A study of older adults in the United Kingdom finds that people who are lonely are more likely to develop type 2 diabetes, independent of other risk factors such as smoking, alcohol consumption, and weight.
Loneliness, in which a person’s social needs are not met, may be on the rise. A recent report found that almost half of people in the United States sometimes or always feel alone.
Loneliness is even more common among younger generations, with almost 80% of Gen Z and more than 70% of millennials experiencing this feeling.
Some believe that technology may play a part in feelings of loneliness among younger generations, with social media and other forms of online communication increasingly replacing genuine human connection.
Beyond the negative emotional impact of feeling isolated, loneliness is also a major risk to physical health. Research has associated loneliness with coronary heart disease and found that loneliness may be a greater threat to health than obesity.
One study even suggested that people who are lonely have a higher mortality risk than individuals who do not feel alone.
A new study from Kings College London in the U.K. adds to the list of health concerns associated with loneliness, finding that people who are lonely may be more likely to develop type 2 diabetes.
The researchers found that loneliness was a significant predictor of diabetes. This finding held when they took account of potential confounding factors, such as age, sex, ethnicity, wealth, smoking, physical activity, body weight, alcohol consumption, hypertension, and cardiovascular disease.
The study, which is the first to find an association between loneliness and type 2 diabetes, is based on data from more than 4,000 people aged 50 years and above, with an average age of 65 years. The collection of the data took place during the English Longitudinal Study of Ageing.
At the start of the current study, none of the participants had diabetes, and they all had blood glucose levels within a healthy range.
During a follow-up period of 12 years, 264 people in the study (roughly 6% of the sample) developed type 2 diabetes.
The researchers found that the level of loneliness that people experienced at the start of the study was a significant predictor of who would go on to develop diabetes.
Loneliness predicts diabetes onset
The assessment of loneliness occurred at the start of the study using a scale that a psychologist at the University of California, Los Angeles, developed. The scale requires people to rate questionnaire items such as “How often do you feel that you lack companionship?” and “How often do you feel part of a group of friends?”
The researchers found a significant association between loneliness and the onset of type 2 diabetes, even when they controlled for confounding factors, including smoking, alcohol consumption, weight, blood pressure, and cardiovascular disease.
The association was also independent of mental health factors, such as depression and whether a person lived alone.
“The study also demonstrates a clear distinction between loneliness and social isolation, in that isolation or living alone does not predict type 2 diabetes, whereas loneliness, which is defined by a person’s quality of relationships, does,” explains lead author Dr. Ruth Hackett.
This finding highlights the importance of the quality of human interactions that a person has, rather than the quantity.
Stress-related mechanism?
Although the reason for this association is not yet clear, the researchers suggest that it could be related to how the body manages stress.
Previous research has shown, for example, that loneliness is associated with changes to levels of the stress hormone cortisol, which plays a role in diabetes.
“If the feeling of loneliness becomes chronic, then every day you’re stimulating the stress system, and over time, that leads to wear and tear on your body, and those negative changes in stress-related biology may be linked to type 2 diabetes development,” explains Dr. Hackett.
However, it is important to note that this is currently only a hypothesis. Although this study provides a correlation between loneliness and type 2 diabetes, it does not show a causative link between the two factors.
Other limitations of the study include the fact that there was only one measurement of loneliness during the study. Also, the data on type 2 diabetes were based on self-reporting, rather than objective medical records.
The authors also note that the overall strength of the association between the two factors was small. Nevertheless, the study highlights loneliness as a potential risk factor for type 2 diabetes and provides a basis for future studies to investigate this connection in more detail.
Hallucinations are sensory perceptions that appear in the absence of stimuli. Although they are often associated with illnesses such as schizophrenia, these phenomena can occur in the absence of mental ill health. But what explains these uncanny occurrences?
There are many types of hallucinations. They can be visual (sight hallucinations), auditory (sound hallucinations), olfactory (smell hallucinations), gustatory (taste hallucinations), or tactile (touch hallucinations).
For every sense, a form of hallucination is possible. The reason for this is that these phenomena are “ghost sensations” — perceptions of stimuli in the absence of actual external stimuli.
More often than not, when people think of hallucinations, they associate them with illnesses that can involve psychosis, such as schizophrenia, or neurocognitive disorders, such as forms of dementia.
