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

by Johann Hari

You need your nausea. It is a message. It will tell us what is wrong with you.

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?

We all lose some hope when we’re subjected to severe stress, or when something horrible happens to us, but if the stress or the bad events are sustained over a long period, what you get is “the generalization of hopelessness,” Tirril told me. It spreads over your whole life,15 like an oil slick, and you begin to want to give up.

The attitude of his employers, he told me, was: “You’re going to do it this way. And you’re going to show up at this time. And as long as you do that, you’re fine.” But he found himself thinking, as he put it to me, “Where’s the ability to change? Where’s the ability to grow? Where’s the ability to really make an impact on this company that I’m working for? Because anyone can just show up on time, do what they tell you to do.”

“You have to be challenged in a healthy way,” he told me, shrugging a little; I think he felt embarrassed to say it. “You have to know that your voice counts. You have to know that if you have a good idea, you can speak up, and change something.” He had never had a job like that, and he feared he never would. If you spend so many of your waking hours deadening yourself to get through the day, it’s hard—he explained—to turn that off and be engaged with the people you love when you get home.

Michael remembers a woman named Marjorie. She worked as a secretary in the typing pool, where she had to type documents all day, every day. It was “heaven,” she said, to be allowed to smoke and eat sweets at your desk, but it was “absolutely soul-destroying,” she told him, to sit there doing work that was shoveled to you and that you didn’t understand.

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.”

The worst stress for people isn’t having to bear a lot of responsibility. It is, he told me, having to endure “work [that] is monotonous, boring, soul-destroying; [where] they die a little when they come to work each day, because their work touches no part of them that is them.”

If these tax inspectors worked really hard and gave it their best, nobody noticed. And if they did a lousy job, nobody noticed, either. Despair often happens, he had learned, when there is a “lack of balance between efforts and rewards.”

I assumed, at first, when I hadn’t thought about it much, it meant just being physically alone—being deprived of contact with other people. I pictured an elderly woman who’s too frail to leave the house and who nobody comes to see. But John was discovering this wasn’t true. In his studies, it turned out that feeling lonely was different from simply being alone. Surprisingly, the sensation of loneliness didn’t have much to do with how many people you spoke to every day, or every week. Some of the people in his study who felt most lonely actually talked to lots of people every day. “There’s a relatively low correlation between the objective connections and perceived connections,” he says.

As he researched this, John discovered that there was a missing ingredient to loneliness, and to recovering from it. 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.

For thousands of years, philosophers2 had been suggesting that if you overvalue money and possessions, or if you think about life mainly in terms of how you look to other people, you will be unhappy—that the values of Pinellas County and Edgware were, in some deep sense, mistaken.

Twenty-two different studies have,10 in the years since, found that the more materialistic and extrinsically motivated you become, the more depressed you will be.

Twelve different studies found that the more materialistic and extrinsically motivated you become, the more anxious you will be.

Imagine if, when Tim was playing the piano every day, he kept thinking: Am I the best piano player in Illinois? Are people going to applaud this performance? Am I going to get paid for this? How much? Suddenly his joy would shrivel up like a salted snail. Instead of his ego dissolving, his ego would be aggravated and jabbed and poked. That is what your head starts to look like when you become more materialistic. If you are doing something not for itself but to achieve an effect, you can’t relax into the pleasure of a moment. You are constantly monitoring yourself. Your ego will shriek like an alarm you can’t shut off.

When you are extremely materialistic, Tim said to me, “you’ve always kind of got to be wondering about yourself—how are people judging you?” It forces you to “focus on other people’s opinions of you, and their praise of you—and then you’re kind of locked into having to worry what other people think about you, and if other people are going to give you those rewards that you want. 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.”

“On Friday at four, I can stay [in my office] and work more—or I can go home and play with my kids,” he told me. “I can’t do both. It’s one or the other. If my materialistic values are bigger, I’m going to stay and work. If my family values are bigger, I’m going to go home and play with my kids.” It’s not that materialistic people don’t care about their kids—but “as the materialistic values get bigger, other values are necessarily going to be crowded out,” he says, even if you tell yourself they won’t. And the pressure, in our culture, runs overwhelmingly one way—spend more; work more. We live under a system, Tim says, that constantly “distracts us from what’s really good about life.” We are being propagandized to live in a way that doesn’t meet our basic psychological needs—so we are left with a permanent, puzzling sense of dissatisfaction.

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.

This system trains us, Tim says, to feel “there’s never enough. When you’re focused on money and status and possessions, consumer society is always telling you more, more, more, more. Capitalism is always telling you more, more, more. Your boss is telling you work more, work more, work more. You internalize that and you think: Oh, I’ve got to work more, because my self depends on my status and my achievement. You internalize that. It’s a kind of form of internalized oppression.” He believes it also explains why junk values lead to such an increase in anxiety. “You’re always thinking—Are they going to reward me? Does the person love me for who I am, or for my handbag? Am I going to be able to climb the ladder of success?” he said. You are hollow, and exist only in other people’s reflections. “That’s going to be anxiety-provoking.”

