Lost connections - part 2: The causes of depression
You can read part one here: A deeper understanding of depression, but it’s not necessary for understanding what is written in this post
Writer and journalist Johann Hari discovered that depression and anxiety are not simply due to a chemical imbalance in the brain (as is commonly thought). Rather, he found that depression and anxiety is caused due to human needs not being met. In his book “lost connections” he identified nine causes of depression and anxiety.
Here is an overview of those nine.
Cause 1: disconnection from meaningful work
Most people don’t do work that is meaningful to them. They work to pay the bills. And seeing as people look at emails early in the morning and are finishing last minute projects till late at night (much more than the so-called “9-5”), most people spend an enormous amount of time doing things they don’t like doing. Depression is a natural side effect of that.
Here’s something fascinating: you might think that the higher your position at work, the more likely you are to have mental or physical issues due to all the pressure and responsibility you’re under. But research suggests the opposite is actually true.
Because the higher you are in a company, the more control and meaning you have in your work. You get to envision the future of the company, make important decisions, re-organise your schedule etc. But if you’re just doing meaningless, monotonous paperwork and have little control over anything, that’s a very different story. In spite of the fact that you have less pressure, your likelihood of depression goes up. With this kind of monotonous job, you’re more likely to crash on the couch at the end of the day, whereas someone in a higher ranked position is more likely to have more social connections and experiences that enrich their lives outside of work.
In other words, work might be hard and stressful, but if it fills you up and excites you, that is far better for you than if you feel it’s easy but meaningless and boring.
Meaningless and monotonous jobs take from our humanity and our health. If nobody notices what you do, nobody rewards your efforts etc it is easy and arguably natural, to feel despair.
Cause 2: disconnection from other people
Surveys show that we are more lonely than ever. And I think few of us are fooled into thinking that social media creates actual connections. The thing is, loneliness has very real consequences. Loneliness causes our stress hormones to rise so much that it can be as stressful as being physically attacked!
One experiment took people with different amounts of social connections, and then exposed them (with their consent) to the cold virus. People who were more isolated were three times more likely to catch the cold than people who had lots of close connections.
Other research has shown that loneliness makes almost every disease more fatal. It has the same effect on your health as obesity! It is literally deadly and leads to depression. The more lonely we feel, the more depressed we feel. The more connected we feel, the less depressed we feel. In fact, in most cases, loneliness precedes depression.
Even a small change in loneliness can have a significant impact on how likely you are to be depressed. Imagine a scale from 0-100 (0 being not lonely at all, 100 being the most lonely you can be). If you move from 50 to 65, your likelihood of developing depressive symptoms increases eight times.
Even rats who were isolated developed 84 times the number of cancer tumours than rats raised in groups.
All of this makes sense from a hunter gatherer perspective. If we left our tribe, our chances of dying skyrocketed. Yet in the modern day, independence is highly regarded. We no longer have as deep connections with people, and so we can feel homesick even when we’re home.
Loneliness also causes you to become hyper vigilant and not trust other people as much. You scan the world for danger because you subconsciously know that nobody is looking out for you. This means you become afraid of the very thing you need the most.
But loneliness is not just being around other people. You can be lonely in a crowd. To feel connected instead of lonely, you need to feel that you are sharing something with someone (or a group) that is meaningful to both parties, and it has to go both ways. A nurse taking care of you will not completely alleviate loneliness (though it can help), because help is only flowing one way.
Our addiction to social media and our phones seem to be a symptom of a lost connection that is deeply needed for humans.
Cause 3: disconnection from meaningful values
Just like junk food makes us sick, junk values can make us sick and depressed. The values many of us hold in the modern western world are consumeristic. We tend to focus on our money, looks and possessions.
Research found that people who think happiness comes from accumulating material stuff and a superior status, had much higher levels of depression and anxiety. These values cause you to always be worrying about what other people think of you (that’s a heavy burden). And you are vulnerable because someone will always have more money, better looks etc.
We are often told to set goals, but when those goals are extrinsic, we do not become happier when we achieve them. However, when those goals are intrinsic, (eg: becoming a better friend because it’s the right thing to do or playing a sport because you enjoy it), we do. The more materialistic and extrinsically motivated you become, the more depressed and anxious you will be. You will also experience fewer flow states because you’re always worrying about being the best. And your relationships will be shorter and of a lower quality (because if all you care about another person are their looks, it’s easy to dump them when you see someone else that’s more attractive).
