Bloomsbury USA Lost Connections: Why You're Depressed and How to Find Hope

This book takes a fresh, practical look at the causes of depression which are under our control. Hari gives a hopeful checklist - things we can change or improve in our everyday lives which have been shown to influence the likelihood of depression.Take a look at this video summary.My hesitations are:He seems to miss out some causes such as repetitive thought (and hence mindfulness practice) and, curiously, adult trauma.

This is a very powerful and important book. I heard an interview with the author on a podcast and was deeply moved by the stories he told about people around the world whose experiences offer a profound, challenging and paradigm-shifting perspective on the causes and solutions for depression and anxiety. Each chapter is beautifully written – the writing is compelling, actually – and has left me a lot to think about and implement. Depersonalising depression by talking about the societal causes for it is long overdue and for me, unbelievably helpful. People's brains aren't broken. Our pain is a messenger. The message? We badly need to reconnect. I wish everyon would read this book.

Johan Hari's has written a really interesting book here. For many of us who either suffer from depression or know people who do, these pages are extremely relevant. Hari himself has battled "the black dog" since his late teens and so this book was very personal to him. Hari's basic (and obvious) argument is that the most effective way to treat depression, and its close friend anxiety, is not with the prescriptions of never-ending doses of anti-depressants, but by addressing the underlying causes of the condition. Hari identifies what he believes to be those causes and then makes recommendations and suggestions as to how one can practically alleviate depression via lifestyle changes.In the course of researching the subject of depression and anxiety Hari has travelled many thousands of miles. From the USA and Canada to Europe and East Asia, Hari traversed the globe talking to various people, some highly qualified, in his quest for answers and ideas. Some of his conclusions will surprise you.Johann Hari is a well-known Left-wing writer in Great Britain and so it's no surprise that he attributes many of the causes of depression in the West to its capitalist lifestyle and culture.The huge wealth inequalities, selfish "junk" values and our almost constant exposure to advertising, has, according to Hari, created a society that has made us all prone to deep depression and anxiety. He believes that we have abandoned our natural social instincts and now live in cut-off small groups that are "disconnected" from the greater society. By isolating ourselves from each other we have removed the traditional support structures that human communities have enjoyed for many thousands of years. Only by reconnecting with each other can we solve this mental health problem. Hari points to groups such as the American Amish, where rates of depression are extremely low: these groups are tightly knit and its members look after each other.Personally, I don't agree with everything he's saying here. For instance the reason why some people put the acquisition of wealth above everything else isn't just because of advertising: often it's cultural. In many Asian societies, for example, wealth is revered above everything else, and so you'll hear stories of Japanese men working 80-hour weeks in the pursuit of riches just so that they can improve their social status. The fact that their neglected families are ruined doesn't seem to register with them.Where I believe that Hari is dead right is when he ascribes the causes of much depression to the way we have disconnected from each other. Most of us don't ever talk to our neighbours. In the book Hari tells the inspiring story of they way a number of disparate members of a Berlin community joined forces to fight local rent rises. During the struggle, gay, straight, Muslim, Christian, old and young all connected and found that they had more in common than they had believed. The members were uplifted and freed of the depression that had plagued their community.This is a fascinating book about a very important subject. It's well worth a read.

What a fabulous book. Why?Firstly, I don’t think Johann Hari’s research has shown anything that a lot of people don’t already know – that ‘simple’ depression at least (ie not bipolar) is rarely if ever just due to a chemical imbalance and that for this reason, antidepressants rarely work. He explains well backed-up research showing this to be the case but admits that when he took his research to eminent psychiatrists and others in the mental health field, they were shockingly unsurprised at his findings that antidepressants largely worked no better than placebos. So, while these findings are not new, his summary and coverage of the research is good and he presents this in a clear way … and indeed some people may find this a shocking conclusion, especially those suffering from or close to someone suffering from depression.Secondly, Johann Hari puts forward explanations for depression that point more to social, environmental and psychological roots than chemical, and again this isn’t new; although historically the biological cause was stressed more, these days most people understand the complex interplay of other factors, particularly psychological ones.The reason this book is so good is the way the author explains his research, intersperses this with personal and very moving stories from people he met along the way, and analyses the causes (though he admits this isn’t an exhaustive list) as ‘lost connections’ – with self, others, and meaningful values in our modern – and sick - society. His arguments ring very true and this is another reason I found this book so good; it resonated very deeply with what I have observed and have talked about with friends – that our western society throws all kinds of values at us daily that are incompatible with a truly meaningful life, telling us that we are ‘not right’ if we do not have the right things, do not look the right way etc, and our fear and shame lead us to isolation from one another.Hari believes depression is actually not a sickness or biochemical imbalance but actually a healthy and expected response to pain, whether the obvious griefs of bereavement or less-than-ideal upbringing or the less obvious grief of being disconnected from people in our modern western society … and the only solutions come not from pills but exploring and coming to terms with these sources of grief and, where possible, changing things for the better.Unfortunately, despite the fact that I was with him 100% up to this point, even Johann Hari does not have the power to change many things that run deep. Thus the final third of the book – where Hari outlines possible solutions to the problems outlined thus far – was less good. Hari is not to blame; it is simply that the societal transformation required is so huge that it cannot easily be tackled. However, he does have some ideas of things that people can do personally, and even if these practical measures are small, I feel the book still has enormous value. This is because for many people, just reading the first half and perhaps recognising some things they hadn’t previously thought about may, in itself, provide very valuable insights – and those insights might themselves be of enormous value in beginning to change those things that bring us so low.So, while I found the final third of the book a little disappointing – perhaps inevitably so – without doubt this is a timely analysis not only of depression but actually of the age in which we live. It is an analysis but that’s not to say it’s a difficult-to-understand scientific document. On the contrary, it is full of personal anecdote, of sad but also uplifting stories.Above all, this book MAKES SENSE of why so many people – and certainly not just those labelled as depressed – feel bad about themselves or about life or relationships in our society today.

