First, a confession. I am moody. I sometimes suffer from sadness and depression and anxiety. I have, as an example, seriously worried about overpopulation as if it were my personal problem to solve. I can recall lying awake at night, stewing about starvation and disease and the loss of wild places. I can recall standing in the shower arguing aloud with myself about what should be done to save our planet from overpopulation. I might have been ten years old. I was also unpopular at school, had few friends, my mother was seriously ill, and my father smoked too much. I had been molested on the playground. I worried about overpopulation because I precocious and smart and all around me my favorite places to play were being turned into housing developments. My worry was a response to my environment and real life experiences.
When I was a child, I was terrified about what the world would be like if the growth of world population continued to grow and double. It did more than double, of course, growing from 3.1 billion to an estimated 7.6 billion today. I was not worried for nothing, and all the woodlands and swamps and cow fields I recall in my old neighborhood north of Seattle are long drowned under pavement and 3-bedroom homes. So, sometimes I was worried or anxious. Sad. I dealt with it as best I could, sometimes better than others. As an adult I am generally determined to find that illusive silver lining in any dark cloud.
It might be raining over my head, but focussing on how wet I felt, decades ago, brought me close to death. I looked for brightness then and still do now, not because everything is perfect in my life, but because I am determined to live.
While my mother was dying and I was also working 60-70 hours a week and driving home from work in tears, feeling overwhelmed, useless, and unfocused, I gained pounds. After my mother died, I lost 40 pounds in a few weeks. One day a colleague asked me how I’d managed to lose so much. I looked at her and said, “Grief.” Pills would not have made any of that situation better, would not have helped me cope better, would not have made my mother come back to life. I needed time. I needed to find my own way back. And I did.
Sometimes I read a good book—proven to improve mood—and I avoided the genuine downers (three novels by Cormac McCarthy were enough for me.) I sleep too little and eat too much when I am depressed. Improving both helps. Running used to be essential, but even walking now is good. I do things for other people. I commit random acts of kindness. I contact a friend. I listen to music that stirs my heart. It would be easier to take a pill—don’t think I haven’t thought of it—but my reading and research has convinced me that pills are mostly a false promise of an easy fix. For most people, and certainly for long term, drugs profit Big Pharma, not people. My research revealed we have been sold a bill of goods.
I recently read Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions by Johann Hari. Hari reviews the story he was taught about his brain as a teenager, and which remained his truth for more than a decade afterward: depression is caused by a chemical imbalance in your brain and this can be corrected with medication.
The trouble was that while medication provided him with some relief for a while, that relief did not last. It did not make him feel good, only “better” for a short time before he was back in his doctor’s office looking for something better. That might be because no one has proven there is any chemical imbalance in the brains of depressed people, medication fails to “cure” depression in the vast majority of people, and could not cure his own depression. (He was prescribed Paxil, a medication that the company had proven did not work for teens.) As ineffective as antidepressants are in curing depression they have very real and potentially catastrophic side effects. Big Pharma sold a story that we wanted to hear: The problem is personal, out of the control of the individual, and can only be addressed with pills.
It is mostly a lie.
Instead, most scientists agree, depression and anxiety are related, on a continuum with ordinary sadness—yes! they are actually the same thing—and they are normal, reasonable, and sometimes even healthy emotional responses to our lives. Our emotions slide along a scale that runs from dancing with joy to standing on the edge of a cliff. Fortunately, most of the time, most of us are closer to dancing than jumping off the edge, but there is no medical truth to the story we have been told.
It’s not our brains that are broken, it’s our lives.
When Margaret Thatcher declared: “There’s no such thing as society, only individuals and their families” she denied the truth of our species. We are social animals. We want connections with others, we want our lives to contribute and to have meaning to others. We need this as surely as we need food and water. People are not isolated individuals, we are social beings starved for community.
One “symptom” of clinical depression is isolation. “Have you stopped meeting with family or friends?” Hari documents how isolation is not a symptom of depression. Depression is a symptom of isolation. The entire checklist for depression reads like an indictment of modern life.
