Book Review – Lost Connections

     Can depression be fixed with a pill?  British journalist Johann Hari proposes to “uncover the real causes of depression – and the unexpected solutions” in his 2018 book Lost Connections.  Hari describes his own experience of being prescribed antidepressants as a teenager.  Despite having spent thirteen years taking the highest possible dose of chemical antidepressants, Hari continued to be haunted by depression.  To get to the bottom of his struggle, Hari embarked on a 40,000-mile odyssey around the world to interview leading scientists and mental health researchers.  The result is his second New York Times bestselling book.

     Hari challenges the widely accepted belief that depression is fundamentally a problem in the brain. When Hari first complained about his depression, his doctor explained that he was simply suffering from a lack of serotonin and that the appropriate medication would remedy the problem and restore his sense of well-being.  Hari’s persistent experience of depression led him to question this diagnosis.  Hari’s thesis is that depression is not primarily a brain problem but is rather a life problem.  Hari has discovered seven causes of depression, stemming from our disconnection from the things that matter the most and upon which our happiness depends.  Instead of seeing depression as simply one more illness to be medicated away, Hari invites us to understand depression as the result of our fundamental needs not being met – our need for connection to others, for meaning, for a sense of purpose and hope for the future.  By improving the factors of our social environment, Hari affirms, we can overcome our depression.

     Hari’s claims about the causes of depression and some possible solutions to it may strike us as commonsensical.  Why has no one said this before?  In fact, many psychiatrists and researchers around the world have raised serious questions over the years about how the medical community goes about diagnosing and treating depression, but they have been largely ignored by the defenders of “depression orthodoxy”.  The story that the medical community has been telling us (and that has made $100 billion for Big Pharma) is that depressed people have a malfunction in their brain, which must be remedied with the appropriate medication.  Hari offers a counter-story which says that depressed people are not broken or deficient – they are rather in pain due to overwhelmingly difficult life situations.  Interestingly, the experience of grief almost always matches the clinical criteria for depression.  The American psychiatric “Bible” is the Diagnostic and Statistical Manual (DSM).  Its fifth edition affirms that it is acceptable for an individual who has just experienced the loss of a loved one to experience the symptoms of depression for a mere two weeks, following which, they can be legitimately diagnosed with a mental disorder.

     In support of his theory that the roots of depression are to be found, not in the brain, but in society, Hari quotes the World Health Organization (2011): “Mental health is produced socially: the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual, solutions”.  He also quotes the U.N.’s official statement for World Health Day in 2017: “the dominant biomedical narrative of depression is based on biased and selective use of research outcomes that cause more harm than good…and must be abandoned…We need to stop using medications to address issues which are closely related to social problems”.  Hari insists that depression is a signal – a signal that there are things wrong with your life and that you need to make positive changes so that your needs will be met.

     I heartily recommend this book.  Hari, a self-confessed atheist, claims in the final chapter that we are not suffering so much from a chemical imbalance as from a social and spiritual imbalance in how we live.  He underlines the fact that we have long been disconnecting from each other and from what matters.  We have lost faith in the idea of anything bigger or more meaningful than the individual and the accumulation of more and more stuff.  Perhaps we can create new forms of community around better stories, about depression and everything else.  Perhaps we can learn how to take care of each other, instead of having to make our way – alone – to the doctor’s office.  Perhaps our community can provide a context within which we can experience suffering in a more human way – by grieving with people who care about us rather than simply popping pills – alone – in an attempt to numb our feelings.  If you are seeking nothing less than a more meaningful life, I invite you to connect with Johann Hari’s Lost Connections.