Hallucinations are also associated with the use of mind-altering drugs, including LSD and DMT.
But hallucinations are not always due to psychotic disorders or psychedelics. Sometimes, they occur in the absence of these factors.
So what explains hallucinations, how common are they, and what role might they teach us about ourselves? In this Special Feature, we investigate.
More common an occurrence than we think
A study that appeared in the British Journal of Psychiatry in 2017 suggests that hallucinations are far more common among people without psychotic disorders than scientists had previously thought.
The study authors — Dr. Ian Kelleher, from the Royal College of Surgeons in Ireland, and Jordan DeVylder, Ph.D., from the University of Maryland in Baltimore — analyzed data that they had obtained through the 2007 Adult Psychiatric Morbidity Survey, a nationally representative study of mental health in England.
These data included information on the mental health of 7,403 people aged 16 years and older throughout 1 year.
Dr. Kelleher and DeVylder found that visual and auditory hallucinations were almost equally prevalent among participants with borderline personality disorder and those with a nonpsychotic mental illness.
They also found that more than 4% of all the survey respondents — including those who had no diagnosed mental health issues — reported experiencing visual or auditory hallucinations.
“Hallucinations are more common than people realize. They can be frightening experiences, and few people openly talk about it,” Dr. Kelleher observed in an interview for International Business Times.
“Our research is valuable because it can show them they are not alone and that having these symptoms is not necessarily associated with having a mental health disorder. It breaks the taboo,” he added.
Research published in the Scandinavian Journal of Psychology in 2015 also showed that auditory hallucinations were surprisingly common in a representative sample of the general population in Norway.
In a cohort of 2,533 individuals, the “current lifetime prevalence of [auditory verbal hallucinations] was 7.3%.”
Phantom smells also seem to be a more common occurrence than people might think. In 2018, a study published in JAMA Otolaryngology — Head & Neck Surgery showed that 6.5% of people aged 40 years and over had experienced phantom odor perception.
This percentage is based on data from a cohort of 7,417 participants with a mean age of 58 years. However, when it came to explaining this phenomenon, the researchers were at a loss.
“The causes of phantom odor perception are not understood. The condition could be related to overactive odor-sensing cells in the nasal cavity or perhaps a malfunction in the part of the brain that understands odor signals,” says first author Kathleen Bainbridge, Ph.D., from the National Institute on Deafness and Other Communication Disorders at the National Institutes of Health (NIH) in Bethesda, MD.
Surprising potential mechanisms
Researchers have been trying to build a better understanding of the biological mechanisms behind the different types of hallucinations.
In 2019, investigators from the University of Oregon in Eugene conducted a study in mice to try to find out how hallucinations manifest in the brain.
Their study paper — published in Cell Reports — revealed some surprising findings. As the researchers induced visual hallucinations in the rodents by injecting them with a hallucinogenic substance, they saw that this did not “map out” how they expected it to in the brain.
The researchers observed that the hallucinating mice experienced fewer signals firing between the neurons of the visual cortex, the brain region associated with the interpretation of visual information.
“You might expect visual hallucinations would result from neurons in the brain firing like crazy or by mismatched signals. We were surprised to find that a hallucinogenic drug instead led to a reduction of activity in the visual cortex.” – Senior author Prof. Cris Niell
Despite the initial surprise, the study’s senior author notes that it makes sense that visual hallucinations should appear in the brain in this way.
“Understanding what’s happening in the world is a balance of taking in information and your interpretation of that information. If you’re putting less weight on what’s going on around you but then overinterpreting it, that could lead to hallucinations,” he explains.
There is also a large amount of research into the causes and mechanisms associated with auditory hallucinations — some of the most fascinating kinds of ghost sensations.
For instance, a 2017 study featuring in eLife goes some way toward explaining how and why some people may think they hear voices that are actually not there.
According to the authors, this may be the effect of an error or “short-circuit” in processing internal speech and differentiating it from speaking out loud.
When people speak out loud, the researchers explain, the brain does two things. First, it sends instructions to the vocal cords, tongue, and lips — our vocal apparatus — to prompt them to move in the right way so as to vocalize the correct sounds.
