Keenan's Book Reviews: Lost Connections by Hari Johnson

Depression and anxiety are growing problems in the West. The model of depression as a chemical imbalance in the brain is breaking down, and antidepressants are ineffective. (I’m not suggesting you should stop taking antidepressants. Even if they are not working out for you, discuss it with your physician first.) Where do we turn to find relief?

Johann Hari considers this problem in his book Lost Connections. Hari was a long-time sufferer of depression and taker of ever-increasing doses of antidepressants. He was happy with the model that depression was a chemical imbalance that was beyond his control and a pill could fix it. The problem was that a pill didn’t fix it; he was still depressed.

First, it isn’t all in your head—or even in your chemistry. Though there is a physiological, and even hereditary, aspect to depression that can make some more susceptible, depression is triggered by our experience and social environments. Depression is a symptom of problems in your life. To Hari, depression is essentially a social disease and it requires social treatments.

Though Hari does not claim to have completely uncovered the causes of depression, he outlines several that are supported by research. He describes them all as types of disconnection.

For example, many are disconnected from meaningful work. They have no sense of control over their work. There is no connection between effort and reward, and the work can be humiliating drudgery. In addition, work has become much less secure; many have no idea if they’ll have work next week or even tomorrow.

Related to this is disconnection from status. Research of primates suggests that depression is an expression of low status intended to protect apes from the abuse of their neighbors. In highly stratified cultures, like the United States, stress is higher than in cultures with more status equality. Low status people are under constant stress, and high status people experience extreme stress when their status is challenged.

Most of all, we are disconnected from other people. We are less likely than ever to belong to a church, club, civic group, professional organization, sports league or similar structure of getting together with other face-to-face, bonding over common interests and building relationships. Neighborhoods are no longer communities; they’re just clusters of homes.

Though it is more challenging than taking a pill, the solution to depression is to reconnect in those areas where we have become disconnected. It is especially important to reconnect to other people. If you want to feel better, do something to make someone else’s life better.

The difficulty is that it is hard to get better on your own. Fortunately, if you’re willing to take a step, there are things you can do. On the bigger scale, we need cultural reform that supports personal relationships, meaningful values, meaningful work, empathy, hope and time in natural settings. There is no money to be made in prescribing a community garden, a book club or a job where one is treated with respect, so the money will probably continue to pour into drugs (whether they work or not), until we demand—and start to create for ourselves—something better.