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😵‍💫#25: Lost Connections: Why You're Depressed and How To Find Hope | Part 1 | by Johann Hari - Book Summary & Key Takeaways

😵‍💫#25: Lost Connections: Why You're Depressed and How To Find Hope | Part 1 | by Johann Hari - Book Summary & Key Takeaways

How does Disconnection from Meaningful Work, Disconnection from Childhood Trauma, Disconnection to Other People and Disconnection from Meaningful Values make us more depressed and anxious?

Hello courageous people! 👋 Welcome to Edition 25.

This week, we are reading 📚 Lost Connections: Why You’re Depressed and How To Find Hope | Part 1 | 🖋 by Johann Hari.

This is hands down one of the best books I have read when it comes to explaining the many reasons behind why we feel anxious and depressed, and what we can do about them.

Many of us—doctors included—believe and promote the idea that depression is simply a chemical imbalance in the brain, but that is far from the truth. While this may be a small part of the reason, there are many other real life factors that contribute, 9 in fact, that Johann has gone to extreme effort and research to explain for us in this book.

For this reason, I’ve decided to make this a two part summary because every single one of these areas deserves its time in the sun and I would feel like I was doing all of you a disservice to breeze through them!

So let’s jump in! All text in italics are quotes taken directly from the book.

👨‍💻Who is Johann Hari and why did he write this book?

Johann writes that he was eighteen years old when he swallowed his first anti-depressant.

“That morning I had gone to see my doctor. I struggled, I explained to him, to remember a day when I hadn’t felt a long crying jag judder its way out of me.

Ever since I was a small child—at school, at college, at home, with friends—I would often have to absent myself, shut myself away, and cry. They were not a few tears. They were proper sobs. And even when the tears didn’t come, I had an almost constant anxious monologue thrumming through my mind.” - page 5-6

Johann isn’t a doctor or a psychologist or a therapist. He’s a writer and a journalist who on the back of his lived experience and deep research, has dedicated himself in this book to finding answers for all of us who have felt the pangs of depression and anxiety. Lost Connections and its depth and wisdom was shortlisted for an award by the British Medical Association.

In short - this is a phenomenally impactful and game changing book.

😔What are the 9 causes of our Disconnection and how do we Reconnect ourselves?

There are 9 causes of depression and anxiety, mostly stemming from disconnection:

Disconnection from meaningful work
Disconnection from other people
Disconnection from meaningful values
Disconnection from childhood trauma
Disconnection from status and respect
Disconnection from the natural world
Disconnection from a hopeful or secure future
and finally, our genes and brain changes

Luckily Johann has done all the hard work for us of breaking down why each area matters and how we can go about reconnecting ourselves.

Before we get into the first four areas of disconnection and reconnection, here is a true story from the book which beautifully demonstrates the entire premise of this book.

🐄 Story: A cow as an antidepressant in Cambodia

In Cambodia in the early twenty-first century, big pharma was trying to make inroads to sell antidepressant medications there for the very first time. But there was a problem for those companies because there was no translation for the word “antidepressant” in Khmer language. In fact, the entire concept seemed to puzzle them.

Dr Derek Summerfield was in Cambodia studying mental health,

“Derek tried to explain it. Depression is, he said, a profound sense of sadness that you can’t shake off. The Cambodians thought about this carefully and said, yes, we do have some people like that. They gave an example: a farmer whose left leg was blown off by a land mine, who came to the doctors for medical help and got fitted with a new limb but didn’t recover. He felt constantly anxious about the future and was filled with despair.

They then explained that they didn’t need these new-fangled antidepressants, because they already had antidepressants for people like this in Cambodia.” - page 193-194

Derek couldn’t understand what they meant, so he asked them to tell him more about their version of antidepressants.

“When they realized this man was despondent, the doctors and his neighbors sat with him, and talked through his life and his troubles. They realized that even with his new artificial limb, his old job—working in the rice paddies—was just too difficult, and he was constantly stressed and in physical pain, and that was making him want to just stop living, and give up.

So they had an idea. They believed that he would be perfectly capable of being a dairy farmer, and that would involve less painful walking on his false leg and fewer disturbing memories. So they bought him a cow.

In the months and years that followed, his life changed. His depression—which had been profound—went away. “You see, doctor, the cow was an analgesic, and antidepressant,” they told Derek. To them, an antidepressant wasn’t about changing your brain chemistry, an idea that seemed bizarre to their culture. It was about the community, together, empowering the depressed person to change his life.” - page 194

I don’t know about you, but the Cambodians’ approach seems far more effective for the person involved than perhaps how many GPs would treat this man with that set of problems in other countries.

And changing our approach, broadening it, treating the real cause is what this book is all about.

