If you’re not careful, loneliness might kill you.

Everyone feels lonely at predictable times, like when a special friend or relative dies. But doctors are quick to point out that it’s the continuing, persistent kind of loneliness that carries very real health risks.

In a 2010 AARP survey, 35 percent of all responders reported feeling lonely. Of those, nearly half said their loneliness had persisted for at least six years. That’s a lot of time for a harmful condition to unleash its dangerous effects.

Here are just a few of the consequences of persistent loneliness:

Studies suggest that loneliness is more dangerous than packing on some extra pounds. Yet Americans spend billions of dollars on diet products and often make little effort to address their loneliness.

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  • Loneliness increases the risk of premature death by 14 percent.
  • Loneliness affects not only our current mental health—think depression. One recent study also suggests it increases the risk for dementia later.
  • Loneliness often brings fragmented sleep, the choppy kind that seriously affects health.
  • Loneliness can increase inflammation throughout the body, which carries its own risks. That inflammation can also exacerbate existing conditions like arthritis and heart disease.

Mother Teresa—the impoverished nun who spent her life helping the poor—described loneliness as the “most terrible poverty.”

A personal note: I was lonely growing up in Ithaca and going to Cornell as a day student when it seemed like everybody else was having a great time at their fraternities. In my middle years, I had eruptions of loneliness as a married closeted gay, but I nurtured friendships with work colleagues to offset that. Today, I rarely feel lonely, though I’m often alone. I love the time I spend with family and friends. But time alone—not lonely time—is essential for me to recharge. It’s always been that way.

But now, as I head into the home stretch, I sometimes worry about loneliness while not actually experiencing it. Fortunately my current living arrangement—sharing my house with a young couple that I love—is-ideal. They both have full-time jobs and their own circle of friends and activities. So I get plenty of "me time" and yet I'm not "home alone."

Time with friends

The July 2014 issue of the Mayo Clinic's Health Letter suggested strategies for combating loneliness, including these ideas for nurturing friendships:

  • Reach out: An unexpected phone call or email, even just to say hello, is a meaningful gesture.
  • Be positive: Think of friendship as an emotional bank account. Make deposits of kindness and approval, keeping in mind that criticism and negativity draw down the account. Nonstop complaining also puts a strain on a friendship.
  • Listen up: Ask what’s going on in your friends’ lives. Let people know you’re paying close attention through eye contact, body language and reaffirming comments. When friends share details of hard times they are experiencing, be empathetic.
  • Extend and accept invitations: Invite a friend to join you for coffee or lunch. When you’re invited to a social gathering, say yes. Contact someone who recently invited you to an activity and return the favor.
  • Respect boundaries: Don’t overtax the friendship with your own needs. Remember that friendships require both give and take.

I get a pretty good score on this checklist. One thing I've done is sign up for season subscriptions to theaters and the ballet with different special friends so that I can be sure we stay in contact.

Need more friends? That same Mayo Clinic article offers these ideas for finding new friends:

  • Attend community events: Get together with a group of people working toward a goal that you believe in, such as an election or the cleanup of a natural area. Find a group with similar interests in an activity, such as reading, sports, crafting or gardening.
  • Volunteer: Offer your time or talents at a hospital, place of worship, museum, community center, charitable group or other organization. You can form strong connections when you work with people who have mutual interests.
  • Take up a new interest: Take a college or community education course to meet people who have similar interests. Join a class at a local gym, senior center or community fitness facility.
  • Join a faith community: Take advantage of special activities and get-to-know-you events for new members.
  • Take a walk: Put on some good shoes and keep your eyes open. Chat with neighbors who also are out and about, or head to a popular park and strike up conversations there.
  • Think beyond two legs: Whether it has four legs or even wings, a pet can provide many of the same companion benefits as human friendships can.

I'd add to that list "Activate old interests." I've made new and interesting friends, thanks to signing up for the weekly bridge game at the local senior center.

Every list I see about maintaining wellness invariably includes a recommendation for staying socially engaged. It’s good for body, mind, and spirit. Communicating via email and cellphone is nice—and certainly convenient. Still, there will never be anything like the real thing: spending time—together, face to face—with other people.