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

by Johann Hari

neuroplasticity.

Imagine you are subjected to some of the seven causes of depression or anxiety I have been discussing up to now.

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.

The pain caused by life going wrong can trigger a response that is “so powerful that [the brain] tends to stay there [in a pained response] for a while, until something pushes it out of that corner, into a more flexible place.”

trap them.

riffing on JFK: “Ask not what’s inside your head,”9 he said. “Ask what your head’s inside of.”

You aren’t broken, we’d tell them. The culture is.

You can have everything a person could possibly need by the standards of our culture—but those standards can badly misjudge what a human actually needs in order to have a good or even a tolerable life. The culture can create a picture of what you “need” to be happy—through all the junk values I had been taught about—that doesn’t fit with what you actually need.

wanted to see it as a brain malfunction, I realized now—because I didn’t want to see what our culture was doing to him.

without control over her own life

laziness, or weakness, or self-indulgence. I have been told this various times in my life.

You wouldn’t hector a person with cancer to pull themselves together, so it’s equally cruel to do it to somebody with the disease of depression or severe anxiety.

we have been told there are only two ways of thinking about depression. Either it’s a moral failing—a sign of weakness—or it’s a brain disease. Neither has worked well in ending depression, or in ending its stigma. 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.

looking at it this way makes people less cruel, to themselves and to other people.

bio-psycho-social model.

depression and anxiety have three kinds of causes:23 biological, psychological, and social. And yet almost nobody I know who has become depressed or severely anxious was told this story by their doctor—and most were not offered help for anything except their brain chemistry.

Montreal to meet with Laurence Kirmayer, the head of the Department of Social Psychiatry at McGill University,

“Things have changed in psychiatry,”

mainstream psychiatry has become very biological.” He furrowed his brow. “It’s very problematic.” We have ended up with “a grossly oversimplified picture” of depression that he said “doesn’t look at social factors … But at a deeper level for me, it doesn’t look at basic human processes.”

it is “much more politically challenging”25 to say that so many people are feeling terrible because of how our societies now work. It fits much more with our system of “neoliberal capitalism,” he told me, to say, “Okay, we’ll get you functioning more efficiently, but please don’t start questioning … because that’s going to destabilize all sorts of things.”

“I think we’re distressed for good reasons,” Rufus said. This, I realized, was the biggest division between the old story about depression and anxiety and the new story. The old story says our distress is fundamentally irrational, caused by faulty apparatus in our head. The new story says our distress is—however painful—in fact rational, and sane.

He sometimes quotes the Eastern philosopher Jiddu Krishnamurti,

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

talked through his life and his troubles.

he was constantly stressed and in physical pain, and that was making him want to just stop living, and give up.

To them, an antidepressant wasn’t about changing your brain chemistry, an idea that seemed bizarre to their culture. It was about the community, together, empowering the depressed person to change his life.

Derek realized this was true in his own psychiatric practice, back in a leading London hospital. He thought about the people he worked with there,2 and it hit him: “When I make a difference, it’s when I’m addressing their social situation, not what’s between their ears,”

This seems strange to most of us in the Western world in the age of chemical antidepressants. We have been told depression is caused by a chemical imbalance, so the idea of a cow as an antidepressant seems almost like a joke. But here’s the thing. That Cambodian farmer did cease to be depressed when his social circumstances were changed. This wasn’t an individualistic solution—they weren’t telling him the problem was all in his head and to pull his socks up or swallow a pill. It was a collective solution. He could never have gotten that cow on his own; the solution couldn’t h...

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

if disconnection is the main driver of our depression and anxiety, we need to find ways to reconnect.

You could fill aircraft hangars with studies of what happens in the brain of a depressed person. You could fill an aircraft with the research that’s been conducted into the social causes of depression and anxiety. And you could fill a toy airplane with the research into reconnection.

seven kinds of reconnection that early evidence suggests can begin to heal depression and anxiety.

in the West, we mostly have an individualistic way of looking at life. In Asia, they mostly have a collective way of looking at life.

In the West, we have shrunk our sense of self to just our ego (or, at most, our family),

His patients were often depressed, he realized, because their lives had been stripped of the things that make life worth living.

a karaoke life1—her job was to sing along to a song sheet written by somebody else. It wasn’t a life where she would ever get to write her own song. At the age of twenty-four, she could see this stretching out before her for the next forty years.

a pervasive sense of anxiety she couldn’t quite understand. On Sunday nights, she’d feel her heart pounding in her chest,2 and a sense of dread about the week to come. Before long, she found she couldn’t sleep during the week, either. She kept waking up feeling cripplingly nervous,

for all these reasons—pretty miserable. You could bear it as a teenager, but as you got into your twenties and started to think about the future, you found there was just a big hole ahead of you.

this system—of having one guy at the top, giving orders—seemed to Josh to be quite inefficient. The guys working on the shop floor had loads of good ideas about how to make the business better. They could see things the boss couldn’t see. But it made no difference. Their thoughts were irrelevant. And that actually harmed, Josh suspected, the business itself.

cooperatives.

He had explained to me: It’s not the work itself that makes you sick. It’s three other things. It’s the feeling of being controlled—of being a meaningless cog in a system. It’s the feeling that no matter how hard you work, you’ll be treated just the same and nobody will notice—an imbalance, as he puts it, between efforts and rewards.

“I can certainly see depression and anxiety being related to the fact that people feel really, really confused and helpless … I think it’s hard for people to live in a society where you have got no control over anything … You don’t control your economic life,

this recipe for mental health could be distilled down to the three words that everyone in our culture instinctively understands: Elect Your Boss. Work wouldn’t be an ordeal that’s done to you, something to endure. It’d be a democratic tribe that you are part of, and that you control as much as anyone else.

this longing for meaningful work—to have a say over what you spend most of your life doing—is there, just below the surface, in everyone. “Happiness is really feeling like you’ve impacted another human positively. I think a lot of people want their work to be like that,”

as she began to read about envy, she realized that our culture was priming her to feel this way. She had been raised to constantly compete and compare, she said. “We’re highly individualistic,” she explained, and we’re constantly told that life is a “zero sum game. There’s only so many pieces of the pie, so if somebody else has success, or beauty, or whatever, somehow it leaves less for you.

now we just know how to curate and market our own lives, without any conscious process. We just culturally learn it.” So you display your life on Instagram and in conversations as if you are the Chief Marketing Officer of Me,

“sympathetic joy,”

Sympathetic joy is a method for cultivating “the opposite of jealousy or envy … It’s simply feeling happy for other people.”

This kind of meditation is about “setting the intention to feel different,” she told me—“almost like saying ‘I want to feel differently about you,’ and saying it enough times, until you really do.

“I’ve pursued happiness for myself my whole life, and I’m exhausted, and I don’t feel any closer to it—because where does it end? The bar just keeps getting moved.” But this different way of thinking, she said, seemed to offer a real sense of pleasure, and a path away from the depressing, anxiety-provoking thoughts she’d been plagued by.