Loneliness across the life span isn’t soft or sentimental. It’s structural and pervasive, and in therapy, it often goes unnamed. Clients may talk about being tired, numb, overcommitted, under-stimulated. They might say they’re fine or just busy. But underneath, many are lonely in ways that shape their mental and physical health.

In 2023, the U.S. Surgeon General called loneliness a public health crisis. Approximately half of U.S. adults report measurable levels of loneliness. Its health effects are on par with smoking 15 cigarettes daily, and worse than obesity. The numbers are bleak, but the lived experience is more complex, and it changes across the life span. If you’re working with people, you’re working with loneliness.

Loneliness tends to manifest differently across age groups, so let’s take a look at what to listen for in client sessions, as well as interventions to consider.

Young Adults (18–29): Hyperconnected but Deeply Isolated

Young adults are supposedly in the prime of their social lives. In practice, this is one of the loneliest groups. In the 2025 Cigna “Loneliness in America” report, 67% of young adults reported frequent or constant loneliness. They’re often in transition – leaving home, finishing school, starting work, trying to build relationships outside of institutions.

This age group is digitally fluent and constantly “connected,” but that doesn’t mean they’re relationally nourished. Many scroll through curated lives online while struggling to form authentic, mutual bonds offline. At the same time, mental health stigma has softened, however the language of needs and intimacy hasn’t always kept up.

What you might hear in session:

• “I’m around people all the time, but I feel alone.”
• “I don’t have anyone I’d call in an emergency.”
• “Everyone else seems to have it figured out.”

What helps:

• Normalize that making adult friendships is hard and awkward.
• Explore relational avoidance. What feels threatening about closeness?
• Help clients notice what “connection” feels like in their body.
• Use group therapy or structured social practice to support risk-taking and emotional expression.

Be curious about how technology serves and fails them. Many are actively trying to form meaningful ties but have no model for how.

Adults in Midlife (30s–50s): Productive but Disconnected

Clients in this stage are often surrounded by people, like partners, coworkers, and kids – but feel emotionally depleted. Midlife tends to be marked by role overload and invisible labor. Social life shrinks. Friendships go dormant. Marriages become functional. Everyone is busy. And yet approximately 65% of adults aged 35–49 report feeling lonely regularly (Cigna, 2025).

In therapy, this often shows up as resentment, burnout, or numbness. It can be hard to identify because it’s not acute; it’s ambient.

What you might hear:

• “I love my family, but I don’t feel seen.”
• “I haven’t had a meaningful conversation in months.”
• “I’ve forgotten how to be around people without an agenda.”

What helps:

• Name loneliness as a legitimate form of suffering. Don’t fold it into a broader narrative of stress and move on.
• Invite clients to grieve the relationships they’ve lost or outgrown.
• Help them reconnect with people who feel safe, or initiate small new relational steps.
• Address the emotional drought in marriages and caregiving roles without shaming.

Folks aren’t “fine” because their calendar is full. The social performance of competence often hides deep isolation, especially among women, queer folks, and caregivers.

Older Adults (60+): Grief, Shrinking Circles, and Cultural Invisibility

Older adults are stereotyped as the lonely demographic, but that doesn’t mean their isolation is taken seriously. It’s often treated as inevitable. According to a 2020 report conducted by the Pew Research Center, 27% of Americans over 65 live alone – the highest amount worldwide. Compounding that, 32% feel socially isolated (JAMA, 2024). These clients are navigating losses – of friends, partners, roles, routines – and often face real logistical barriers to connection.

Ageism plays a quiet but strong role here. It’s not just that people withdraw from older adults; it’s that many don’t think of them as fully social beings anymore. Clients often internalize this erasure.

What you might hear:

• “My world keeps getting smaller.”
• “I feel like I’ve disappeared.”
• “I don’t want to be a burden.”

What helps:

• Get specific: Who do they miss? What do they long for?
• Help them identify relationships that feel restorative, even if new ones are hard to come by.
• Explore intergenerational connection, like mentorship, grandparent roles, or peer groups.
• Offer tools for digital literacy if relevant – but don’t assume all older adults are offline.

Also: be aware of physical and cognitive changes that make connection harder, but don’t let that be the end of the story. Adaptation is always possible.

How Culture, Class, and Identity Shape How Loneliness Shows Up

Loneliness isn’t just personal. It’s political and structural. It’s more common among people with fewer material and social resources, including:

• LGBTQ+ clients without affirming community
• People with disabilities navigating inaccessible environments
• People of color managing racial trauma and tokenism in professional spaces
• Clients with low income or housing instability who’ve been displaced from social networks

These clients may have adapted to survive chronic disconnection, but that doesn’t mean it’s sustainable. Loneliness here is often complicated by mistrust, trauma, and cultural alienation.

What helps:

• Use a structural lens. Ask: What systems have failed this client’s need for community?
• Validate adaptive withdrawal. Then ask what conditions would make connection safer.
• Don’t pathologize isolation when it’s protective. Help clients build toward relationships that offer dignity and choice.

If your client doesn’t feel safe or wanted in public spaces, that’s not a clinical issue – it’s a design problem.

What Loneliness Might Look Like in Therapy

Many clients won’t say “I’m lonely.” They’ll say:

• “I’m bored.”
• “I feel off.”
• “I don’t know what I want.”

You might notice:

• Flat affect, vague somatic complaints, or looping thoughts
• Sessions that feel like a lifeline – not just support, but survival
• A strong pull for attachment that’s then followed by shame

It’s not your job to be your client’s only source of connection. But it is your job to name what’s happening and to treat loneliness as legitimate. Avoid assuming it’s just a symptom of depression or trauma. It may be a primary condition – especially in long-term clients where progress plateaus.

Therapy Can Be a Bridge, Not the Destination

Your office might be the first place where a client feels seen without having to perform. That matters. But therapy shouldn’t be the only place where they experience connection. You can help them develop the capacity – and the courage – to seek and sustain it elsewhere.

Across the life span, that might mean:

• Naming friendship as a clinical goal
• Teaching relational skills in real, embodied ways
• Referring to peer-led groups or interdependent community resources
• Sitting with the grief that comes from wanting more connection than life is offering

Connection isn’t extra. It’s not soft. It’s health. And loneliness, left unattended, will calcify into something harder to treat. You already know this. The work is to name it, map it, and help clients walk toward what they’ve been taught to avoid needing.