“Lost Connections – Uncovering the Real Causes of Depression – and the Unexpected Solutions,” by Johann Hari, 2018
You know the feeling you get when you read something you already knew, but it confirms in detail what you’ve always known? This is the kind of book this is, at least if you are suspicious of the capitalist pharmaceutical industry and bourgeois psychology. Hari is a person who suffered from depression for years, then became a journalist and ultimately looked into the mystery of why his anti-depression drugs didn’t work. Hari was a somewhat naïve, internal and apolitical person until he went on this journey. This is his answer, based on many miles of travel, interviews, research citations, depression stories and his own experience.
At its heart, the book is pretty simple. Drugs don’t work because the overwhelming cause of depression is not in a lack of serotonin or dopamine, which is the myth the population has been fed by academe, the government, but primarily by the industry itself. Nor are the drugs people are prescribed by doctors – Paxil, Prozac, Xanax, Zoloft, Effexor, Duronin and Celexa – even able to increase these biochemicals. The whole approach is basically a profitable charade, though it might result in temporary improvements, as these are powerful drugs. Tests indicate that about 1.2% of patients improve with these drugs. They are only for short-time use, though they are prescribed for years sometimes. 1 in five adults and 1 in four women is taking an anti-depressant in the U.S. while 1 in 10 boys in high school are on drugs to ‘increase their attention.’
Hari identifies the real sources of depression and anxiety in 9 separate effects generated by the present social structure. He tiptoes around the topics of capitalism, neo-liberalism, profiteering or Marx’s concepts of alienation and commodity fetishism, but they are there between the lines. He discusses ‘affluenza’ without naming it that. Then he proposes real ‘prescriptions’ unlike anything most conventional doctors are even trained to prescribe.
These are some of the issues Hari dug up:
- Depression and anxiety are two parts of the same thing.
- Unhappiness and depression; worry and anxiety are all on a continuum.
- Placebos work for awhile, which indicates the link between mind and body.
- Emotional stress creates physical sickness.
- No one knows how anti-depressants actually work.
- Most tests are funded by pharmaceutical companies, which ignore negative or neutral results. Sometimes they outright lie. It only takes 2 tests showing positive results for the FDA to allow a drug.
- U.S. drug regulator's salaries are 40% paid by drug companies. In the U.K. it is 100%.(!)
- The ‘grief exception’ was gotten rid of in the last 2015 Diagnostic and Statistical Manual (DSM) to keep the ideology of ‘chemical imbalances’ in the brain consistent. Previously, if someone close to you died, and you got depressed, the DSM did not recommend drugs. That is no more. You are now ‘sick’ if you grieve.
- Neither Freudianism nor purely biologic pill approaches work. There is a third approach, which Hari identifies as consisting of ‘social prescriptions.’ It is because depression and anxiety are caused by life experience and can be reversed.
- The psychology professions conventional view of the two types of depression: ‘reactive depression’ (sources outside the person) and ‘endogenous depression (internal to the person) are meaningless. All types of depression – psychological, social and biological – are linked.
Hari, after looking at many psychology studies, identifies 9 long term environmental stressors which lead to depression and anxiety:
A. Lack of control over your job or meaningful work.
B. Lack of real connections with other people, i.e. loneliness.
B. Lack of real connections with other people, i.e. loneliness.
C. Lack of meaningful values – instead valuing money and buying things, which is the standard definition of materialism.
E. Lack of respect or real status in a community, the result of increased inequality.
F. Disconnection from nature.
G. A lack of a future, i.e. the future is dystopian or consists of only living day to day with no good prospects.
H. Brain ‘plasticity’ – i.e. the brain changes in real time to adapt to whatever stressors, impacts or tasks are set before it. Brains are impacted by depression or anxiety, but can also change back.
