Not Only the Depressed and Anxious Should Read This Book about Depression and Anxiety

Book Review: Lost Connections – Why You’re Depressed and How to Find Hope – by Johann Hari

Being English and Swiss, I occasionally take an unnatural, almost obsessive, interest in the work of Anglo-Swiss public intellectuals in England. Fortunately, as far as I’ve been able to establish, this is a small group of people of which Alain de Botton is one, and Johann Hari the other.

A few years ago I was greatly saddened when Hari’s high-flying journalistic career stalled due to some trouble concerning his journalistic integrity. I think he reported quotes from other people as if they had been given to him in conversation when in fact the subjects of his reporting had given them to someone else or published them somewhere else. To make things worse, Hari then attacked his critics by making critical edits to their pages on Wikipedia using a pseudonym. But he seems to have overcome that unfortunate episode. It probably explains why the brilliant books he’s written since are punctiliously backed up by documented evidence and audio recordings and littered with footnotes providing sources. I guess sometimes when a door shuts on being a prize-winning journalist writing for major British newspapers, another one opens to writing brilliant books – did I mention that his books are brilliant?

So this one is about depression and anxiety. And it’s among other things a personal journey for Hari. A journey from being told, and convincing himself, that his depression and anxiety were results of a chemical imbalance in the brain that could be addressed with ever increasing doses of pharmaceutical anti-depressants, to exploring the true roots of his depression and potential routes out of it.

At one point Hari worries that his book will be placed in the self-help shelves of bookstores. This is a worry because the very idea of self-help demonstrates how misguided our thinking on these matters is. As Hari says:

I’m conscious that in some bookstores, this book will be shelved in the Self-help section. But I now see that whole way of thinking is part of the problem. When I have felt down, up to now, most of the time, I tried to help myself. I turned to the self. I thought there was something wrong with the self, and the solution would come from repairing and aggrandizing the self. I puffed it up. But it turns out—the self isn’t the solution. The only answer lies beyond it.

The more serious worry, in my opinion, would be if this book were to be seen as a book only for those with depression and anxiety, a misconception that the subtitle “Why You’re Depressed and How to Find Hope” will only give rise to. I really hope it was forced on an unwilling Hari by the publisher’s marketing department. There are at least two reasons why this shouldn’t be the case:

Firstly, Hari writes about research that shows that there is a dose-response effect between the amount and strength of trauma that human beings experience and their depression and anxiety later in life. That is to say the more trauma, the greater a likelihood of depression and anxiety later. Put this together with the persuasive narrative that he constructs that depression is not a brain disease unrelated to the suffering and sadnesses in our lives, but on a continuum with these, exacerbated by a lack of connections that would help us cope better. As he puts it “depression, I realised, is itself a form of grief – for all the connections we need, but don’t have.” This I think would easily lead to a view that even non-depressive low-level dissatisfaction or occasional frustration could be alleviated by the connections Hari advocates (more about which shortly). In other words, if we all by virtue of being alive as human beings suffer some dose of trauma somewhere along the way, we all have as a result some level of suffering in our lives that could be alleviated by being more connected. That is what ancient Buddhist texts and modern Western mindfulness instructors like to refer to as dukka, I guess. This chimes with something from another great book I’ve just read. That book is “Maybe You Should Talk to Someone” by the psychologist and writer Lori Gottlieb who points out that “there’s no hierarchy of pain. Suffering shouldn’t be ranked because pain is not a contest.” Put this all together and you’ll find that Hari’s cures for depression should be of use to everyone.

Secondly, even if we were only interested in helping the clinically depressed, Hari’s point is that the solutions to their depression are not restricted to actions the individual should take. The causes of their depression are in things that are wrong with our world. They have no individual-based solutions, only societal, environmental, collective, economic and therefore political ones. The fact that some people are depressed is a problem all of us need to solve. Hari cites a British psychologist who “sometimes quotes the Eastern philosopher Jiddu Krishnamurti, who explained: ‘it is no measure of health to be well-adjusted to a sick society.'”

