Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions

By Johann Hari

THE INTERNATIONAL BESTSELLER: A radically new way of thinking about depression and anxiety

'A book that could actually make us happy' SIMON AMSTELL
'This amazing book will change your life' ELTON JOHN
'One of the most important texts of recent years' BRITISH JOURNAL OF GENERAL PRACTICE
'Brilliant, stimulating, radical' MATT HAIG
'The more people read this book, the better off the world will be' NAOMI KLEIN
'Wonderful' HILLARY CLINTON
'Eye-opening' GUARDIAN
'Brilliant for anyone wanting a better understanding of mental health' ZOE BALL
'A game-changer' DAVINA MCCALL
'Extraordinary' DR MAX PEMBERTON

Depression and anxiety are now at epidemic levels. Why? Across the world, scientists have uncovered evidence for nine different causes. Some are in our biology, but most are in the way we are living today.

Lost Connections offers a radical new way of thinking about this crisis. It shows that once we understand the real causes, we can begin to turn to pioneering new solutions – ones that offer real hope.

• Language: English
• Publisher: Bloomsbury Publishing
• Release date: Jan 11, 2018
• ISBN: 9781408878705

Johann Hari

Johann Hari is a writer and journalist. He has written for the New York Times, Le Monde, the Guardian and other newspapers. His TED talks have been viewed over 70 million times, and his work has been praised by a broad range of people, from Oprah to Noam Chomsky to Joe Rogan. He lives in London. www.johannhari.com @johannhari101

Reviews for Lost Connections

[larryerick · Rating: 3 out of 5 stars]

Much like the previous book I read from this author, Chasing the Scream, I saw his propensity toward using various approaches to his topic and to his writing. The initial part of the book is a memoir, which leads him and his readers to his book's topic of depression and anxiety. Many times he projects himself as just an average guy trying to chase down answers, sometimes in a rather flamboyant way, but he inevitably grabs hold of some serious research to focus his study, at each point along the journey, and we can take him much more seriously. After his initial personal comments about how the topic has affected his own life, he jumps into nine "disconnections" (or how we commonly get to our depressed states), and then responds to those by having the reader consider seven proposed methods to "reconnect." (Trust me, there's a logic to it all.) At one point in the book, he admits his work might end up in the self-help section of our local bookstores, but I find the book more personal and the presentation more investigative journalism than a stereotypical self-help work. While there was more than one instance along the way where I feared we were going to go off on a wild goose chase, it never got that far, and there was really only one point where he mentioned a particular dynamic where I asked myself, "Really? People do that?", but it was clear from the way he presented it, that I was apparently the odd one, and thankfully so, in my mind. All in all, I didn't learn a great deal new from this book, other than the existence of several studies that helped confirm how I've been approaching many life situations. In that respect, I felt lucky I'd already figured out much of what the author mentions. It was also clear that much of what he presented was new to him. I attribute that to the value of a longer life experience than him, for clearly he is more intelligent than me. The day after I finished reading this book, my wife was talking with me about a friend in our small town who (1) had lost her husband in a tragic boating accident, (2) moved to a new house in a new town by herself, (3) had her daughter-in-law very seriously injured in a head-on automobile collision, and (4) a new grandchild to help care for belonging to said daughter-in-law and son. I mentioned this book, which I think would be of help to her friend and to my wife in talking with her friend, but I think they are going to use the old hit-and-miss method of dealing with her friend's depression, i.e., keeping her mind off it until her psyche simply won't let her anymore.

[dono421846 · Rating: 5 out of 5 stars]

This book was a surprise. Hari carefully challenges the still-popular belief that depression is fundamentally an imbalance of brain hormones like seratonin. Instead, he convincingly (very convincingly, in fact) marshals the alternative view that people how are depressed are victims not of brain chemicals, but of social malfunctions. Loneliness, pursuit of "junk values" such as material acquisition, dead end and humiliating work conditions, are among the variables that research has shown align with diagnoses of depression--independent of brain functions. This is why antidepressants are largely ineffective, at least over the long term. Besides the captivating ideas, the prose itself is engaging, and does an excellent job of leading the reader through an ocean of research literature.