I. Genes lead to an increased sensitivity to depression or anxiety, but genes are not determinant.
A cursory look at this list shows that the present form of capitalism is the prime cause of depression. Hari doesn’t call it that, but he identifies its various aspects. A. His statistics show the overwhelming majority of people – 87% - either hate their jobs or just work for a paycheck. Most blue, pink and white collar workers are basically minions, with little to no control over their jobs. B. The second item indicates that capitalist individualism has run rampant, destroying the human social groupings that used to exist in society. Hari thinks the concern with the egoistic 'me' is a dead-end. Facebook is no substitute unless it leads to face-to-face interactions on a continuous basis. C. Capitalist advertising tells us we won’t be happy without buying some new crap. Tests reveal that the more materialist people are, the unhappier they are. D. Childhood traumas – sexual or physical abuse; constant parent negativity or verbal abuse – play a role. Families under financial or social stress, or with twisted ideas promoted by the more backward parts of society, break down and much of it lands on the children. E. Inequality in all neo-liberal societies has only gotten worse, so most people have been pushed into a subservient position and this affects their emotions. In studies of various countries, there is a direct connection between social inequality and increases in depression. The growth of the precariat is a prime example. As one person said, “I don’t need a social worker, I need a social worker’s wage!” F. As the natural world is being destroyed, and more people are pushed into cities or into rooms in cities staring at screens, the long-time human connection with nature is being severed. Under capital, nature is merely a commodity, to be used up for ‘free.’ G. It is no accident that dystopian films or fiction, not just environmental or economic realities, give us a negative vision of the coming ‘future.’ The world seems to be headed into an impasse. H. &I. As to genes and the brain’s chemicals, according to Hari’s studies, they are not determinants. This is not the line of the drug companies however.
The profiteers who run the drug companies do not want this kind of ‘diagnosis,’ of course. Most drug companies are criminal enterprises that should be nationalized and put under workers control, but this government protects and coddles them. These greater issues Hari does not comprehend. From this list, Hari has left out traumas like war or rape, major accidents or disasters like hurricanes, fires, droughts or floods. The increase of these is related to global warming. So ‘childhood’ trauma should really be refined as general ‘trauma.’ People over-medicate with bad food, dangerous drugs, excessive alcohol, obsessive sex, internet/game addictions or ‘retail therapy,’ which all have their own consequences. Even the explosion in pet ownership is part of this. They are attempts to reconnect or to temporarily dull pain. Hari does point out that a good number of overweight women eat to protect themselves from the attentions of men, as they have been raped in the past.
Hari’s prescriptions are social solutions, and while he is afraid to use the word ‘socialism’ they seem to lean in that direction:
- His suggestion about lack of control or meaningful work is to form worker-owned cooperatives.
- His suggestion for reconnecting with people is joining decent groups and staying with them, not pretending your life is purely individual. Family is not enough. What is needed is a wider connection with society, your neighbors, your co-workers, your co-thinkers, which means Margerat Thatcher was wrong. "Society" is the key.
- His suggestion to defeat pure materialism is to try to buy less in this commodity-based society.
- His prescription for avoiding trauma is to reduce stresses throughout the society. Hari recognizes that humans have to work, but suggests a Universal Basic Income to reduce the stress of economic inequality. (He thinks it will be instituted without taking away other benefits…)
- He recommends gardening and spending lots of time in nature as a way to break from the pressures of urban environments. The massive concentration of people in large cities, which is the natural process of capital, has exacerbated this problem.
- Of course, dealing with the lack of a future means a whole change in society, not the endless ‘now.’ His example, indigenous Crow elders whose memories stopped when they were imprisoned on reservations, was key. Native communities that are reclaiming their languages, traditions, economies and work are the ones that have reduced the suicide rates the most.
Hari mentions meditation and other methods as non-drug alternatives, though these seem to be lowest on his list. He also mentions LSD and psilocybin therapies for people with more serious situations. All of these psychological, environmental and social changes can change the brain.
Hari’s book has been praised by all the usual left-liberal suspects, even right-centrists like Hillary Clinton. I am of the opinion that most of them do this only because they do not know where this analysis leads. It undermines the whole psychology profession, drug industry and medical establishment regarding the issues of depression and anxiety, but goes beyond that. As such, I am only waiting for him to be accused of being a very tricky and sophisticated Russian agent.
Relevant books reviewed below, use blog search box, upper left: The Precariat; Capital in the 21st Century; Four Arguments for the Elimination of Television; Salt, Fat, Sugar; The Truth About Drug Companies; Missoula; Propaganda.
And I bought it at May Day Books!
April Fools Day – You might be a fool to think Christ actually ‘rose’ today.