours’ names, we’re much more mobile,” Leckie says.

A recent loneliness survey by Lifeline Australia underscores this view, finding over a third of Australians don’t have someone to confide in when they feel lonely. Lifeline’s executive director for research, Alan Woodward says personal connection with other people is a major factor in suicide.

“From Lifeline’s perspective we have some visibility of that in that 33 per cent of the calls that come to our telephone crisis line where the caller is explicitly disclosing their suicidality, the most frequently reported issue is one of feeling loneliness or needing support from others,” he says.

Sarah’s family is not close, a main reason she feels alone.

“There’s not a lot of us and you know, we’re not averse to each other, we don’t fight or anything, but we also don’t have a strong connection,” she says. Sarah also believes community breakdown is partly responsible for her separation from family.

“Part of the reason I don’t have a lot of contact with my family is because my siblings both have had to go work overseas in order to get more money so they can afford to buy a house,” she says.

How to help

Volunteer programs abound to help lonely people connect with others. Relationships Australia runs Neighbour Day, which encourages people to get to know their neighbours in small, non-threatening ways that hopefully opens the doorway for people who are lonely.

Campaign Manager Sam Robinson says people overwhelmingly maintain those connections.

“It’s not about being best friends (but) neighbours are very important to our social infrastructure,” she says. “It doesn’t have to be a big thing, for a lot of people they have no one to talk to. Simple smiling and waving. In the good times it’s great to know your neighbours but in the difficult times it’s even more important,” she says.

While these programs work well for many, they often don’t succeed with the chronically lonely, who have few social skills and often a mental health issue.

Leckie says projects that creatively give people the skills to help them forge connections work better. For instance, one GP whose patients were not responding to medication decided to create a gardening club at the rear of his surgery.

“And people got better, because they had a reason to get out of the house, a reason to get together, something to talk about, a common purpose. They had a topic to discuss and things to do alongside each other,” she says.

Lim has worked in this way with young people with psychosis, a highly stigmatised condition. They were asked to improve one relationship in their lives and were taught how to send the right friendship signals.

“That social confidence actually really helped them get out there. And a lot of them started to seek work and got jobs and went back to school, things like that,” she says.

Meanwhile, Sarah still bravely confronts her solitude every day, sometimes attending informal meet-ups arranged through social networking sites.

“It’s pretty tacky,” she says, “But at the end of the day you have to do things like that otherwise you just sit at home and sort of feel shitter really.” Mostly, though, she’s learnt to be a better friend to herself.

“I always have hope that I’ll make more connections with people, but I truly don’t think that will happen. I’ve thought, actually no I’m just gonna sort of self-soothe.”

Together but no connection

Mandy* sips on her tea as she calmly describes the way loneliness eased itself into her marriage and gradually intensified its grip, bringing with it an acute sense of loss.

The 42-year-old teacher and mother-of-two from outer eastern Melbourne was 30 when she met Joe, a kind man with a good job who was grounded and secure. They bought a home with views in the foothills of the Dandenong Ranges, and started a family.

Listen to the Mamamia Out Loud team discuss what women are talking about this week - including the woman who's lost her best friend. Post continues after audio.

But happiness was elusive. After a while, she felt there was no intimate connection between them. Her husband, a practical man raised in Africa, didn’t share his feelings or emotions and wasn’t comfortable with physical contact. There was sex, but there were no hugs, there was no hand holding.

“As time passed I realised that what I needed was more emotional connection, and that life wasn’t just about the practicalities,” she says.

“I remember having so many conversations with him saying I need intimacy. But I would say to him a hundred times, ‘I don’t mean sex, I’m not talking about sex’.

“We did have sex but it wasn’t intimate. It was just practical. It was the same as him giving me a cup of tea. It would be like, there you go, my job’s done. That sort of thing, like not emotional at all.”

Mandy says she understands many men find it difficult to express themselves, especially when masculinity is still so bound up with notions of physical strength, self-reliance, restricted emotions and sex disconnected from intimacy.

Her family advised her to stick with her marriage because men were just like that and she had to live with it. They also counselled her to seek intimacy and emotional support from friends because no man could offer everything. They didn’t want to see her alone.

Mandy thought about this and tried to do as they advised.

“I contemplated that for a long time. I gave that a red hot go. But I just kept thinking, ‘It’s not good enough for me’. And just coming back to, if I feel alone in my marriage, I may as well be alone. I would rather be alone.”

Not wanting to end her marriage, Mandy began a frenetic search for the closeness and understanding she needed, which alienated her friends and led to an eventual fall into depression.

“I felt sad, I was really sad a lot of the time,” she says. “Initially I couldn’t articulate what I was feeling the way I can articulate it now. I just knew I felt shit, and I knew I hated everything and was constantly upset. I was seeking intimacy from every single person in my life other than my husband, because I knew I wasn’t going to get it from him.

“I’m not talking about affairs but being very needy of everyone, to the point that I was quite destructive.”

Her depression meant she did not function well and there were days when she was frozen with inertia. She also drank a lot. Mandy’s husband bore her cups of tea, and busied himself with the children and housework.

“But he couldn’t let me talk, or ask me how I felt or what I was going through. I guess like a lot of men he had that sort of attitude of, like, ‘Chin up, you’ll be right’. No matter how many cups of tea he made me it wasn’t going to help,” she says.

They saw a counsellor together, and alone, but Mandy sensed that her husband, while saying the right things, could never fulfill her in the way she needed. After 13 years of marriage, eight months ago she asked him to leave.

Today she feels less lonely, though she is single. She stopped drinking after separating, and relies on a healthy network of friends. She’s also kept up the counselling, which she credits with teaching her self-love.

“In my marriage I was seeking intimacy and emotional connection constantly, but then once we separated… that seeking stopped because I don’t need it to make myself feel good about myself anymore. I have that within,” she says.

Mandy says she now has more energy for others and has never doubted her decision.

“I was so caught up with the marriage and trying to make it work … that I didn’t have the energy for my kids, especially,” she says. “By taking myself out of that situation I feel less lonely because I can connect with them and with other people.

“I was drinking every day by myself, every day without fail. I went through that for a long time but then I did come out stronger and better and happier.”

*Names have been changed for privacy reasons.

This story originally appeared on Raw Words and has been republished with full permission.