Lost connections (Johann Hari)

TL;DR version:
https://nuclearbae.tistory.com/37

This summary is brief, unstructured, and is mostly consisted of quotes from the book. The quotes are followed by page numbers in parentheses.

There’s a troubling increase in the amount of people who are on antidepressents, stimulants, and mental chemicals. ``What once seemed startling has become normal. Without talking about it much, we’ve accepted that a huge number of the people around us are so distressed that they feel they need to take a powerful chemical every day to keep themselves together’ (11)’. 

The writer has been told all his life that depression is due to his brain chemistry being `off’.

He took Selective Serotonin Reuptake Inhibitors (SSRI)  - Paxils - all his life, and believed he was getting better (7-11). However, he noticed that increasing his dose did not work anymore, and that he was still very sad. He looked into the issue, and the more he found, talking to experts, he was in denial, since they said that the whole part about depression caused by the imbalance in the brain chemistry was wrong (Part 1). But it was hard because ``once you settle into a story about your pain, you are extremely reluctant to change it. It was like a leash I had to put on my distress to keep it under control. I feared that if I messed with the story I had lived with for so long, the pain would be like an unchained animal, and would savage me.’’

In the introduction to the book, he points out two things:

One, depression and anxiety go hand in hand (12). `` Depression and anxiety are like cover versions of the same song by different bands. Depression is a cover version by a downbeat emo band, and anxiety is a cover version by a screaming heavy metal group, but the underlying sheet music is the same.’’ Tow, unhappiness and depression are totally different things.``There is nothing more infuriating to a depressed person than to be told to cheer up, or to be offered jolly little solutions as if they were merely having a bad week. It feels like being told to cheer yourself up by going out dancing after you’ve broken both your legs.’’(13)

Part1: The crack in the old story

Chapter1: The wand

This chapter tells the story of a `magic wand’, that was believed to cure all disease, that turned out to be a demonstrative story of the placebo effect. The author explains how strong the placebo effect is and how that is somewhat related to the seemingly effectiveness of the antidepressants. 

Chapter2: imbalance

There’s no evidence that a chemical imbalance in the brain causes depression. We first do not know what a chemically balanced brain looks like, and the conclusion initially was built on mistakes and errors. ``Almost everything you were told was bullshit. The serotonin theory is a lie’’ (30). The effectiveness of the antidepressants have been overstated by the drug companies, who manipulate and `select’ data to sell the drugs.

Chapter 3: The Grief Exception

The difference between grief and depression is the length. If grief prolongs for a long period, it is considered depression. ``To say that if grief lasts beyond an artificial time limit, then it is a pathology, a disease to be treated with drugs, is - she believes - to deny the core of being human’’ (41). `` We have to stop talking about mental health - which conjures images of brain scans and defective synapses - and start talking about emotional health. Why do we call it mental health? Because we want to scientize it. We want to make it sound scientific. But it’s our emotions.’’ (42) Taking antidepressants is like ``putting a band-aid on an amputated limb. When you have a person with extreme human distress, we need to stop treating the symptoms. The symptoms are a messenger of a deeper problem.’’ (43)

``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?’’ (44)

Chapter 4: The First Flag on the Moon

``Depression is the ultimate form of irrationality: that’s how it feels from the inside, and that’s how it looks to the outside. ``Clinical depression is an understandable response to adversity.’’, ``generalization of hopelessness’’. (51)

 

Part 2: Disconnections: Nine causes of Depression and Anxiety

 

Chapter 5: Picking up the Flag (An Introduction to Part Two)

Chapter 6: Cause one: Disconnection from Meaningful Work

According to a Gallup survey from 2011 to 2012, 87 percent of people `hate their jobs’. (64) ``A common symptom of depression is something called `derealization’ - which is where you feel like nothing you are doing is authentic or real. ‘’ (64)

Chapter7: Cause Two: Disconnection from Other People

``Loneliness hangs over our culture today like a thick smog. More people say they feel lonely than ever before.’’ (73) ``Feeling lonely, it turned out, caused your cortisol levels to absolutely soar - as much as some of the most disturbing things that can ever happen to you. Becoming acutely lonely, the experiment found, was as stressful as experiencing a physical attack. (74).’’ ``Loneliness is not the physical absence of other people, he said - it’s the sense that you’re not sharing anything that matters with anyone else. … To end loneliness,  you need to have a sense of `mutual aid and protection’. ‘’ (83) ``Social media can’t compensate us psychologically for what we have lost - social life. … our obsessive use of social media is an attempt to fill a hole, a great hollowing, that took place before anyone had a smartphone. It is - like much of our depression and anxiety - another symptom of our current crisis.’’ (89)

Chapter8: Cause Thress: Disconnection from Meaningful Values

``...there are two different ways you can motivate yourself to get out of bed in the morning. The first are called intrinsic motives - … things you do purely because you value them in and of themselves, not because of anything you get out of them. ...Extrinsic motives are the things you do because you’ll get something in return - whether it’s money or admiration, or sex, or superior status.’’ (95) The author draws a parallel between food and values - that a person’s value is their food for the mind. He also explains that ``we have shifted en masse from eating food to eating junk food .. materialistic values, telling us to spend our way to happiness, look like real values; they appeal to guide us through life; yet they don’t give us what we need from values - a path to satisfying life. Instead they fill us with psychological toxins. Junk food is distorting our bodies. Junk values are distorting our minds.’’ (96-97)