[triscuit_1 · Rating: 4 out of 5 stars]

Set aside the controversy over his argument against medications for depression and this is an excellent coverage of the causes of the disease and the treatments. The ones we all know - exercise, being out in nature, connections with family and friends, having a sense of community, having hope for your future, doing work with a purpose. For thousands of years, philisophers have said that if you overvalue money and possessions or care to much about how you look to other people, will be unhappy. Everyone is driven by extrinsic and intrinsic motivations, but inly the latter will make you happier.On the other hand, status, whether at work or in the jungle, give you control so unless your are being challenged by a rival you will be less anxious and depressed than someone down the ladder.Other tips- loving kindness meditation; a secular version of confession where another listens nin-judgementally to something you are ashamed of that gapoened to you or that you did; removing fear of the future with moncome or other programs (see Denmark); mental health requires societal as well as individual solutions.

[aehotchkiss · Rating: 4 out of 5 stars]

This book is an honest exploration of the reasons why anxiety and depression are at such high levels in the modern world. Written not by a psychologist or sociologist, Johann Hari uses his journalistic training and passion for self-search to thoroughly interview and cite scientists and researchers across multiple disciplines of psycho/social/emotional knowledge.The result are 9 reasons we are disconnected (which exacerbates anxiety + depression) and, more important, how to reconnect without relying on SSRI's and the western compulsion to label everything a disorder or disease.An eye-opening read for anyone, but especially folks who have dealt with depression or anxiety.

[judygibson-1 · Rating: 3 out of 5 stars]

I was very skeptical about this book but it was recommended by someone whose opinion I respect so I read it. I think it is a fair analysis of important issues and brings some insights that are new to me and worth thinking about. I don't myself suffer from depression or (often) from anxiety but know people who do, and found useful ideas in this book.

I feared it would fall into one of two camps: either the "big medicine is a scam and I have the cure" camp or the "here's a tiny preliminary bit of research that's going to change the world" camp. Instead the author pulled together several lines of thought, giving full citations to the research papers for each, and proposed some helpful steps toward making changes in one's own life and society.

[arubabookwoman · Rating: 3 out of 5 stars]

Subtitle: Uncovering the Real Causes of Depression--and the Unexpected SolutionsFirst let me say that the author of this book is not a scientist, but rather a journalist who suffered from depression for most of his life, starting from early youth. There are, however, many, many scientific studies cited in the book, however, so I can't say the theories he expounds in this book are unsupported and off-the-wall. If you are suffering from depression, read this book, but do more research/consultation with doctors before taking action.Hari basically concludes that contrary to what the popular wisdom of the past several decades has told us, depression is not caused by a chemical imbalance in the brain: that it is not the lack of serotonin causing depression, and that all the new anti-depressants based on that theory are actually little better, if even that, than a placebo. Rather, he concludes that in most cases the causes of depression are circumstantial, grief being a form of depression (in fact the only form on which a chemical imbalance was not blamed) caused by circumstances. He calls the circumstances causing depression "disconnections," and lists the following causes: 1. Disconnection from meaningful work; 2. Disconnection from other people; 3. Disconnection from Meaningful values; 4. Disconnection from childhood trauma; 5. Disconnection from status and respect; 6. Disconnection from the natural world; and, 7. Disconnection from a hopeful future.After describing these causes, he then discusses various ways to "reconnect." There are some interesting ideas here; read it and decide or yourself.3 stars

[trinker-2 · Rating: 5 out of 5 stars]

Wow! What great, affirming ideas for fighting back against rampant depression and anxiety. Who wants to join me in a fight for universal basic income?

[thewestwing-864351 · Rating: 3 out of 5 stars]

Overall an interesting book though I personally didn’t find any new ideas on depression and it’s causes. But it’s well written and worth a read.