When you are depressed—as Isabel knows from her own experience—you feel that “now everything is about you.” You become trapped in your own story and your own thoughts, and they rattle around in your head with a dull, bitter insistence. Becoming depressed or anxious is a process of becoming a prisoner of your ego, where no air from the outside can get in.

Faced with a natural landscape, you have a sense that you and your concerns are very small, and the world is very big—and that sensation can shrink the ego down to a manageable size. “It’s something larger than yourself,” Isabel said, looking around her. “There’s something very deeply, animally healthy in that sensation. People love it when it occurs—its brief, fleeting moments.” And this helps you see the deeper and wider ways in which you are connected to everything around you. “It’s almost like a metaphor for belonging in a grander system,” she says. “You’re always embedded in a network,” even when you don’t realize it; you are “just one more node” in this enormous tapestry.

I had noticed something else about my depression and anxiety over the years. It often made me feel, in some peculiar way, radically shortsighted. When it came, I would only be able to think about the next few hours: how long they would seem, and how painful they would be. It was as if the future vanished.

As I talked with many depressed or severely anxious people, I noticed that they often described a similar sensation. One friend told me that she always knew her depression was lifting when she felt her sense of time expanding again—she would find herself able to think about where she would be a month from then or a year from then.

At some profound level, Michael had discovered, extremely depressed people have become disconnected from a sense of the future, in a way that other really distressed people have not. From this early research, though, it was hard to tell if these kids’ symptoms were a cause or an effect. It could go either way. Maybe losing a sense of the future makes you suicidal—or maybe being extremely depressed makes it hard to think about the future. How, he wondered, could he figure this out?

It was, he concluded, the loss of the future that was driving the suicide rates up. A sense of a positive future protects you. If life is bad today, you can think—this hurts, but it won’t hurt forever. But when it is taken away, it can feel like your pain will never go away.

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.

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.

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. Don’t be you. Be us. Be we. Be part of the group. Make the group worth it. The real path to happiness, they were telling me, comes from dismantling our ego walls—from letting yourself flow into other people’s stories and letting their stories flow into yours; from pooling your identity, from realizing that you were never you—alone, heroic, sad—all along. No, don’t be you. Be connected with everyone around you. Be part of the whole. Don’t strive to be the guy addressing the crowd. Strive to be the crowd.

She could never have done it alone. It took a doctor to prescribe it—to talk her gently through its medical value, and to urge her on—for it to happen. Without it, she fears she might still be shut away in that house, guzzling Ben and Jerry’s, afraid to be seen, slowly shutting down.

An antidepressant, they have learned, isn’t just a pill. It’s anything that lifts your despair. The evidence that chemical antidepressants don’t work for most people shouldn’t make us give up on the idea of an antidepressant. But it should make us look for better antidepressants—and they may not look anything like we’ve been trained to think of them by Big Pharma.

On an individual level, a few of us might escape. If you can move to a job where you are controlled less, and have more autonomy, or are doing something you believe matters—do it. Your anxiety and depression levels will likely dip. But in a landscape where only 13 percent of people have jobs they find meaningful, that advice seems almost cruel. Most of us aren’t—in this environment, as it stands today—going to get to work that we find personally meaningful.

I remembered what I had learned from Michael Marmot, the social scientist who carried out the research into British civil servants that showed the ways in which our work can make us sick, physically or mentally. 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. And it’s the feeling of being low on the hierarchy—of being a low-status person who doesn’t matter compared to the Big Man in the corner office.

But there is a large amount of evidence—as I discussed before8—that feeling controlled and ordered around at work, and feeling you’re at the bottom of a hierarchy, makes you more depressed, and more anxious. It

I kept getting signals that the way to be happy is simple. Buy stuff. Show it off. Display your status. Acquire things. These impulses called to me, from every advertisement, and from so many social interactions. I had learned from Tim Kasser that these are junk values—a trap that leads only to greater anxiety and depression.

Advertising is only the PR team for an economic system that operates by making us feel inadequate and telling us the solution is to constantly spend. My hunch is that, if we start to really talk about how this will affect our emotional health, we will begin to see the need for more radical changes.

We end up on a seesaw of feeling envy and then trying to make others envious. “It’s like we’ve learned so well from the advertisers over the years, we’re marketing experts ourselves, and 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, “not trying to get other people to buy anything other than the idea that we’re awesome and worthy of envy ourselves. You know?”

