Lost Connections: Uncovering the Real Causes of Depression - and the Unexpected Solutions

by Johann Hari

Loneliness isn’t the physical absence of other people, he said—it’s the sense that you’re not sharing anything that matters with anyone else.

There’s strong scientific evidence that we all get most pleasure from what are called “flow states”13 like this—moments when we simply lose ourselves doing something we love and are carried along in the moment. They’re proof we can maintain the pure intrinsic motivation that a child feels when she is playing.

“We have been animals that move for a lot longer than we have been animals that talk and convey concepts,” she said to me. “But we still think that depression can be cured by this conceptual layer. I think [the first answer is more] simple. Let’s fix the physiology first. Get out. Move.”

Imagine, he told me, that “your marriage just broke up, and you lost your job, and you know what? Your mother just had a stroke. It’s pretty overwhelming.” Because you are feeling intense pain for a long period, your brain will assume this is the state in which you are going to have to survive from now on—so it might start to shed the synapses that relate to the things that give you joy and pleasure, and strengthen the synapses that relate to fear and despair. That’s one reason why you can often start to feel you have become somehow fixed in a state of depression or anxiety even if the original causes of the pain seem to have passed.

“Ask not what your country can do for you. Ask what you can do for your country.” Marc told me that if you want to understand how to think about the origins of depression, and how they relate to the brain, in a more truthful way than we’ve been taught to for the last few decades, it helps to know something the psychologist W. M. Mace said years ago, riffing on JFK: “Ask not what’s inside your head,”9 he said. “Ask what your head’s inside of.”

But everything I had learned suggests that there’s a third option—to regard depression as largely a reaction to the way we are living. This way is better, Marc said, because if it’s an innate biological disease, the most you can hope for from other people is sympathy—a sense that you, with your difference, deserve their big-hearted kindness. But if it’s a response to how we live, you can get something richer: empathy—because it could happen to any of us. It’s not some alien thing. It’s a universal human source of vulnerability. The evidence suggests Marc is right—looking at it this way makes people less cruel, to themselves and to other people.

“It is no measure of health to be well-adjusted to a sick society.”

But what if we started to think of antidepressants as something very different? What if changing the way we live—in specific, targeted, evidence-based ways—could be seen as an antidepressant, too? What if what we need to do now is expand our idea of what an antidepressant is?

“How different would it be,” she said,3 “if when you went to your doctor, she ‘diagnosed’ us with ‘disconnection’?” What would happen then?