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Summary
Summary
The New York Times bestseller from the author of Chasing the Scream , offering a radical new way of thinking about depression and anxiety.
There was a mystery haunting award-winning investigative journalist Johann Hari. He was thirty-nine years old, and almost every year he had been alive, depression and anxiety had increased in Britain and across the Western world. Why?
He had a very personal reason to ask this question. When he was a teenager, he had gone to his doctor and explained that he felt like pain was leaking out of him, and he couldn't control it or understand it. Some of the solutions his doctor offered had given him some relief-but he remained in deep pain.
So, as an adult, he went on a forty-thousand-mile journey across the world to interview the leading experts about what causes depression and anxiety, and what solves them. He learned there is scientific evidence for nine different causes of depression and anxiety-and that this knowledge leads to a very different set of solutions: ones that offer real hope.
Author Notes
Johann Hari is the New York Times bestselling author of Chasing the Scream . He was a columnist for the Independent in London for nine years and was twice named Newspaper Journalist of the Year by Amnesty International UK. He has written for the New York Times , Los Angeles Times , Slate , Le Monde , and others.
Reviews (5)
Publisher's Weekly Review
Journalist Hari (Chasing the Scream) explores common causes of anxiety and depression in contemporary society, proposing that antidepressants do not address the true nature of the problem. Critiquing the chemical-imbalance theory of depression as an idea sponsored by the self-interested pharmaceutical industry, he quotes one psychologist as saying, "The symptoms [of depression] are a messenger of a deeper problem." Hari interviews numerous psychologists who explain how factors such as loneliness, work-based dissatisfaction, and consumer culture can fuel mental-health issues. Chasing possible solutions to these problems, Hari's research takes him throughout the world. He stops in a Berlin housing project where tenants waged a yearlong protest against rising rents, fostering a sense of empowerment and unity among themselves. He also visits a London mental-health clinic where doctors prescribe community volunteer projects instead of pills and a Baltimore bicycle shop that uses a nonhierarchical workplace to give employees a sense of having a voice in the business. Hari aims to demonstrate that the feelings of depression and anxiety experienced by individuals are symptomatic of a larger societal ailment that must be addressed. He makes a good case for this theory, supplying the reader with overwhelming (and engrossing) evidence, though his preferred solutions are somewhat grandiose and utopian. Agent: Peter Robinson, Rogers, Coleridge & White (U.K.) (Jan. 2018) © Copyright PWxyz, LLC. All rights reserved.
Booklist Review
At 18, Hari ingested his first Paxil tablet for diagnosed depression and recalls how it felt like a chemical kiss. For the next 13 years, he continued swallowing increasing doses of the antidepressant medication, but alas, the sadness would always outrun it. From his personal experience, anecdotes, and interviews with experts, Hari became convinced that the public has been misinformed about depression and anxiety. Here he argues that the problem isn't solely altered brain chemistry. Rather, the sources of depression exist in society and the way we live lives increasingly disconnected from meaningful work, other people, important values (altruism, family time), the natural world, and an optimistic future. He compares depression to a form of grief lamenting an unfulfilled life and failed potential. His recommendations include reconnecting to community, gratifying employment, and social interaction. Hari concludes his discussion of the biological, psychological, and social causes of depression by reiterating his belief that the real imbalance in depressed lives lies not in the brain, but rather in spiritual and social difficulties It's not serotonin; it's society. --Miksanek, Tony Copyright 2017 Booklist
Guardian Review