He also points out the role advertisements play in the role of `mass depression’. He says that ads are created to bring you down, to make it sound like you are in need of something, you actually do not need. The worst ad in the world would be an ad that says: ``you are a good person, you don’t need anymore. Enjoy life.’’ (101)

**sidenote

Reading this part, it sort of got me thinking about relationships, and how a lot of people find themselves in relationships, romantic or not, where they stick with someone that lowers their self esteem. In Korea, there is also a sort of formal terminology that denotes the `technique’ of making your partner nervous, by making it seem like you’re not fully committed. It translates poorly, but roughly translated, it means `push and pull’. I think the logic is similar to that of the advertisement companies - to create demand, by putting someone down. Like capitalism, this method works in creating demand but is toxic to the person involved, causing them to pursue something that ultimately won’t make them happy. But like buying a new lipstick one doesn’t really need, we fall prey to such strategies, because, like the book said, we are surrounded by materialistic `nudges’, and now it has become our identity.

Chapter 9: Cause Four: Disconnection from Childhood Trauma

There was an experiment to help people lose weight. Some people lost a lot of weight - but some people gained back. When asked, there was a startling amount of people who experience sexual abuse as a child, stating that them `gaining weight to 400 pounds would make them undesirable, invisible to men, thereby making me safe’. (110)

Emotional abuse as a child is highly likely to cause depression than other kind of trauma - even sexual molestation. Being treated cruelly by your parents was the biggest driver of depression, out of all these categories. (112)

``Depression isn’t a disease; depression is a normal response to abnormal life experiences. It takes you beyond the comforting, limited idea that the reason I’m depressed is I have a serotonin imbalance, or a dopamine imbalance, or what have you. .. it is not a causal explanation, it is a necessary intermediary mechanism.’’ (112)

Chapter 10: Cause Five: Disconnection from Status and Respect

``I began to wonder, if depression is, in part, a response to the sense of humiliation the modern world inflicts on many of us’’ (120) He goes on to list the examples of TV celebrities, unrealistic body images on instagram, and an intense work environment. He also explains that we have choice - we can ``find practical ways to dismantle hierarchies and create a more equal place, where everybody feels they have a measure of respect and status. Or we can build up hierarchies and ramp up the humiliation - as we are doing today.’’ (122)

`` feel we are being pushed down, almost physically, and many of us will show signs of submission. We’ll lower our heads and our bodies and silently say: Leave me alone. You beat me. I can’t take this any more.’’ (122)

Chapter 11: Cause Six: Disconnection from the Natural World

``You feel that `now everything is about you’. You become trapped in your head with a dull, bitter insistence. Becoming depressed or anxious is a process of becoming a prisoner of your ego, where no air from the outside can get in. … being out in the natural world is the precise opposite of this sensation - a feeling of awe’’ (129) The author explains that being in natural landscapes allow people to feel awe, and to realize how small they are in the world, and that the things that they are anxious about, is nothing but a miniscule drop in the grand scheme of the universe. 

Chapter 12: Cause Seven: Disconnection from a Hopeful or Secure Future

`` Extremely depressed people have become disconnected from a sense of the future, in a way that other really distressed people have not. … loss of the future was driving the suicide rates up. A sense of a positive future protects you. If life is bad today, you can think - this hurts, but it won’t hurt forever. But when it is taken away, if can feel like your pain will never go away. (138)

Chapter 13: Causes Eight and Nine: The Real Role of Genes and Brain Changes

`` The story we have been told … that we are depressed and anxious because they are simply and spontaneously low in serotonin - is not true’’. The author explains the depressed or anxious people do have abnormal brain scan results, where specific parts of their brain will light up. He also explains that there is a genetic inheritance - a sensitivity to outside stimulation, sort of, that are activated by the environment - ``The genetic factors that contribute to depression and anxiety are very real, but they also need a trigger in your environment or your psychology’’ (148)

So why do we cling to the story of the whole serotonin and brain chemistry shit? The author lists four reasons (150-152): First is that the culture is broken against you, saying that your being is not enough or good. Second is because historically depressed people were rendered lazy and weak, and thus making it a disease defended them from such accusations. `` The only route out of stigma is to explain to people that this is a biological disease with purely biological causes’’(152) But he points out a healthier way to look at depression is that it is ``largely a reaction to the way we are living’’ (153) The other two reasons are by works of the pharmaceutical companies that sell the antidepressants. They shape a lot of the discipline of psychiatry, because they have billions of dollars that fund the researchers. It is also more ``politically challenging to say that so many people are feeling terrible because of how our societies now work.’’ (154) 