At the same time, the brain also makes an internal copy of these instructions, which scientists call the “efference copy.” This duplicate allows the brain regions associated with hearing to predict the sounds that the vocal apparatus is about to make correctly.
This is part of how we recognize our own voice and speech.
“The efference copy dampens the brain’s response to self-generated vocalizations, giving less mental resources to these sounds because they are so predictable,” explains first author Prof. Thomas Whitford.
Through their study, Prof. Whitford and his colleagues found that the brain makes an efference copy not just of the thoughts intended for vocalization, but also of the inner talk — the internal chatter that people process in the background without expressing out loud.
It is likely, the scientists hypothesize, that auditory hallucinations arise when something goes wrong with the efference copy of people’s internal monologues.
“We all hear voices in our heads. Perhaps the problem arises when our brain is unable to tell that we are the ones producing them.” – Prof. Thomas Whitford
What hallucinations teach us
Many of the hallucinations that people might experience are, in fact, of the run-of-the-mill variety. For example, a vague sensation that you have heard the phone ringing when no one actually called or catching the shadow of a silhouette from the corner of the eye when there is no one there.
Dr. Philip Corlett and Dr. Albert Powers, two scientists from Yale University and the Connecticut Mental Health Center in New Haven, CT, have conducted many experiments into the nature of hallucinations.
They argue that there is a spectrum of phantom sensations and that many hallucinations might actually reflect how our brains work — namely, by making predictions about stimuli and the environments that we navigate.
In a paper published in World Psychiatry in 2018, they write that hallucinations might emerge from a “mismatch” between the predictions that our brains make about our surrounding reality and the actual reality.
In another study paper, published in 2017 in the journal Science, the two researchers and Dr. Christoph Mathys, an associate professor at Aarhus University in Denmark, present the evidence they collected through a series of experiments that appear to support this notion.
“When we go about the world, we’re not just passively perceiving sensory inputs through our eyes and ears. We actually build a model in our minds of what we expect to be present,” Dr. Corlett told The Atlantic, noting that when those expectations do not come to pass, this may sometimes translate as a hallucination.
Other scientists note that even more pronounced hallucinations could sometimes be of benefit to the person experiencing them.
In a 2017 paper in Psychology and Psychotherapy: Theory, Research and Practice, Drs. Filippo Varese, Warren Mansell, and Sara Tai — from the University of Manchester in the United Kingdom — note that not all auditory hallucinations are distressing.
Their study, which enlisted people with mental health issues who also experienced auditory hallucinations, found that how people reacted to the voices that they thought they heard made an important difference to whether those voices hindered or encouraged them in their daily pursuits.
“Most voice-hearers with mental health difficulties in our study experienced their voices as a hindrance to achieving their goals and viewed their voices as distressing and problematic. But other voice-hearers find that voices facilitate their valued goals and are, therefore, a pleasant and constructive part of their lives,” Dr. Varese points out.
Going forward, the researchers say, such insights might help mental health professionals assist their clients in turning the tables on potentially distressing hallucinations.
“[…] we should seek to help clients explore how their voices relate to goals that are important to them and empower them to progress toward those goals. That would be a more meaningful and acceptable way of supporting them,” he suggests.
Some people believe that masturbation can cause erectile dysfunction, but this is a myth. Masturbation is a common and beneficial activity.
While most men have trouble getting or keeping an erection at some point in their lives, frequent difficulties getting an erection is called erectile dysfunction (ED).
Learn more about ED and masturbation, if watching porn affects sexual function, and when to see a doctor.
Can masturbation cause ED?
No, masturbation cannot cause ED — it is a myth.
Masturbation is natural and does not affect the quality or frequency of erections.
Research shows that masturbation is very common across all ages. Approximately 74 percent of males reported masturbating, compared to 48.1 percent of females.
Masturbation even has health benefits. According to Planned Parenthood, masturbation can help release tension, reduce stress, and aid sleep.
A person may not be able to get an erection soon after masturbating. This is called the male refractory period and is not the same as ED. A male refractory period is the recovery time before a man will be able to get an erection again after ejaculating.
What does the research say?
Universally, researchers are confident that masturbation does not cause ED. However, difficulty getting and keeping an erection either while masturbating or while having sex may be a sign of other conditions.
