Why are We Depressed?

I've been reading the book, “Lost Connections: Uncovering the Real Causes of Depression – And the Unexpected Solutions” by Johann Hari. Hari is actually a world renowned journalist, not a mental health professional, and because of this he got a few bad reviews on Amazon, reviews that stated since he was only a journalist, he is ill qualified to make any assessments or conclusions in the field of mental health.

The funny thing is, if one actually reads his book, one realizes that he's not so much making assessments or conclusions as he is doing what journalists do best: trying to find answers. And because he is a journalist, he goes all in, traveling around the world, interviewing doctors and experts alike, asking the deep questions nobody really wants to ask, and researching.

He never once claims to be any kind of expert – and yet cites many of those experts and doctors in a well-researched, logical book that, when one really thinks about it, makes a lot of sense and is almost painful in its simplicity. He has thirty-six pages of notes and citations, and a full index backing up and supporting the research in his book.

I can't understand why anyone would give this book one or two stars in a review except maybe someone who is still in denial. Although one one-starred review was given strictly because the reviewer claimed Hari as an atheist, and there is no way one can not be depressed if they don't have spirituality and religion in their lives.

I discount reviews like this. They have nothing to do with the subject matter of the book, and they just make the reviewer look silly.

I have long been a skeptic of modern medicine and doctors, and no, I am not anti-vaxxer. I'm not against antibiotics or doctors or hospitals. If I break my leg, you bet your boots I'm going to call an ambulance and have my ass hauled to the emergency room to get it set, and yes, to get a nice prescription of painkillers.

I just don't believe that doctors know everything, and I don't think the almighty pharmaceutical pill is the answer to all our woes. And anyone who thinks that the pharmaceutical companies actually want to help people feel better are extremely naïve. This is a country of capitalism, and the first goal of any company is to make a profit. If you don't believe me or Hari, just YouTube an antidepressant commercial and set your stopwatch for how long it takes them to list the side effects. No, I believe if you want to feel better and healthier, it is your job to take your health into your own hands and do as much reading and researching you can to figure out what works best for you.

I've struggled with depression and anxiety for several years now, and I am in treatment for it. The one thing I absolutely refuse is to take antidepressants. That's my choice. But I understand why people do take them. As Hari points out in his book, clinical depression is defined as a chemical imbalance in the brain, as if something has gone haywire, one's supply of serotonin has run out, and one is then prescribed an antidepressant to boost serotonin levels and bring the brain back in balance.

Hari actually discusses in Chapter 2 the history of how the, as he calls it, “serotonin story” first began, and it was quite by accident. I guess this made a lot of people angry, because as long as we hang on to the idea that there is something wrong with people's brains when they are depressed, then there is an easy way to fix it (antidepressants) and we don't have to talk about it so much.

Or you just sweep the loonies under the rug with their drugs, and call them cured. I have actually likened antidepressants to a lobotomy in the past, but only in my own situation. I can't even take Midol without going a little crazy, so pharmaceuticals have never really been my bag. As Hari points out in his book, he is not trying to take away antidepressants, or tell people they can't take them. If something is helping someone, by all means, they should continue its use.

What he is saying is, what if there is more to the story than just serotonin levels? What if instead of just putting a pill shaped bandaid on a person's mental health, we dig deeper and try to discover what is really going on here?

And this is what I think is so painfully simple. It really isn't that far of a stretch to believe that someone is severely depressed after they discover their spouse of twenty years is cheating on them. Or after the death of a child. Or because of some repressed trauma from childhood. Or being fired from a job they were working for fifteen years and then suddenly, pink slip. Or even some physical illness or pain that won't go away. These people are given an allotted time to grieve, and then told to get over it and move on with their lives, as if there is some kind set-in-stone time period for grieving.

I started getting depressed about the fact that for almost a year I had constant stomach issues and no doctor was able to tell me why, and then all they did was prescribe Nexium and tell me I had acid reflux. When every single thing you put in your mouth is a perpetual minefield, that starts to weigh on your mood. It's of course not the only thing that was causing my depression, but it was a good bit of it. So I got Nexium for my stomach and Prozac for my depression, and no one, except my naturopath practitioner thought to ask, hmmmm, are these two things connected and what can we do about it?

