Psychiatrist Prof. Nevzat Tarhan stated that the Japanese-origin concept “Hikikomori” can be defined as “self-isolation syndrome” or “social withdrawal disorder.” He explained:
“This condition, which particularly emerges during adolescence, was first described in Japan in the 1990s. Although it was initially thought to be unique to Japanese culture, it has now become a global issue.”
Highlighting that loneliness has now turned into a concrete public health problem, Prof. Tarhan said: “Statistics show that the risk of chronic disease is 26% higher among people who say ‘I feel very lonely.’ This damages the body as much as smoking a pack of cigarettes a day.”
Tarhan also emphasized that in cases resembling Hikikomori, where individuals shut themselves at home and even struggle with basic activities such as going to the bathroom, the first step should be to investigate whether there is an underlying biological cause:
“With these young people, we first screen for conditions such as depression or autism spectrum disorder, which may involve social communication difficulties.”
Prof. Nevzat Tarhan, President of Üsküdar University and Psychiatrist, evaluated the topic “Silent Epidemic: Hikikomori Loneliness Disorder” on the program Akla Ziyan with Nevzat Tarhan aired on EKOTÜRK TV.
Shutting oneself inside the home…
Explaining that the Japanese-origin word “Hikikomori” derives from “hiki” (to withdraw/avoid) and “komori” (shutting oneself inside), Prof. Tarhan continued:
“In Turkish, conceptually, it can be translated as ‘self-isolation syndrome’ or ‘social withdrawal disorder.’ This condition, which especially arises during adolescence, was first defined in Japan in the 1990s. Though initially thought to be unique to Japanese culture, today it has become a global issue.
The core symptoms of Hikikomori are as follows: The individual avoids social environments, does not want to leave the house, locks themselves inside, withdraws not only physically but also emotionally and mentally, and reduces social interactions to nearly zero. They may appear cheerful but are inwardly isolated. Excessive attachment to virtual games is observed. They avoid structured responsibilities such as school or work. The home becomes the only safe space, and although there is attachment to parents, this bond is distant and contradictory; they do not show emotional closeness to family members yet cannot detach from them either.”
Diagnosis after six months or longer
Stating that a diagnosis can be made if the condition persists for six months or longer, Prof. Tarhan said: “There is a 25-item assessment scale developed in Japan, with an 8-item adapted version available in Türkiye. This syndrome is considered a subtype of depression.”
He noted that these children are usually raised by overprotective mothers and distant fathers preoccupied with work: “Overprotectiveness causes the child to grow up without taking responsibility. Children who are not given sufficient responsibilities at a young age become insecure toward the outside world. Additionally, their limited areas of interest restrict their mental development. Parents directing the child toward various social activities, such as games, art, and nature, helps strengthen brain development and resilience. Children who do not take responsibility also fail to experience the satisfaction that comes from working. Yet, even contributing to housework or helping an elder is extremely important for a child’s development.”
School refusal and peer rejection as the process progresses
Prof. Tarhan pointed out that in families where such children grow up, there is often a lack of healthy communication: “Conflicts at home can escalate into major tensions from even small issues. In such cases, the child creates a safe zone in their room and gradually normalizes social isolation. As the process progresses, school refusal develops, followed by peer rejection. Normally, after the age of 10, peer relationships become more important for children than their parents, but these children avoid peers as well. This situation makes them vulnerable to peer bullying and deepens the cycle of loneliness. Indeed, both Japan and the UK have established ministries of loneliness to draw attention to this issue. It has now become not just an individual problem but also a societal one.”
Becoming dependent, not just attached, to parents
Prof. Tarhan emphasized that these children often form fake bonds through social media and digital platforms: “They are satisfied with superficial, temporary, and artificial praise, far from real relationships. These fake bonds give children a false sense of ‘being valued.’ Since they cannot distinguish between the real and the fake, they perceive these environments as safer. Excessively critical or judgmental attitudes of parents may cause the child to feel as if they are in a courtroom even at home. As a result, the child tends to connect more in the digital world. Human beings cannot live without bonds; thus, the child tries to fill this void with virtual connections. However, these connections are artificial and further deepen the sense of loneliness. Over time, being alone becomes a habit, creating a false sense of peace. Eventually, the child becomes not merely attached but dependent on the parents, and as the process advances, they begin to reject them as well.”
Loneliness damages health as much as smoking a pack of cigarettes a day
Prof. Nevzat Tarhan emphasized that loneliness, declared by the United Nations as one of the three major global threats to the future, has now become a concrete public health problem. He said: “Statistics show that the risk of chronic disease is 26% higher among people who say ‘I feel very lonely.’ This damages the body as much as smoking a pack of cigarettes a day.” Stating that modernity fuels this global epidemic by glorifying selfishness under the name of individualism, Prof. Tarhan described the selection of the phrase ‘crowded loneliness’ as Türkiye’s “word of the year” as the silent scream of modernity. He underlined that as social beings, humans are being pushed into a way of life that goes against their nature, under the teaching of living without needing others.
Chosen loneliness as wisdom…
Pointing out that not all loneliness is harmful, Prof. Tarhan explained: “Chosen loneliness is an ‘inner journey of discovery’ in which a person comes to know themselves and a chance for wisdom. The real danger is being pushed into loneliness against one’s will. I define the selfishness underlying this as a social cancer. Selfish and narcissistic people are like tumor cells, that is, limitless, irresponsible, and insatiable. Just as our bodies fight these cells, society must also struggle against such toxic personalities.” He added that the chronic stress created by loneliness suppresses the immune system, disrupting the body’s self-repair mechanisms. According to Tarhan, the next step of this global threat is depression, and the solution lies in strengthening social bonds.
