A gay writer is making headlines with his new book on the causes of depression – and not everyone’s happy.
British journalist Johann Hari’s latest book, Lost Connections – Uncovering the Real Causes of Depression and the Unexpected Solutions, went on sale this month.
Its premise is simple: Depression is not usually caused by a chemical imbalance in the brain; people are over-relying on chemical anti-depressants; and many people’s depression is more a reaction to the way we live.
He identifies and explores key ‘lost connections’ that are driving an epidemic of depression.
These include: being trapped doing meaningless work; a lack of social connections with the community around you; prioritizing materialism as a route to happiness; and a lost connection with the natural world.
Other factors include a disconnection from status and respect (when others treat you badly), childhood trauma, and being unable to see a hopeful or secure future for yourself.
Why has this message not gone down well with some readers?
Primarily, Hari believes, because there are now more people taking anti-depressants than ever before. Some of them have not taken kindly to being challenged on their choice of treatment.
‘It’s a shame,’ Hari tells me over the phone. ‘Ninety per cent of the book is about what causes depression and anxiety and how to solve it. About 10% is about this debate about chemical anti-depressants.’
Diagnosed as having a chemical imbalance
However, it’s the chemical anti-depressant debate that much of the media coverage has concentrated on. This has colored many people’s views of the book before they’ve read it.
My own quibble with the book is not Hari’s views on the over-prescribing of anti-depressants, but that he presents his conclusions as radical or new.
For example, as a journalist in the LGBTI media, I’m only too aware our community is far more likely to suffer from depression. I never believed this was simply due to low serotonin in our brains. Did this not occur to Hari?
‘I wouldn’t have known LGBT have higher levels of depression when I was 18,’ he justifiably points out. ‘As I got older, yes.’
Hari experienced depression throughout his teenage years, leading him to seek medical help at 18. When he consulted a doctor, he was told it was due to a chemical imbalance in his brain and anti-depressants would correct this.
The message had a deep impact on him. Comforted to be told there was a straightforward solution to what he now believed was a biological problem, he took increasing doses of anti-depressants for the next 13 years.
Each increased dosage had a short-term benefit – but these included side effects such as weight gain. Hari wrote articles about extolling the benefits of anti-depressants. Ultimately, though, he found deep feelings of sadness would return.
Why don’t pills always cure depression?
‘As I got older I began to be haunted by two mysteries,’ he explains. ‘One was why was I still depressed? Because I was doing everything I was told to do, and yet I was still feeling terrible.
‘The second thing was “Why are there so many other people like me?” One in 11 British people are now taking anti-depressants.
‘So I began to think, can it really be that all these people have chemical imbalances in their brain?
‘That’s when I started to learn about LGBT mental health and think, “It’s obviously not that gay people have defective brains, right?” That can’t be what’s going on.’
Much of Lost Connections examines – through interviews with scientists and those who have experienced depression – the other factors driving people to despair.
It’s a thoroughly researched overview that takes a stand against the pharmaceutical industry’s promise of a quick fix. Its particular strength lies in Hari’s exploration of the way modern living is disconnecting us from contentment.
‘Everyone knows human beings have innate physical needs: food, water, etc,’ says Hari.
‘Deprived of them, things will go wrong quite quickly. In a similar way, you have innate psychological needs. You need to feel you belong; you need to feel your life has meaning and purpose, that you have a stable and secure future.
‘One of the reasons why we have this growing addiction and anxiety epidemic is because we live in a culture that is not meeting those psychological needs.’
Over-reliance on doctors for answers
So should we even be consulting doctors when we’re depressed?
‘I think we’ve asked too much of doctors,’ he replies, making a metaphor between mental health and car accidents
‘Doctors have a really important role in treating people who have been in car accidents,’ but, he says, they’re not society’s only response to reducing harm.
‘Air bags, speed limits, seatbelts, arresting drunk drivers … the whole of society deals with the potential of a car crash. And in a similar way, to extend the metaphor, what we’ve been doing up to now, we’ve been acting as if the only people who should be dealing with car crashes are the doctors in A&E. And actually we need a much bigger response.’
He’s keen to stress, he’s not against the use of chemical anti-depressants. In the book, he devotes a chapter to the biological causes of depression. However, his research has led him to conclude this applies to a very small minority of those who are depressed.