🙇1️⃣ Disconnection from Meaningful Work

Johann offers (and rather convincingly I might add over a number of chapters) that for some people who believe they have a problem with their brain—an anxiety disorder or depressive disorder—might actually have a problem with their work life.

The research shows that the people most at risk of suffering due to their working life are the people at the bottom of the pecking order. They have less control, more depression, more anxiety and worse physical health overall.

“It’s not the work itself that makes you sick. It’s three other things.

It’s the feeling of being controlled—of being a meaningless cog in a system.

It’s the feeling that no matter how hard you work, you’ll be treated just the same and nobody will notice—an imbalance between efforts and rewards.

And it’s the feeling of being low on the hierarchy—of being a low status person who doesn’t matter compared to the Big Man in the corner office.” - page 251

So then if we are suffering due to our work life, what can we do about it?

There was a story shared about a bike repair man called Josh. He worked at a small business where the boss wasn’t terrible, but he felt stuck. He had no control over his work. He had nowhere to progress to. None of his suggestions were ever taken on board or listened to. When he looked ahead to his future, all he saw was a big black hole.

Josh and his colleagues tried to create a labour union to tackle these issues, but it was complex and expensive to go down that route. So instead, they decided,

“Let’s run our own bike store and do it as a cooperative. That means we’ll share the work, and we’ll share the profits. We’ll make the decisions democratically. We won’t have a boss—because we’ll all be the boss. We’re going to work hard—but we’ll work differently. And it might just make us feel better.” - page 248

And it did. It worked.

Which is amazing! But that also means for anyone whose work life is causing them to feel anxious and depressed, this is a radical action to have to take in order to make it better.

Here is the lesson, and there is both good news and bad news.

The bad news is that improving your work life, if you have a job in an organisation which makes you feel disempowered and in despair, would likely require you to find a job with a different organisation (or do what Josh did and start your own business) where the culture is better.

The good news is, it’s not about the job itself. This means if you are a mechanic, it does not mean you have to go and re-train as a masseuse in order to feel better.

Everyone who went over to work with Josh in the new cooperative was doing the same job as before. The bike repair people were still repairing bikes. The sales and marketing person was still doing sales and marketing. The admin people were still doing admin.

But the company culture, the organisation was so much better and made each and every one of them feel valued and that they had a purpose.

💔2️⃣ Disconnection from Other People

In this section Johann describes the type of solution he craved for his own depression and anxiety:

“If I’m honest, that’s the kind of solution I craved. Something individual; something you can do alone, without any effort; something that takes twenty seconds to swallow every morning, so you can get on with life as it was before. If it olden’t be a chemical, I wanted some other trick, some switch I could flip to make it all fine.” - page 221

Who can relate?! 🙋‍♀️

But what he ended up finding was that all the evidence was pointing to any quick, individual solution as a trap. Uh oh.

He goes on to say,

“When I have felt down, up to now, most of the time, I tried to help myself. I turned to the self. I thought there was something wrong with the self, and the solution would come from repairing and aggrandising the self. I puffed it up. But it turns our—the self isn’t the solution. The only answer lies beyond it.

My desire for a solution that was private and personal—the psychological equivalent of a pill—was in fact a symptom of the mindset that had caused my depression and anxiety in the first place.” - page 222

How do we move from being isolated to being connected?

Sam was a medical doctor who had been taught that any and all problems that patients present with are biomedical. And that was fine until he started actually seeing patients and listening to them.

“Sam felt uncomfortable because he kept noticing something that he wasn’t meant to notice. Many patients came to him with depression and anxiety, and he had been told by his training how to respond. “When we went to medical school,” he explains, “everything was biomedical, so what you described as depression was [due to] neurotransmitters—it was a chemical imbalance.” The solution, then, was drugging.

But that didn’t seem to match the reality of what he was seeing. If Sam sat and talked with his patients and really listened, the initial problem—the idea of something going wrong inside their brains—“very rarely ended up being the real issue that mattered to them.” There was almost always something deeper, and they would talk about it if he asked them.” - page 233

So he decided to do something about it and stop just prescribing medication to every person who walked through his door with depression or anxiety, and added something else to the mix. Sam believed that something was wrong in the lives of his depressed patients as opposed to their bodies and brains and knew what they needed was to reconnect.

“He was part of a team who helped to turn this doctor’s office suite into a hub for all the volunteering groups in East London, as part of an unprecedented experiment. When you went to see your doctor, you didn’t just get pills. You were prescribed one of over a hundred different ways to reconnect—with the people around you, with the society, and with values that really matter.” - page 234

Lisa was one of Sam’s patients. Interestingly, she was a mental health nurse herself and felt frustrated and bewildered that she was suffering from depression when she was the person who was supposed to be helping others recover.