Age is the most significant predictor of ED. Erectile dysfunction is common in men over 40 years old, with approximately 40 percent being affected to some degree.
Rates of complete ED, or the inability to get an erection, increase from 5 percent in men aged 40 to about 15 percent at age 70.
Other risk factors for ED include:
diabetes
being overweight
heart disease
lower urinary tract symptoms (bladder, prostate, or urethra issues)
alcohol and cigarette use
ED in younger men
Although ED generally affects older men, a 2013 study found that as many as a quarter of men under 40 years old received a new ED diagnosis.
In younger men, ED is more likely to be caused by psychological or emotional factors. Younger men also have higher levels of testosterone in their bodies and are less likely to have other risk factors for ED.
Anxiety about sexual performance or erection quality can lead to further stress, sometimes creating a “vicious circle.”
Factors that can contribute to ED in younger men include:
stress
anxiety
depression, post-traumatic stress disorder, bipolar disorder, or medications for these illnesses
being overweight
insomnia or lack of sleep
urinary tract problems
a spinal cord injury, multiple sclerosis, or spina bifida
having a high-stress job
relationship stress
performance anxiety
Porn and ED
There is no evidence to suggest that watching porn causes ED.
Internet porn usage rose at the same time that the rate of ED diagnoses increased in men under 40 years old.
This led some researchers to believe that porn might affect male viewers’ ability to get and maintain erections.
While it is true that internet porn access and diagnoses of ED in younger men increased at about the same time and rate, this does not prove a link between the two.
Until recently, there was little research into ED in young men, making numbers difficult to interpret. Also, due to stigmas and reluctance to speak to a doctor about sexual health, ED may be underreported in both younger and older men.
It is also difficult to separate the psychological effect of watching porn from other psychological factors, such as performance anxiety.
When to speak to a doctor
ED is sometimes a sign of underlying conditions, such as heart disease or anxiety.
Telling a doctor about ED can prevent potential problems that these conditions might cause, and also provide solutions to ED.
For example, doctors may recommend that men with ED who are overweight lose some weight. This is because maintaining a healthy weight can increase testosterone levels, making it easier to get an erection.
A doctor may also recommend stress-relief techniques or cognitive behavioral therapy for those dealing with ED due to emotional or psychological issues.
Summary
Masturbation does not cause ED, but many underlying health problems, including heart disease, urinary tract symptoms, alcohol use, depression, and anxiety, can.
Research does not suggest that masturbation using internet porn could cause ED. Some people who watch porn may also experience performance anxiety, resulting in difficulties with erections, but performance anxiety is common without porn use.
Anyone experiencing problems getting or maintaining an erection should speak to a doctor, as ED is often treatable.
Your choice of partner can affect your health in many ways, both positively and negatively. Anything from their exercise habits and working hours to their personality can have an impact on your well-being. We investigate the surprising ways that your significant other can affect your health.
Whether you are in a new relationship or a long-term one, newlyweds or celebrating your golden wedding anniversary, a same-sex couple or of the opposite sex, the time spent with your partner can influence your health outcomes.
Having a healthy relationship is not only rewarding, but it also significantly shapes our long-term health in a similar way to getting a good night’s sleep, eating healthfully, and not smoking. Studies have shown, time and time again, that people who are in satisfying relationships feel happier, have fewer problems with health, and live longer.
On the flip side, having unhealthy connections or a lack of social ties is linked to depression, cognitive decline, and an increased risk of premature death.
Here are some of the beneficial and detrimental effects that your relationship could have on your well-being.
Positive effects of a partner on health
Pain relief
A partner’s touch has been found to relieve pain in women.
It is well known that people subconsciously synchronize their footsteps when they walk together or mirror a friend’s posture during a conversation.
Investigators from the University of Colorado, Boulder and the University of Haifa in Israel have now discovered that when heterosexual lovers touch when the woman is in pain, couples’ heart rates and respiratory patterns synchronize and the woman’s pain dissipates.
These findings add to a growing body of evidence on “interpersonal synchronization,” a phenomenon in which people begin to physiologically mirror those that they spend time with. “The more empathic the partner and the stronger the analgesic effect, the higher the synchronization between the two when they are touching,” explains lead author Pavel Goldstein, a postdoctoral pain researcher at the University of Colorado, Boulder.