As materialistic values get bigger, they make our other values smaller. Because if you’re at work and it’s time to go home and play with your kids but there’s still more work you could do, you have to either leave or stay and work, you can’t do both.
Here’s an experiment which highlights some of this:
“In 1978, two Canadian social scientists got a bunch of four- and five-year-old kids and divided them into two groups. The first group was shown no commercials. The second group was shown two commercials for a particular toy. Then they offered these four- or five-year-old kids a choice. They told them: You have to choose, now, to play with one of these two boys here. You can play with this little boy who has the toy from the commercials—but we have to warn you, he’s not a nice boy. He’s mean. Or you can play with a boy who doesn’t have the toy, but who is really nice.
If they had seen the commercial for the toy, the kids mostly chose to play with the mean boy with the toy. If they hadn’t seen the commercial, they mostly chose to play with the nice boy who had no toys.
In other words, the advertisements led them to choose an inferior human connection over a superior human connection—because they’d been primed to think that a lump of plastic is what really matters.
Two commercials—just two—did that. Today, every person sees way more advertising messages than that in an average morning. More eighteen-month-olds can recognize the McDonald’s M than know their own surname. By the time an average child is thirty-six months old, she already knows a hundred brand logos.”
Unfortunately a vast majority of advertising is specifically designed to make us feel that if we don’t have the thing that’s being advertised, then we’re missing out, we’re a loser.
Cause 4: disconnection from childhood trauma
There’s a famous study called the Adverse Childhood Experiences (ACE) study. It has been conducted many times with similar results. It looks at traumatic experiences in childhood and how that affects you later in life. It found that for every category of traumatic experience someone had as a child, they were more likely to be depressed as an adult. If you have seven categories of traumatic events from childhood, you are 3,100% more likely to attempt to commit suicide as an adult (that percentage is not a typo, it has four digits!).
But it turns out, emotional abuse (not sexual abuse or physical abuse), is the most likely form of abuse to cause depression.
Many times, people who are severely overweight, have significant unhealed childhood trauma. One experiment took severely overweight people and got them to stop eating, and live off the fat stores their bodies had accumulated. But when they did lose weight, many felt depressed, panic, rage and even became suicidal. They did not feel safe without their weight. Many left the program and immediately put on the weight again. It was discovered that many of these people had had very traumatic childhoods and that they’d started putting on weight when they were sexually abused. If you’re overweight, you’re less likely to be sexually desired and people don’t expect as much from you.
Cause 5: disconnection from status and respect
If you are not being respected and/or have very low status, a reasonable response to that is to feel depressed.
Research into baboons found that the baboons at the bottom of the hierarchy consistently showed they were defeated to not get attacked. It was their way of saying “No more, please, I’m beaten, you don’t have to attack me, I’m not a threat to you, leave me alone”. They did this by lowering their heads and crawling on their bellies (ie: making themselves look small and submissive). What’s interesting is that this is a lot like a human being who is experiencing depression. There’s also a loss of appetite, of movement, of energy and they back away when approached.
The hormones of a low ranking baboon and that of a depressed human being are the same. It is possible that depression is a submission response, a way of saying “No more, please, I’m beaten, you don’t have to attack me, I’m not a threat to you, leave me alone”. So what if depression is a response to the humiliation of the modern world: we get the message that celebrities are important (and the chances of you being one are slim to none), that your body isn’t as good as all these instagram models. Then you go to work and have to obey what your boss says etc. Our world is filled with insecurity: you could lose your job, your home, the economy could crash, you could get sick etc. And incidentally, when your status is insecure, that causes more stress than being at the bottom of the hierarchy.
In humans, hierarchy is different depending on where you live. In some places there is a very large gap between a small number of powerful and rich people at the top and most other people at the bottom. While in other areas that gap is smaller and things are more evenly spread out. Research has found that the more unequal a society, the more prevalent all forms of mental illness are. This is true whether you look at different countries, or if you look at different states within a country.
While this seems to have the worst effect for those at the bottom, it also affects the people at the top. Because the more unequal a society, the farther you can fall. That’s cause for anxiety. You need to look out for who might attack you and whether or not your position is safe. In baboons, when the alpha is challenged, and eventually knocked out of top place, the baboons to whom the alpha was mean, take revenge and the alphas stress levels rise significantly.
Cause 6: disconnection from the natural world
When animals or humans are disconnected from the natural world, the problems that are present go beyond what is natural. For example, in nature, a baboon who is low in status might scratch themselves a lot. But in captivity, they’ll scratch themselves until they bleed, develop ticks and howl. Parrots will rip out their own feathers, horses will sway a lot, elephants will grind their tusks (which are normally a source of pride in the natural world), and many will lose the desire to have sex (hence why mating is so hard in zoos). This is not seen when they are in their natural habitat.
