What the best science really says about depression | Johann Hari

For almost the last 100 years, mental health professionals have told us that depression is caused by a chemical imbalance in the brain. However, there is a much more realistic theory that depression occurs due to an imbalance that occurs outside of your skull. New York Times journalist Johan Hari believes that depression these days comes from social problems. Johann offers some amazing statistics that show that antidepressants seem to be doing far more harm than good, among them, that one in four middle-aged women in the United States is taking a chemical antidepressant in a given year. If we want to get rid of modern depression, he says, we have to change society.

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I continued to learn intellectually about the causes of depression and anxiety.

And that is much deeper than the story that my doctor told me, which is just a chemical that is missing in your brain.

But I think it was really emotional when I went and I met an amazing South African psychiatrist named Derek Summerfield. Then Derek was in Cambodia when the chemical antidepressants were first introduced there. And the Cambodian doctors did not know what they were, right? They had never heard of that. Then he explained it to them and they said: "Oh, we do not need them." We already have antidepressants. "

And Derek said, what do you mean?

He thought they were going to talk about some kind of herbal remedy or something like that.

Instead, they told him a story. There was a farmer in his community who one day, a rice farmer, who one day had stopped at a land mine and had his leg blown off. And then they gave him an artificial limb and he went back to work in the fields. But apparently it is very painful to work in water when you have an artificial limb. And I imagine it was quite traumatic: it will return to the fields where it was flown.

And he started crying all day. He did not want to get out of bed. Classical depression, right? And then they told Derek, "Well, we gave him an antidepressant." Derek said what did you do? They explained that they sat with him, they listened to his problems, they realized that his pain made sense. I was depressed for perfectly good reasons. They thought that if we bought him a cow, he could become a producer of dairy products, then he would not be so depressed. They bought him a cow. In a few weeks her crying stopped, it felt good.

They told Derek: "You see, doctor, that cow was an antidepressant." Now, if you have been raised to think about depression in the way you have indoctrinated us, that is just the result of: there are real biologicals. factors, but it's just the result of a chemical imbalance in your brain, that sounds like a joke, a bad joke. Did the boy get a cow as an antidepressant and stopped being depressed?

But what those Cambodian doctors knew intuitively is what the World Health Organization has been trying to tell us for years. Depression is a response to things that go wrong in our lives and our environments. Our pain makes sense.

As stated by the World Health Organization, mental health occurs socially. It is a social indicator. It requires both social and individual solutions. It requires a social change, right?

Now that's a very different way of thinking about depression and anxiety but it fits the best scientific evidence.

And it really required me to re-evaluate how I had felt about my own pain and how I tried to treat it unsuccessfully and open a completely different way of responding to my depression and anxiety that worked for me.

And I think that as the World Health Organization says and the UN says, if we talk less about chemical imbalances and more about power imbalances we will get more at the heart of depression and anxiety and we will find better solutions.

This was a … this was such a personal and difficult trip for me. There were these two mysteries that really tormented me, and it's a sign of how scared I was to see them. I wanted to start doing this seven years ago and I thought that it would actually be easier to make a book that would force me to spend time with the hit men of the Mexican drug cartels, which I did then.

And the first was: why was he still depressed? I went to see my doctor when I was a teenager and I explained that I had the feeling that the pain was running away from me. I did not understand. I could not regulate it. I was very afraid of that. I was very embarrassed about that.

Video credits to Big Think YouTube channel

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    What the best science really says about depression | Johann Hari

    Comments 40

    1. There still neurological causal reasons for depression…..but he's right a better environment and a sense if empowerment and high quality of life helps so so much to positively affect our biology.

    2. When you "take an antidepressant medication" you're just *doing drugs*. You're doing a psychotropic drug that (may) induce a desirable effect, such as feeling less depressed. There's a difference between a drug that REMOVES a disease state – Tamiflu, for instance – and a drug that INDUCES a desirable state. Prescribed psychotropic drugs, also known as psychiatric medications, are members of the latter category.