[booktsunami · Rating: 5 out of 5 stars]

Before I started writing this review I thought I would have a look at what other reviewers thought about it. So I looked up the reviews on "Goodreads". I guess, not surprisingly, the reviews seemed very polarised. The majority of people were giving it 5 stars but there were a number of sharply critical reviewers who were rating it as one star. I was curious about this polarisation and it seemed to me that those rating it as one star felt that Hari was dumbing down the science too much (as one reviewer said....Hari "thinks about things a lot" and then seems to assume that this counts as scientific research). Surprisingly, there was not too much criticism of his two basic theses: 1. that there is no evidence that depression is due to a chemical imbalance in the brain and that drugs can cure it. 2. that there is a lot of reason to suspect that depression is caused by the loss of social connections and support and can be either cured or dramatically improved by various techniques to re-connect with other people. A couple of people felt that Hari was unduly dismissive of the role fo drugs and insulting to big pharma but most reviewers seemed to accept this.So much for what other people were thinking. Generally I am a bit suspicious when a professional writer turns their hand to a subject (about which they know little) and by interviewing various experts in the field they produce their book to the deadlines given by the publishers. There are a few problems with this; how did they select their experts? they have no real experiential expertise themselves....hence, can we trust their judgement or their selective reporting?, and have they really explored the whole field thoroughly enough within the time frame. In Hari's case, he actually does have first hand experience of being depressed and of being treated with antidepressants over a long period. So I give him some marks for that. What he says about anti depressants: basically that the chemical imbalance theory (generally purported to be a deficiency of serotonin) is either just wrong ...or there is virtually no supporting science to back it up....is not new to me. Nor is the evidence of the overwhelming evidence that if the drugs work it is only because of the massive placebo effect. And there is maybe a 2% real success rate. Hardly enough to offset the nasty side effects. Hari travels over familiar ground (see the book "Cracked") that big pharma have corrupted the whole psychiatric profession so completely and have so much money at stake, that it is understandable that the chemical imbalance theory is perpetuated. He also covers some of the same ground as "Cracked" in highlighting how there are no objective tests for mental disease and the Diagnostic and Statistic Manual (DSM) used by the psychiatric profession to diagnose mental illness is really just a social construct..decided on by a majority vote. I find this pretty scary.Hari comes up with nine causes of depression (all of which have social origins).1. Disconnection from meaningful work2. Disconnection from other people3. Disconnection from meaningful values4. Disconnection from childhood trauma5. Disconnection from status and respect6. Disconnection from the natural world (the outdoors)7.Disconnection from a hopeful or secure future8. A biological cause of endogenous depression (maybe less than 1% of people who become depressed) 9. A genetic contribution (maybe about 37% is inherited but maybe requires environmental triggering)I guess it is hard to argue that all of these causes are significant. But, as a lot of reviewers have pointed out, Hari's contention that modern psychiatrists ignored all of these is probably overstating the case.The second half of the book is devoted to solutions: to re-establishing those connections that we seem to have lost in modern society. And Hari comes up with seven techniques or ways of reconnecting. Here, he seems to argue very much anecdotally.....it works up to a point but there seems to be a shortage of good research in this field so that one can say with confidence that x technique works for these sort of people.The techniques described are:1. Reconnection to other people2. Social prescribing...basically this is the idea that the Dr prescribes "taking a role in a community garden" as the cure...or something similar rather than prescribing an antidepressant drug. (Seems like No. 1 above).3. Reconnection to meaningful work4. Reconnection to meaningful values5, Sympathetic joy: training yourself to be happy for others) and overcoming addiction to the self6. Acknowledging and overcoming childhood trauma....the basic idea seems to be that you need to have the hurt/shame acknowledged by an authority figure ...such as a Doctor.....in a sympathetic way.7.Restoring the future. This seems to be rather controversial...it is proposing a universal minimum income. It seems to have generally worked where it has been tried but seems to be very unpopular as "Socialism"....a dirty word for many Americans. A number of reviewers were obviously offended by this "politicisation" of the message. Personally, I just found it fascinating...and it is being talked about more and more. It might overcome the problems of young people who are on some sort of dole payment...which is not enough for them to live on properly , or to travel to a job interview, or to study to prepare themselves better for a role in society etc. Generally, I really liked the book. it's well written. Easy to follow. Very anecdotal...but that is deliberate and clearly contributes to the readability of the book. I have few arguments with his basic theses and he seems to have made some really positive suggestions for a way forward. The fact that he has suffered the pain of depression himself makes the work much more meaningful. Four and a half stars from me.

[castlelass · Rating: 2 out of 5 stars]

Johann Hari takes a stand against the commonly held belief that anxiety and depression are caused by chemical imbalances in the brain. Instead, he cites studies that have shown the causes to be cultural, environmental, and sociological. He recommends fixing the sources of depression through reconnecting with people, values, meaningful work, the natural world, a hopeful future, and respect/status. He contends we have lost these important forms of connection in our modern individualistic society.