But the long-term meditators had plenty of words, because to them, the drug seemed to be bringing them, they said, to “the same place” that really deep meditation, at its highest peaks, could sometimes reach. “By and large,” Fred told me, “they’re saying that these places are, if not similar, identical.” So they asked: What do both these practices do? What do they have in common? As we sat over dinner in a Thai restaurant, Fred gave me an explanation that stopped me in my tracks. They both, he said, break our “addiction to ourselves.” 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.

It also helps us to understand why the small early trial at University College London seems to have shown such remarkable results with severely depressed people. “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. And “in spite of the fact that the [drug] experience fades,” Roland told me, “the memory of that experience endures,” and it can become a new guide through life.

circumstances. When you see a person under the influence of psychedelics, you see why we need an ego. Their ego is switched off—and they are literally defenseless; you wouldn’t leave them alone to walk down the street. Our egos protect us. They guard us. They are necessary. But when they grow too big, they cut us off from the possibility of connection. Taking them down, then, isn’t something to be done casually. To people who feel safe only behind walls, dismantling their walls won’t feel like a jail break; it will feel like an invasion. I wasn’t ready, in that natural landscape, on that day, to let down the ego walls that I felt I needed. That’s why none of the people I spoke with thought it was a good idea for depressed or anxious people to just go and get some psychedelics and take these drugs, unprepared and unsupported. They’re powerful. Bill Richards told me it’s like downhill skiing: doing it without guidance is foolish. What they think people might want to do is fight to change the current laws so these drugs can be administered medically, in the right circumstances, to people who could benefit. 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.

Every single person reading this is the beneficiary of big civilizing social changes that seemed impossible when somebody first proposed them. Are you a woman? My grandmothers weren’t even allowed to have their own bank accounts until they were in their forties, by law. Are you a worker? The weekend was mocked as a utopian idea when labor unions first began to fight for it. Are you black, or Asian, or disabled? You don’t need me to fill in this list.

The response to a huge crisis isn’t to go home and weep. It’s to go big. It’s to demand something that seems impossible—and not rest until you’ve achieved it.

You aren’t a machine with broken parts. You are an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you’ve been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated.

You are not suffering from a chemical imbalance in your brain. You are suffering from a social and spiritual imbalance in how we live. Much more than you’ve been told up to now, it’s not serotonin; it’s society. It’s not your brain; it’s your pain. Your biology can make your distress worse, for sure. But it’s not the cause. It’s not the driver. It’s not the place to look for the main explanation, or the main solution.

In a world that thinks there’s no such thing as society, the idea that our depression and anxiety have social causes will seem incomprehensible. It’s like talking in ancient Aramaic to a twenty-first-century kid. Big Pharma was offering the solution that an isolated, materialistic culture thought it needed—one you can buy. We had lost the ability to understand that there are some problems that can’t be solved by shopping. But it turns out we are all still living in a society, even if we pretend we aren’t. The longing for connection never goes away. So instead of seeing your depression and anxiety as a form of madness, I would tell my younger self—you need to see the sanity in this sadness. You need to see that it makes sense. Of course it is excruciating. I will always dread that pain returning, every day of my life. But that doesn’t mean the pain is insane, or irrational. If you touch your hand to a burning stove, that, too, will be agony, and you will snatch your hand away as quickly as possible. That’s a sane response. If you kept your hand on the stove, it would burn5 and burn until it was destroyed. Depression and anxiety might, in one way, be the sanest reaction you have.6 It’s a signal, saying—you shouldn’t have to live this way, and if you aren’t helped to find a better path, you will be missing out on so much that is best about being human.

Once you understand that depression is to a significant degree a collective problem caused by something that’s gone wrong in our culture, it becomes obvious that the solutions have to be—to a significant degree—collective, too. We have to change the culture so that more people are freed up to change their lives. Up to now, we have put the onus for solving depression and anxiety solely on depressed and anxious individuals. We lecture or cajole them by saying they have to do better (or swallow the pills). But if the problem doesn’t originate with them alone, it can’t be solved by them alone. As a group, together, we have to change our culture—to strip out the causes of depression and anxiety that are causing such deep unhappiness. This, then, is the main thing I would want to tell my younger self. You’re not going to be able to deal with this problem alone. It’s not a flaw in you. The hunger for this change is out there all around you, waiting just beneath the surface. Look at the people opposite you on the subway as you read this. Many of them are depressed and anxious. Many more are unnecessarily unhappy, feeling lost in the world we have made. If you stay broken up and isolated, you will likely stay depressed and anxious. But if you band together, you can change your environment.

We need to stop trying to muffle or silence or pathologize that pain. Instead, we need to listen to it, and honor it. It is only when we listen to our pain that we can follow it back to its source—and only there, when we can see its true causes, can we begin to overcome it.