``The first thing that happens when you’re told [that your depression is due to your biological malfunction] is you leave the person disempowered, feeling they’re not good enough - because their brain is not good enough. It also pitches us against parts of ourselves. There’s a war taking place in your head.’’ (154) It also ``tells you that your distress has no meaning - it’s just defective tissue. But I think we’re distressed for good reasons’’ (155) ``It’s not measure of health to be well-adjusted to a sick society’’ (155)

Part 2: Reconnection. Or, a Different Kind of Antidepressant

Chapter 14: The Cow

Chapter 15: We Build This City

The author tells a story of a Berlin neighborhood that came together to fight for their survival. They were originally so distant to one another and different, but they came together for the cause of affordable housing, and became much happier. The crux of the story was that when they were alone and isolated in their apartments, they thought that the reason why they were so depressed was solely on oneself. It’s because ``you didn’t succeed - you didn’t get a job where you earn much more money. It’s your fault. You are a bad father. Then suddenly, when we went on the street, a lot of people realized - hey, I’m the same! I thought I was the only one… It was what a lot of people told me too - I was feeling so lost and depressed, but now, okay… I am a fighter. I feel good. You come out of your corner crying, and you start to fight.’’ (178)

Chapter 16: Reconnection One: To Other People

``My desires for a solution that was private and personal - the psychological equivalent of a pill - was in fact a symptom of the mindset that had caused my depression and anxiety in the first place.’’ (183) Whenever the author felt depressed, he would do something for himself - go shopping or watch a film - but he started to do things for other people - like go see a friend and empathize with them - which made him feel much better. 

Chapter 17; Reconnection Two: Social Prescribing

The author says to not ask people ``What’s the matter with you?’’, but ask them ``What matters to you?’’. To ``find a solution, you need to listen to what’s missing in the depressed or anxious person’s life - and help them find a way to resolving this, the underlying problem.’’ (197) There was a study where a group of depressed people were assigned to manage a community garden. This resulted in a lot of people feeling better, since they had a chance to not only reconnect with people, they also ``stopped obsessing about me so much, I had other people to worry about.’’ (195) However, due to the large funds and influences of the large pharmaceutical companies, this sort of `social prescribing’ is not done, since it does not necessarily generate revenue, while prescribing and selling antidepressants do.

Chapter 18: Reconnection Three: To Meaningful Work

The author tells a story of a bike shop employee that was mistreated by his worker, which led to him building a democratically-run collective bike shop. Doing so, he and his colleagues regained autonomy and control of their work and thereby was much happier. The author explains that people hunger for meaningful work, and to do something passionately, and modern society is robbing them of this desire. 

Chapter 19: Reconnection Four: To Meaningful Values

It is rare that we are asked about our intrinsic values. The society focuses on tapping into our extrinsic values - we are asked in job interviews, advertisements and social media. Studies show that ``materialism correlates strongly with increased depression and anxiety’’ (217) By intervening and asking about their intrinsic values, the researchers were able to ```significantly lower materialism and significantly higher self-esteem.’’ (217)

Chapter 20: Reconnection Five: Finding Sympathetic Joy, and Overcoming Addiction to the Self

Two things: Meditation and LSD

``Changing relationship with her own ego.’’ The world constantly tries to shrink our ego and weaken our connections through advertisements and the materialistic values it promotes. Through meditation and self centering, one can strengthen one’s self confidence and robustness to these attacks because their values and how they view the world changes.

LSD or `magic mushrooms’ seem to have a similar effect, but in a much more intense, condensed way.

Chapter 21: Reconnection Six: Acknowledging and Overcoming Childhood Trauma

People tend to have childhood trauma and are shameful of themselves for it happening. Because it happened during childhood, they mostly put the blame on themselves, and think that it is a huge defect in their life and that someone knowing this will cause them to be not accepted by another person. However, through therapy, where the patients addressed and talked about their childhood experience extensively, and realizing that after telling another person about their trauma, and still being accepted - the realization of it, is transformative. 

Chapter 22: Reconnecting Seven: Restoring the Future

Universal Basic Income (UBI) lowers the future uncertainty that a lot of people in modern undergo and allow them to explore their passion. People tend to do things they don’t want or is humiliating for money (job), but UBI removes this humiliation and adds security.

 

Conclusion

`` Because you’ve been given the wrong explanation for why your depression and anxiety are happening, you are seeking the wrong solution. Because you are being told depression and anxiety are misfirings of brain chemicals, you will stop looking for answers in your life and your psyche and your environment and how you might change them … Your distress is not a malfunction. It’s a signal - a necessary signal.’’ (257)

``Depression and anxiety might, in one way, be the sanest reaction you have. It’s a signal, saying - you shouldn’t have to live this way, and if you aren’t helped to find a better path, you will be missing out on so much that is best about being human’’ (258)

`` I have tried to tie myself more deeply into collective - with friends, with family, with causes bigger than myself. I changed my own environment so I’m not surrounded by triggers that get me thinking about things that depress me - I’ve radically cut back on social media, I’ve stopped watching any TV with advertising. Instead, I spend more time face-to-face with people I love, and pursuing causes I know really matter. I am more deeply connected - to other people, and to meaning - than I have ever been before. ‘’ (259)