This is a book of “big audacious claims;” however, I did not find it particularly innovative. Many others have pointed to people struggling with grief, poverty, and childhood traumas as being candidates to develop depression. Avoiding overreliance on social media, digital devices, and advertising are also fairly commonly espoused solutions, as is the value of mindfulness and talk therapy.

I enjoyed the success stories where people have connected with each other. These are uplifting and heartwarming stories of community activism, gardening groups, a small business collective, and several others. But these are anecdotes not proofs. Hari is a journalist, not a scientist. I would have appreciated more quotes containing evidence from the footnoted sources. Hari’s social solutions are oriented toward cultural changes that, as he admits, would be difficult to agree upon, fund, and implement.

In summary, this is not the scientific book that I thought it was when I picked it up. This is a topic of interest to me, and I have read many books with different approaches. In my opinion, the field is not as clear-cut as Hari paints it in this book. I recommend reading widely and consulting qualified professionals before making any health-related decisions or discontinuing any prescribed medications.

2.5

[sjh4255 · Rating: 5 out of 5 stars]

This is a great book to help you with understanding what is important in life and to reevaluate what should be important in order to be mentally healthy. Outlines the 9 important connections that will help you towards understanding yourself and having a healthy lifestyle.

[mh_at_home · Rating: 1 out of 5 stars]

As a mental health professional and person living with major depressive disorder, I was fairly certain going in that I wasn’t going to agree with this book, which argues against any sort of biological causation for depression. What I wasn’t prepared for was the amount of absurdity and apparently deliberate misunderstanding/misinterpretation that I found.From my perspective, the absurdity began when the author wrote the he had an “epiphany” at age 18: “I’m not happy, I’m not weak - I’m depressed! … There is a term for feeling like this! It is a medical condition, like diabetes or irritable bowel syndrome! I had been hearing this, as a message bouncing through the culture, for years, of course, but now it suddenly clicked into place. They meant me! And there is, I suddenly recalled at that moment, a solution to depression: antidepressants. So that’s what I need! … I knew about the cure [Prozac], because it had been announced by the global media just a few years before.” Years later his therapist observed that he seemed depressed, and he insisted that couldn’t possibly be the case, because his antidepressant was boosting his serotonin levels. This does not in any way sound like anyone I’ve ever encountered who suffers from a serious mental illness, and cast serious doubts on the author’s judgment.Hari cites a number of researchers that are proponents of the stance that he takes, but his interpretation of their findings demonstrates a fundamental lack of understanding of the principles of scientific research. He held up as a credential for one scientist the fact that he’d been deemed one of the most influential scientists alive by a social commentary-oriented magazine, as if this somehow backed up the validity of this scientist’s arguments. He also makes misleading statements about how the Diagnostic and Statistical Manual (DSM) deals with bereavement.He holds up the disproven hypothesis that depression is due to a lack of the neurotransmitter serotonin as evidence that depression is not biologically caused. This hypothesis was originally developed to try to explain why medications that inhibited the reuptake of serotonin were helpful for people with depression, and at the time there weren’t the scientific techniques available to verify whether this was accurate. It has since been found that depression is not correlated with a deficiency in the absolute amount of serotonin, but it is utterly illogical to say that because scientists came up with an inaccurate explanation decades ago we should throw the baby out with the bathwater and say biology and neurotransmitters are simply not involved.The author comes up with a list of 9 causes for depression, although he has no formal training in psychiatry or psychology. These causes involve various social/environmental factors, entirely overlooking that many people who develop mental illness (including myself) may experience none of these. The author isn’t arguing that some people’s depression is related to situational stressors (which is absolutely true) or that broader societal existential malaise is attributable to social/environmental factors (which is quite possibly true); he is saying that all depressive illnesses fit into his narrow box, which is incredibly insulting to those of us living with serious mental illness. So what can I conclude personally from this book?  Apparently to get better from my severe illness that has caused multiple hospitalizations and suicide attempts, I'm supposed to engage in local activism, participate in a community garden, start a co-op, hang out in nature, and get laid. Forget meds, according to the author sex is the best antidepressant.  The author writes about depression involving various disconnects, but by the end of the book I could only conclude that the author was well and firmly disconnected from the reality of mental illness.

