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

The US suicide rate has risen nearly 30 percent since 1999. The rate in 2017 was the highest it has been in at least 50 years. Why are more Americans suffering from depression?Johan Hari interviewed prominent researchers in the field to find the answer. An award-winning journalist and best selling author, Hari suffered from depression, which ran in his family. He took antidepressants in progressively stronger doses, but inevitably the sadness returned.Hari noticed a tremendous increase in the American use of antidepressants over several decades. Today about one in four middle-aged women in the United States is taking antidepressants. His book explains why are so many more people apparently feeling depressed and severely anxious. Something changed. Hari came to understood that depression is not caused by a defective brain. Instead, anxiety and depression are reactions to how we are living.What are environmental factors causing anxiety? In a word, the cause is disconnection -- from meaningful work, from other people, from meaningful values, from nature, from a secure future.Gallup finds that 87 percent of workers are either not engaged or are actively disengaged from their jobs. Nearly twice as many people hate their jobs as love their jobs. Depression among British civil servants correlates with their rank, with higher ranked bureaucrats suffering less depression than those lower on the totem pole. The degree of control a worker has over his job is the key factor, even among workers with the same ranking."More people say they feel lonely than ever before," and research shows that loneliness leads to depression. In most cases in one five-year study, loneliness preceded depressive symptoms.Humans evolved in tribes, and being part of a tribe was necessary for survival. "Loneliness isn’t just some inevitable human sadness, like death. It’s a product of the way we live now." Highly social groups such as the Amish and the Hutterites have very low rates of loneliness.In his book Bowling Alone, Robert Putnam of Harvard meticulously documented the sharp decline in community involvement in the US since the 1960s. Putnam also found we do fewer activities with our families, such as eating meals or watching tv together.Americans have been polled for decades about how many close friends they have; at one time the answer was three, but today the most common answer is none. In short, there has been an unprecedented social crash, which prevents us from fulfilling our desire for belonging.Cyberspace connection doesn't fill the void. The inordinate amount of time young people spend on smartphones further reduces the time they spend in face-to-face interaction."Online connection is a pale imitation of face-to-face connection that we social animals crave. The difference between being online and being physically among people is a bit like the difference between pornography and sex: it addresses a basic itch, but it’s never satisfying. Social media can’t compensate us psychologically for what we have lost—social life."Another cause of depression is the loss of status and respect. Among baboons, the lowest ranking members of the troop have the highest levels of stress hormones, although having an insecure status was the one thing even more distressing than having a low status. In other words, stress is highest when status is low or is threatened. Depressed humans have the same stress hormone found in low-ranking male baboons. Human depression and anxiety are responses to the constant status anxiety many of us live with today.Research by Wilkinson and Picket finds that the more unequal the society, the more prevalent all forms of mental illness are. The higher the inequality, the higher the depression, which strongly suggests that something about inequality seems to be driving up depression and anxiety. This doesn’t affect only people at the bottom; in a highly unequal society, everyone has to think about their status a lot, and whether they are in danger of falling into lower status.What role do genes play in depression? The best research on identical twins reveals that 37 percent of depression is inherited, while for severe anxiety, it is between 30 and 40 percent. "So genes increase your sensitivity, sometimes significantly, but they aren’t—in themselves—the cause. Experts agree that depression caused solely by internal brain malfunction is rare or nonexistent, with the exception of bipolar or manic depressive disorders where genes play a bigger role.If Hari is right that depression is not a brain disease, then pills are not the appropriate treatment for most people. So what is? Hari says treatment would change if doctors called depression disconnection. "If disconnection is the main driver of our depression and anxiety, we need to find ways to reconnect." The Amish have low rates of depression because they have a dense community network that provides a profound sense of belonging and meaning.Alienated workers need to become reconnected to meaningful work. They need to overcome the feelings of being controlled and having no say and little status. An alternative to the corporation is the democratic cooperative, which better engages partner/workers than the hierarchical corporate structure. Partners are happier, less anxious, and less depressed than they had been working in the kind of top-down organizations that dominate our society. People are less anxious where they feel they have some control and input, as opposed to just being given orders.Finally, he would address anxiety related to low income by having government provide a guaranteed basic income. Studies of this policy show recipients have less stress, a reduced sense of financial insecurity, fewer doctor visits for anxiety and depression, and more time with their kids.Lost Connections reads like a series of stories rather than an academic journal. Hari's interviews with researchers and formerly depressed people make the book more interesting and readable. Some of his contentions are debatable, but he certainly persuades readers to rethink what we know about depression. ###

