Social withdrawal, also known as social isolation, refers to a lack of social connections and interactions with other people. It can manifest as spending large amounts of time alone, avoiding social situations, and not having close relationships. While some level of solitude can be normal, excessive social withdrawal may indicate an underlying mental health issue.
What is social withdrawal?
Social withdrawal refers to greatly reduced social interaction, communication, and participation in social activities. People experiencing social withdrawal may:
- Avoid social events and gatherings
- Stay at home most of the time
- Have little interest in going out or doing activities
- Have very few close relationships or friendships
- Prefer to be alone
- Feel anxious or uncomfortable in social settings
This is different from occasional solitude or taking time for oneself. With social withdrawal, there is an ongoing lack of interest in spending time with others. It can occur along with mental health conditions like anxiety, depression, schizophrenia, and autism spectrum disorder.
What causes social withdrawal?
There are several potential causes of increased social isolation and withdrawal:
- Mental health disorders – Conditions like anxiety, depression, schizophrenia, and autism often involve symptoms of social withdrawal. The symptoms of the disorder make social interaction challenging.
- Trauma – Past traumatic experiences like abuse, assault, or bullying can make people wary of others. PTSD may cause someone to avoid people and potential triggers.
- Grief – The loss of a loved one can lead to periods of self-isolation and loss of interest in social activities.
- Physical health – Illness, chronic pain, and mobility challenges can make going out and socializing difficult.
- Age-related changes – Hearing and vision loss, cognitive decline, and increased frailty can contribute to older adults becoming more isolated.
- Personality – Some people are just more introverted by nature and feel comfortable with less social stimulation.
For some people, social withdrawal is a protective response to reduce stress and anxiety. But if it becomes too extreme, it can negatively impact mental health and quality of life.
Mental illnesses associated with social withdrawal
Many different mental health conditions may involve increased social isolation as a symptom. Some of the main ones include:
Depression
Social withdrawal is one of the hallmark symptoms of major depressive disorder (MDD). Other symptoms like low energy, lack of motivation, and feelings of worthlessness commonly cause people with depression to retreat from their social circles.
In a 2019 study of over 46,000 people, those with depression were:
- 5 times more likely to be socially isolated
- Twice as likely to live alone
- Had fewer close contacts on average
The social withdrawal worsens other depression symptoms, forming a vicious cycle. Loneliness then further erodes mental health and makes depression more severe.
Anxiety Disorders
Many types of anxiety, including generalized anxiety disorder (GAD), social anxiety, panic disorder, and OCD often involve social isolation. Anxiety creates persistent fear and worry that make social situations intimidating.
Some key facts about social withdrawal and anxiety:
- Around 50% of people with social anxiety disorder have symptoms of social isolation
- The anticipation of panic attacks can make going out frightening for those with panic disorder
- OCD compulsions around cleanliness/contamination can make social settings uncomfortable
Avoiding triggers like crowded spaces, interactions with strangers, and fear of embarrassment maintains anxiety. But this avoidance prevents learning how to manage anxiety symptoms long-term.
Schizophrenia
Social withdrawal is one of the early signs of schizophrenia in many patients. Negative symptoms like apathy, flat affect, and loss of pleasure motivate people with schizophrenia to isolate further. Paranoia and disorganized thinking also make relating to others difficult.
Results from a 2012 meta-analysis showed that patients with schizophrenia have:
- Smaller social networks
- Less diverse social contacts
- More limited social functioning
The social isolation tends to worsen as schizophrenia progresses without treatment. Building social support is an important part of management.
Autism Spectrum Disorder
Many people with autism spectrum disorder (ASD) have challenges relating socially and communicating effectively. Common symptoms like:
- Difficulty understanding social cues
- Discomfort making eye contact
- Preference for set routines
Can lead to avoidance of unpredictable social situations. Some key facts about autism and social difficulties include:
- About 50% of children with ASD tend to withdraw from social scenarios
- Many adults with autism have very small social networks
- Making and keeping friendships may be challenging
Social skills training, managing overstimulation, and finding accepting communities can improve quality of life.
