At age 31, Johann Hari found himself, as he puts it, “chemically naked” for the first time in his adult life.
He had been on antidepressants since age 18 but woke up one morning and flushed away his final packs of Paxil, spurred by a growing existential crisis - he terms it his “negative epiphany” - that he could no longer ignore: he was still depressed despite his drugs.
by antidepressants as : “we are literally awash in these drugs,” Hari says.
But as he asks in his new book Lost Connections, “why were there so many people like me?” What is causing this epidemic of misery yoked to medication, the “great curse of our age,” according to Guardian columnist George Monbiot, and can it really be fixed by a daily pill?
It is not our brain chemistry that is making us ill. It is modern life
Hari, a London-based freelance writer and author of the bestselling Chasing the Scream, set out to pursue answers. His journey took three years, 40,000 miles of travel and over 200 interviews with social scientists, neuroscientists, psychology professors, evolutionary biologists, former addicts and even a universal basic income advocate. He ended up in an Amish village in Indiana, a Berlin housing project, a Brazilian city that had banned advertising, a Baltimore laboratory. He climbed mountains in Banff, Canada, and spoke to patients at an American Internet rehab centre.
His conclusion? It is not our brain chemistry that is making us ill. It is modern life.
We need to look at mental health through a wider prism - social rather than chemical, he argues.
Depression is not a brain disease that can be “cured” by popping a pill, but rather, a consequence of a toxic society and our damaging lifestyles.
But instead of examining these wider causes, our misery has been medicalised, fuelling a multibillion dollar pharmaceutical industry that continues to grow despite the fact that “nobody seems to know quite what these drugs do to us, or why – including the scientists who most strongly support them. There is a huge argument among scientists and no consensus.”
Hari cites, among others, the research of Professor Irving Kirsch,
He also cites that depression is caused by a chemical imbalance - a lack of serotonin - that can boosted by selective serotonin reuptake inhibitor (SSRI) antidepressants.
Antidepressants do have a minor effect, he says. But Kirsch’s research showed that on the Hamilton scale of depression – a measure of emotional state – they resulted in a mood improvement of only 1.8 points: essentially, there’s “no meaningful effect at least for the average person,” Hari says.
So why have they been so widely used? Hari cites Kirsch’s belief that it is simply an “accident in history…produced by scientists initially misreading what they were seeing and then drug companies selling that misperception to the world for cash.”
Big Pharma is invested in keeping this chemical-based view of depression going, even to the point of falsifying data, he claims.
So why, then, are we all so unhappy? What is driving this epidemic of depression and misery all over the world?
Hari identifies nine sources, and most have to do with disconnections: from meaningful work, from real values, from community, from the natural world, even from childhood trauma (Hari reveals he suffered violence and abuse growing up). We are fundamentally, terminally, lonely. We have lost our tribe and our hope for a meaningful future and so we drown our misery in the white noise of social media and electronic screens, in ravenous consumption and materialism (“the KFC of the soul”).
We need to reconnect, knit together a broken web. This can mean anything from cutting down on social media and avoiding advertising to meditation or even joining a community garden, a choir, volunteering
Popping a pill is not going to alleviate our anomie, he says.
Instead, we need to reconnect, knit together a broken web. This can mean anything from cutting down on social media and avoiding advertising to meditation or even joining a community garden, a choir, volunteering.
It’s a message that has not gone down well in some quarters,
Far from being a revelation, the biopsychosocial model of depression “was mooted back in the 70s and has been part of standard teaching for at least 20 years.”
But by “condemning antidepressants with such apparent enthusiasm,” Burnett says, “Hari can only risk increasing the stigma attached to those who may be taking them for all the right reasons.”
In his defence, Hari says he’s never claimed to be presenting original findings on the causes of depression and that he simply wants to address the ignorance that he feels most patients have about non-chemical causes and solutions.
He also reiterates that he does not advocate anyone abandoning their medication “If you feel helped by them and the positives outweigh the side effects”, and certainly never stop cold turkey as a reader of his book did, experiencing nasty withdrawal effects.
Ultimately, keep an open mind and be prepared to explore all avenues, he says. And remember - “you aren’t a machine with broken parts. You are an animal whose needs are not being met.”
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