It's ridiculous to me that more people don't wrap their heads around the fact that our bodies work as a unit. We so often treat symptoms. Stomach ache? Here's some Pepto. Allergies? Here's some Allegra. Depression? Let me get the Prozac. But is it really so hard to believe that an issue with one body part might have something to do with another body part not working right? Dr William Davis of Wheat Belly and Undoctored fame says that all health begins in the gut. When the stomach ain't happy the rest of the body is miserable. But of course people don't want to adhere to that when it means that most of what we love to eat is the number one problem. Me included. I have to give up wine? And chocolate? And horror upon horrors, CHEESE? Well, shit.

Hari outlines nine causes for depression and anxiety in his book, at least the nine he feels he has uncovered so far. There are probably many more, he writes, but these are the nine he focuses on.

Cause One: Disconnection from Meaningful Work

• Basically, we are trapped in a rat race of the most mundane, ridiculously boring work that takes up twelve hours of each day, and pays us shit. And what's more, companies don't care about their workers, won't give them decent health insurance or care, and can fire them on a whim (my state particularly is a right to work state). There is more to this story, but that about sums it up.

Cause Two: Disconnection from Other People

• People are lonely. They can't figure out how to connect with each other anymore so they withdraw into that twelve hour work day that treats them like garbage, the Internet, or overindulging in substances or food. There was an interesting anecdote Hari added about gaming addicts, and how some people are so starved for some kind of connection they get hooked on online games just to have someone to talk to. I have actually seen this happen to a couple people in my life.

Cause Three: Disconnection from Meaningful Values

• We are obsessed and addicted to stuff, and acquiring more and more stuff. Materialism has taken over. Every three years people buy new cars. They try to keep up with the Joneses. I'm guilty of it too. I've become obsessed with collecting tea sets. One really only needs one teapot when you think about it, but I just love them, so I have four.

Cause Four: Disconnection from Childhood Trauma

• People who have suffered horrible things in childhood tend to be more depressed and anxious into adulthood. This is not to say that everyone who suffered childhood trauma is depressed, or everyone who is depressed has suffered childhood trauma. It's just another big factor.

Cause Five: Disconnection from Status and Respect

• There is a reason why Facebook exists. It gives people the opportunity to post about themselves, screaming "look at me, look at me!" Hari discusses an interesting anecdote about baboons and the relationship between stress and status in baboon tribes. The omega baboon is infinitely more depressed than the alpha, unless it's "Fight for position in the tribe" time. And then the alphas are more stressed, trying to protect their status. Now we are not baboons, though we are related to them genetically (although, come to my job with me for a day, and tell me we are not baboons).

Cause Six: Disconnection from the Natural World

• We crave nature even if we think we "don't do nature." I actually took that from Hari, who readily admits that he "doesn't do nature." And I laughed out loud. How do you not do nature? It's everywhere. A thirty minute walk outside with my dog peps me up more than anything else sometimes. I've started gardening every summer, because just being outside in the dirt is therapeutic. I don't have much a green thumb, but I still try. And waking up every morning to see the mountains in the near distance has still been one of my favorite things in the world.

Cause Seven: Disconnection from a Hopeful or Secure Future

• Depressed people can't see the forest for the trees (to use an overused cliche), and I've been right there with the rest of them. It's almost impossible to look into the future and see anything good when one is at the bottom of a well of despair. 

Cause Eight and Nine: The Real Role of Genes and Brain Changes

• This one I really found interesting. It's almost a chicken or the egg question. Are depression and anxiety caused by a changed brain, or do depression and anxiety change the brain? And as it turns out, according to one neuroscientist, the brain is always changing. And of course experiences over the years, and life in general is going to change someone's brain. The brain looks different from when someone is severely depressed as when that person is no longer depressed.

What it comes down to is that it's easier to “fix” a problem by doing nothing other than swallowing a pill. To believe that a problem stems from a chemical imbalance and all one has to do is take a pill and “fix” it, like an antibiotic, is intoxicating. One doesn't have to face issues. One doesn't have to change one's lifestyle (buy less, eat healthier, exercise, actually get outside and enjoy that tree). And the big one, society doesn't have to face the fact that in actuality it is sick and needs to change. One quote from the book stood out to me: "In a world that thinks there's no such thing as society, the idea that our depression and anxiety have social causes will seem incomprehensible" (pg. 258). And then, "But it turns out we are all still living in a society, even if we pretend we aren't. The longing for connection never really goes away" (pg. 258).

And maybe that's why Hari got one star reviews on his book. Demanding that society change is always a risky business.

And yet, having just looked at Amazon, the book is temporarily out of stock and listed as a bestseller.