[soylentgreen23 · Rating: 5 out of 5 stars]

I've often wondered about depression. It seems to take so many forms, from people who are miserable because of their life situation, to those suffering the most excruciating grief over the loss of a loved one. How could it be that one 'illness' could show the same symptoms despite the massive variety of possible causes? How could all of this be because of a chemical imbalance in the brain? If I feel sad, does it mean that the same thing is going wrong with my brain as is happening to the brain of a woman who miscarries? It doesn't make sense.In 'Lost Connections' Johann Hari looks at depression from the inside. His own diagnosis of clinical depression led him to taking antidepressants for years, yet he never seemed to truly recover. As he wondered why, he began to question the assumptions that we have made in the past hundred years as to what the causes of depression are, and what depression actually is. This enlightening book is the result of his research, and as a lay reader on the topic I found it fascinating. His conclusions can be summed up rather simply: how is it possible to live happily in a world designed to make us miserable? When we re-frame depression that way, we see that the drugs won't work, they'll just make it worse: reconnection, as the title implies, is the route we must follow to escape our unhappiness.There are those who have written negative reviews of this book, and I can certainly sympathise with the them - for three reasons. Firstly, Hari calls into question a lot of what we take for granted, and when you are convinced that the solution to your depression lies in finding the right drug cocktail, being told that the drugs are unlikely to work at all can feel like a slap in the face. Secondly, some readers have long been aware of the research that Hari references; nothing in the book will come as a surprise to them. To those of us who have never before read up on this issue, however, the book serves its purpose very well, summarising what we know and what we don't know about depression. And third, the writing style is not perfect; it's what I would call 'Gladwell-lite.' There are too many attempts to make of the story a real narrative, which means backtracking again and again to introduce characters the 'proper' way. Doing this once or twice would be forgivable, but the fact that it happens dozens of times every chapter means that reading the book is sometimes more of a struggle than it should be.Despite any slightly negative words that I might offer about this text, I really have no hesitation in recommending it to everyone out there who either has depression, or is wondering how they might help somebody with depression. There's useful stuff in here - perhaps not the stuff that everybody wants or will use, but if you dig around and look for what resonates, you might find a new approach to living within these pages.

[rivkat_2 · Rating: 4 out of 5 stars]

Hari argues that we don’t really know what the relationship between serotonin and mental states is, contrary to what popular science writing of the past 20 years indicated. More to the point, he argues that cultural, economic, and psychological factors are far more significant to many cases of depression than purely “endogenous” depression. Hari himself was on antidepressants for years, and suggests that they work for some subset of depressed people, but says that the evidence for long-term utility is far less than that for short-term assistance. He also argues that biologizing an explanation is not going to lead to more cultural acceptance by pointing to an experiment in which people who were told that mental illness was a result of biochemistry “zapped” a subject they perceived to be mentally ill more than people who were told that the illness was a result of what had happened to them in life. I want more data, but I’m open to persuasion.As Hari points out, when upper-class white women complained of “the problem with no name” in the 1950s/60s, they had everything that their culture told them they were supposed to want. The problem was that their culture had crappy values, and adhering to those values was depression-making. Similarly, economic insecurity, huge inequalities, and constant media exposure to the life we “should” be living is depression-generating for many people today. So is trauma; he tells the heartbreaking, and Freud-evoking, story of an obesity doctor who started to ask people what else had happened to them around the time they started to put on weight, and heard numerous rape/abuse stories; he was then chastised by a colleague for believing his subjects. But for them, obesity seemed like a solution to the problem of being the target of predatory men; telling them to learn how to eat right would be “grotesque.” More generally, Hari considers depression “a response to the sense of humiliation the modern world inflicts on many of us”—the powerlessness at work, the lack of feeling that you matter, the constant comparisons to richer and better-looking people in ads, the insecurity that means you could lose status at any moment. These are the things that we ultimately need to fix, along with generating authentic connections to other people through volunteering and other kinds of social engagement. Hari concludes that we shouldn’t tell ourselves that, until those fixes exist, pills are likely going to be enough.