Help achieve healthy goals
Two heads are better than one when it comes to taking up healthy habits. Funded by Cancer Research UK, the British Heart Foundation, and the National Institute on Aging, scientists at University College London (UCL) in the United Kingdom revealed that if you want to swap bad habits for good, then you would be more successful if your partner also makes those changes.
Among women who smoked, the researchers found that 50 percent succeeded in quitting smokingif their partner gave up at the same time, compared with 17 percent whose partners were non-smokers already, and just 8 percent whose partners smoked regularly.
“Unhealthy lifestyles are a leading cause of death from chronic disease worldwide,” says study author Prof. Jane Wardle, director of Cancer Research UK’s Health Behaviour Research Centre at UCL. “The key lifestyle risks are smoking, excess weight, physical inactivity, poor diet, and alcohol consumption. Swapping bad habits for good ones can reduce the risk of disease, including cancer.”
Improve fitness
Echoing these findings, the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, conducted research finding that improving your fitness could also improve the fitness of your spouse.
Couples were asked about their physical activity levels at two medical visits conducted around 6 years apart. On the first visit, if a wife met the recommended guidelines for physical activity, her husband was 70 percent more likely to also reach those targets at subsequent visits than those whose wives were less active.
Conversely, when a husband met recommended activity levels, his wife was 40 percent more likely to also achieve these levels at follow-up visits.
When it comes to physical fitness, the best peer pressure to get moving could be coming from the person who sits across from you at the breakfast table,” says co-author Laura Cobb, a doctoral student at Johns Hopkins Bloomberg School of Public Health. “There’s an epidemic of people in this country who don’t get enough exercise, and we should harness the power of the couple to ensure people are getting a healthy amount of physical activity.”
Alter microbiome
Microbial exchange with your partner can occur simply from walking on the same bathroom floor.
Researchers from the University of Waterloo in Canada found that couples who live together influence the microbiome – that is, the community of bacteria and other microbes – on each other’s skin.
Commonalities between couples’ skin microbiome were strong enough that computer algorithms could detect couples that cohabit with an accuracy of 86 percent.
Skin regions that were the most similar between partners were on the couples’ feet. “In hindsight, it makes sense,” says Prof. Josh Neufeld, of the Faculty of Science in the Department of Biology at the University of Waterloo. “You shower and walk on the same floor barefoot. This process likely serves as a form of microbial exchange with your partner, and also with your home itself.”
Improve physical and mental health
While analyzing whether or not relationships are good for your health, David and John Gallacher, from Cardiff University in the U.K., confirmed that long-term, committed relationships are good for physical and psychological health, and that these benefits increase over time.
On average, individuals who are married live longer; women have better mental health when they are in committed relationships, while men have better physical health when in a committed relationship. The study authors say, “On balance it probably is worth making the effort.”
Decrease risk of health conditions
Studies have shown that partners can also affect each other’s risk and development of disease.
Persistent nagging from your partner could slow down diabetes progression.
For example, a study by Michigan State University (MSU) in East Lansing deduced that for men who are in an unhappy marriage, the development of diabetes is slower and treatment is more successful once they are diagnosed.
The researchers said that wives who continuously regulate their husband’s health behaviors and who are seen as annoying and provoking hostility and emotional distress in the husbands could explain this finding.
The study challenges the traditional assumption that negative marital quality is always detrimental to health,” says lead investigator Hui Liu, an associate professor of sociology at MSU. “It also encourages family scholars to distinguish different sources and types of marital quality. Sometimes, nagging is caring.”
Researchers from the University of Michigan have also determined that having an optimistic spouse predicted fewer chronic illnesses and better mobility over time.
A growing body of research shows that the people in our social networks can have a profound influence on our health and well-being,” says lead study author Eric Kim, a doctoral student in the University of Michigan’s Department of Psychology. “This is the first study to show that someone else’s optimism could be impacting your own health.”
In other research, people who are happily wed are more than three times as likely to be alive 15 years after coronary bypass surgery as their unmarried counterparts. Married people also are less likely to have cardiovascular problems than individuals who are single, divorced, or widowed.
