Every 10 October is World Mental Health Day. This year we don't want to talk to you about cold figures or give you textbook advice. We want to open up a conversation about something we see up close, day after day, from behind the counter of our pharmacy in Palmera.
Some neighbours come in on the pretext of "having their blood pressure checked" and, once it's done, stay a little longer. They talk about the weather, the news or any everyday detail. But deep down, what they really need is to feel heard. Because knowing there's someone on the other side changes things.
Unwanted loneliness and its impact on mental health
Being alone is not the same as feeling lonely. Some people enjoy their own company, while others, even surrounded by people, feel a deep emptiness. Unwanted loneliness is that silent feeling of having no one to open up to, or of sensing that nobody cares about how you're feeling.
It affects older people and is more common in villages, although cities are not spared. It deepens when children live far away or a partner is gone. But we increasingly see it in young people, in exhausted carers and in people who, from the outside, "have it all".
The impact of unwanted loneliness on mental health is deep and multidimensional. The World Health Organization (WHO) now recognises it as a global public health priority, warning that social isolation significantly increases the risk of cognitive decline, depression and cardiovascular disease, with an impact on mortality comparable to classic risk factors such as smoking. It doesn't only affect mood: it acts as a trigger and aggravating factor for anxiety and depressive disorders, creating a spiral of social isolation that is hard to break without the right support.
When loneliness hurts the body: the invisible symptoms
As a pharmacist, it's worth remembering that mental and physical health are closely linked at a neuroendocrine and metabolic level. The ongoing psychosocial stress caused by loneliness triggers sustained activation of the hypothalamic-pituitary-adrenal (HPA) axis, which raises cortisol levels and promotes low-grade systemic inflammation. When someone has been alone, sad or distressed for a while, symptoms such as these often appear:
- Insomnia or sleep that doesn't refresh you.
- Constant tiredness and lack of motivation.
- Headaches, back pain or digestive problems with no clear cause.
- Changes in appetite.
- Drinking or smoking more, or using sleeping pills "just to get by".
- Not wanting to leave the house or see anyone.
And here's the trap: the more you isolate yourself, the worse you feel, and the worse you feel, the more you isolate yourself.
Tackling unwanted loneliness through self-care and community
Breaking the cycle of loneliness takes small, gradual steps. Alongside seeking professional support, some effective strategies include:
- Reconnect gradually: get back in touch with friends or family through short calls or simple messages.
- Take part in community activities: sign up for workshops, volunteering or local activities in your town to meet people with similar interests.
- Set daily routines: regular times for sleeping, eating and walking outdoors help regulate your emotional state.
- Know how to ask for psychological help: going to your health centre or talking to your trusted pharmacist are the first steps to find out about the resources available.
How to ask for psychological help and face loneliness
Many people don't ask for help out of embarrassment. They think "I'm not crazy", "it'll pass" or "with all the problems everyone has, I'm not going to bother them with mine".
Asking for help is not a weakness. Just as you'd see a doctor if your chest hurt, you can go if you're hurting inside. Emotional suffering is a health problem and it can be treated. Often that treatment isn't medication: seeing a psychologist is, in many cases, the best option.
Psychology and psychiatry professionals are key to a comprehensive approach to unwanted loneliness. Through evidence-based interventions such as cognitive behavioural therapy (CBT) or acceptance and commitment therapy (ACT), they help restructure cognitive distortions, regulate emotions and build coping tools. Although medication or supplements under clinical supervision may sometimes be needed for a while, psychotherapy is essential to restore emotional wellbeing in the long term: seeing a psychologist is looking after your overall health, and any stigma attached to it has to go.
Suicide warning signs and the role of prevention
This is the hardest part of this article, and that's exactly why we don't want to skip it. According to Spain's National Statistics Institute (INE), 3,953 deaths by suicide were recorded in Spain in 2024. That's around eleven people a day. The figure has fallen for two years in a row, which shows that prevention works, but every one of those lives mattered.
We already covered this in our article on World Suicide Prevention Day: prevention is everyone's business.
There's a myth worth debunking: talking about suicide does not cause it. Asking someone directly whether they're thinking of taking their own life doesn't give them the idea. On the contrary, it's often a relief for that person, because someone has finally noticed.
Signs to watch for in someone close to you:
- They talk about being a burden or say "you'd be better off without me".
- They say goodbye or give away things that matter to them.
- They suddenly withdraw or stop doing things they used to enjoy.
- Their mood changes a lot, including a sudden calm after a very bad spell.
- They express hopelessness: "there's no way out of this".
How to help someone who is struggling
You don't need perfect answers or specialist knowledge of psychology to help. What really matters is being there and offering a safe space.
- Ask simply: "You seem different, how are you really?".
- Listen without judging and without rushing. You don't need to have the answers.
- Don't downplay it. Avoid "cheer up" or "other people have it worse".
- Go with them to get help: to their GP, a mental health professional or the 024 helpline.
- Stay there afterwards. A call a few days later means a lot.
Support resources and the 024 prevention helpline
If reading these lines has left you with a knot in your stomach because you recognise yourself in what we describe, thank you for making it this far. Recognising what's happening to us is the first big step. You are not alone, and what you're going through can change for the better.
- Talk to your GP. They are the main point of entry and referral to the public mental health network.
- Tell someone you trust.
- If you're thinking about harming yourself, contact the 024 Suicidal Behaviour Helpline run by the Spanish Ministry of Health. It's a free, confidential public service available 24 hours a day.
- If you're in immediate danger, call 112.
- You can also call the Teléfono de la Esperanza: 717 003 717.
Your pharmacy is here to listen too
At Farmacia Sendra we've been in Palmera for more than 40 years. We know our neighbours by name, and we know that sometimes the most important thing we do isn't dispensing a medicine, but asking "and how are you?" and waiting for the answer.
If you need to talk, we're here. No judgement and no rush.
Because talking heals too.
José Sendra Lillo, owner pharmacist at Farmacia Sendra
Frequently asked questions
Can talking about suicide cause it?
No. Asking directly and respectfully reduces the risk, because it opens the door to asking for help.
What is the 024 helpline?
It's the Spanish Ministry of Health's suicidal behaviour helpline. It's free and available 24 hours a day, every day of the year.
What's the difference between being alone and unwanted loneliness?
Unwanted loneliness is the feeling of not having enough meaningful relationships, even if you live with other people. That's what affects your health.
What are the main suicide warning signs?
They include sudden withdrawal, comments about being a burden, unusual goodbyes, giving away valued belongings and drastic mood changes. If you notice these signs, it's crucial to listen actively and contact the 024 helpline.
Who should I turn to first if I'm not feeling well emotionally?
Your GP. If there's an immediate risk, call 024 or 112.
Source: Spanish Ministry of Health: Suicides in Spain fall for the second year in a row (INE data 2024)
