Lost connection - part 3: The reconnections
Lost connections - part 1: A deeper understanding of depression
Lost connections - part 2: The causes of depression
A different kind of antidepressant
When we think “antidepressant” we think “drug”. This is mostly because the problem has been framed as one that is in the brain, so people look for answers in the brain. But what if the diagnosis is “disconnection”? That would mean antidepressants would take a different form., because the problem would no longer just be in our heads, but in our lives. What if changing the way we live is the medicine we need?
What follows are social and psychological antidepressants. They do not take the form of a pharmaceutical drug, yet the research we have on them show they are effective for addressing depression and anxiety. There are likely more things that are needed, and a deeper understanding of each, but these are tentative steps to a different kind of antidepressant, creating a vital shift in perspective.
Reconnection 1: To other people
When we reconnect with other people, we realise: “I’m not the only one who’s struggling, I’m not such a failure and such a bad person, we’re all in this together”. We have people to lean on and we all become strong together. Unsolvable problems seem solvable. It’s about people standing by your side, walking with us. It’s a collective solution, not a single person needing to take a pill.
There were researchers who wanted to know: “if you try to make yourself happier, do you become happier?” Turns out it depends on what you do. If you focus on yourself eg: buying things for yourself, furthering your own success etc you don’t become happier. But if you do things to make other people’s lives better (which is how people go about being happier in some non western countries), you do become happier. The individual notion of happiness we have in the west doesn’t seem to work all that well. But the collective notion does. We should think of happiness as a social thing. Rather than focusing on ourselves and our own ego, we should connect with others.
Reconnection 2: Social prescribing
The sense that you have a purpose, that your life is worth living, can be very helpful for addressing depression. There was one doctor who gathered a group of patients with depression and other issues and gave them the task of turning an ugly alley that was around the corner from the clinic into a beautiful garden. This gave the participants something to do that was somewhat meaningful. It was challenging at first, but they gradually connected with each other and got in touch with nature by planting things and being aware of the seasons etc and they helped each other out in improving the conditions of their lives. They gradually and naturally became less depressed and by the end didn’t need their medications anymore.
Another example of this was with the use of “therapeutic horticulture” in which people’s depression dropped by more than double of what normally happens with chemical antidepressants.
Some clinics are beginning to use these findings to help patients. For example, in one medical clinic, you can choose to either see a doctor, or be referred to one of over a hundred social programs. And if you go to the doctor, they sit next to you, not behind a desk. Because the reality is, most doctors' visits are not straight forward like having a chest infection. It’s often stress and social conditions. Pain is made worse if you have nothing else in your life.
Reconnection 3: To meaningful work
It is only recently (in the late 19th Century), that it has become standard for humans to work in an environment where there is one person at the top giving commands to people below who have little to no say in their work. There are alternative business structures, such as democratic cooperatives, where everyone is the boss, everyone works in cooperation without one person being higher or lower in the hierarchy. This is not a perfect solution, and some people actually prefer having less responsibility and pressure by working for someone else. Yet this different business structure allows people to infuse their work with more meaning, have an equal status and a sense of the future (you won’t get randomly fired in a restructuring).
This different business structure has helped some people feel less anxious and depressed at work even though they’re doing the same job they did before (and sometimes even working harder). How they work has changed and that has changed them. They have more ownership, if there’s something they don’t like, they can do something about it, discuss it and be heard etc.
And before you go thinking “this is too hard, it wouldn’t work”, think about how you’ve done things with family, teams, groups etc. It’s applying this same group dynamic of doing things together as equals, to the work environment.
In fact, one study looked at 320 small businesses. The ones that operated more democratically grew 4 times more. So there’s an economic advantage to this as well.
One social scientist pointed out that it’s not the work itself that creates problems, it’s:
The feeling of being controlled, being a meaningless cog in a system
The feeling that no-matter how hard you work, you’ll be treated the same ie: there’s an imbalance between effort and reward
The feeling of being low in the hierarchy.
When the environment is well structured, we actually want to work, we want to do something. It’s just that this desire has been buried in a working environment that so often makes us just want to rest or leave.
Reconnection 4: To meaningful values
Similar to how factories, power plants etc can pollute the air we breathe and make us feel bad, advertisements can pollute our minds and make us feel bad. Ads are constantly telling us that we need this new thing, that we’re not enough, that we need to be fitter and richer, that other people are happier and living a better life and much more. What if, just like we do things to remove pollution from the air, we did things to remove what pollutes our minds?
This has been done in some places. Ads were removed from cities and the majority of people said it made the city better and psychologically cleaner and clearer.
An important understanding here is that even if we do have the money to buy the things that are being advertised, or we get the burger that’s shown on the side of a building etc, most of the time when we get the thing, we no longer want it. It’s not what we truly value. Our true values are submerged under all the pollution we’ve been bombarded with.
But we can uncover those values for the better even if ads aren’t removed. Experiments were done in which people were simply asked to talk in groups about what they truly valued (eg: spending time with their kids) compared to what they actually spent money on (eg: a new pair of shoes they didn’t actually need), and to notice the gap between those two things. Just bringing this to mind and taking little action steps to re-align with their true values reduced people’s depression and materialism while boosting their self esteem.
