lonely in an empty nest

Years ago, when I first heard about Bhutan being more concerned about the Gross National Happiness Index than about the GDP, unlike the rest of the countries in the world, I thought how idealistic and lovely that was. The king of Bhutan seemed to have his heart in the right place.

The initiative by Teresa May to appoint a Minister of Loneliness feels somewhat like that, though I also get that there is a practical necessity to take care of the more than ten million people aged over sixty-five living in the UK, many of them staying alone. This is a great idea if it can be implemented effectively.

As a psychiatrist I often see people who are desperately lonely. In recent years there’s been a spurt in the number of one group of people from tier-2 cities and small towns coming for a consultation. They are parents of techies working here in Bangalore, visiting their children. They usually have one or two more children that have settled down permanently in the US, so all of their children are physically distant.

This is roughly how the story goes. In phone conversations one parent, say the mother, tells her children that she feels sad a lot of the time. So the son/daughter that lives in India invites both parents to come and stay with them for a change of scene – spend time with grandchildren, go on a short holiday, etc. While here in Bangalore, they decide that she should have a psychiatric consultation to treat the ‘depression’ so that she can go back home in a happier frame of mind.

This group is a new demographic in India: parents of people who have moved permanently to the US or elsewhere. These people’s problem is a catch-22 situation. They have worked hard to ensure their kids’ success, including a farewell to India, and are now left alone and lonely precisely because they have succeeded in sending their kids to greener pastures far from home. If the kids hadn’t been so very successful, they would have been living near them, but perish the thought.

Typically, the father might be a retired bank manager, or something similar, his only goal throughout life having been to earn and save, so his kids would have a better life. The mother might be a homemaker whose life revolved around her children and home. Of course, they are genuinely happy and proud that their children are successful, but this wasn’t exactly how their own lives were meant to pan out, was it? How did life as a happy family end so fast? That’s the unspoken question in their eyes.

Their kids’ successful lives are now being played out in a faraway country. They miss seeing their grandchildren grow, they miss being part of their children’s lives. They see them in pictures on whatsapp, talk to them on facetime, go stay with them and experience a small slice of their lives, and return to India to their silent, empty homes. Some get green cards and emigrate, but I’m not sure that can work for everyone.

Separation. Sadness. Loneliness. It is the zeitgeist. The days of three-generational families are long gone. In the bigger Indian cities there are apparently NRI Parents Organisations to help meet the social needs of people whose children have settled abroad, but not in smaller cities and towns.

There’s only a little bit I can do for them, like listen, give a couple of practical suggestions, and draw their attention to the good things in their lives here.

There is so much written about how social connections and volunteering are the most effective protection against loneliness, but this is easier said than done for many of the people I see. They already have plenty of relatives, neighbours and friends for company. But the hole in their hearts can only be filled by the children whose faces they long to see, and whose stomachs they long to fill with good home-cooked food. When their children visit with their families, they find themselves unable to connect with their grandchildren because there is nothing Indian and relatable about them after they cross the toddler stage, and there is often a language barrier as well.

What usually happens at the end of a consultation is that they ask if they can meet me again, because talking has made them feel better. I say of course they can, and they look relieved. They come back a couple of times more before they have to leave Bangalore. They talk, they just pour out their feelings. Existential despair is not far beneath the surface, and I see that what keeps them from being overwhelmed is the firm belief that they did the right thing by their kids. I guess I tacitly reinforce this one strength they have, and I guess that helps. I don’t know for how long, but I hope it endures until they find something to get involved in when they get back home. Angst is part of the human condition and everyone goes through bouts of it in some form, some time. There is no diagnostic category for loneliness in DSM-5 because it is not a mental disorder, and loneliness is not the same as clinical depression, though it can lead to it over time.

So, well, I think having a minister in charge of garnering information on loneliness – and what to do about it – is an idea whose time has come. It is a public mental health problem, not a psychiatric one, so the approach taken by Teresa May to gather input from various sources is sound. In terms of how this idea applies to India, I don’t know. It is likely to be low on our government’s list of priorities because of two reasons: one, there are much bigger issues like farmer suicides, and two, there are far fewer people living alone and lonely in this country than in the UK.

Two months ago my friend Ruby and I met a 79-year-old British woman, Marion, who was on a visit to Bangalore. We spent a little time chatting in a coffee-shop near by. The next morning she came with me to the lake when I went for my daily walk, a camera slung around her neck. She busily took pictures, her new pastime. I came to know she lives alone with her cat, Daisy, near London. She has a group of friends around her age who meet in a hobby circle every week, and since longevity runs in her family, she’s got relatives who are really old too… When I e-mailed her to wish her at Christmas she told me she was going to Southampton to spend the holiday with her brother who is in his eighties. So I quite understand how this could work in the UK, for everyone nearing eighty may not be as spry and self-sufficient as my new friend.