The group she was prescribed was to take an urban plot of grass in London nicknamed “Dog Shit Alley” and alongside 19 other group members they were to turn it into an a beautiful garden for people to enjoy.

“Normally, depressed or anxious people—when they are offered treatment beyond drugs—are put in a position where they have to talk about how they feel, but often that’s the last thing they want to do. There was something slow and steady to do, and their feelings are unbearable.

Here they had a place where there was something slow and steady to do, and there was no pressure to talk about anything but that. But as they began to trust one another, they would talk about how they felt—at a pace they felt comfortable with. Lisa began to explain her story to the members of the group she liked. In turn they began to explain things back to her. And what Lisa realised is that everyone there had understandable reasons to feel terrible.” - page 236

One man was homeless and slept on the Number 25 bus every night. Another had been bullied at work. One man was so angry and violent previously that the centre had been hesitant to even put him into a group in the first place, but then he became the biggest and strongest advocate for two other members of the group with learning difficulties.

These groups—over one hundred that were offered by the centre from pottery to exercise classes to gardening—all achieved the goal of healing deep disconnection, softly and gently. And people got better.

A study of a different program in Norway (but very similar to this one in London) found that people improved an average of 4.5 points on the depression scale, which is more than double the effect of chemical antidepressants!

🤷‍♀️3️⃣ Disconnection from Meaningful Values

As a kid, American psychologist Tim Kasser grew up in Florida. In the early 1970’s it was relatively undeveloped but it soon became one of the fastest growing areas in the USA. By the time Tim left home, the environment where he grew up had changed completely. He went from spending time outside at the beaches and marshes, to spending time in shopping malls. Eventually he found himself longing for the toys he saw.

Johann also reflects on his time as a child, spending three hours a day watching tv. He says,

“I don’t remember anyone ever telling me this explicitly, but it seemed to me then that happiness meant being able to buy lots of the things on display. I think my nine year old self, if you had asked him what it meant to be happy, would have said: somebody who could walk through the Broadwalk Centre and buy whatever he wanted.” - page 112.

And this is the beginning—for many of us—of our disconnection from Meaningful Values and how these have changed over the years.

Tim went on to study these values and looked to the writing of philosophers, who had been suggesting that overvaluing money and possessions will only cause unhappiness. But he found no studies or research which backed this up - were these musings actually true?

He went on to study this area for the next twenty-five years.

One of his first studies showed that:

“Materialistic people who think happiness comes from accumulating stuff and a superior status, had much higher levels of depression and anxiety.” - page 113

These results were replicated across different age groups, different countries and then also went on to prove that materialistic people experienced less joy and more despair.

Pursuing materialistic things falls into the category of extrinsic goals, ie. things that we want because we will get something external in return. (As opposed to instrinsic goals which we pursue because we love something and because we truly want to do it.)

Tim also found that,

“People who achieved their extrinsic goals didn’t experience any increase in day-to-day happiness—none. They spent a huge amount of energy chasing these goals but when they fulfilled them, they felt the same as they had at the start. Your promotion? Your fancy car? The new iPhone? The expensive necklace? They won’t improve your happiness even one inch.

But people who achieved their instrinsic goals did become significantly happier, and less depressed and anxious.” - page 116

The difficulty is, our entire modern culture is built on achieving extrinsic goals and the big culprit for the shift towards these “junk values” as Johann calls them? Advertising.

“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.” - page 119

So what do we do about it?

The good news is, our values aren’t fixed. The research has proved we can shift and change our value systems.

Tim recommends,

“You’ve got to pull yourself out of the materialistic environments—the environments that are reinforcing the materialistic values,” he says, because they cripple your internal satisfactions. And then, he says, to make that sustainable, you have to “replace them with actions that are going to provide those intrinsic satisfactions, [and] encourage those instrinsic goals.” - page 125

After discovering all of this in the research, Tim and his family even moved to a small country. He has a donkey and goats, and a television in the basement that isn’t connected to any stations or cable network. Him and his wife both work part time so they can spend more time with their kids as well as volunteer and engage in activism work. They play games, have conversation and play music together.

There’s something very beautiful about that - something that has the echos of a family holiday, but in every day life. We too, can go towards these things and feel happier.

🥺4️⃣ Disconnection from Childhood Trauma

In the 1980’s Dr Vincent Fellitti was a doctor for morbidly obese patients - a last port of call after people have tried absolutely everything to lose weight and restore their health.

Vincent and his team were tasked with coming up with radically different, blue sky thinking ways of helping these patients. They came up with an extremely effective treatment plan by which the patients ate virtually nothing, but were given supplements like potassium and magnesium to make sure they didn’t go into organ failure.