      There is no "antidepressant" drug that's somehow fundamentally different from, say, alcohol, or opium. If we don't know what "depression" actually is in terms of pathophysiology (and we don't), then we can't say that something like Prozac is anything at all like Tamiflu or Tenofovir. The best scientific evidence today indicates that to the extent that so-called antidepressants "work" (which is, putting it mildly, highly highly doubtful), they work because of a) expectation effects in human beings and b) they introduce desirable mental states.

      Taking an SSRI and finding that it helps you is fundamentally no different than drinking a glass of whiskey and finding that it helps you. The whiskey has greater potential for addiction, of course, and maybe its side-effect profile is less desirable than the SSRI, but again, at bottom, they're no different.

    3. I believe depression and anxiety arises from your childhood. You can be born with it or suffered physical and mental abuse from the time you were 5 to adulthood. Being abused in anyway for a long time has to have something to do with it. If your parents hit you or verbally abused you for years how can that be good for you?

    4. I hope those of you on medication do not stop taking them. THAT would be disastrous. If you want to get off medication, you need to wean yourself off bit by bit, day by day and then find yourself a crutch! That could be therapy or mindfulness meditation, but please don't watch this and leave your meds cold turkey. You will regret it.

    5. It’s confusing. One group says drugs does help, the other says doesn’t. I had depression and anxiety since I was a kid, recently found out it was inherit from my dad, cause he was depress and tried so many times to commit suicide. His doctor prescribes every type of anti-depression drug, anti-schizophrenia drug, but his condition even worsen. So we took him to to have electric shock treatment, lost few memory but the result still not very positive. Finally, we decided to give up. We notarise his testament as he wish , I throw his drugs away and accept the fact that he will gonna die eventually. Up until now, fourth months, he still alive and seems recovering gradually.

    6. I think this world needs to understand that not everything can be understand from the perspective of the brain (ego).
      This is not only a clinical thing, this is something that has a lot to do with the heart.

      Ego vs heart. U need them both. Most scientist ignore there heart, they think their brain can explain it all. ( just throw some antidepressant inside of it )

      WE ARE SOULS made by intelligence beyond us. We are not some meat bags +randomly here, yeah that is what the ego wants you to believe.

    7. I think much of depression is partly existential – we are aware on some level that we are going to die one day, and that's not a happy thought, so we do everything we can to suppress this understanding. It sometimes shows up as chronic low level depression and I think most people feel it at least some of the time. Life circumstances and a shitty society that fosters shame and exclusion and also part of the problem. I do not believe that it is purely an within-the-individual problem. I also don't believe that medications are the solution, though they may help short term for some people

    8. Underhanded trojan horse for socialism: You don't need medicine, you need the government to take care of you. Moving on…