Part personal odyssey and part investigation, this rigorous if flawed study finds fault with contemporary treatment of depression and anxiety When Johann Hari was 18 he took his first antidepressant. That morning he had visited a doctor and explained how, ever since he was small, he had battled with feelings of overwhelming sadness. When he wasn¿t taking himself off to cry quietly, an anxious monologue would be running in his head. ¿Get over it,¿ it would say, ¿stop being so weak.¿ The doctor was reassuring, explaining that these feelings were to be expected since Hari was one of many people whose brain had depleted levels of serotonin. And so he prescribed some pills that would restore the balance. As Hari swallowed his first tablet, he says, ¿it felt like a chemical kiss¿. It wasn¿t until he was in his 30s that he thought of all the questions the doctor didn¿t ask, such as: what was his life like? What was making him sad? What changes could be made to make life more tolerable? The push and pull between ¿reactive¿ depression (the kind that relates to our environment and life experience) and ¿endogenous¿ depression (where something goes wrong in the brain) forms the basis of Lost Connections, an eye-opening, highly detailed though sometimes frustrating investigation into the causes and cures of depression. The book is part personal odyssey, in which Hari gets to grips with the flaws in his own treatment, and part scholarly reflection, where he sifts through the varying perspectives of scientists, psychologists and people with depression. In the first half, he examines the social and psychological factors that can cause reactive depression, which include hardship, trauma, loneliness, lack of fulfilment, absence of status and disconnection from nature. He casts a damning eye on the research practices of the pharmaceutical industry, which has a clear investment in the endogenous argument, and deftly debunks the popular notion that depression stems from faulty genes. It¿s no surprise that Hari is meticulous in revealing his methods, given his past misdemeanours while working at the Independent. In 2011 it emerged that he had been using quotes from his interviewees¿ books, and from previous press interviews, as if they had been given to him. Thus there are copious notes at the back of Lost Connections containing websites, journals and books consulted, while his interview recordings have been made available online. As well as sifting through hundreds of academic papers, Hari has talked directly to people who have made great strides in understanding depression. He meets a junkie-turned-neuroscientist in Sydney, climbs a mountain with a primatologist outside Banff in Canada, visits a rehabilitation centre for gaming addicts in Washington state and observes an Amish community in Indiana. So it¿s somewhat baffling, given the legwork put in, how little his interviewees actually get to say. In London he meets George Brown and Tirril Harris, authors of a groundbreaking study of the social causes of depression that saw them going into the community and interviewing women about their lives. He makes clear the importance of their work and spends 10 pages telling their story, but quotes just a few sentences from each. It¿s a recurring theme: Hari crisscrosses the globe to meet prominent thinkers only to tell their stories on their behalf, throwing in a couple of quotes if they are lucky. (He does, at least, give his case studies a louder voice; his conversations with those dealing with depression are extremely moving.) Elsewhere, the prose suffers from Hari¿s tendency to underestimate the reader¿s capacity to comprehend digestible concepts, leading to some overwrought metaphors and flashes of daft melodrama. At one stage the chemical imbalance theory lies ¿broken on the floor, like a neurochemical Humpty Dumpty with a very sad smile¿. He meets a junkie-turned-neuroscientist in Sydney, climbs a mountain with a primatologist outside Banff ¿ The research is thorough, however, and his ability to locate a narrative in what one might fairly assume to be bone-dry source material is undeniable. The lazy, oversimplified and unimaginative attitudes of the medical establishment to anxiety and depression laid out here beggar belief. You could argue that finding fault in the current system isn¿t that hard ¿ it¿s the solutions that present the real challenge. But Hari is clear about the difficulties of the task ahead and, in offering new ways of thinking, presents not surefire solutions, but, he says, ¿an alternative direction of travel ¿ points on a compass¿. Put in the broadest terms, his argument is that if our current malaise lies in disconnection from vital human requirements such as neighbourliness, professional fulfilment, acknowledgment of trauma and so on, then we need to find ways to reconnect. Hari is by no means the first writer to call for a compassionate, common-sense approach to depression and anxiety, or to point out how medical and societal attitudes have fallen short. But his book brings with it an urgency and rigour that will, with luck, encourage the authorities to sit up and take note. - Fiona Sturges.