Chronic loneliness causes early brain deterioration
Prof. Nevzat Tarhan emphasized that chronic loneliness, which has increased among young people especially after the pandemic and manifests itself in problems such as school refusal, causes concrete and measurable damage to the brain. “Research shows that in people suffering from chronic loneliness, brain regions such as the hippocampus (responsible for memory), the anterior cingulate cortex (regulating emotions), and areas related to meaning-making physically shrink. This leaves individuals vulnerable to premature deterioration and mental disorders.” He also warned that the constant stress caused by loneliness disrupts gene expression, making the body send “danger” signals even when there is no danger, which can lead to autoimmune diseases such as thyroid disorders. He stressed that young people raised in environments where family communication is weak and rules are not balanced with kindness are more vulnerable to this risk, and the solution lies in teaching children healthy communication and problem-solving skills.
Why are men at greater risk in the loneliness epidemic?
Prof. Nevzat Tarhan noted that men are at greater risk than women when it comes to loneliness and social isolation, due to genetic differences in male and female brains. “The female brain, thanks to innate maternal codes, is more advanced in empathy and verbal expression skills. Under stress, women seek solutions by talking and socializing, while the male brain withdraws into its mental refuge and isolates itself,” he said. This fundamental difference, according to Tarhan, makes men more prone to peer bullying, social isolation, and shutting themselves off from life. He added that young people who close themselves off may even lose their sense of time, forgetting which month or day it is. Tarhan concluded by noting that women, carrying more social genetic codes, are theoretically expected to be more resilient to this global loneliness epidemic.
Post-pandemic increase in young people “being trapped in the virtual world”
Prof. Nevzat Tarhan stated that the increasing epidemic of loneliness and the tendency of young people to be “trapped in the virtual world,” especially after the pandemic, stems from the unlimited comfort and misguided life philosophy offered by families to their children. He said: “Parents who do everything their child wants just to avoid problems, and who surrender the leadership of the home to them, actually fail to teach them the boundaries of life.”
Prof. Tarhan emphasized that children growing up in high-stress households see the virtual world, where pleasure sources are accessed easily and without effort, as a refuge. He noted that there are babies given tablets as “cheap babysitters,” swiping screens even in their sleep, while Scandinavian countries completely ban screens until the age of 3.
“We are teaching our children a life focused only on instant pleasure and dopamine rather than medium- and long-term goals. A young person who never asks themselves, ‘Where will I be in 5–10 years?’ becomes a prisoner of the virtual world filled with money, fame, and applause,” said Prof. Tarhan, calling on families to offer their children a life centered on meaning and purpose.
Communication in the virtual world is not “social,” but “virtual”
Underlining that communication in the virtual world is not truly social but rather virtual, Prof. Tarhan explained that such interactions, lacking real physical contact, only stimulate the brain areas related to imagination. “In real social life, children learn through the five senses, motor skills, empathy, and social boundaries. In the virtual environment, however, they cannot make mistakes and learn from the reactions of others, so they grow up without learning social limits,” he said. Prof. Tarhan added that individuals with low self-confidence and poor stress management tend to escape into virtual environments, particularly games that provide fake approval and a sense of immersion.
He stressed that human beings are relational creatures and that when people feel socially secure, the brain’s threat circuits are silenced. He noted a direct causal link between happiness and loneliness: “Those pushed into loneliness seek temporary pleasures to escape real problems. Yet if they choose a life centered on purpose and meaning, they may struggle at first but ultimately benefit in the medium and long term. Humans desire to be part of a whole and a source of meaning; true happiness and the solution to loneliness lie there.”
Families should increase the positive instead of fighting the negative
Prof. Tarhan noted that the protest and negative attitudes of a 15-year-old often stem from parents’ overinvolvement mixed with excessive affection. He said: “After the age of 10, you cannot control a child; instead of trying to sculpt them like a statue, you should be a ‘companion on the road of life.’”
He emphasized that an authoritarian attitude, especially toward children who have developed a sense of autonomy, leads to the opposite reaction and the development of a reversed identity. He recommended that families adopt a strategy of “increasing the positive” instead of “fighting the negative.”
“To enter the child’s world, open a door through their interests (music, computers, art). Instead of giving lectures and advice, start by praising their positive qualities. Once the trust relationship is renewed, the child will naturally abandon mistakes,” Prof. Tarhan explained.
Screening for depression and autism
Prof. Tarhan underlined that in Hikikomori-like cases, where young people lock themselves at home and even struggle to go to the bathroom, the first step is to investigate whether there is an underlying biological cause: “With these young people, we first screen for conditions such as depression and autism spectrum disorder that involve social communication difficulties. If there are problems such as nonverbal learning disorder, the treatment completely changes.”
He noted a significant increase in such cases and adolescent suicide attempts after the pandemic, stating that whereas in the past inpatient treatment was rarely needed, now it has become difficult to find places in adolescent clinics. “If the mother and father speak the same language, act consistently, and avoid creating polarization among siblings, these young people recover quickly,” he added.
The fundamental need: to be valued
Prof. Tarhan stressed that the most basic need of adolescents experiencing loneliness and social isolation is “to be recognized as a person of worth.” He recommended that instead of asking simple questions like “How are you today?”, families should include the child in decision-making processes by asking “How should we do this?”
However, he also issued a serious warning: “If despite all these efforts, a young person frequently brings up the subject of death, asks related questions, or shows signs of being in a mood such as ‘I’m going on a long journey,’ this is a very serious alarm signal. In such a situation, it is life-saving for families to immediately seek professional support without delay.”