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

by Johann Hari

Everything that causes an increase in depression also causes an increase in anxiety, and the other way around. They rise and fall together.

I started to see depression and anxiety as like cover versions of the same song by different bands. Depression is a cover version by a downbeat emo band, and anxiety is a cover version by a screaming heavy metal group, but the underlying sheet music is the same. They’re not identical, but they are twinned.13

that I remembered regular sex is one of the best natural antidepressants in the world.

“Why do we call it mental health?” she asked me. “Because we want to scientize it. We want to make it sound scientific. But it’s our emotions.”

What if depression is, in fact, a form of grief—for our own lives not being as they should? What if it is a form of grief for the connections we have lost, yet still need?

He would leave home at seven in the morning, work all through the day, and get home at seven at night. He began to wonder—you “go through this forty- to fifty-hour workweek, and if you don’t really like it, you’re just setting yourself up for depression, and anxiety. And questioning—why am I doing this? There’s got to be something better than this.” He started to feel, he said, that there was “no hope. What’s the point?”

I wondered if this was because the Oxy made him as blank and empty as the job itself.

“Like—you like what you do, right?” he said to me. I stopped writing in my notebook for a moment. “When you wake up in the morning, you look forward to your day. When I wake up, I don’t look forward to work … It’s just something I have to do.”

“people would come in with problems in their lives,5 and we would treat them with a bottle of white mixture.”

When he talked with the top-level civil servants, they would lean back and take charge of the conversation, demanding to know what Michael wanted. When he talked with the lower-grade civil servants, they would lean forward and wait for him to tell them what to do.

It turned out the people at the top of the civil service were four times less7 likely to have a heart attack than the people at the bottom of the Whitehall ladder.

You have to shut yourself down inside yourself to get through this—and Michael uncovered evidence that this affected your whole life.11 The higher up you went in the civil service, he found, the more friends and social activity you had after work. The lower you went, the more that tapered off—the people with boring, low-status jobs just wanted to collapse in front of the television when they got home. Why would that be? “When work is enriching, life is fuller, and that spills over into the things you do outside work,” he said to me. But “when it’s deadening,” you feel “shattered at the end of the day, just shattered.”

Despair often happens, he had learned, when there is a “lack of balance between efforts and rewards.

“You can get real in-depth and intellectual with all that stuff, but when it comes down to it—doing anything, and not having a purpose behind it, and then feeling like you don’t have any other option except to continue: it’s terrible. At least for me, it turns into—well, what’s the point?”

I’ve been trying to understand why Joe probably won’t go. Something keeps many of us trapped in those situations that’s more than just needing to pay the bills. I was going to investigate it soon.

It was as if they thought your brain is an island, cut off from the rest of the world and never interacting with it.

When John and his colleagues added up the data,1 they were startled. Feeling lonely, it turned out, caused your cortisol levels to absolutely soar—as much as some of the most disturbing things that can ever happen to you. Becoming acutely lonely, the experiment found,2 was as stressful as experiencing a physical attack. It’s worth repeating. Being deeply lonely seemed to cause as much stress as being punched by a stranger.

It’s a beautiful theory. But John began to wonder—how could this be tested? It turns out there are still some people who live in the way most humans did at earlier stages in our evolution. For example, John learned that in the Dakotas, there’s a very closed, highly religious farming community—a bit like the most fundamentalist wing of the Amish—called the Hutterites. They live off the land, and they work and eat and worship and relax together. Everyone has to cooperate the whole time. (Later in my journey, I went to visit a group like this, as you’ll see.) So John teamed with anthropologists who had been studying the Hutterites14 for years, to figure out how lonely the Hutterites are. There’s one neat way to test it. Anywhere in the world where people describe being lonely, they will also—throughout their sleep—experience more of something called “micro-awakenings.” These are small moments you won’t recall when you wake up, but in which you rise a little from your slumber. All other social animals do the same thing when they’re isolated too. The best theory is that you don’t feel safe going to sleep when you’re lonely, because early humans

literally weren’t safe if they were sleeping apart from the tribe. You know nobody’s got your back—so your brain won’t let you go into full sleep mode. Measuring these “micro-awakenings” is a good way of measuring loneliness. So John’s team wired up the Hutterites, to see how many of them they experienced each night. It turned out they had barely any.15 “What we found was that the community showed the lowest level of loneliness that I’d seen anywhere in the world,” John explained to me. “It really stunned me.” This showed that loneliness isn’t just some inevitable human sadness, like death. It’s a product of the way we live now.

Lonely people are scanning for threats because they unconsciously know that nobody is looking out for them, so no one will help them if they are hurt. This snowball effect, he learned, can be reversed—but to help a depressed or severely anxious person out of it, they need more love, and more reassurance, than they would have needed in the first place. The tragedy, John realized, is that many depressed and anxious people receive less love, as they become harder to be around. Indeed, they receive judgment, and criticism, and this accelerates their retreat from the world. They snowball into an ever colder place.

