Book review: Lost Connections

Why our society creates depressed people, and what to do about it

Lost Connections presents us with an opportunity that doesn’t often come around Capitalist headquarters, a problem with identifiable solutions that we can immediately implement in our own lives. We don’t need powerful allies and the next election is meaningless as we turn our attention to the local relations that can rejuvenate our spirit of living.

What does depression have to do with capitalism and this Substack? Well, the tagline for my publication is “Modern society doesn't make any sense, but why..?” And Lost Connections proves that some of the societal deficiencies that have resulted in one of the most depressed populations ever recorded, are also responsible for some of my grievances like extreme political polarization, demonization of the other, heavy-handed ideological trends, and so forth.

So I think there is a strong case for why this book is worth reviewing, and perhaps more simply… I just thought it was a really damn good read. Let’s dive in, shall we?

Loneliness hangs over our culture today like a thick smog.

Lost Connections is a book about depression. I loved it, even though I’m not depressed, because I recognized so many themes that pertain to my life. The book’s core thesis is something like: modern humans are increasingly alienated from their environment and each other. We work at bullshit jobs that don’t matter, we “connect” through screens instead of in person, and a frightening number of us lack the social bonds that were present throughout almost all of human history.

It was only a long time into talking with these social scientists that I realized every one of the social and psychological causes of depression and anxiety they have discovered has something in common. They are all forms of disconnection. They are all ways in which we have been cut off from something we innately need but seem to have long along the way.

While I maintain the philosophy that we are each responsible for the outcome of our life, Lost Connections repeatedly reminds the reader that we’re not living in a society that encourages connection.

“If the culture you are embedded in isn't healthy, you're going to end up with an unhealthy individual. So I've been thinking of that a lot lately. And then” –she ran her fingers through her hair and looked around – “feeling discouraged.” We are living, she has come to believe, in a culture where people are not “getting the connections that they need in order to be healthy human beings,” and that is why we can't put down our smartphones, or bear to log off.
We tell ourselves that we live so much of our lives in cyberspace because when we are there, we are connected, we are plugged into a swirling party with billions of people. “That is such BS,” Hilarie said. – We're social creatures. We're meant to be in connection with one another in a safe, caring way, and when it's mediated by a screen, that's absolutely not there.”

Apart from a lack of connection, another common cause of depression is feeling impotent at your job. Johann cites a study which followed English bureaucrats and their likelihood of becoming depressed. Those at the highest levels of the organization were the least likely to become depressed, even though they had the most stressful position. Why? Because the top level guys called the shots and could make meaningful decisions about what they worked on and how they got that work done.

It turned out the people at the top of the civil service were four times less likely to have a heart attack than the people at the bottom of the Whitehall ladder. - If you worked in the civil service and you had a higher degree of control over your work, you were a lot less likely to become depressed or develop severe emotional distress than people working at the same pay level, with the same status, in the same office, as people with a lower degree of control over their work.

When a person can’t make decisions about their professional life they are far more likely to become depressed. For instance, last week I wrote about Joe, a gentleman working an unpleasurable post at a hardware store yet too afraid to chase his dream of becoming a fishing guide.

In my article I considered the reasons why Joe wouldn’t take a chance at the good life, but I didn’t explain why he felt so unhappy in the first place. Anytime that Joe suggested a way to improve the workplace he was ignored, and the only time his boss acknowledged his existence was to levy criticism. Without agency over his time Joe crumbled into an extended bout of depression.

OK, so can I suggest any solutions? Yes, later in this article I’ll explain a few of Johann’s recommendations for how to regain our happiness. But first let us consider a commonly accepted cure that may be rotten at its core.

The SSRI Scandal

Let’s have a look at this scary chart. It’s astonishing how many Americans are taking anti-depressants, particularly older women. One in five women in the 40 to 59 age bracket is on anti-depressants, while the number is as high as one in four for the 60 and over bracket. The use rate for men is about half, but it’s still far from “good.”

For more on this subject, Substack author Freya India has written a great article entitled: Why Are So Many Girls On SSRIs?

Source

At this point I’m going to make a disclaimer: I’m not a doctor. Three is the pinnacle of fucks I ever gave at high school or college, and I’m about as likely to make it through Med school as Elon Musk is to join a monastery. That all being said, one doesn’t need a medical degree to read a book and interpret its arguments. I am only going to repeat what Johann Hari has said, and if you find it implausible please take it up with Johann not me.

SSRIs don’t work. Not only that, but the “science” upon which they’re founded is almost entirely ephemeral. The link between serotonin and depression is weak at best, and only became commonly accepted after of years of pharmaceutical lobbying. Big pharma loves the chemical imbalance narrative because it allows them to sling a kazillion pills every month, and if we understood depression largely* as a social not chemical phenomenon it would deprive the pharmaceutical complex of billions in profits.

*Throughout the book Johann is careful to point out that there are many causes of depression, and a chemical imbalance may affect a small percentage of people. However, for a vast majority the cause of depression is socially not chemically based.

After twenty years researching this at the highest level, Irvin has come to believe that the notion depression is caused by a chemical imbalance is just “an accident of history,” produced by scientists initially misreading what they were seeing, and then drug companies selling that misperception to the world to cash in. And so, Irving says, the primary explanation for depression offered in our culture starts to fall apart. The idea you feel terrible cause of a “chemical imbalance” was built on a series of mistakes and errors. It has come as close to being proved wrong, he told me, as you ever get in science.