Reaction to Lost Connections
He says he has been largely ‘thrilled’ by the reaction to the book. Hilary Clinton describes Lost Connections ‘a wonderful and incisive analysis of the depression and alienation that are haunting American society.’ Another jacket quote from Elton John simply states ‘this amazing book will change your life.’
Not everyone has been so kind on social media.
‘I don’t follow the kind of online reaction because I just don’t think it’s good for people’s mental health to be following that stuff in real time,’ says Hari. ‘I’ve got friends who look at my Twitter feed for me.
‘My understanding is that some people have responded in a concerned way to the material about chemical antidepressants. I totally understand that. I was extremely reluctant to challenge my [own] story about chemical antidepressants.
‘But people who’ve read the book, almost none of them have talked to me about that stuff. They want to talk about the stuff that’s actually causing depression and anxiety and how we actually solve it.’
Social media vs. social life
And, as his own experiences suggest, social media isn’t helping our mental health.
‘I think the relationship between social media and social life is a bit like the relationship between porn and sex. Porn will meet a certain basic itch. I’m not against it. But after having a wank over some porn, you don’t feel held and valued and satisfied the way you do after sex when it goes well.
‘And in a similar way, you know, I’m not against Facebook, but after two hours on Facebook, you don’t feel as seen and valued the way you do if you spend two hours with your friends.’
There’s another reason why some people online have reacted negatively to the book. As demonstrated by a scathing piece on The Quietus.
Hari himself was caught up in a plagiarism controversy in 2011. In some of his published interviews, he used quotes his subjects had previously written in books or given to other interviewers. Hari did so without attributing to their original source.
He also edited, rather negatively, the Wikipedia pages of some of his critics. He lost his job with the Independent newspaper. It was a very public and humiliating fall from grace. Going by some comments online, it’s one that some people think he should continue to be punished over.
Given that his book is about mental health, how did that episode affect his own mental wellbeing?
He politely declines to answer.
‘When you fuck up, it should hurt’
‘The reason I’m not going to answer that is because, when you fuck up, it should hurt. And obviously it hurt. I don’t think, if you’ve fucked up, should sit there and say “See it from my point of view”.
‘When you fuck up you should encourage people to see it from the point of view of the people you were harmed by your fuck up, which in my case was the readers of the Independent who put a lot of trust in me, the people I worked with at the Independent, and the people I wasn’t nice about online.
‘So the reason I’m not going to talk about how it made me feel is I think that’s kind of disrespectful to them. It will inevitably will be a way of saying “See it from my point of view”.’
Since that time, Hari has meticulously credited all his sources – to the extent of posting the audio files of his many interviews for Lost Connections on the book’s website.
Hari stopped taking anti-depressants in 2011 and says he benefitted from doing so.
‘I gained two and half stone when I started taking antidepressants and lost it within six months of stopping.
‘Seventy-five per cent of men who take antidepressants have some form of sexual dysfunction: something called genital numbing. For me, it was just much harder to ejaculate.
‘It sounds like a good thing,’ he laughs, ‘but actually that can make sex painful if it goes on for ages and ages, and it just makes sex somewhat less appealing to me.
‘One of the things I realized when I stopped taking them and started having a lot more sex was, “Oh, sex is a really powerful, natural anti-depressant!”
‘I stress, I’m not against chemical anti-depressants but we do need to have a bigger, broader conversation about it.’
And what would he say to someone who feels they are benefitting from their pills?
‘I’m on their side and I give them my love and congratulations. Anything that’s working for anyone, my advice is only to continue if it’s working.’
We need to change society
He describes his own mental health now as ‘brilliant’, but acknowledges he has enjoyed privileges others don’t. He doesn’t want people to see him as the living embodiment of his book’s conclusions.
‘I think the reason people should read it is not personal anecdotes from me. I interviewed some really leading scientists about this, so that’s the first thing.
‘Secondly, I was in an unbelievably privileged position where I could change my life. I had some monies from my previous book [and] amazing people around me. I had all sorts of privileges.
‘When I think of someone very close to me who’s a struggling single mum who’s got two kids and is struggling just to pay the rent every week, it would be insulting to her for me to be like “I changed my life – you can change yours”.
‘A big part of the book is that we need to change the way the whole society works so that more people can make those kind of changes that I made.’
Lost Connections – Uncovering the Real Causes of Depression and the Unexpected Solutions by Johann Hari is out now.