What therapists wish everyone understood about loneliness

Why loneliness hurts like actual physical pain

For thousands of years, human survival depended on staying connected to a group. Being alone meant you were more vulnerable to predators, starvation, and exposure. Your ancestors who felt motivated to seek connection when isolated were the ones who survived long enough to pass on their genes. In other words, loneliness evolved as a survival signal; just like hunger motivating you to eat, loneliness motivates you to reconnect.

But your brain doesn’t just nudge you toward connection, it makes isolation hurt. Literally. Your brain processes social rejection using some of the same neural pathways it uses for physical pain. Research published in Proceedings of the National Academy of Sciences found that when people experienced intense social rejection (like looking at photos of an ex-partner after an unwanted breakup), their brains showed increased activity in regions that process physical pain—the same areas that light up when you burn your hand on a hot stove.

What’s more, another study found taking acetaminophen (Tylenol) for three weeks reduced both self-reported hurt feelings and brain activity in pain-processing regions when people were socially excluded. A physical painkiller literally acted as a “social painkiller.”

The physical consequences go beyond just feeling bad. A comprehensive meta-analysis of loneliness research found that social isolation and loneliness increase the risk of heart disease by 29% and stroke by 32%—comparable to known risks like anxiety and job strain. Another recent meta-analysis examining more than 310,000 participants found that loneliness was associated with a 14% increase in risk of early death.

The bottom line: Connection isn’t a luxury. Your body needs it the same way it needs food and sleep.

“Relationships offer grounding, support, shared experience, validation, and a reminder that we exist with others in the world,” explains Cynthia Shaw, Psy.D., a licensed clinical psychologist. When those connections are missing or feel hollow, the pain is real—emotionally and physiologically.

The self-reinforcing trap

Loneliness creates a vicious cycle. You feel lonely and crave connection, but at the same time, the thought of actually reaching out makes you anxious. Dr. Shaw explains that when you spend enough time alone, being around people starts to feel foreign. Just the idea of having a conversation or expressing yourself can feel overwhelming. Anyone who lived through the Covid-19 pandemic can likely relate.

Your self-esteem takes a hit too. You start telling yourself stories—that you’re socially awkward, you don’t have much to offer, or people probably don’t want to hear from you anyway.

And when that anxiety combines with feeling bad about yourself, your body responds. Dr. Shaw explains that your nervous system starts pumping out more cortisol, the stress hormone. You become hypervigilant, always on alert for rejection, even when there’s no real threat. Your ability to think clearly, make decisions, and follow through on plans all start to suffer.

Loneliness can actually change how you think and function, which is why understanding what’s really going on matters so much.

What 14 therapists want you to know about loneliness

We asked 14 mental health professionals the same question: What’s one thing people misunderstand about loneliness that might actually help them feel less alone?

Their responses challenge common assumptions and offer new ways to think about connection. These aren’t generic tips you’ve heard a dozen times before. They’re the insights therapists see play out repeatedly with real clients, and the reframing that actually helps.

1. Loneliness is part of being human. It says nothing about who you are.

A common misconception is that feeling lonely means something is fundamentally wrong with you. In reality, loneliness is woven into the human experience and something we continuously navigate throughout our lives. Learning how to tolerate being alone is actually a skill that deepens your connection to yourself and can strengthen the relationships you build with others.

Our sense of closeness with others naturally rises and falls. When you can accept that natural ebb and flow, loneliness becomes less of a threat. Instead, it becomes a reminder of how meaningful connection truly is.

– Jacob Glose, licensed professional counselor with Thriveworks

2. Being lonely is not the same as being alone.

Loneliness is different from solitude, and recognizing that distinction matters. If you’re lonely—alone not by choice—then making connections and doing self-work can help. But if it’s closer to solitude, when you intentionally choose to be alone with yourself, naming that difference and embracing it can help you use the experience for growth rather than fighting against it.

– Kate Hanselman, psychiatric-mental health nurse practitioner at Thriveworks

3. You feel lonely because you’re performing, and it’s exhausting.

You can feel profoundly lonely in a room full of people if you’re performing—pretending to feel one way when you actually feel another. When we mask our true feelings, we create distance. We keep others from really seeing us, and we keep ourselves from genuinely connecting with them. It becomes a cycle where the protection we think we’re creating actually deepens the loneliness.

The antidote? Vulnerability. When we’re authentic and honest about how we’re really doing, we give others permission to do the same. That’s where true connection happens, and where loneliness starts to lift.

– Saba Harouni Lurie, licensed marriage and family therapist

4. Loneliness is your brain signaling a need.

Loneliness isn’t a sign that you’re failing socially. It’s a sign that your internal system wants connection. That’s it. Your brain isn’t judging you; it’s signaling a need. Feeling lonely doesn’t mean you don’t have people. It means the current connections aren’t meeting the type of contact you need.

When clients understand that, they stop thinking in absolutes (“I’m alone in the world”) and start identifying the specific gap: depth, frequency, reciprocity, or belonging. Once you name the type of loneliness, it becomes solvable instead of existential.

