GQ. In looking up the words’ etymology, there is a slight difference: A hermit tends to get out and live off of the land vs. a recluse who is holed away. In both cases, they have the desire to be anti-social. It could be due to a difference in their personality make-up or for a spiritual reason.
Are either mentally disturbed or suffering in some way? It seems like we all want time to be alone, and some desire it more than others. Since hermits and recluses have chosen their lifestyle, I’d venture a guess that they are happier in solitude than attempting to survive in a sociable environment. Then again, it depends upon why they chose this way of life.
I don’t personally know any person who is a recluse. My ex-BIL probably qualifies as a hermit. He lives on 17 acres of rural land in an old farmhouse. There is well and cistern for water, a garden and an outhouse. The few bills that he has are funded by doing odd jobs in the local town, mainly for elderly widows. He rarely talks, and when he does, it’s to impart information that a stranger would find odd. For those of us who have been around him for years, we’ve learned to accept it.
As for the need of medical assistance, I’m not sure what you mean. There are plenty of people that avoid medical care whether they are anti-social or not.