Some of their patients successfully lost 300 pounds in a year. The team expected the people in the program to be jumping for joy—except they didn’t.

“The people who did best, and lost the most weight, were often thrown into a brutal depression, or panic, or rage. Some of them became suicidal. They often fled the program, gorged on fast food, and put their weight back on very fast.” - page 130

Vincent couldn’t understand how they could go from a “healthy” body to an “unhealthy” body that could kill them. He genuinely wanted to understand and provide true help and assistance, and their approach was clearly not working. So he set about understanding what was really going on.

A twenty-eight year old woman called Susan went from 408 pounds to 132 pounds in a year. Then she put it all back on and returned to 400 pounds. Susan also couldn’t understand why this had happened, so her and Vincent sat down and had a very long, gentle, detailed conversation to try and work it out together.

There were 2 key factors:

When she was very obese, men never hit on her. When she lost the weight, she got propositioned by a colleague and then immediately fled to eat compulsively and couldn’t stop.
Susan started to put weight on when she was eleven years old. Vincent asked why? Why not ten years old or why not fifteen years old? It was because at eleven her grandfather began to rape her.

Vincent spoke to 183 other people on the program and a strong pattern emerged. 55% of his patients had been sexually abused and this correlated to when they started to put on weight. Outside of that, almost all of their patients had extremely traumatic childhoods. It turned out,

“What we had perceived as the problem—major obesity—was in fact, very frequently, the solution to problems that the rest of us knew nothing about.” - page 132

“After meeting a person who had been raped, he told me, “I thought with tremendously clear insight that sending this woman to see a dietitian to learn how to eat right would be grotesque.” - page 132

Hear hear.

Vincent then teamed up wit Dr. Robert Anda and came up with the Adverse Childhood Experiences (ACE) Study. Basically a questionnaire with different terrible things that can happen to you as a child. (Link in resources at the bottom!) They found:

“For every category of traumatic experience you went through as a kid, you were radically more likely to become depressed as an adult. If you had six categories of traumatic events in your childhood, you were five times more likely to become depressed as an adult than somebody who didn’t have any. If you had seven categories of traumatic events as a child, you were 3100% (and no that’s not a typo) more likely to commit suicide as an adult.” - page 134

“There’s a house fire inside many of us, Vincent had come to believe, and we’ve been concentrating on the smoke.” - page 135

People have been told that their brains are malfunctioning or imbalanced and getting treated with medication, when in fact these are very normal responses to very awful life experiences. The drugs don’t solve the problem at the core of it all. Vincent says,

“Medications have a role,” he told me. “Are they ultimate and end all? No. Do they sometimes short change people? Absolutely.” - page 136

For Vincent, these discoveries about the role of childhood trauma were interesting, but he was dissatisfied.

“He didn’t want to tell people who’d survived trauma that they were broken and doomed to a diminished life because they were not properly protected as kids. He wanted to help people out of this pain. But how?” - page 293

After they came up with the ACE study, they began exploring what would happen if they began encouraging doctors to compassionately enquire and ask their patients about the things that had happened to them. The results were extremely positive, and what they were able to find out is that,

“You need to tell somebody what has happened to you, and you need to know they don’t regard you as being worth less than them. This evidence suggests that by reconnecting a person with his childhood trauma, and showing him that an outside observer doesn’t see it as shameful, you go a significant way toward helping to set him free from some of its negative effects. “Now, is that all that needs to be done?” Vincent asked me. “No. But it’s a hell of a big step forward.” - page 296

So there we have it: disconnection from meaningful work, disconnection from other people, disconnection from meaningful values and disconnection from childhood trauma as potential causes for our depression and anxiety.

I’m sorry it’s so long, and there is still the entire second half to go, but I hope you have gotten as much value from this summary as I have from the book. If you’d like any more information on any section, don’t hesitate to reach out!

Can’t wait to unpack disconnection from status and respect, disconnection from the natural world, disconnection from a hopeful and secure future, and genes and brain changes next.

Until next week my friends,Eleanor ❤️🙏

Thank you for reading Post Traumatic Growth Weekly. If you have found this post valuable, why not share it with a loved one?

🧠 Resources & Links

🤝 Human Rights list of Mental Health Support Services

📸 Follow Johann Hari on Instagram - 75k followers

🐥 Follow Johann Hari on Twitter - 133k followers

🖥 Adverse Childhood Experiences Questionnaire for Adults

📕 Next week’s book

Coming out next Friday 22nd July 2022 is #26 and I bet you can’t guess what it is 😜📚 Lost Connections: Why You’re Depressed and How To Find Hope | Part 2 |🖋 by Johann Hari