Johann Hari was diagnosed with depression as a teenager, and was prescribed the antidepressant Paxil, because his doctor told him that depression was a disease of the brain, so his brain chemistry needed to be fixed. He stayed on antidepressants for 13 years, dealing with side effects like weight gain and sexual dysfunction, until his therapist gently nudged him by saying “it seems you are still really quite depressed” despite the antidepressants. Investigating that mystery of why antidepressants don’t actually seem to help with depression (despite a widespread increase in both diagnosed depression and prescribed antidepressants) led to this book, where he spent several years talking to researchers around the world and assembled this journalistic summary.
The book makes several claims:
- “the notion depression is caused by a chemical imbalance is just “an accident of history,” produced by scientists initially misreading what they were seeing, and then drug companies selling that misperception to the world to cash in.” Essentially, the initial drug trials demonstrated improvement through the placebo effect, but once companies realized how much money they could make, they marketed the perspective that fixing your brain chemistry depended on their drugs.
- The causes of depression and anxiety he identifies are all “forms of disconnection. They are all ways in which we have been cut off from something we innately need but seem to have lost along the way.” He later shares a doctor’s analysis that “If you want to find a solution, you need to listen to what’s missing in the depressed or anxious person’s life – and help them to find a way to resolving the underlying problem.” This approach matches what I remember from reading Toxic Psychiatry back in 1994.
- Our Western capitalist culture and society have led us astray in disconnecting us from meaningful work and from community, and instead created an unequal individualistic materialistic environment that is a terrible mismatch for our brains; he quotes the Eastern philosopher Jiddu Krishnamurti, who explained: “It is no measure of health to be well-adjusted to a sick society.” In other words, rather than think about depression as a moral failing or a brain disease, he suggests depression is “largely a reaction to the way we are living”.
The forms of disconnection (and the prescriptive forms of reconnection) he identifies are:
- Disconnection from Meaningful Work
- Disconnection from Other People
- Disconnection from Meaningful Values
- Disconnection from Childhood Trauma
- Disconnection from Status and Respect
- Disconnection from the Natural World
- Disconnection from a Hopeful or Secure Future
After reading Together, the Disconnection from Other People chapter really hit home, especially when he wrote “Loneliness hangs over our culture today like a thick smog.” One major reason for that is:
“When we talk about home today, we mean just our four walls and (if we’re lucky) our nuclear family. But that’s never been what home has meant to any humans before us. To them, it meant a community— a dense web of people all around us, a tribe. But that is largely gone. Our sense of home has shriveled so far and so fast it no longer meets our need for a sense of belonging. So we are homesick even when we are at home.”
It’s not just about having other people around (that’s why one can feel lonely in Times Square or on social media). It’s about the feeling that “you are sharing something with the other person, or the group, that is meaningful to both of you. You have to be in it together— and “it” can be anything that you both think has meaning and value.” This requires being vulnerable and actually sharing what is meaningful to you, and then connecting with courage and vulnerability as my new mantra puts it.
I also appreciated the Disconnection from Meaningful Values chapter, especially the idea that our culture is leading us astray by pointing us at external markers of success as the key to happiness when “Twenty-two different studies have found that the more materialistic and extrinsically motivated you become, the more depressed you will be.” These material values
“fill us with psychological toxins. Junk food is distorting our bodies. Junk values are distorting our minds. Materialism is KFC for the soul. … What you really need are connections. But what you are told you need, in our culture, is stuff and a superior status, and in the gap between those two signals — from yourself and from society — depression and anxiety will grow as your real needs go unmet.”
Companies make us feel bad about our lives through showing us unrealistic comparisons in advertising, and then brainwash us into believing our dissatisfaction will be solved by buying their products. And then other companies exploit us because we “need” to work hard to earn the money to buy things, creating a nice little reinforcing loop; we feel miserable because we’re working too hard at meaningless tasks, we buy things to make ourselves feel better, which means we have to work harder to keep getting the money to keep buying things, which makes us more miserable. The frustrating thing is that these companies are constantly distracting us from what will actually make us feel better, like real community and connection with humans, because they can’t sell those.
He also shares studies that show “the more unequal your society, the more prevalent all forms of mental illness are. Other social scientists then broke this down to look at depression specifically — and found the higher the inequality, the higher the depression. This is true if you compare different countries, and if you compare different states within the United States. It strongly suggested that something about inequality seems to be driving up depression and anxiety.” Building on the previous paragraph, the countries with the greatest inequality are also those that have let capitalism go unchecked without regulation.
Along those lines, a study that really hit home for me was one where researchers asked whether pursuing happiness helps you achieve it. In Russia and Japan and China, it did. In the United States and Britain, it didn’t. The difference?
“If you decide to pursue happiness in the United States or Britain, you pursue it for yourself — because you think that’s how it works. You do what I did most of the time: you get stuff for yourself, you rack up achievement for yourself, you build up your own ego. But if you consciously pursue happiness in Russia or Japan or China, you do something quite different. You try to make things better for your group —for the people around you. That’s what you think happiness means, so it seems obvious to you. These are fundamentally conflicting visions of what it means to become happier. And it turns out that our Western version of happiness doesn’t actually work, whereas the collectivist vision of happiness does. “The more you think happiness is a social thing, the better off you are,” Brett explained to me, summarizing her findings and reams of other social science.”
In other words, when you feel down, don’t do something for yourself. As I was once chastised by a startup CEO, “Less me, more we!”
“The real path to happiness, they were telling me, comes from dismantling our ego walls—from letting yourself flow into other people’s stories and letting their stories flow into yours; from pooling your identity, from realizing that you were never you—alone, heroic, sad—all along. No, don’t be you. Be connected with everyone around you. Be part of the whole. Don’t strive to be the guy addressing the crowd. Strive to be the crowd.”
When we see ourselves as part of a larger community, one that values connection and helping each other and treating each other with dignity and respect, and doing meaningful work together, we are happier and healthier. I loved his example of a Berlin housing project where residents came together to protest for rent stabilization, and in the process transitioned from being a set of lonely, disconnected individuals to becoming a thriving community. Tribal living is our evolutionary heritage, and that indigenous wisdom has been lost in the single-minded capitalist focus on productivity and efficiency. As Hari wonders, “What if depression is, in fact, a form of grief — for our own lives not being as they should? What if it is a form of grief for the connections we have lost, yet still need?”
Reading this book after reading Together made me want to prioritize connection as a primary focus of my time. I am reaching out to others more, I am asking for help more (acting as if I am a respected community member who can lean on others, rather than as an individual that has to solve for everything myself), and I am figuring out what I can do to help those around me re-connect to meaningful values (time to write a book!). It felt hard to find time to connect because life was so busy, and yet once I decided to make it important, it became easy. Clarity and focus yet again.