Review: Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions by Johann Hari

Within Lost Connections, Johann Hari universally and with great sincerity connects the experience of depression with the idea that what people are largely suffering from is a profound and debilitating sense of disconnection; disconnection from people, values, meaningful work, and other experiences of loss. Hari articulates the different ways this disconnection can appear in a person’s life, some of which may be more or less obvious than others, or less commonly publicized – particularly the forms of disconnection that are supported by capitalist, individualistic structural systems.

By deconstructing the label of depression, its diagnostic criteria, and the most popular (and misleading) narratives concerning its etiology, Hari provides a foundational understanding of how, historically, the human spectrum of emotion has been pathologized by certain industries for the sake of deriving a profit and providing a temporary solution at best. Without calling for an end to antidepressants or forms of treatment that genuinely appear helpful for people, Hari instead offers an opportunity to explore various perspectives into the human psyche and reasons for why rates of depression appear to be rocketing upwards at an alarming speed.

The book is divided into three parts: first, explaining the inaccuracy of the purely biological model of depression; Hari’s proposed “causes” of depression and anxiety (i.e. disconnection); and a final part focused on reconnection.

The first part of the book presents a beneficial introduction to the complexity of depression as far as it challenges what’s become the mainstream notion of what “causes” depression – i.e. unbalanced levels of chemicals in the brain. Contrary to dismissing science, disrupting this narrative  reintroduces the scientific evidence most studies have actually gathered regarding the role of serotonin and other neurochemicals insofar as they trigger or resolve depression. As someone who’s familiar with the myth of the serotonin theory, I was already on the same page with Hari as he introduced this “crack in the old story” but nonetheless appreciate the care he takes in explaining the historical context of the current understanding of depression in a way that isn’t reproachful or inaccessible.

On the contrary, as someone who’s lived with chronic depression himself, Hari maintains an admirable tone of empathy throughout the book, allowing his own vulnerability and incredulity to make regular appearances within the pages.

Within this first part, Hari skillfully introduces a perspective now adopted by many mental health and neuroscience experts that is skeptical of traditional psychiatry, as far as it perpetuates a misleading characterization of depression as a purely biological illness curable through pharmaceutical drugs. Although anti-medicine talk can rub a lot of people the wrong way – including those similarly wary of Big Pharma – with great empathy, Hari is quick to provide a nuanced argument. His broader statement on treatment methods follows that people should pursue or maintain treatment approaches that are beneficial for them, including the use of antidepressants if a person perceives the benefits to outweigh the cons. Much of the criticism I’ve seen myself of Hari’s book comes down to this ‘are antidepressants the work of the devil???’ controversy, which from anti-psychiatry supporters can admittedly become quite inflexible.

Hari, however, is not so inflexible. Early on in his introduction of research that disputes the effectiveness of popular antidepressants such as Paxil and Prozac, Hari writes:

 “I want to stress – some reputable scientists still believe that these drugs genuinely work for a minority of people who take them, due to a real chemical effect. It’s possible. Chemical antidepressants may well be a partial solution for a minority of depressed and anxious people – I certainly don’t want to take away anything that’s giving relief to anyone. If you feel helped by them, and the positives outweigh the side effects, you should carry on.” (37)

The real antidote that is, dare I say prescribed by Hari is some venue of reconnection. Although I have reserves about one ‘solution’ proposed later on – namely a universal basic income (UBI), I’ll grant satisfaction in that it is at least proposed as an approach to relieve the enormous stress posed by poverty and an inability to cover basic expenses of survival. My skepticism of a UBI proposal is derived from the fine print within most (all? still looking at you, Andrew Yang) that dictates what amounts to a decimation of social welfare programs. Hari’s discussion of the benefits of a UBI program with Utopia for Realists author, Rutger Bregman, however is persuasive.

My primary criticisms of the book lie in Hari’s recurring fatphobic remarks (including an entire chapter focused on the evils of obesity…skipped most of that, thanks!), some tediousness, and despite Hari’s acknowledgment of the need for larger, structural social reforms – there remains a sense of simplicity in his proposals for ‘solutions’; although, to be fair, I’ll grant it’s difficult to conceptualize an effective treatment strategy for each individual experience of depression.

Despite some tedious or redundant chapters and other criticisms, I believe Hari’s book can serve as a helpful resource for many people who have experienced confusion surrounding the perpetuation of their own struggles with mental health. The book certainly provides a solid introductory understanding of depression, which may be helpful for those struggling to understand their own or that of others.

Lost Connections provides a hopeful, if somewhat more complicated view of a collective path out of the isolating grip of depression; proposing avenues to reconnect not only with other people in a culture that values the individual over the collective, but to the wants and desires of oneself as well.

★★★★/5 stars

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