If Johann - and myriad of doctors he cites in the book - is correct it means that anti-depressants are naught but glorified placebos with unfortunate side effects. If this is accurate and the truth gets revealed, it will be the second-biggest pharmaceutical scandal of the 21st century so far.

“The pharmaceutical [companies] are major forces shaping a lot of psychiatry, because it’s this big, big business—billions of dollars,” he said. They pay the bills, so they largely set the agenda, and they obviously want our pain to be seen as a chemical problem with a chemical solution. The result is that we have ended up, as a culture, with a distorted sense of our own distress. He looked at me. The fact that “the entire program of psychiatric research should look like [this],” he said, “is really disturbing.”

Could Johann be wrong? Sure, it’s possible, but Lost Connections makes an awfully compelling argument. Furthermore, to claim that Johann is wrong you’re going to be taking the side of the pharmaceutical industry. That is an unenviable position to be in.

It was the same story I had been hearing everywhere. Giving people drugs for depression and anxiety is one of the biggest industries in the world, so there are enormous funds sloshing around to finance research into it (and that research is often distorted, as I learned). Social prescribing, if it is successful, wouldn’t make much money. In fact, it would blast a hole in that multibillion-dollar chemical market—there would be less profit. So none of the vested interests want to know.

So if anti-depressants are largely ineffectual, what does work to reduce depression?

Real solutions

I know it might seem daunting to read about the causes of depression and anxiety at first, because they run very deep in our culture. It daunted me. But as I pressed on through the journey, I realized what was on the other side of it: the real solutions. When I finally understood what was happening—to me, and to so many people like me—I learned there are real antidepressants waiting for us. They don’t look like the chemical antidepressants that have worked so poorly for so many of us. They aren’t something you buy, or swallow. But they might hold the beginning of a true path out of our pain.

Even though Lost Connections is about depression the message is ultimately empowering because the solutions are within reach. We must reengage with our community and take back control of how we spend our time. Johann is realistic about the challenges this entails. He readily admits that we can’t all just quit our jobs, join a club on the weekend or otherwise revolutionize our days to revitalize their meaning. I’m reminded of a comment that Angry Immigrant left on last week’s article.

Joe is lucky in the sense that he’s unencumbered by family or debt... most have both and jumping off of the cliff into a new life is extremely hard.

Yes, absolutely. But it’s not impossible or hopeless. What do the solutions look like? Again, please just read the book… But briefly,

• Work somewhere that gives you control over your day-to-day activities. It may be better to deal with stress than to contend with powerlessness.

• Engage with your community, meet your neighbors, create social bonds in your local neighborhood.

• Acknowledge childhood trauma, bring it into the open and discover how unresolved conflicts may be affecting your decisions/lifestyle. Probably best done in a therapeutic setting, but even discussing childhood trauma with a friend or family member can be beneficial.

• Find a way to be present in your environment. This could be spending time in nature, gardening, meditating, etc. Some activity that is connected to the “natural” world and does not require a screen.

Sam, the doctor who helped transform the clinic, told me he suspects that a century from now we will look back on the discovery that you need to meet people’s emotional needs if you want them to recover from depression and anxiety as a key moment in medical history. - Saul Marmot, one of the general practitioners there, told me that the benefits of the approach they have developed at Bromley-by-Bow are “so obvious I don’t know why I couldn’t see it before, and I don’t know why the whole society can’t see it.”

Conclusions

Even if you have a healthy social life and the bluest thing about you is your jeans, the effects of alienation have almost surely knocked on your door in other ways.

One “solution” to a lack of connection and/or depression is to join a mass movement. Ideology is a shitty salve for the soul, but it may be better than nothing. Hence I don’t believe it’s a coincidence that depression and anxiety are at record highs at the same time that our culture feels like it’s overrun with humorless hoards of ideologically committed true believers.

All of us have certain innate needs—to feel connected, to feel valued, to feel secure, to feel we make a difference in the world, to have autonomy, to feel we're good at something. Materialistic people, he believes, are less happy because they are chasing a way of life that does a bad job of meeting these needs.
What you really need are connections. But what you are told you need, in our culture, is stuff and a superior status, and in the gap between those two signals—from yourself and from society—depression and anxiety will grow as your real needs go unmet.

On a different note, I’m intimately familiar with how a lack of social connections can lead to degraded mental well-being. While I’m remarkably lucky to have a great connection here, my friend Paul is frequently away on extended work trips.

During his absence I feel noticeably worse, like a goldfish swimming in a poorly oxygenated bowl. There is a very clear correlation between my mood and the lack of human contact that his absence inevitably brings. As such I have tremendous empathy for people suffering from a lack of social connection. Depression appears like a perfectly rational response to that situation.

Perhaps it’s presumptive of me to expend a few thousand words on depression when it’s a topic so removed from my line of “expertise.” My reply to that criticism would be this: don’t take my word as the final measuring stick on this topic. Buy a copy of Lost Connections and learn directly from Johann. He spent thousands of hours researching this book and has wrestled with depression his entire adult life. There are timeless lessons within and a roadmap to a healthier more fulfilling life for ourselves, our country and the human world at large.