Many studies show that mental health problems (no-matter how extreme) are significantly worse in cities than in the countryside. Furthermore, moving to the country causes a drop in mental health issues, while moving to the city increases them. The cause seems to be a loss of connection with nature.
A walk in nature has shown to increase mood and concentration. And for people with depression, the effects are five times greater.
One perspective on this is to remember that we are animals. We have a body that is made to move. Exercise significantly reduces anxiety and depression, perhaps because it returns us to a more natural, embodied state. But it’s not just movement, it’s also nature. People who run in nature have a greater drop in depression and anxiety than those who run on a treadmill. We need our natural environment, we’re part of it. A frog can technically live on land, it’ll just be depressed as fuck. Why should we be any different?
Another aspect of this is that depression tends to cause us to look inwards and get trapped in our own thoughts and feelings. But being out in nature causes us to look outwards. It shrinks our ego’s and puts our problems into a more balanced perspective.
In one prison, it was found that the people whose cells looked out onto farmlands and trees were 24% less likely to get mentally sick than those whose cells looked out onto bare brick walls.
If the effects of nature could be put in a pill, the pharmaceutical industry would be all over it. Think about it: going out in nature has no side effects, is’t not expensive, it doesn’t require a professional to prescribe it and it’s very effective.
Cause 7: Disconnection from a hopeful or secure future
Depressed people are often disconnected from a sense of the future. For example, when suicidally depressed kids were asked to describe themselves 5, 10, 20 years from now, they were at a loss, they couldn’t do it. While kids who were very sick but not depressed could. This was also true when describing fictional characters.. They could not see who they or someone else would be in the future. It was like their future had disappeared. The question is, is this a cause or an effect?
If we look at indigenous communities who went through the horrors of what the Western invasions did, there have been communities that have been able to regain some control and independence of their lives, their culture, their language, their education etc, while others have not. Thos who did have control, who were able to envisage a future, who could build things together etc, had lower suicide rates than those who were still under greater control from the government. The correlation was so strong you could almost predict suicide rates just by looking at the level of control (though this is not the only factor). This suggests that being able to see your future is a cause, not an effect on mental health.
When there is hope in your future, when you can envision it, when you are empowered to do things to make it better, you can experience pain in the present and think “it will be better tomorrow”. But when that future is taken away, all you see is pain.
In today's world, jobs are far less secure than they used to be. For most of us, a stable sense of the future is dissolving, yet we are told to see it as a form of liberation.
Causes 8 and 9: the real role of genes and brain changes
Despite all of this, there are biological causes for depression and anxiety. If you look at the brain scans of people with depression or anxiety, they look different than those of people who don’t have these conditions. For example, the areas that relate to feeling unhappy or of being aware of risk light up more for those who are depressed or anxious.
But our brain changes depending on how we use it. The more we use it in a particular way, the more the brain will change to suit that use. That means that even if you are depressed and your brain is now wired for depression, it doesn’t have to stay that way, it can change.
One of the challenges is that if you feel depressed for a long period of time, your brain will begin to prune the neurological wiring for joy and use it so that you are more easily depressed. But the opposite is also true. This is why it sometimes feels like you’re stuck in a state of depression or anxiety even if the thing that caused it has long since passed.
There seems to be some evidence that there are genes that can cause depression or anxiety. But it doesn’t account for most of the depression. And even then, the importance of genes has been greatly misunderstood. Because while we have many genes, they are turned on or off by our environment (internal and external). In other words, you can have a gene for depression, but have it lay dormant your whole life. Having the gene may make you more vulnerable, but it’s not a life sentence. And there is an increasing wave of extraordinary research coming out showing just how much we can change which genes we activate and which genes we turn off.
A metaphor Hari uses is that it’s a bit like how some people are stick thin no-matter what they eat while other people put on weight very easily. But to put on weight, they still have to eat food. If they stop eating food they will lose weight regardless of what genes they have.
A final note
You might have everything by the standards of your culture (eg: a house, a partner, kids etc), but the standards of the culture are wrong. There are much deeper needs that we have as human beings.
Depression is biological, psychological and social. To say it’s purely biological is saying that your distress has no meaning, that it’s a dysfunction that needs fixing. That’s a very dangerous message.
“It is no measure of health to be well-adjusted to a sick society.”
Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions by Johann Hari