Like many who will consider reading this book I have suffered from bouts of extreme clinical depression for a long time, despite a life that has been, by any standard measure, filled with success, recognition, and good fortune. And I know, like most who suffer from depression do, that 1. the pain is very real, and 2. career recognition, material success, and a comfortable life have little to do with the ultimate quality of life.Three decades ago I was finally forced to seek help. And I mean forced. I was that guy in the corner office of a large organization, I owned an impressive amount of stuff, traveled the world, and split my holidays between Aspen and the Caribbean. And I couldn’t get out of bed in the morning. There was no reason to. And if I hadn’t addressed it, I’d probably still be there.I, too, was treated with SSRIs and they worked remarkably well. And I could not have cared less if that was a function of the placebo effect or the drugs were addressing some chemical imbalance in my brain. I still don’t, to be honest.I do, however, care about continuous improvement in my overall health and well-being. View the beautiful valley before you from atop the mountain and you’ll seek a more magnificent mountain. I have little fear of falling back to where I was because I ultimately went through extensive psychotherapy with a brilliant and insightful doctor and he taught me how to fish, or climb, as it were.Johann Hari has provided a delightful refresher course, although that understates the contribution of this book. He has also reframed the discussion in a way that only a fellow traveler and gifted writer could. He has made both the problems and the solutions very accessible and in so doing has broadened both the audience and the quality of the dialogue.Which is why, I think, this is a book not for the depressed and anxious, but for all of humanity. Depression is often defined as a very specific manifestation of issues each and every one of us faces at some time in our lives. That doesn’t mean that different manifestations are any less painful or debilitating. Addiction is just one example. Are you drinking too much because you’re addicted or depressed? It doesn’t matter.That’s not to suggest that the source of all pain is universal. That, I think, would be naïve. We are quite literally defined by our experiences and once you’ve been around for a couple of decades or more you are experientially unique.Mark Twain once quipped, “History does not repeat itself but it often rhymes.” And so it is with mental and physical well-being. We’re more alike with each other and with the baboons of the savanna than we are different.I won’t give away the details of the book because you need to experience the context within which the author unveils the problems and their solutions. Let’s just say that the title is appropriate. It’s all about connections.I have given a great deal of thought, and now have the time to do so, as to how to re-establish the connections that have been lost in our current world. As Johann so clearly established, it is the loss at the heart of our growing collective angst and disillusionment. I have been particularly interested, in light of my executive career, with re-establishing purpose and connection in the workplace. When I began my career we never talked about work/life balance, not because we didn’t work hard or our lives outside of work weren’t important, but because our careers were an integral part of our life. We achieved connection, purpose, identity, and status there, no matter what job title you held.But that is all gone today and I have met few, even in the C-suites of corporate America, who honestly claim to get any real fulfillment from their work. And that is a function of lost connection. That loss, however, has resulted in an even bigger loss - the loss of trust that connection enables. There is no trust in the world most of us live and work in today. And by trust I don’t mean the trust to set a pile of money on the table and leave the room. I mean the trust to know that the people you work with have compassion, humility, and optimism; are competent in what they do; and have some sense of how they and we, as human beings and as a work unit, fit into the world.I read a lot of books. And this is one of the best I’ve read in a long time. Johann never says so, but he is a fellow Pyrrhonist, I suspect. That, by the way, is the ultimate compliment – it’s where trust comes from. You can’t trust a person who hasn’t challenged himself or herself. And he clearly has.This is a book you should read. Perhaps more importantly, this is a book your adolescent children should read. (I feel the same way about psychotherapy, actually. It should be mandatory when you turn sixteen.)Thank you, Johann Hari.

This book did at least relieve my depression momentarily by replacing it with feeling of intense irritation, turning into anger the more I read. What a long winded and patronising piece of plagiarism which adds nothing to the field.The writing style caused the initial irritation. It’s like a TED talk extended to 10 hours. Endless formulaic personal stories that take a chapter to make a single point better suited to a sentence. And oh-so patronising, written in that dumbed down journalistic way that I find intensely insulting.As I read more, it was the fraudulent self-congratulatory content that caused my increasing anger. That the author has the gall to claim he discovered 9 causes of depression (which are a rehash of bog standard theory known for decades) suggests his delusion and narcissism are much bigger issues than his depression. It’s no wonder then that he is a proven plagiarist. The real disgrace is the number of celebrity endorsements.On a personal note, I disagree with his conclusions about blaming ‘society’. Take individual accountability and stop playing the victim.My advice? Read the chapter headings on the free kindle sample as they tell you his whole message. Then look up the Human Givens approach which summarised this much better 20 years ago. And watch any Jordan Peterson YouTube clip on depression as it gives you far greater depth in 5 minutes from a trained clinical psychologist not a disgraced leftie hack.