You also need, he explained to me, to feel you are sharing something with the other person, or the group, that is meaningful to both of you.

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. If

“Nobody can help you except you.”

The Internet was born into a world where many people had already lost their sense of connection to each other. The collapse had already been taking place for decades by then. The web arrived offering them a kind of parody of what they were losing—Facebook friends in place of neighbors, video games in place of meaningful work, status updates in place of status in the world. The comedian Marc Maron28 once wrote that “every status update is a just a variation on a single request: ‘Would someone please acknowledge me?’ ”

“The kind of connection we need is this connection”—she waved her hand between me and her—“which is face-to-face, where we are able to see, and touch, and smell, and hear each other

Now VR has been invented and other tools to immense the cyber connection

must belong to a tribe.”

When a kid plays, she’s acting totally on intrinsic motives—she’s doing it because it gives her joy.

They’re the things you do not because you actually want to do them, but because you’ll get something in return

Yet most of us, most of the time, spend our time chasing extrinsic goals—the very thing that will give us nothing.

What Tim had discovered is that the message our culture is telling us about how to have a decent and satisfying life, virtually all the time, is not true.

Just as we have shifted en masse from eating food to eating junk food, Tim has discovered—in effect—that we have shifted from having meaningful values to having junk values. All this mass-produced fried chicken looks like food, and it appeals to the part of us that evolved to need food; yet it doesn’t give us what we need from food—nutrition. Instead, it fills us with toxins.

That’s a heavy load to bear, instead of walking around

doing what it is you’re interested in doing, or being around people who love you just for who you are.”

You have to picture all the values that guide why you do things in your life, Tim said, as being like a pie. “Each value” you have, he explained, “is like a slice of that pie.16 So you’ve got your spirituality slice, and your family slice, and your money slice, and your hedonism slice. We’ve all got all the slices.” When you become obsessed with materialism and status, that slice gets bigger. And “the bigger one slice gets, the smaller other slices have to get.” So if you become fixated on getting stuff and a superior status, the parts of the pie that care about tending to your relationships, or finding meaning, or making the world better have to shrink, to make way.

“When are people materialistic?”

In other words, the advertisements led them to choose an inferior human connection over a superior human connection

When they talk among themselves, advertising people have been admitting since the 1920s that their job is to make people feel inadequate—and then offer their product as the solution to the sense of inadequacy they have created. Ads are the ultimate frenemy—they’re always saying: Oh babe, I want you to look/smell/feel great; it makes me so sad that that at the moment you’re ugly/stinking/miserable; here’s this thing that will make you into the person you and I really want you to be. Oh, did I mention you have to pay a few bucks? I just want you to be the person you deserve to be. Isn’t that worth a few dollars? You’re worth it.

If you peeked through their window, you’d think they have everything you need for happiness—each other, two kids, a good home, all the consumer goods we’re told to buy. Both of them work really hard at jobs they have little interest in, so that they can earn money, and with the money they earn, they buy the things that we have learned from television will make us happy—clothes and cars, gadgets and status symbols.

This couple has no vocabulary to understand why they feel so bad. They are doing what the culture has been priming them to do since we were infants—they are working hard and buying the right things, the expensive things. They are every advertising slogan made flesh.

“Never,” he says right away. “People ask me that: “Don’t you miss this? Don’t you wish you had that?” No, I don’t, because [I am] never exposed to the messages telling me that I should want it … I don’t expose myself to those things, so—no, I don’t have that.”

When I yelled after him “Go to Florida!” I was yelling into a hurricane of messages, and a whole value system, that is saying the exact opposite.

Why do so many people who experience violence in childhood feel the same way? Why does it lead many of them to self-destructive behavior, like obesity, or hardcore addiction, or suicide? I have spent a lot of time

thinking about this. When you’re a child, you have very little power to change your environment. You can’t move away, or force somebody to stop hurting you. So you have two choices. You can admit to yourself that you are powerless—that at any moment, you could be badly hurt, and there’s simply nothing you can do about it. Or you can tell yourself it’s your fault. If you do that, you actually gain some power—at least in your own mind. If it’s your fault, then there’s something you can do that might make it different. You aren’t a pinball being smacked around a pinball machine. You’re the person controlling the machine. You have your hands on the dangerous levers. In this way, just like obesity protected those women from the men they feared would rape them, blaming yourself for your childhood traumas protects you from seeing how vulnerable you were and are. You can become the powerful one. If it’s your fault, it’s under your control.

This became a quite personal question for her when she was writing up some of her research at an Oxford college. Shut inside all day, trying to work, she found herself depressed for the first time in her life. She couldn’t sleep, couldn’t bring her mind to focus on how to get out of her terrible sense of pain. She took antidepressants, but like most people who take them, she was still depressed. She started to ask herself: Could her own depression be linked to the depression she’d seen in the caged bonobos? What if, she wondered, humans become more depressed when we are deprived of access to the kind of landscape we evolved in, too? Was that why she felt so bad?

Their improvement was five times9 greater than the improvement for other people.