Reconnection 5: Sympathetic joy, and overcoming addiction to the self
We are primed to think that there are scarce resources in life, that it’s a pie and if someone has one piece of that pie, there is less for us. But that’s not very accurate. Someone else being smart does not take away from your intelligence. Someone else writing a book or starting a project does not prevent you from writing a book or starting a project and fully engaging in that process. Yet seeing other people succeed can bring up a sense of jealousy or scarcity within ourselves.
The practice of sympathetic joy is about cultivating the opposite of jealousy or envy. It’s about feeling happy for others. Here’s a practice that can help with this:
Close your eyes, picture yourself in your mind's eye and imagine something good happening to you (eg: falling in love, doing something you enjoy etc). Feel the joy that would come from that.
Then picture someone you love and imagine something good happening to them and again, feel the joy of that.
Then do the same process for someone you don’t really know, then for someone you don’t like, then for someone you really don’t like or envy.
Try doing this for 15 minutes every day. The effects seem to take place below the level of conscious awareness. At first it can seem strange and like you’re faking it, but after a while, you may find you genuinely feel joy for others. It allows you to have more reasons to feel good. There’s always something good happening to someone somewhere (even when you’re not doing well).
Prayer has also been shown to make you less depressed as has psilocybin, which some initial studies have shown works for 50% of people with depression. With psilocybin, the research found that the more intense the spiritual experience, the more likely that person was to recover from depression. The state that psilocybin takes you to seems to be the same that master meditators go to. Both meditation and psilocybin break the addition to the self. People in these states often talk about feeling at one with everything, being connected, having a deeper sense of meaning, seeing the bigger picture of life etc. The walls we build up to protect ourselves also become our own prison, and these methods show us that we no longer need those walls. Depression causes you to only see your pain. These methods open you up.
Reconnection 6: Acknowledging and overcoming childhood trauma
Research has found that if an authority figure (such as a doctor) shows compassion for a person's trauma and offers to talk to them about it, that reduces the person's illnesses to the point where they are 35% less likely to return for medical help for any condition. There was one study which gave patients the option to discuss what had happened with a psychoanalyst. The result was that they were 50% less likely to come back reporting illness or getting drugs in the following year.
If someone has experienced an intense trauma, most of the time they haven’t told anyone about it. It is far more common for us to hide these kinds of things and feel ashamed about what happened. But shame can be lethal. Showing someone else our traumas and not being shamed for it can be incredibly potent medicine.
Using mind-body methods has also been shown to be incredibly effective at overcoming trauma. Far more effective than talking to someone about it.
Reconnection 7: Restoring the future
The poorer you are, the more likely you are to be depressed or anxious and get sick in almost every way. One solution to this is providing a universal basic income. That is, everyone gets a certain amount of money regardless of what they do.
This was tried in a place called Dauphin in Canada in the 1970’s. The benefits:
People felt safer
People didn’t worry about money as much
Some people used the money to get a higher education when no-one in their family had gone past secondary school
Students stayed at school longer and performed better
There was a decline in the number of low-birth-weight babies because more women waited until they were ready to have children.
Parents with newborn babies stayed at home longer to take care of them.
Work hours fell modestly, as people spent more time with loved ones or learning.
Depression and anxiety fell significantly.
Kids had a 40% drop in behavioural issues like ADHD and depression because parents weren't as stressed and were better able to be present (there is nothing else that compares to the significance of this change in this short period of time.)
Seeing as people knew they would have an income next month and the month after, they could create a picture of themselves in that future that was stable. It also gave people the power to turn down jobs that were humiliating, demeaning or pointless.
While many people say that if you just gave people money they would watch Netflix and do nothing else, that’s not what the research shows. People start projects and try new things. It also gives people the chance to do things that take work (like taking care of kids or elderly people) but aren’t financially beneficial. If this happened on a larger scale, it could change the definition of work. It would be about adding something beautiful to the world, not making the most money you can.
While you may be thinking “isn’t this a utopian idea?”, keep in mind that things like women’s rights, gay marriage, the welfare state, weekends etc, were mocked and considered utopian ideas when they were first proposed, but that changed.
We are off track in today's work culture. Because when people hear of an unfulfilled manager quitting his job and becoming an opera singer people say it’s brave and might ask that person “are you really going to do that? Are you really going to start doing something that actually fulfils you?” Doing something that fulfils you should not be the exception.
These ideas are not just some wacky thinking by an individual. They resonate in the views of world leading medical institutions. The WHO said “Mental health is produced socially: the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual, solutions” 2011. The United Nations said that the narrative of depression is based on biased and selective use of research outcomes that do more harm than good. They acknowledge that there are deeper causes and that we need to stop focusing on chemical imbalances and focus on power imbalances.
If you put your hand on a hot stove, you feel pain. That is a sane response. Similarly, depression is a signal that will guide us in the right direction, to not put our hand on the stove. In this sense, the pain of depression and anxiety is an ally, it’s sanity. Depression is a form of grief for the connections we need but don’t have. Even if you are not depressed, the solution is a collective one.
Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions by Johann Hari Photo by Amadeus Moga on Unsplash