How Scared Should I Be of Living Alone?

This article originally appeared on VICE US.

The other day, I turned around while I was cooking, kitchen knife in hand, and tripped on my cat. I caught myself on my counter, but I’m certain that if I hadn’t been standing in that perfect spot, I would have tried to brace myself with my knife hand, and accidentally sunk nine inches of Williams Sonoma steel deep into my own ribcage. (My cat, meanwhile, walked away looking mildly annoyed, as she would have had I stabbed myself.)

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Thank God my girlfriend lives with me. If I’d been impaled on my knife she would have surely used her valuable skills as a comedy writer to save me. But if she ever left, I assume I’d be vulnerable not just to knives, but to all the hazards that presumably plague solo dwellers like choking, falling in the shower, and mental illness. But am I being presumptuous?

Sasha Cagen, the author of Quirkyalone, a guide for non-hermits who nonetheless enjoy being alone, told me there are dangers associated with living alone, but that in a way, they’re irrelevant. In cities, she said, “living alone has a kind of status to it. It’s a luxury.”

“People who want to live alone will live alone. It’s good to be aware of the cons so you can compensate for them,” Cagen added.

When it comes to physical danger, everyone I talked to about living alone had a story: One person found a solo-dwelling friend locked in her bathroom for hours after the doorframe warped. Another accidentally swallowed a grape. Another got a jolt from a lamp with faulty wiring. And as I’ve written before, back when I used to live alone I once gorged myself on raw vegetables, and got a giant wad of broccoli caught in my throat.

If those stories gave you a surge of panic as you remembered your own close call (sound off in the comments!), you could probably use a warm bath of science and data to soothe your irrational fear. A 2009 report from the Journal of Community Health found that over the course of four years, the percentage of people who fell in their homes was generally about 4 percent higher for people living alone. But that study only looked at people over 50, and only covered accidents that got reported. A study from 2012 on the more general effects of solitude notes this problem: “Most studies in this field of research have been cross-sectional and have concentrated on selected populations such as elderly people living alone or single parents,” that report says. Very few scientists are studying that important group of people who live alone by choice and are totally fine with that so their parents should stop asking about them, really.

As for choking, I couldn’t find data about the relative risk for people who live on their own. In fact, the vast majority of choking fatalities that make it to the news happen with other people around. I only found one clear-cut news story about a lonely, Liz Lemon–esque choking death: In 2007, a guy in England who lived alone choked to death on a dried apricot and was found later by one of his kids. While tragic, the story is a bit “dog bites man,” so it seems entirely possible that reporters simply don’t write stories about these incidents when they happen. (Choking—alone or otherwise—kills 2,500 Americans every year.)

Even if the numbers don’t suggest that lonely people are under attack by under-chewed Blue Apron pork cutlets, the need for caution is obvious. Jonathan Epstein, senior director of science and content development at the American Red Cross and also a paramedic, told me when I spoke to him about a year ago that “the most important thing you can do if you’re choking is to make someone aware that you are struggling to breathe.” That means it’s a good idea to flag down a neighbor and signal that there’s a problem by doing the old “I’m choking” gesture.

If you live alone and in a secluded area, you’re really fucked if you choke, and you should consider reading up on the latest in self-administered first aid. A paper published earlier this year by the journal Resuscitation pulls from multiple sources in medical literature, and concludes that—no joke—doing a handstand, or a modified handstand assisted by a chair (see diagram above), and then just letting gravity perform the Heimlich maneuver is among the best ways to save your own life. If you live alone in a log cabin, you should teach yourself to do this right now.

According to Cagan, accidents don’t really register as a hazard for people who spend long stretches of time alone. Instead, a much more general “fear of dying alone” is one of the two main problems. The other is “the extreme discomfort of being sick alone.” No matter how defiantly independent you are, Cagan said, there’s simply no denying that sometimes it’s natural to be around others. “We need other people in our times of weakness, and to share happy moments as well,” she told me.

The psychological effects of isolation are well-documented. The journal Social Psychiatry and Psychiatric Epidemiology published a report earlier this year in support of this idea. Social isolation and loneliness in young people were two different observable mental health factors that were “moderately correlated,” the study found, but both were linked to depression. A report from the journal Heart last year tied both loneliness and social isolation to increases in coronary heart disease and stroke. And according to a Finnish study from 2011, living alone—regardless of whether you say you feel lonely—is linked to a significant increase in death from the long-term effects of alcohol dependency.

So there are serious signs to watch for. To avoid them,Cagan suggested, you need to “make sure you have social contact,” which she said gets harder when you start getting on in years, and “friends who are not living alone begin spending all their time with their families.”

Even if the psychological effects aren’t serious in your case, Cagan told me, there’s also a risk that you might get too weird to ever live with another human being. She told me that people she’s counseled about solo living, who then got into relationships, have reported long term effects like, “not really sharing the same bed all the time,” and trouble adapting to another person’s need to, y’know, clean up around the house.

When you’re on your own, Cagan explained, “you get to live in the jungle, and return to what you feel like doing.” And if jungle life is what you’re really into, you’re running the risk that you might never want to return to civilization.