So what are the lost connections that cause depression according to Hari? They are: disconnection from meaningful work, from other people, from meaningful values, from childhood trauma, from status and respect, from the natural world and from a hopeful or secure future. In making this case, Hari describes his travels from Rio to Berlin and from Baltimore to East London visiting individuals and organisations who have provided a piece to this bigger picture.

This is the kind of non-fiction book that relies on tons of research findings. But Hari doesn’t sit in a library poring over journals to give us a dumbed down summary and original compilation of academic writings. He travels a lot. He goes to cities where communities have done things differently. He describes the geography of the places he goes to. He goes to meet the researchers and their research subjects. He talks to them. He describes the cafes where they meet. He describes the backstory of the researchers. 

So, the description of the anthropologist George Brown’s, work on the biographical and social causes of depression starts with an episode taking place just after the Second World War wherein a young woman – fresh from giving birth – walks through the ruins of the London suburb Kensal Rise to the Grand Canal to commit suicide by drowning herself in “its dust-choked waters.” This woman, it turns out had been a close neighbour of the teenage Brown and had looked after him for months when he had developed an infection. No one talked about her depression at the time. There was a sense of shame around it, Brown remembers more than seventy years later.

Whereas the researcher Isabel Behncke says she “will only explain to [Hari] how being cut off from the natural world can cause depression” if he agrees to climb Tunnel Mountain which towers over the Canadian town of Banff with her. Hari doesn’t like nature. He likes concrete, skyscrapers and bookshelves. But for an interview with Isabel he agrees to go. Surrounded by beautiful natural environment, he feels that he is looking at screensavers and is forced to confront his own fears of being in nature. Among other things, she describes that low status among primates has some of the same physical effects as depression in human beings but that it never gets as bad in nature, as it does in zoos.

And there are dozens of really fascinating findings in this book along similar lines:

For example, there’s the research that showed that obese people, even if helped to lose weight through a very severe diet, normally put it back on. When the researchers had the idea of looking at psychological factors, they found that in many cases, obesity was a kind of unconscious strategy for people who had suffered abuse or other traumatic experiences. Obesity protected them from the sexual interest of others, from the expectations of others (“people assume you are stupid, lazy”) and sometimes simply by adding a physical layer of protection.

But Hari also visits urban areas where people from vastly dissimilar outsider communities (eg. Turkish immigrants in Germany and members of the LGBTQ community), after years of ignoring each other, develop solidarity and friendships against rising rents and evictions and achieve real empowerment. Or he describes a bicycle business where people decided to run the business as a co-operative rather than just be exploited with low wages.

And Hari also cites the work by Michael Marmot as relevant who, in a famous study using the hierarchical system of the UK Civil Service as a massive group of test subjects, found that the highest levels of stress were caused by “work that is monotonous, boring, soul-destroying; [where] they die a little when they come to work each day, because their work touches no part of them that is them.” This kind of work also leads to the worst health outcomes – physical and mental – for those who do it.

Then there’s also the work of Tim Kasser who showed that people whose values are focussed on things to do with themselves, like material goods they could possess, or their looks, are less happy than people whose values are focussed on things outside themselves, such as the environment or their relationships with other people. And Hari backs this point up with descriptions of research where people in focussed discussions with each other managed to change their values from consumerist values to others. Then he goes to Rio and describes the effect it had when advertising was legally constrained in the city. And he also has the story of a Canadian town where an experiment was done that gave everyone a basic income.

It all adds up to an argument that the existence of anxiety and depression in some people is a massive warning to all of us that as a society we are way off the track that leads to a good life for human beings and that we would all be happier if we could changed things. The changes we would make, following Hari, would touch every aspects of our lives and would be social, economic, political and lifestyle changes. They would be nothing short of utopian. Realising the size of the project, Hari discusses his initial fears that a programme of this magnitude would never be taken seriously enough to get off the starting blocks. He decides not to be put off:

So I told myself: if you hear a thought in your head telling you that we can’t deal with the social causes of depression and anxiety, you should stop and realize—that’s a symptom of the depression and anxiety itself.

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