I'd say it's not necessarily isolation, but lack of opportunity. Presumably the higher up you are, the less transport links and settlements there are, so geogra

I'd say it's not necessarily isolation, but lack of opportunity. Presumably the higher up you are, the less transport links and settlements there are, so geographically you now have less opportunities within a commutable distance. When I say "opportunity" I mean it in a very general sense - it could be social opportunity, dating opportunity, work opportunity, hobby opportunity whatever. When you're deep in the hole of depression, by definition you have lost hope of things improving, which would indicate a dearth of opportunity or novel experiences that could change your mindset. I'd say that cities can feel extremely lonely, because you can see all these people all around you but you can't connect with any of them so you kind of feel disconnected or unwanted which heightens the feeling of loneliness. Wheres if you are in a rural location, you might be lonely for lack of people but feel that if you were to find some people that you would get on with them well. Tying this back to the original point, I think if you can take advantage of the huge variety of opportunities the city offers you can easily overcome "city loneliness" whereas "rural loneliness" is much harder to overcome - if you don't get on with the small set of people nearby or don't enjoy any of the small hobby groups available, you're shit out of luck in terms of social interaction and will have to either move, hope someone new moves nearby, attempt to start your own hobby club or get used to your own company.