Loneliness is an epidemic in America. A Mayo physician explains how to keep your mental health in check with loneliness on the rise

CATHY WURZER: I'm Cathy Wurzer. You may have missed this bit of news earlier today, but US Surgeon General Vivek Murthy declared that loneliness is an epidemic in this country. The surgeon general issued an advisory today laying out the medical and mental consequences of being lonely, and he outlined a series of actions that Americans can take to address the growing issue.

This advisory comes at a good time. May is Mental Health Awareness month. And since the pandemic began more than three years ago, we've been made more aware of how isolation and loneliness can lead to struggles with mental health. So today, we're going to continue our two part conversation with Dr. Jay-Sheree Allen about stress and mental health in Minnesota. Dr. Jay is a family medicine physician at Mayo Clinic in Rochester. Welcome back.

JAY-SHEREE ALLEN: Thank you so much for having me again.

CATHY WURZER: Being lonely obviously plays into one's mental health-- physical, too, which I didn't really realize, the physical ramifications of being lonely. So this advisory from the Surgeon General is really quite interesting. I don't know if you saw it. What do you make of it?

JAY-SHEREE ALLEN: Yes, I actually just glanced at it earlier today. I am so happy that we are having these conversations in the mainstream. The stigma is-- we're really trying our very best to put an end to that so that we can have these very important conversations and empower people to seek the help that they so desperately need, so I am very happy that this is at the top of the news the news stations this morning.

CATHY WURZER: What are the most common mental health issues that Minnesotans face?

JAY-SHEREE ALLEN: Yeah. So the big ones are the anxiety disorders. So generalized anxiety disorder is one, but also in that category-- some of the panic disorders and also fall within that category. Outside of the anxiety disorders, depression is also at the top of the list, so major depressive disorder being the biggest one there. And then post traumatic stress disorder is also quite common-- PTSD, believe it or not. So there are a lot of others, but those are the big ones.

CATHY WURZER: When you are seeing a patient, what are you looking out for? What questions are you asking your patients when it comes to their mental health so you can kind of suss out if there's an issue?

JAY-SHEREE ALLEN: Yeah, absolutely. So I always put in a little plug for primary care whenever I try to talk to you, Cathy. One of the good things about being a primary care physician is that you have a relationship with your patients, and so you can tell when they're doing well or when they're having an off day and going from there and seeing, is this just one bad day, or are we dealing with something else that's a little more serious here?

But the questions I ask pertain to some of the screening questionnaires that we administer when you come in for a clinic visit. So the most common ones being a PHQ-9, so that's a questionnaire asking about depression or symptoms related to depression, or a GAD-7, which asks about questions related to anxiety.

CATHY WURZER: Now, how do you deal with a patient who just is not really thinking about their mental health? It's like, I'm tough. I'm fine. Everything's good. Why is she asking me these questions? How do you break through maybe that barrier?

JAY-SHEREE ALLEN: That's a really good question. That's probably the million dollar question. But I think it's important to really stress what it is that you are concerned about and kind of asking those questions upright. So whether it's about their work or about the way they're functioning in their daily lives, if they're having issues with sleep or excessive drug use or substance abuse, if they're having significant behavioral changes or emotional outbursts that are just not kind of like them-- or the opposite.

They're more withdrawn or more isolated-- such dramatic changes in their mood. It's important to use those key points or the evidence of the things that you are seeing or that you are concerned about to then use that to broach the subject of, "These could be signs that we're dealing with a mental health issue here." So bringing that objective evidence forward, and then trying to tie it back to, "This actually could be a mental health thing," and then take the conversation from there.

CATHY WURZER: Have you seen stigma decrease around talking about and treating mental health since the pandemic?

JAY-SHEREE ALLEN: I have, but I also need to add my bias that the generations that I work with-- the majority of my patients are younger. And so we do see that younger generations-- the millennials and Gen Z-- are more open and forthcoming about mental health disorders than older generations, so I think that's probably skewing the perspective I have based on my patient population.

But I think we are having conversations like this-- the Surgeon General putting out statements like he does-- I think are starting to open the playing field a lot more. Celebrities are speaking out about their mental health struggles and how they've sought help. I think all of that really does help to decrease the stigma.

CATHY WURZER: And finally, what advice do you have for folks who are starting to realize that they might be struggling with their mental health?

JAY-SHEREE ALLEN: The first thing is to recognize that you are not broken. This is not your fault. There's nothing wrong with you. I think that's the first issue. Sometimes, we can close in on ourselves and shut other people out, so I think that's the most important thing to not do. Second, it's important to ask for help.

And sometimes, you just don't have the words to say what it is that you're feeling-- the words to describe what's happening or what's going on. But it's honestly OK to seek the help of your primary care physician, or honestly, any doctor that you keep in close contact or have a relationship with, and just say, "I'm not doing well. I'm not doing well."

And your trained health care professional will then have the follow up questions to kind of tease out what exactly you mean by, "I'm not doing well." But just don't close off the world, and it is OK to seek help. And you can start that by reaching out to your health care professional that you have a relationship with.

CATHY WURZER: All right. All good advice. Thank you. Always great talking to you.

JAY-SHEREE ALLEN: Thank you so much for having me. Great talking to you, too.

CATHY WURZER: I just talked to Jay-Sheree Allen. She's a family medicine physician at Mayo Clinic, host of the podcast Millennial Health.