Lost connections is a new book about uncovering the real causes of depression, and the unexpected solutions.
This book takes a fresh look at what really causes depression. The author, Johann Hari, tells his own story. He suffered from depression from childhood. He was on medication for decades. And it was only after decades of not getting any better that he began to question whether pharmaceuticals were the right answer to depression.
This book is the outcome of 30 years of thinking about depression. He proves that almost everything we know about depression and anxiety is wrong.
Chemical Theory of Depression
The accepted explanation of depression is that it is the result of a chemical imbalance in the brain. All mainstream efforts are aimed at correcting that chemical imbalance.
Depression is a brain disease, and Seroxat is its cure. That has been the accepted wisdom for more than 40 years. According to the Prozac theory, depression is caused by lack of serotonin in the brain. Seroxat, Paxil, and all the other selective serotonin reuptake inhibitors restore your serotonin balance and banish depression. Although they don't.
Johann Hardy realised that the pills made you feel good for about six weeks, and then they didn't. The doctors' answer is to increase the dose. That makes you feel better for about six weeks, and then it stops. So the answer is to increase the dose again. And so on. Until you are walking around like a zombie. You don't have depression, but you don't have any real life either.
No support for serotonin theory
The core of this book is about how he started to question the reality of chemical treatment of depression. He realised that even after 20 years of taking the medication, he was still depressed.
So he started thinking about what other things might be associated with depression. He went to see his doctor early on. The doctor asked about his symptoms, and prescribed him medication. And every time he saw doctor after that, they asked about his symptoms. He eventually realised that they did not ask anything else about his life.
No doctor asked what was going on in his life that moment. Nobody asked if he had had any emotional shocks. Nobody asked about money worries. As long as you believe that it is a chemical imbalance, there is no need to look for any other explanation.
The doctors assumed that all his troubles are the result of the common chemical imbalance. In fact it was the other way round. It is the emotional shocks, and economic circumstances, that give you depression.
Depression is in your environment
The rest of the book examines two things. One, the results of the chemical imbalance theory. And two, the factors that really cause depression.
The first few chapters are a detailed analysis of the astonishing rise in antidepressant prescription. At the time of writing one person five in the US is on some sort of drug for a psychiatric problem. This is an incredible level of drug consumption.
The analysis looks at what is driving this level of consumption. He details the vast profits made by pharmaceutical companies, and the incentives for doctors and hospitals to keep prescribing these things. That story is well known.
What is not well known is the hidden truth. there is not one shred of evidence to actually show serotonin has any connection whatsoever to depression. The entire industry is built on a lie. Every scientific study that has tried to find a connection has failed.
His first breakthrough was to realize that depression and anxiety are simply different aspects of the same thing. They are always found together. When one goes up the other goes up. When one goes down the other goes down. They are not separate illnesses.
The second was to realize that unhappiness and depression are strongly related. There is a continuum between unhappiness and depression and anxiety.
The nine causes of depression and anxiety
It is not all in your head. The cause of depression is in your environment. His researches showed that there are nine interconnected environmental issues which are leading to an increase in depression and anxiety for everyone.
The first cause is disconnection from meaningful work.
People who hate their jobs, people who can't see any point what the doing, have stepped on to the conveyor belt towards depression.
The second cause is disconnection from other people.
Human beings evolved from groups of apes. Humans are happiest when they're in a group. But most of us lead fairly solitary lives. The nuclear family is quite different from the way humans used to live. Most of us have lost the warm interconnections of an extended family and even a village. Social isolation is a driver of depression.
The loss of meaningful values is the third cause of depression.
Society has changed so much that the principal leisure activity is now buying stuff. Our principal social actions are about meaningless fluff on social media. People are driven by extrinsic values, that is, we do things for rewards, physical rewards mostly. Intrinsic values are things that we do because we love it. The Western world has become obsessed with extrinsic values. And depression is the price.
The fourth cause childhood trauma.
This is widely understood. An unhappy childhood leads to an unhappy adult. Childhood trauma is one of the most obvious indicators of depression and anxiety. Children who have been sexually abused, emotionally abused, or neglected are at very high risk of depression. Nothing to do with genetics or brain function. The scientific results are quite simple. The more types of childhood abuse you had, the more likely you are to have depression.
Disconnection from respect
Studies with baboon society showed that the lowest member of the hierarchy was constantly stressed. The highest member of the anxiety was also highly stressed if his position was threatened. Other research showed that the more social distance there is between the haves and the have-nots, the greater the prevalence of mental illness. There is much more mental illness in the USA then there is in an egalitarian society like Norway.
Cause six is disconnection from the natural world.
Spending a couple of hours in the natural woodland has a remarkable effect on people's feelings. This can be measured by the stress hormones in the blood. Living in modern cities is the exact opposite of that.
Cause seven is disconnection from a hopeful or secure future.
The more insecure your future income or personal security is, the more likely you are to have depression.
The length of time you have been under stress is the eighth cause.
Your brain is constantly changing to meet your needs. Your brain changes as you suffer life changing challenges. If this goes on for long enough, your brain changes to deal with it. Part of the brain become more sensitive to bad things and parts that are sensitive to good things get smaller. This leads to the common feeling of being stuck in anxiety and depression. The good news is that once the external factors begin changing your brain can repair itself.
The ninth cause is genetics.
There is a clear and proven correlation between certain genes and the tendency to become depressed. However having the gene only gives you a tendency. If the other eight factors don't happen, then you are no more likely to get depression and anyone else.
"Depression isn't a disease. Depression is a normal response to abnormal life experiences."
Hari, Johann. (2018) Lost Connections. London: Bloomsbury Publishing. ISBN 978-4-1-4088-7868-2