by Andrew Thompson
In his most recent book Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions, acclaimed British-Swiss author & journalist Johann Hari takes his readers on a journey through his own path to understanding his long struggles with depression and anxiety, and how he feels what we think we know about depression and its treatment may all be wrong. Hari opens the book with a wrenching and forthright account of his early struggles with depression and anxiety throughout his teenage years and into adulthood. As a young adolescent, he suffered physical and emotional abuse at the hands of a close relative. Only later in young adulthood would Hari explore through psychotherapy the depth of suffering and abuse that was meted out to him and the toll this took in his life as it played a major role in chronic depression. Hari explains that as a teenager he saw innumerable psychiatrists and tried a number of medications. He ran the gauntlet of high priced, well-educated psychiatric and psychological services in England. Yet, he felt on an intuitive and almost instinctual level that what he describes as ‘biological determinant psychiatry’ was only part of the picture in explaining his anguish. As a young adult, he tried a bevy of medications and he self-medicated, self-mutilation, and experienced panic attacks while his burgeoning literary career took off. However, he felt that there had to be a ‘meaning in his suffering,’ and that as British Psychologist Dr. Rufus May describes plaintively how Hari felt with regard to his medication and the treatment models provided, ‘‘you can only hope to drug the enemy within into submission- forever.” In the late 1890s, a European anthropologist, when exploring and trying to understand the destruction and transformation of the Crow First Nations in Montana by the arriving settlers and their forced ‘Europeanization’, asked a Crow leader how he felt about these changes, who responded sagaciously saying, “I am trying to live a life I do not understand.” If you were to briefly summarize the thesis of Hari’s work and experience, it would be that. Depression is rooted equally as deeply in the biology of our species (Hari argues the raining model the ‘chemical imbalance theory’ has weak evidence to support its validity), as they are in the way that we live our lives and the messages that the cultural zeitgeist broadcasts about what is ‘healthy’ and what it means to be ‘well.’
As a journalist, he claims no expertise in the treating or diagnosing of mental illness, but expertly and methodically weaves the narrative of his lived experience with the mental health system through the countless interviews and conversations with leading researchers the world over. He attempts to change the paradigm on which our understanding of depression is built. Hari takes his readers on a journey through the African Savanna, post-war Cambodia, the rough streets of tenement housing in Kotti, Berlin, and the lonely and barren streets of former industrial hubs in northern England and the Midwest, in an audacious endeavor to pursue this kind of change in understanding. Current models of depression heavily emphasize the biological etiology of depression. Hari unpacks and dispels myths surrounding the underpinnings and limitations of what many call the chemical imbalance theory of depression. With the help of researchers throughout the world and across several domains and disciplines, Hari posits a broader approach to understanding depression. In conversation with Laurence Kirmayer, the head of Social Psychiatry at McGill University, Hari quotes him saying that our current model of depression “doesn’t look at social factors...but at a deeper level, it’s doesn’t look at basic human processes.” Hari proposes a model that explores what he feels is our disconnection from meaningful work, meaningful relationships, meaningful values, childhood trauma, cultural overemphasis on status and sources of respect, neglect of our individual relationship to the natural world, and the precarious future that so many young people feel and witness in their work and educational lives. He does not simply use glancing broad strokes to explore each theme; with a scholarly bent, he unpacks the research and methodological groundings of each dimension that plays a role in depression. I believe with humility, compassion, openness and most importantly a willingness to explore disparate models of both illness and wellness, Hari makes a strong case for reevaluating how we look at the origins, causes and path out of depression. I don’t want to spoil the book, but the final third of the book broaches and examines how we can reconnect with both ourselves and our communities in a way that promotes wellness and prevention. Hari does not pretend to have a panacea that will cure and eliminate depression as an illness. Rather, he strives to inspire those who read his book to explore their inner worlds and pasts openly and honestly, harness and cultivate meaningful communities that support and empower, and ultimately reexamine their relationship to wellness. It is our sincere hope at Friends for Mental Health that we can play this role for our members and for the larger West Island community.