Content Warning: This section of the Study Guide discusses depression, anxiety, suicide, self-harm, addiction, violence, and other public health concerns.

While loneliness is often associated with one’s mental state, the negative impact of loneliness on both physical and mental health is the core theme of Murthy’s book.

In his Preface, Murthy writes that his time as the 19th surgeon general of the United States brought the country’s loneliness problem into sharper focus. In December 2014, at the start of his tenure, Murthy and his team embarked on a listening tour of America, traveling across the country to speak to people about their health. Their primary question was, “How can we help?” (12). Responses ranged from concerns about addiction to health conditions like diabetes and heart disease. As recurring topic, however, was not a health ailment per se, but loneliness: “Loneliness ran like a dark thread through many of the more obvious issues that people brought to my attention, like addiction, violence, anxiety, and depression” (12). Murthy spoke to teachers and school administrators concerned about their students’ social isolation. In Oklahoma City, he spoke to parents who were experiencing loneliness after their son died of an opioid overdose.