– Blaine Stephens, licensed professional counselor with Thriveworks

5. The loneliness you feel might actually be about your relationship with yourself.

Much of today’s loneliness is less about your social circle or social calendar and more about your relationship with yourself. Loneliness often stems from a lack of self-love, difficulty spending enjoyable time alone, or struggling to be your true, authentic self when you’re with others.

If you focus on cultivating these abilities with yourself first, you’ll find it easier to make meaningful, fulfilling connections with others.

– Jami Dumler, licensed clinical social worker at Thriveworks

6. Loneliness often develops from behavioral patterns.

Think about the behavioral patterns behind loneliness, not just the emotional toll. People who feel chronically lonely often view it as a deficit in themselves. But loneliness frequently develops from avoidance (“I might not have fun at that party, so I just won’t go”) and unhelpful beliefs (“I’ll just be bothering people if I reach out”).

When you see loneliness as a changeable pattern instead of a character flaw, that shift alone is powerful. Start small: reaching out to people you already know, committing to learning a new skill or activity in a group, and questioning some of your beliefs about other people. It takes time to build these new routines and tolerate the discomfort, but it’s doable.

– Caitlyn Oscarson, licensed marriage and family therapist

7. One person who really gets you beats 10 people who kind of don’t.

People often believe loneliness means they need to spend time with more people. That isn’t always true. One person who truly understands you can be more grounding than 10 people who don’t know you deeply.

Your brain can sense the difference. It pays attention to who feels aligned with your values, your emotions, and your way of moving through the world. When people understand this, they often feel less ashamed of their loneliness and more focused on finding real connection.

– Courtney Tracy, Psy.D., licensed clinical social worker and author of “Your Unconscious is Showing”

8. Loneliness isn’t a state you’re stuck in—it’s more like weather.

Loneliness isn’t concrete; it’s more like a river. There are calm waters where you feel happy and connected, and choppy rapids where you feel consumed by loneliness—maybe even in a crowd or with your best friends.

So many factors contribute to feelings of loneliness. But when you feel that way and you have someone you can talk to, tell them. Someone around you might be feeling similarly. And suddenly, in the spirit of solidarity, you both might feel a little less lonely.

– Taylor Hiers, licensed professional counselor at Thriveworks

9. Your barista remembers your order. And that actually matters.

Separate the idea of loneliness from feeling alone, because they often become interchangeable when they aren’t. Start small with micro-connections: saying hi to your doorman or barista, making brief eye contact and smiling at someone on your walk.

Loneliness creates a cycle that makes you want to withdraw, which reinforces those feelings. Micro-connections remind your brain about the positive feelings that come from connecting with others and motivate you to continue seeking connection.

– Eliza Davis, licensed clinical social worker

10. Being home on Saturday night is normal, no matter what social media suggests.

We often see images on social media of people spending time together, which can make us feel like something is wrong with us because we aren’t out doing the same things. We’re constantly receiving messages that we should be attending events, parties, and social engagements. It’s important to remind ourselves that in reality, most of us aren’t living the lives of a social butterfly. It’s completely normal to be at home on a Saturday night without plans.

– Stella Kimbrough, licensed clinical social worker

11. Loneliness isn’t about being alone. It’s about feeling unseen.

Once clients realize this, they stop blaming themselves and start asking better questions: “Where do I feel most known?” “Who sees me without needing me to explain?” That’s where the connection begins.

– Melissa Galica, Psy.D., licensed professional counselor

12. The loneliest you’ll ever feel is next to someone who doesn’t see you.

The loneliest feeling isn’t necessarily being alone, it’s being in a relationship where you feel unseen. When you have a partner who’s supposed to love and support you, and you feel ignored or invisible to them, it hurts worse than being single with no one at all.

– Cindy Johnson, licensed marriage and family therapist at Thriveworks

13. You’re lacking places where you feel emotionally seen, not lacking friends.

Most lonely people aren’t actually lacking friends and support. Rather, they’re lacking places where they feel emotionally seen. You can be surrounded by people and still feel alone. When clients understand that loneliness is often about wearing emotional armor or performing to feel acceptable, they can stop blaming themselves and become curious about what parts of them want to be seen but aren’t.

– Lisa Chen, licensed marriage and family therapist

14. Sometimes the loneliest you feel is because you’ve abandoned yourself.

Sometimes the loneliest feeling isn’t about other people at all. It’s about abandoning yourself. I see this in clients who are so focused on being what everyone else needs that they’ve completely lost touch with what they actually think and feel. They’re lonely for themselves. They’ve been performing for so long, they don’t even know who they are anymore.

The path out of that loneliness is strange because it often starts with being alone—actually alone—long enough to remember what you like and what you think without anyone else’s input. Once you know yourself again, you can show up as yourself. And that’s when real connection becomes possible. You need people who can hold the real you, not just the polished version.

– Lauren Auer, licensed clinical professional counselor

Want more unfiltered advice from therapists?

This article is part of our Clinician Confidential series, in which we collect useful tips and advice from a wide variety of experienced mental health professionals. Check out some of the other articles in the series here:

• What 20 therapists do when they feel overwhelmed
• Relationship advice couples therapists swear by—and why it works
• The best self-help books of all time, according to therapists
• 23 podcasts that can change how you think