Uncovering the Real Causes of Depression | Johann Hari This Wasn’T an Easy Journey for Me

Lost Connections: Uncovering the Real Causes of Depression | Johann Hari This wasn’t an easy journey for me. I clung to my old story about my March 18th, 2019 depression being caused by my brain being broken. I fought for it. I refused for a long time to see the evidence they were presenting to me. This wasn’t INTRODUCTION a warm slide into a different way of thinking. It was a fight. ― Johann Hari Johann Hari is the author of two New York Times best-selling books. His first, ‘Chasing the Scream: the First and Last Days of the War on Drugs’, is currently being adapted into a major Hollywood feature film, and into a non-fiction documentary series. His most recent book, ‘Lost Connections, has been praised by a very broad range of people, from Hillary Clinton to Tucker Carlson, from Elton John to Naomi Klein. He gave one of the most-viewed TED talks of all time and has written over the past seven years for some of the world’s leading newspapers and magazines, including the New York Times, the Los Angeles Times, the Guardian, the Spectator, Le Monde Diplomatique, the Melbourne Age, and Politico. He is a regular panelist on HBO’s Realtime With Bill Maher and was twice named ‘National Newspaper Journalist of the Year’ by Amnesty International. I don't believe people are looking for the meaning of life as much as WHY DO I CARE? they are looking for the experience of being alive. – Joseph Campbell It seems that stories about homecomings follow me everywhere. I invited Johann onto Hidden Forces after hearing him on an episode of Sam Harris’ Waking Up podcast. I don’t remember what it was that drew me to him, other than that I found his message compelling. What was his message? Now that I’ve finished reading Lost Connections, I believe the message that Johann is here to deliver is that anxiety and depression are not signs of a broken brain. They are the signs of a broken society. They are not malfunctions caused by chemical deficiencies, but rather a healthy body’s response to a deficient society. It is not we who are sick. It is the world we inhabit that has become increasingly ill and hostile. Depression and anxiety are evidence of something profoundly wrong with how we live, empty of human values, removed from meaningful work, apart from each other It’s not serotonin; it’s societyit’s serotonin; not It’s and from ourselves. It’s not serotonin; it’s society. The symptoms are a signal. We can try to muffle 1 that signal with drugs, possessions, and more junk values, but this won’t solve the problem. It will only make it worse. We need to listen to what the signal is saying and let it guide us away from the things that are hurting and draining us and towards the things that will meet our truest needs. Many of us can feel that things have gone horribly wrong in the world today. Life often, for many feels needlessly destitute, stripped of meaning and full of poisonous messages, images, and junk values. Many have not known any other way. Others may remember things having been different, but often doubt their memory as time moves by and as some find themselves increasingly lost beneath the rubble of a dilapidated life. The anxiety and depression that so many of us feel at different moments and in different degrees is a signal. It’s a sign, pointing us back home. We don’t need to live our lives in detached from the things that make us human. In plain fact, we can’t. We need to listen to theto signal. listen to Weneed This subject is important to me, because I have experienced periods of grief, sadness, and suffering in my own life. I spent most of my early years living with unbounded levels of anxiety and bouts of sadness and grief that I was at a loss to explain or even acknowledge. Feeling sad was normal. I didn’t know what to do with happiness when it came, or maybe, I didn’t trust that it would stay. It took many of the things that Johann highlights in his book for things to change in my life, for me to learn how to laugh again after years of sadness. This show has been part of that long journey back to childhood – to where I first began to see myself as broken, separate, and unworthy of love and affection. I hope that my conversation with Johann can help spread the light of this book. Its My own journey home. journey own My message is desperately needed. THE SCIENCE OF ANTIDEPRESSANTS The Placebo: You open the first chapter with the story of Elisha Perkins’ “tractor,” which you refer to eponymously in the chapter’s title as “the wand.” It was a thick, metal rod that was run over the patient’s body without ever touching him/her. The claim was that it would draw the sickness out of their a shocking conclusion shocking a bodies and expel it into the air. – In an effort to understand how this wand worked, doctor John Haygarth decided to run an experiment. He created a fake “tractor” made of wood, but coated with metal so as to appear identical to Perkins’ wand. The fake tractor had the same results as the original. This, of course, is what is known as the placebo effect, and it lead you to your commentary on the work of Irving Kirsch, who is famous for his research on placebo effects and antidepressants. Irving, along with the help of his From John Haygarth to Irvingto Kirsch Haygarth FromJohn graduate student Guy Sapirstein, began comparing the results for antidepressants from every study that had ever been published and came to a shocking conclusion. The numbers showed that 25 percent of the effects of antidepressants were due to natural recovery, 50 percent were due to the story you had been told about them, and only 25 percent to the actual chemicals. 2 The Bias: Apparently, if you want to release a drug onto the U.S. market, you have to apply to the Food and Drug Administration (FDA), the official drug regulator. As part of your application, you have to submit all the trials you have conducted, in full— whether they’re good or bad for your profit margin. Irving learned that the drug companies had—for years—been selectively publishing research, and to a greater degree than he expected. For example, in one trial for Prozac, the drug was given to 245 patients, but the drug company published the results for only twenty-seven of them. Those twenty-seven patients were the ones the drug seemed to work for. According to Professor John Ioannidis, who the Atlantic Monthly has said “may be one of the most influential scientists alive,” explains that the rules and regulations are designed to make it extraordinarily easy for drug companies to get a drug approved. All you have to do is produce two trials—anytime, anywhere in the world—that suggest some positive effect of the drug. If there are two, and there is some effect, that’s enough. So you could have a situation in which there are one thousand scientific A corrupt drug approval process drug corrupt A trials, and 998 find the drug doesn’t work at all, and two find there is a tiny effect—and that means the drug will be making its way to your local pharmacy. It is no measure of health to be The Results: According to Irving and Guy, antidepressants well adjusted to a profoundly sick do cause an improvement in the Hamilton score—they do society. ― Jiddu Krishnamurti make depressed people feel better. It’s an improvement of 1.8 points. That’s a third less than getting better sleep. And yet, the side-effects are very real. The Imbalance: According to Irving, the theory that depression and anxiety are caused by a “chemical imbalance” in the brain is totally unsubstantiated. In fact, there doesn’t even seem to be a scientific understanding of what a “chemically balanced” even looks like. In short, the scientists that he cites in the book call the theory everything from “a lie” to “a myth” to “bullshit.” The Criticisms: The criticisms that Hari puts forward to Irving’s research are mainly channeling those of Dr. Peter Kramer, and they consist of three main points. The first criticism that Kramer puts forward is that Irving was not giving antidepressants enough time – that the clinical trials he Benefits are minimal; side effects are not are effects minimal; side are Benefits has analyzed typically last for four to eight weeks – but that it takes longer for these drugs to work. 3 Irving found two trials in which the drug trials lasted longer and found that in the first trial, the placebo did as well as the drug and that in the second trial, it outperformed the drug. The second objection Kramer made was to say that Irving was lumping severely depressed people in with moderately depressed people, and that this was a mistake, because these drugs were most effective on severely depressed people. When Irving looked over the data, he found that, with a single exception, he had looked only at studies of people classed as having very sever depression. The third criticism was the most devastating, but not for the reasons one would expect. After looking deep into the methodology used for these studies, Peter Kramer concluded that the results from clinical trials of antidepressants—all the data we have—are meaningless, and that Irving built his conclusion that their effect is very small (at best) on a heap of garbage.

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