Post-Traumatic Stress Disorder (PTSD)
PTSD develops after experiencing trauma like assault, disasters, serious injury, or combat. To avoid potential triggers, people with PTSD often isolate themselves following the traumatic event.
withdrawal and PTSD:
- Up to 42% of people with PTSD have symptoms of social isolation
- Avoiding crowded venues helps prevent anxiety reactions
- Detachment from loved ones reduces emotional closeness
PTSD treatment encourages carefully re-establishing social connections while managing trauma triggers.
When is social withdrawal harmful?
Mild social withdrawal is not always concerning. But excessive isolation can negatively impact both physical and mental health. Potential risks include:
- Increased inflammation and weaker immune function
- Higher blood pressure and cardiovascular risks
- Cognitive decline and dementia
- Anxiety, depression, and suicide risk
- Substance abuse
- Financial instability
- Premature death
Lack of social connections limits support systems for managing mental health conditions and life stressors. Ongoing social withdrawal needs evaluation when it:
- Is extreme or pervasive
- Interferes with work/school/relationships
- Causes significant distress
- Worsens depression, anxiety, or psychosis
Treatments for social withdrawal
Treatment approaches focus on the underlying cause while also improving social skills and increasing social activity. Treatment may include:
- Medications – Antidepressants, anti-anxiety medicines, and antipsychotics can treat symptoms allowing socializing.
- Psychotherapy – Talk therapy builds coping strategies for mental health symptoms and fear of social situations.
- Social skills training – Group classes can teach communication, relationship building, and coping tactics.
- Support groups – Group therapy provides social interaction and support from peers struggling with similar issues.
- Gradual exposure therapy – Anxiety is gradually confronted by slowly re-entering avoided social situations.
For social withdrawal tied to aging or disability, treatment focuses on accessible transportation, adult day programs, and senior social engagement. Support from loved ones also makes a difference in overcoming barriers.
Coping strategies for social withdrawal
In addition to formal treatment methods, there are self-help coping strategies that can reduce isolation. Useful techniques include:
- Setting small social goals each day/week, like chatting with a neighbor or texting a friend.
- Joining virtual social communities to interact with people with common interests.
- Participating in online forums or support groups for connection.
- Scheduling regular video calls with long distance friends/relatives.
- Volunteering or helping neighbors to increase community interaction.
- Getting exercise outside the home, like walking in a park or hiking.
- Considering adopting a pet for daily companionship.
- Asking for support from loved ones in increasing social activities.
- Joining an educational, recreational, or special interest group.
- Making a list of potential social activities to try.
Starting small and gradually increasing interaction can help ease anxiety and depression symptoms. Supportive psychotherapy also assists in making and achieving manageable social goals.
When to seek professional help
It is advisable to see a doctor or mental health professional if social withdrawal:
- Is extreme or gets progressively worse over time.
- Is accompanied by symptoms of a mental disorder like excessive worry, sadness, paranoia, etc.
- Is causing significant life impairment and isolation.
- Does not improve with self-help efforts.
- Involves suicidal thoughts or self-harm behavior.
A psychiatrist can diagnose any underlying mental illness and develop a treatment plan. Psychotherapy and medications can help manage symptoms promoting social re-engagement. For older adults, a geriatric assessment identifies causes and appropriate interventions.
The takeaway
Social withdrawal and isolation can stem from mental illnesses like anxiety, depression, schizophrenia, PTSD, and autism spectrum disorder. It may also relate to past trauma, grief, health limitations, introverted personality, and other factors.
While some solitude is normal, excessive social withdrawal can negatively impact both physical and mental health. Seeking help is recommended if isolation becomes disabling or is worsening. Treatment typically involves psychotherapy, medication, social skills training, group support, and gradually increasing social contact. Self-help strategies can also supplement professional treatment.
With professional support, personalized strategies, and understanding from loved ones, it is possible to reverse problematic social withdrawal and regain quality of life.