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Social and structural context
Limited contact or connection; loneliness is the subjective experience of insufficient connection.
Fit, function and alternatives
A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.
Check alternatives
Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.
Next steps
Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.
Qualification
Distinguish chosen solitude. Evidence in clinical bipolar samples is limited and causal direction can be reciprocal.
Caveats for this record