Kirkus Review
Mining the root causes of depression and anxiety.Acclaimed British journalist Hari researched and wrote his bestselling debut, Chasing the Scream: The First and Last Days of the War on Drugs (2015), while pushing aside work on a subject that was much too personal to accept and scrutinize at the time. This book, the culmination of a 40,000-mile odyssey and hundreds of hours of interviews with social scientists and depression sufferers (including those who've recovered), presents a theory that directly challenges long-held beliefs about depression's causes and cures. The subject matter is exquisitely personal for the author, since he'd battled chronic melancholy since his teenage years and was prescribed the "chemical armor" of antidepressants well into his young adulthood. Though his dosage increased as the symptoms periodically resurfaced, he continued promoting his condition as a brain-induced malady with its time-tested cure being a strict regimen of pharmaceutical chemicals. Taking a different approach from the one he'd been following for most of his life, Hari introduces a new direction in the debate over the origins of depression, which he developed after deciding to cease all medication and become "chemically naked" at age 31. The author challenges classically held theories about depression and its remedies in chapters brought to life with interviews, personal observations, and field-professional summations. Perhaps most convincing is the author's thorough explanation of what he believes are the proven causes of depression and anxiety, which include disconnection from work, society, values, nature, and a secure future. These factors, humanized with anecdotes, personal history, and social science, directly contradict the chemical-imbalance hypothesis hard-wired into the contemporary medical community. Hari also chronicles his experiences with reconnective solutions, journeys that took him from a Berlin housing project to an Amish village to rediscover what he deems as the immense (natural) antidepressive benefits of meaningful work, social interaction, and selflessness.In a sure-to-be-controversial book, Hari delivers a weighty, well-supported, persuasive argument against treating depression pharmaceutically. Copyright Kirkus Reviews, used with permission.
Library Journal Review
In what is likely to be considered a controversial alternative approach to treating depression, Hari, author of Chasing the Scream, a best-selling treatise on the war on drugs and addiction, has provided a fascinating alternative theory to the causes and treatments of depression (heretofore considered a chemical imbalance in the brain). As a long-time sufferer himself, Hari has a personal stake in an investigation that takes him to many sources around the world. Through personal observations and summaries of conversations with professionals in the field, Hari concludes that the sources of depression are most likely found in people who are disconnected from their work, lack sufficient social intimacies, and have lost their empathic need to connect with and understand others. In many ways, he argues that we need to rethink the fundamental causes of anxiety and mental illness and what role our environmental "disconnections" play. VERDICT This well-written and well-documented book offers a powerful argument against the pharmacological treatment of depression and raises some provocative arguments. Highly recommended.-Herbert E. Shapiro, Lifelong Learning Soc., Florida Atlantic Univ., Boca Raton © Copyright 2018. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Table of Contents
| Prologue: The Apple | p. 1 |
| Introduction: A Mystery | p. 5 |
| Part I The Crack in the Old Story | |
| 1 The Wand | p. 17 |
| 2 Imbalance | p. 27 |
| 3 The Grief Exception | p. 38 |
| 4 The First Flag on the Moon | p. 45 |
| Part II Disconnection: Nine Causes of Depression and Anxiety | |
| 5 Picking Up the Flag (An Introduction to Part Two) | p. 59 |
| 6 Cause One: Disconnection from Meaningful Work | p. 61 |
| 7 Cause Two: Disconnection from Other People | p. 72 |
| 8 Cause Three: Disconnection from Meaningful Values | p. 91 |
| 9 Cause Four: Disconnection from Childhood Trauma | p. 106 |
| 10 Cause Five: Disconnection from Status and Respect | p. 116 |
| 11 Cause Six: Disconnection from the Natural World | p. 123 |
| 12 Cause Seven: Disconnection from a Hopeful or Secure Future | p. 132 |
| 13 Causes Eight and Nine: The Real Role of Genes and Brain Changes | p. 143 |
| Part III Reconnection. Or, a Different Kind of Antidepressant | |
| 14 The Cow | p. 159 |
| 15 We Built This City | p. 164 |
| 16 Reconnection One: To Other People | p. 179 |
| 17 Reconnection Two: Social Prescribing | p. 189 |
| 18 Reconnection Three: To Meaningful Work | p. 201 |
| 19 Reconnection Four: To Meaningful Values | p. 211 |
| 20 Reconnection Five: Sympathetic Joy, and Overcoming Addiction to the Self | p. 218 |
| 21 Reconnection Six: Acknowledging and Overcoming Childhood Trauma | p. 241 |
| 22 Reconnection Seven: Restoring the Future | p. 245 |
| Conclusion: Homecoming | p. 255 |
| Acknowledgments | p. 265 |
| Notes | p. 269 |
| Index | p. 305 |
