By Dr David Delvin

Loneliness can be a pretty bitter thing - particularly when you're no longer all that young.

In our psychotherapy practice, my wife and I see quite a few people who are basically suffering from loneliness. And the majority of them are over 40.

Why should this age group be particularly affected? Well, the reasons are fairly obvious. In middle age (and later) people are more likely to be hit by:

· The death of a much-loved partner.
· Divorce
· Separation
· The departure of a child (or children) from the family home.

All of these things can make you pretty miserable. So in this month's article, I'm going to look at ways of avoiding loneliness - and dealing with it, should it occur.

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Depression
But first, I want to kick off by looking at a medical condition, which, in my experience is very often linked with loneliness. It's depression.

You see, in my practice a lot of the people who come to me saying that they're 'lonely' turn out to be depressed. Obviously, loneliness has helped bring on the depressive illness.

Now this is a matter of some seriousness - even of some urgency. I say 'urgency' because to be blunt folk who are depressed will often attempt to do away with themselves. That's particularly common in the over 50s.

So if you are not only lonely, but also depressed, I really would urge you to see a doctor right away - and get some treatment.

Symptoms, which strongly suggest depression, include:

· Constantly thinking about how lonely you are.
· Waking up at two or three in the morning - and not being able to get back to sleep
· Waking up to find that you are 'brooding' on your loneliness
· Finding that your thoughts often turn to death
· Ruminating a lot about illness
· Loss of appetite
· Thinking constantly about loved ones who have passed on.

So if you get any of these symptoms, please seek medical help this week!

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Avoiding Loneliness
Now lets turn to the problem of avoiding loneliness.

Loneliness causes such a lot of human misery! So obviously, it's best to try and avoid it by planning ahead.

So how can you plan ahead? Well, you need to be aware that loneliness is most likely to strike when you are in the later years of your life. Therefore, when you're still in your middle years it's a good idea to think about the future and take steps to ensure that you don't fall into the 'Loneliness Trap'. Good tips are:

· Do try and make lots of friends while you're still in your 40s and 50s. It may not be quite so easy when you're in your 60s.

· Do try and keep up your 'family links' throughout your life. Getting back in touch with relatives when you've retired may not be all that easy - particularly if any family rifts have occurred!

· Don't go off and live somewhere where you don't know anybody. Lots of 'retirees' (to use the American expression) decide that they're going to move to the cosy dwelling they've always dreamed of - maybe a Dorset cottage, or a seaside home in Cornwall. Then they're amazed to find that they have no friends in the new region - and that people from their 'old' life are disinclined to make the long journey to visit them.

· Think very carefully before settling abroad! British people are famous for 'upping sticks' when they're coming up to retirement and going to live in Spain or Portugal or in the middle of France.

· But you need to think to yourself. 'Will there be people there who I know? And if not will I be able to make friends there?' The answer to both questions may well be 'No'.

· Don't go somewhere where you don't speak the language. Although it is possible to learn Spanish or Portuguese or French when you're 55 or 65, not all that man people manage it! And being unable to communicate with the people around you can be very lonely indeed.

I have treated several people who read 'A Year in Provence', went out to live there and ended up being shipped home with minor nervous breakdowns.

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Dealing with Loneliness
But if you are lonely, what measures should you take? Here are some simple ones, which have proved their worth over the years:

· At all costs, do not sit at home moping and expecting that new friends will come to you - they wont.

· The only way you can beat loneliness is to do something about it.

· In order to do something about it, you need to get out and meet people.

· The best way of doing this is to join something.

· In the UK, we've got clubs and associations for everything, from line dancing and amateur dramatics to chess and stamp collecting. You can join political and religious organisations (who are usually very keen to talk to you!) and you can join rambling, music and literary groups. Whatever you've got an interest in; there's an organisation near you that wants you to join.

· Similar, Britain is simply full of excellent Adult Education Classes - at which you meet many nice people who have similar interests to yourself. Ever wanted to take up painting, or yoga, or needlework, or art appreciation, or the study of English Literature? Well, now's your chance.

· Similarly, if you're fit enough then Sports Clubs are a wonderful way of making friends: tennis, badminton, bowls (or even boules), archery and gym - it's all out there. (And it'll keep you fit and young looking - and help ward off illness.)

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Summing Up
This month, I'm not going to deal with the subject of loneliness caused by bereavement - because in March, I'm going to devote a full article to this important subject.

But the message of today's article is simply this. It's miserable being lonely - but in general, you are the only one who can do anything about it. If you want to meet new people and enjoy their company, then you must go out and find them.

Remember: no one ever cured their loneliness by sitting at home!

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Q. I have just retired and feel desperately lonely. Every day, life seems blacker and blacker. Some evenings when I am sitting by myself, I feel I can no longer go on. What would you suggest?
A. You are obviously suffering from a depressive illness. This often comes on immediately after retirement, I'm afraid. So, what you need to do today is to ring your own doctor's practice and make an urgent appointment. Once you've started on treatment for depression, then you should feel more enthusiasm about seeking new friends.

Q. My father, age 91, complains constantly of 'loneliness' even though I try to spend most evenings of the week with him. He has really let himself go recently, failing to shave and wash. So he's not much fun to be with! Do you think this is depression?
A. Well, it's possible. It could also be that your poor Dad is in the early stages of dementia. This illness does sometimes cause the sufferer to feel that he is lonely and neglected by his family, which in this case is clearly not so! The answer is to get him assessed by a doctor as soon as possible, particularly with regard to his 'short term' memory. If this is badly impaired, then the likelihood is that your father is developing a dementia, such as Alzheimer's.

Q. I have been very lonely since the death of my wife. Now I've met a new lady. She's 62 and I am 68. I think I would need some medical help if this relationship became sexual! Do you think I am too old for Viagra?
A. Not at all sir! Viagra and the newer drug Uprima are perfectly suitable for men aged 68. Indeed, in my private practice I have prescribed them for gentlemen aged over 90. So don't hesitate to talk to your doctor about this subject.

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Q. I am flying to see my daughter in Australia shortly. I've heard that it's worth taking Aspirin, in order to avoid 'aircraft thrombosis'. Is this a good idea?
A. Yes on a long-haul flight, taking a small dose of aspirin is probably worthwhile - though occasionally it can cause internal bleeding. Your local chemist will gladly sell you some aspirin of the right strength. However, it's more important to try and keep your legs moving during this very long journey. So walk up and down whenever you can. The 'anti-thrombosis socks' which are available from Scholl and Boots may also be helpful.

Q. Is there any danger in taking up jogging at the age of 58?
A. Very little. Indeed, in the long run (!), it should do you good. But if you've had any heart trouble, consult your GP before you start running.

Q. This winter, I have felt terribly cold. A friend says it could be my Thyroid. Is this possible?
A. Yes, an under-active thyroid is a common cause of feeling very cold - particularly in women aged over 50. Other symptoms of this disorder include putting weight, plus 'coarsening' of the hair and skin. Your GP can readily do tests to find out if you have a thyroid problem.

Q. My doctor is always 'going on' about my blood pressure - so much so that he makes me nervous! In fact, it's only about 140 over 90. I'm 65 years of age. Is such a level abnormal?
A. It's only just on the border of being too high. And it's likely that your nervousness about your GP is pushing it up. So I suggest that you get his nurse to take it in future. Her reading may well prove lower - that is, if you are more relaxed with her than you are with your doctor. Alternatively, you could get on of those 'home BP monitors'. Good luck.

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