Adverse effects of a partner on health
Intensify pain
In contrast to the research that showed a partner’s touch decreases pain, a study by King’s College London in the U.K. found that being in the company of your partner could make pain worse.
The researchers found that the more avoidant of closeness women were in their relationships, the more pain they experienced when given a laser pulse on their finger.
Research led by the University of Edinburgh in the U.K. also found a connection between partners and pain. The team found that partners of individuals with depression have an increased risk of experiencing chronic pain.
The researchers’ analysis showed that depression and chronic pain share common causes. Some of these causes are genetic while others stem from the environment shared by the partners.
Derail your diet
Dieting with your partner could end up derailing your weight loss plans.
Dieting with your partner may seem to be a good idea, but research has indicated that among romantic couples, the more successful one partner is at restricting their diet and eating more healthfully, the less confident the other partner becomes at controlling their food portions.
When people strive to reach a goal, being close (in this case, romantically) with someone who is successfully reaching the same goal can make the other partner less confident in their own efforts to reach the goal,” explains Jennifer Jill Harman, an associate professor at Colorado State University in Fort Collins.
Facilitate weight gain
Marriage has been positively correlated with weight gain among couples. For example, lead researcher Andrea L. Meltzer – an assistant professor at Southern Methodist University in Dallas, TX – and collaborators unveiled that newlyweds who are satisfied with their marriage are more likely to gain weight in the early years of marriage than those who are unsatisfied.
“On average, spouses who were more satisfied with their marriage were less likely to consider leaving their marriage, and they gained more weight over time,” states Prof. Meltzer. “In contrast, couples who were less satisfied in their relationship tended to gain less weight over time.
Other research by the University of Bath’s School of Management in the U.K. showed that marriage makes men gain weight and that fatherhood exacerbates the problem further.
Increase risk of health conditions
In contrast with research signalling that your significant other can decrease your risk of certain health conditions, other studies show the reverse.
For example, the McGill University Health Centre in Canada has suggested that if someone has type 2 diabetes, their partner has a 26 percent increased risk of also developing the condition.
While spouses are not related biologically, they share the same environment, social habits, and eating and exercising patterns – all of which are factors that alter the risk of developing type 2 diabetes.
“When we talk about family history of type 2 diabetes, we generally assume that the risk increase that clusters in families results from genetic factors. What our analyses demonstrate is that risk is shared by spouses,” says senior study author Kaberi Dasgupta, of the Research Institute at McGill University.
Giving your spouse the silent treatment increases your risk of back pain and stiff muscles.
Furthermore, the way that you react to disagreements and argue with your partner could predict health problems later in life. The University of California, Berkeley, and Northwestern University in Evanston, IL, revealed that fits of rage during marital spats can predict cardiovascular problems, and shutting down and giving the silent treatment raises the risk of a bad back or stiff muscles.
“Conflict happens in every marriage, but people deal with it in different ways. Some of us explode with anger; some of us shut down,” says lead study author Claudia Haase, an assistant professor of human development and social policy at Northwestern University. “Our study shows that these different emotional behaviours can predict the development of different health problems in the long run.”
Research has also indicated that individuals may unintentionally worsen their partner’s insomnia. Moreover, other research found that inflammation markers rise in tired partners who argue.
Additionally, in older adults, researchers learned that the frailer an individual – a condition that affects around 10 percent of those aged 65 and over – the more likely it is that they will become depressed. Equally, the more depressed an older person is, the frailer they will become.
What is more, people married to frail spouses had an increased risk of becoming frail themselves, and those married to a depressed partner were also more likely to become depressed.
And interestingly, health changes influenced by a romantic partner do not necessarily end when they pass away.
Kyle Bourassa, a psychology doctoral student at the University of Arizona in Tucson, and colleagues found that couples’ qualities of life are linked even when one partner dies.
The people we care about continue to influence our quality of life even when they are gone. We found that a person’s quality of life is as interwoven with and dependent on their deceased spouse’s earlier quality of life as it is with a person they may see every day.
Kyle Bourassa
Bourassa says that even though we have lost the people we love, they remain with us. The research highlights how important relationships are for our health and well-being. However, he does say that the findings are cut both ways. “If a participant’s quality of life was low prior to his or her death, then this could take a negative toll on the partner’s later quality of life as well.”