When we do meaningless work and feel no connection to others, when we feel powerless over our life choices, when we embrace possessions rather than people, we become sad, anxious, and ultimately “clinically depressed.” Pills will not fix this feeling. We must repair the damage to our communal self-worth. Our depression is not the disease, it is a symptom of a more complex issue that has resulted in millions of people being diagnosed and treated for a disease that interferes with daily function.
The popular definition of depression as a disease over which individuals have no control actually feeds the beast. Taking control and making choices is within our power. While we are not to blame for all our circumstances, it is within our power to change them. We can choose to be active participants in our mental health instead of powerless victims.
Consider just this one fact: One in six Americans (the French are worse off, and so are the English) is on psychotropic medication, some sort of drug to treat the brain. How did we ever manage to survive as a species? If it is our brains that need fixing and the drugs fix the problem in our brains, shouldn’t we be healthier now than we were before these drugs existed? Shouldn’t suicide rates gone down instead of up in the last few decades? Look it up.
I was familiar with much of the research Hari cites. I knew that depression was not caused by a chemical imbalance and that pharmaceutical companies had rigged trials in order to pretend drugs could address depression far more effectively than they do, and made $200 billions in profit as a result.
I already knew from the studies he cites and earlier ones, that it is ordinary working people who feel anxiety and stress and depression most profoundly. Those at the top have choices that those in the middle and bottom seldom have. A sense of agency, of the ability to make decisions and have options makes living worthwhile.
I already knew about the “grief exception.” Grieving the death of a loved one causes all the “symptoms” associated with depression, but the grieving are not sick and do not require medication. They need time.
The medical community accepted that grieving is natural and human . . . so long as those grieving do not feel “depressed” for too long. If your daughter is abducted and burned alive, how long are you allowed to feel bad? If your baby is stillborn, how long? What about the death of a parent? The medical community allowed a year, but then you are supposed to push that pain out of your life and be . . . fine! Because if that grief lasts longer than medically necessary, you must be depressed. So you have a year to get on with your life. Except that the medical community shortened that understandable year of grief to a few months, then weeks, and then eliminated it entirely. You are grieving a death? Get over it, and right now!
I have advocated for years that people socialize, sleep and eat better, be creative, and exercise. These DO have a bigger impact on depression than meds for almost everyone. Whenever I suggest this, I have been thoroughly thrashed. If you are too depressed to get out of bed, how can you be expected to take a walk? I am unwittingly telling people to “pull themselves up by their own bootstraps.” (I do not dare point out that they managed to get to a doctor, to the pharmacist, and to take their little pills.) The story is that this is not our fault and not within our power to control.
Hari explains how our attachment to the story we have about depression makes it difficult or impossible for us to hear another. It is frightening to challenge the narrative we have taken into our most vulnerable psyche. Yet, we need a more truthful story. While he confirms my faith in healthy habits, he advocates something beyond that.
His new story goes like this: We must collectively and for the good of all reconnect to other people, find work that allows us purpose and potential for growth and meaning, and stop blaming our brains for a society gone awry. We must hold hands and do this together. Yes, we will feel sad from time to time. We are allowed. It is normal and a symptom not of brain disfunction but of emotional pain in our lives. Our father died. We did not get the job. Go ahead and feel bad about that. Take a friend out for a healthy meal, go for a walk, read a funny novel. Take all the time you need.
We must not look always inside, but sometimes do our individual best to look out, and look to others and connect to them to find the way out of our personal pain.
His book has its corny moments—even Hari admits this—and I was familiar with most of the research he cites and his narrative began to fall into a pattern I could predict. I wanted some things that I did not find here. I don’t think the author has written a perfect book or the one I would have written, but I do think he’s right. We are not broken.
We need to find a better story to explain our distress.
The book includes copious endnotes and online links to additional source material. He’s done his research, and the book itself is well documented. He offers true stories to illustrate his points. There is a great deal of science, but very little that is too complicated for the average reader.
If I had read this book when I was ten (and it is the sort of thing I was reading at that age) I would have felt a lot better about myself and my mental state. I would have recognized the impact events had on my ability to feel good. Instead, I needed most of my life to figure it out.