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

by Johann Hari

The message my doctors gave me—that our pain is simply a result of a malfunctioning brain—makes us, she told me, “disconnected from ourselves, which leads to disconnection from others.”

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.

To end loneliness, you need other people—plus something else. 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. You have to be in it together—and “it” can be anything that you both think has meaning and value. When you’re in Times Square on your first afternoon in New York, you’re not alone, but you feel lonely because nobody there cares about you, and you don’t care about them. You aren’t sharing your joy or your distress. You’re nothing to the people around you, and they’re nothing to you. And when you are a patient in a hospital bed, you’re not alone—but the help flows only one way. The nurse is there to help you, but you aren’t there to help the nurse—and if you try, you’ll be told to stop. A one-way relationship can’t cure loneliness. Only two-way (or more) relationships can do that. 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 you have lots of people around you—perhaps even a husband or wife, or a family, or a busy workplace—but you don’t share anything that matters with them, then you’ll still be lonely. To end loneliness, you need to have a sense of “mutual aid and protection,” John figured out, with at least one other person, and ideally many more.

When I was in my late twenties, I got really fat. It was partly a side effect of antidepressants, and partly a side effect of fried chicken.

One Christmas Eve, I went to my local branch of Kentucky Fried Chicken, and one of the staff behind the counter saw me approaching and beamed. “Johann!” he said. “We have something for you!” The other staff turned and looked at me expectantly. From somewhere behind the grill and the grizzle, he took out a Christmas card. I was forced, by their expectant smiles, to open it in front of them. “To our best customer,” it said, next to personal messages from every member of the staff. I never ate at KFC again.

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. But that comes at a cost. If you were responsible for being hurt, then at some level, you have to think you deserved it. A person who thinks they deserved to be injured as a child isn’t going to think they deserve much as an adult, either. This is no way to live. But it’s a misfiring of the thing that made it possible for you to survive at an earlier point in your life.

To understand why we feel better in landscapes like this, she said, you have to start with something really basic: “The thing is that we are animals. We keep forgetting that,” and as animals—she indicated toward her body—“this thing is made to move.” When we look for solutions to our bad feelings, she says, we try to find it in language, and in the symbols we have created as a species. But these symbols are—in the long sweep of things—very recent. “We have been vertebrate for nearly five hundred million years now. We’ve been mammals for two hundred fifty, three hundred million years. We’ve been primates for sixty-five [million years].” All those years she spent in the Congolese rain forest, living and sleeping and eating with the bonobos, she explained, she was being educated in how close we are to them. “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.”

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

Rufus tells his patients when they come to him feeling deeply depressed or anxious: You’re not crazy to feel so distressed. You’re not broken. You’re not defective. He sometimes quotes the Eastern philosopher Jiddu Krishnamurti,26 who explained: “It is no measure of health to be well-adjusted to a sick society.”

Another of the protesters, Sandy, told me the protests showed how weird it is—the idea that we should all sit apart from one another, pursuing our own little story, watching our own little TV, and ignoring everyone around us. “It’s normal,” he said, “that you care.”

“The more you think happiness is a social thing, the better off you are,”

When I discussed some of the ideas I was putting forward in this book, one person I know said I’d just been taking the wrong pill—you should, he said, try Xanax instead. I was tempted. But then I realized—how can we say the solution to all the understandable pain and distress I’ve been describing is to take a tranquilizer, and for millions more people to take it, forever? Yet if I’m honest, that’s the kind of solution I craved. Something individual; something you can do alone, without any effort; something that takes twenty seconds to swallow every morning, so you can get on with life as it was before. If it couldn’t be chemical, I wanted some other trick, some switch I could flip to make it all fine. What this evidence was telling me was that this search for quick individual solutions is a trap. In fact, this search for individual solutions is part of what got us into this problem in the first place. We have become imprisoned inside our own egos, walled off where true connection cannot reach us. I started to think of one of the most banal, obvious clichés we have: Be you. Be yourself. We say it to one another all the time. We share memes about it. We say it to encourage people when they are lost, or down. Even our shampoo bottles tell us—because you’re worth it. But what I was being taught is—if you want to stop being depressed, don’t be you. Don’t be yourself.3 Don’t fixate on how you’re worth it. It’s thinking about you, you, you that’s helped to make you feel so lousy....

After I learned this, I made a conscious decision to do something differently. Until I learned this, when I felt depression and anxiety start to set in, I felt a panicked need to keep my head above water—so I would try to do something for myself. I would buy something, or watch a film I like, or read a book I like, or talk to a friend about my distress. It was an attempt to treat the isolated self, and it didn’t work very often. In fact, these acts were often the start of a deeper slide. But once I knew about Brett’s research, I saw the error I had been making. Now, when I feel myself starting to slide down, I don’t do something for myself—I try to do something for someone else. I go to see a friend and try to focus very hard on how they are feeling and making them feel better. I try to do something for my network, or my group—or even try to help strangers who look distressed. I learned something I wouldn’t have thought was possible at the start. Even if you are in pain, you can almost always make someone else feel a little bit better. Or I would try to channel it into more overt political actions, to make the society better. When I applied this technique, I realized that it often—though not always—stopped the slide downward. It worked much more effectively than trying to build myself up alone.

He says he has learned, especially with depression and anxiety, to shift from asking “What’s the matter with you?” to “What matters to you?” If you want to find a solution, you need to listen to what’s missing in the depressed or anxious person’s life—and help them to find a way to resolving this, the underlying problem.

When we’re born, as babies, we have no sense of who we are. If you watch a newborn, before long, she’ll hit herself in the face, because she doesn’t know the boundaries of her own body yet. As she grows, she’ll develop a sense of who she is. She’ll build up boundaries. A lot of that is healthy, and necessary. You need some boundaries to protect yourself. But some parts of what we build up over time have a mixed effect. Mark built up walls, as an isolated ten-year-old, to defend himself against the grief for his father that he couldn’t voice to anyone. But as he grew older, those protective walls became a prison, preventing him from living fully. Our ego, our sense of self, always has both these qualities—protective, and imprisoning.

But what both deep meditation and psychedelic experiences teach us is the ability to see how much of that self—that ego—is constructed. Mark could suddenly see that his social anxiety had been a way of protecting himself—but he didn’t need it any more. My friend Rachel could see that her envy was a way of protecting herself from sadness—and meditation enabled her to see she didn’t have to be that way: she could protect herself with positivity and love instead.

“Depression is a kind of constricted consciousness,” Bill Richards, who also led the experiments at Johns Hopkins, told me. “You could say people have forgotten who they are, what they’re capable of, have gotten stuck … Many depressed people can only see their pains, and their hurts, and their resentments, and their failures. They can’t see the blue sky and the yellow leaves, you know?” This process of opening consciousness up again can disrupt that—and so it disrupts depression. It takes down the walls of your ego and opens you to connecting with what matters.

The goal in the long term isn’t, Bill told me, to annihilate the ego, but to return us to a healthy relationship with our egos. For that, people have to feel secure enough to let down their deepest walls for a time, in a safe space, with people they trust.