I found this audiobook disappointing, I really would have preferred not to as I thought the introduction, contents and structuring of the audiobook were very interesting, so much so that I bought a paperback too in order to revisit some of the ideas or highlight for reference.The audiobook itself is narrated by the author, I had some issues with the pace of narrative, tone and inflection is definitely not neutral either and not in a sense that they are trying to provide emphasis or convey feeling. I just felt that (like the content and paperback) the author has certain "enthusiasms", which may not be readily shared by the reader, and its really reflected in the recording. Some content that really should not seemed really dull because of how it was conveyed in a kind of monotonous drone almost, other parts where delivered with an almost keen joy, though these were not so much what I felt would be the "main content".The first part of the book is a pretty serious criticism of SSRI prescriptions, the evidence base for the same, some of the regrets that some of their original supporters and promoters have about shaping the culture which sells them (either literally or in the sense of promotion to patients as first line treatment). There is a lot about the author's own experience here, early embrace of pharmaceutical remedy is regretted as they relate their view that it was probably all placebo effect, the benefits were not real but the adverse side effects where. Now a lot of this content was properly qualified and I do think the author intended to do more than generalize from their own experiences. I was still a little uncomfortable with this.The rest of the book, I expected at least, would be about "social prescribing", the bio-psycho-social formulation model of mental health assessment and treatment, in practice for years now in most mental health services, maybe some discussion of therapies. It is that but its also a more in depth discussion of a number of protest groups and other lifestyle choices that I think had particular appeal to the author themselves. Even some of these that made sense to me, like a universal basic income, where very quickly linked with other things that I felt where the authors real interest and what they really would have preferred to be talking about instead, such as gay rights.Social prescribing, biopscyhosocial formulations and connectedness are really important ideas but I did not really think the kind of discussion I'd hoped for was present at all. As important as these things are, as important as the pharmaceutical skepticism can be too, there are also legitimate concerns that these can become convenient covers for inadequacy in resourcing. Not simply in terms of prescribing decisions (often money expensive, and costly in other ways, prescription medications) but also in terms of the availability of formal services, therapies and practitioners.The thinking goes that if the individual experiencing illness as a consequence of a "lack of society", ie intangible, informal personal resources, which are not in the gift of services or practitioners to provide, that practitioners can not consider themselves "substitutes" or "alternatives" (not even as "palliatives" or "compensations" for losses, as DW Winnecott wrote about in terms of delinquency and loss of family life).I think the dilemma is a very real one, I have read authors make persuasive cases about "social character" or "shaping social pressures" (often below the level of awareness) for years. I am wary of their findings becoming a rationale for "more of the same", no response or a poor response. In any case I did not think there was a great deal of depth of any discussion on these points in this audiobook.As to the realness of the dilemma, people with connections to satisfying work, to friends, family, positive professional, personal and peer support groups cope better with the precipitation of mental illness, even when they have a predisposition towards it. These things are often not readily available, at least not as readily available as some alternatives.The discussion also relates mainly to some of the more "social malaise" types of mental illness, many of the insights are as close as possible to universal insights. However, there is a real difference between the debilitating effects of a serious mental illness, such as varieties of schizophrenia, personality disorders, such as borderline personality disorder/emotional upset personality disorder, and recurrent depressive illness of which situational stress is the greater part. There is little or no real discussion on those points. So, in that respect, I do not think the book does much to inform the listener, whether they are professionals or public.I found this all pretty disappointing as a listener/reader as I had high hopes. When partially through the paperback I actually let someone else borrow my copy and recommended it to others. When having finished the book and listened to the audiobook over twice I could only reach the conclusions I've outlined here. It could be a matter of taste and I could be approaching the whole thing with lost of reading I've done before. It is good to see social prescribing given a platform at all though, its the often a popularly neglected and prosaic but vital dimension of life.