I've often wondered about depression. It seems to take so many forms, from people who are miserable because of their life situation, to those suffering the most excruciating grief over the loss of a loved one. How could it be that one 'illness' could show the same symptoms despite the massive variety of possible causes? How could all of this be because of a chemical imbalance in the brain? If I feel sad, does it mean that the same thing is going wrong with my brain as is happening to the brain of a woman who miscarries? It doesn't make sense.In 'Lost Connections' Johann Hari looks at depression from the inside. His own diagnosis of clinical depression led him to taking antidepressants for years, yet he never seemed to truly recover. As he wondered why, he began to question the assumptions that we have made in the past hundred years as to what the causes of depression are, and what depression actually is. This enlightening book is the result of his research, and as a lay reader on the topic I found it fascinating. His conclusions can be summed up rather simply: how is it possible to live happily in a world designed to make us miserable? When we re-frame depression that way, we see that the drugs won't work, they'll just make it worse: reconnection, as the title implies, is the route we must follow to escape our unhappiness.There are those who have written negative reviews of this book, and I can certainly sympathise with the them - for three reasons. Firstly, Hari calls into question a lot of what we take for granted, and when you are convinced that the solution to your depression lies in finding the right drug cocktail, being told that the drugs are unlikely to work at all can feel like a slap in the face. Secondly, some readers have long been aware of the research that Hari references; nothing in the book will come as a surprise to them. To those of us who have never before read up on this issue, however, the book serves its purpose very well, summarising what we know and what we don't know about depression. And third, the writing style is not perfect; it's what I would call 'Gladwell-lite.' There are too many attempts to make of the story a real narrative, which means backtracking again and again to introduce characters the 'proper' way. Doing this once or twice would be forgivable, but the fact that it happens dozens of times every chapter means that reading the book is sometimes more of a struggle than it should be.Despite any slightly negative words that I might offer about this text, I really have no hesitation in recommending it to everyone out there who either has depression, or is wondering how they might help somebody with depression. There's useful stuff in here - perhaps not the stuff that everybody wants or will use, but if you dig around and look for what resonates, you might find a new approach to living within these pages.

The media could not be loaded.  This book takes a fresh, practical look at the causes of depression which are under our control. Hari gives a hopeful checklist - things we can change or improve in our everyday lives which have been shown to influence the likelihood of depression.Take a look at this video summary.My hesitations are:He seems to miss out some causes such as repetitive thought (and hence mindfulness practice) and, curiously, adult trauma.

This is a very powerful and important book. I heard an interview with the author on a podcast and was deeply moved by the stories he told about people around the world whose experiences offer a profound, challenging and paradigm-shifting perspective on the causes and solutions for depression and anxiety. Each chapter is beautifully written – the writing is compelling, actually – and has left me a lot to think about and implement. Depersonalising depression by talking about the societal causes for it is long overdue and for me, unbelievably helpful. People's brains aren't broken. Our pain is a messenger. The message? We badly need to reconnect. I wish everyon would read this book.

Johan Hari's has written a really interesting book here. For many of us who either suffer from depression or know people who do, these pages are extremely relevant. Hari himself has battled "the black dog" since his late teens and so this book was very personal to him. Hari's basic (and obvious) argument is that the most effective way to treat depression, and its close friend anxiety, is not with the prescriptions of never-ending doses of anti-depressants, but by addressing the underlying causes of the condition. Hari identifies what he believes to be those causes and then makes recommendations and suggestions as to how one can practically alleviate depression via lifestyle changes.In the course of researching the subject of depression and anxiety Hari has travelled many thousands of miles. From the USA and Canada to Europe and East Asia, Hari traversed the globe talking to various people, some highly qualified, in his quest for answers and ideas. Some of his conclusions will surprise you.Johann Hari is a well-known Left-wing writer in Great Britain and so it's no surprise that he attributes many of the causes of depression in the West to its capitalist lifestyle and culture.The huge wealth inequalities, selfish "junk" values and our almost constant exposure to advertising, has, according to Hari, created a society that has made us all prone to deep depression and anxiety. He believes that we have abandoned our natural social instincts and now live in cut-off small groups that are "disconnected" from the greater society. By isolating ourselves from each other we have removed the traditional support structures that human communities have enjoyed for many thousands of years. Only by reconnecting with each other can we solve this mental health problem. Hari points to groups such as the American Amish, where rates of depression are extremely low: these groups are tightly knit and its members look after each other.Personally, I don't agree with everything he's saying here. For instance the reason why some people put the acquisition of wealth above everything else isn't just because of advertising: often it's cultural. In many Asian societies, for example, wealth is revered above everything else, and so you'll hear stories of Japanese men working 80-hour weeks in the pursuit of riches just so that they can improve their social status. The fact that their neglected families are ruined doesn't seem to register with them.Where I believe that Hari is dead right is when he ascribes the causes of much depression to the way we have disconnected from each other. Most of us don't ever talk to our neighbours. In the book Hari tells the inspiring story of they way a number of disparate members of a Berlin community joined forces to fight local rent rises. During the struggle, gay, straight, Muslim, Christian, old and young all connected and found that they had more in common than they had believed. The members were uplifted and freed of the depression that had plagued their community.This is a fascinating book about a very important subject. It's well worth a read.