    9. Wait, so you mean it's normal to feel sad after something bad has happened to you? weird.

    10. watch wild wild country on Netflix. People felt this disconnect in the sixties and joined cults. We are hip to it but some will be doing this again. history repeats.
      The fastest way to raise people in poverty from poverty is STEM all day in K to 12. The future is tech and all need to be able to code, Etc, and get a job at 75K out of high school. All possible and the best program from trump and betsy. Throw in emotional intelligence training and resilience and we have school systems making mature adults who can get out of poverty. They can listen to Joe Rogan once a week for extra credit. If you want to be a journalist or what ever, you can go to a specific school and write articles and interviews people for two years. No history, or any class that is not centered on being a jernalist. Very specific training. Not making all schools in poverty areas all STEM is cruel. First future job skills, then dreams.
      De criminalization of drugs, I agree with him 100%. People have a right to do to their bodies what they want but they can't drive or get pregnant. The drug war is idiotic and un American.
      Depression is caused by MANY factors. Anyone can listen to Joes show and change their life for the better by a large percentage.
      I agree that work sucks. BUT. Many people are self centered regarding what they want right now. Johann's family member with two kids and little child support for the father is a perfect example of poor planning and living in a fantasy. No intelligent woman who has worked hard to get an education would breed with a man who has not worked as hard as she. People who do Not think they are special plan for a poor outcome, especially to protect their children's future as well as they can. Unless he is in prison, He could be working a job to pay child support. She got herself into the mess she is in and frankly, who would not have seen that coming? Consequences help us learn. Why should someone else bail out people who make really self centered and stupid choices? I'm sure he can take care of her with his job and book sales. Seriously.
      Joe is 100% correct when he says most people are actually lazy. They do not want to learn or change. David Geffen put millions into gay marriage getting to the Supreme Court. It was not a vote by Americans. It was a less religious, more rational Supreme Court. Spirituality is the answer not religion. Geffen made it happen.
      Johann, like everyone who talks about mental health, is completely liberal and ignoring the FACT that many people are IMMORAL. They are under "personality disorders" in the DSM. That is where people who are immoral from a lesser to greater degree are listed with the criteria they exhibit. Trump is a malignant narcissist. Google it. Liberals make excuses for people. They want others to help them while ignoring the fact that personality disorders do not want to change and their core identity is being a victim. No therapy or drug can change that. Johann is delusional about everyone just needing a leg up. It is narcissistic to think others are like you. Immorality is a real thing. Immoral choices made over and over is the only reason people have very shitty lives.
      People are homeless because they made hundreds of immoral choices. No family or friend to help you when down? For good reason. The homeless are suffering the consequences of chronic immorality. Few really suddenly ended up that way. When you work in homeless services, clients have to get sober and take their meds for psychosis. They refuse. If the solution was as simple as housing, Bezos, Zuckerberg, Sorros, Gates, Ellison, Page, would easily solve it. Notice they ignore it? It's not because they are shitty guys. They looked into it and walked the fuck AWAY! Johann is a child about this. They can all get jobs and work. We do not need illegal labor. England has banned free speech. I have zero interest in following England's liberal cult mentality.
      Capitalism can be a harsh environment but it is a cleansing system. Anyone who has worked in our government, especially social services, knows that it is full of fraud. No one cares, they just get through the day, and everyone is on the make for free everything. My friend from Russia states every time I see him "I would rather be homeless on the streets of America, than ever live in a communist country". He got an education, worked in a kitchen, and got a job while learning English. He, like so many, came with nothing. Foreigners laugh at Americans who complain. Perspective and gratitude, with planning, is the way out of any bad childhood. One can get therapy for 35$ an hour in any city. What I learned in social work, anything given for free is not appreciated.

    11. countries, where kids are left with there families being killed by bombs their whole town destroyed that is real depression.
      “They claim their labors are to build a heaven yet their heaven is populated with horrors. Perhaps the world is not made. Perhaps nothing is made. A clock without a craftsman. It's too late. Always has been, always will be…too late.”

      ― Alan Moore, Watchmen

    12. I used to be powerfully manic depressive. And I didn't have any thing to be depressed about. Tried to kill myself once. No reason outside of just being depressed.
      But I got more educated on the subject myself. Now, when I'm feeling up, and soaing though the clouds, I bring myself down a notch by saying, look man, you know you're going to crash. Brace for impact.
      Teaching yourself what to expect in either case goes a long way to evening yourself out. Making your mind more boring. You lose the highs, true, but you also lose that dark, indescribable pit you get sent to.

    13. I'd call that Systemic Gaslighting. That makes me very curious to see if there's a correlation between Narcisistic traits and depression in geographic areas (or cultures).

    14. Yes…
      … but no:

      Psychosocial and chemical imbalance ideas of depression ignore the complexity of it, to satisfy our own biases.

      Also, to say it's a social problem ignores the disease problem… and to say it's a disease problem ignores the social problem; thus, resolute action is taken on neither.

    15. This bullshit idea that a doctor can diagnose a chemical imbalance. You can't do that without a brain biopt! Depression is a symptom of a western degenerate lifestyle. It's not that a single factor like diet, genetics, social status, sun exposure, sleep, circadian rhythm, sense of purpose matters exclusively, but it's that THEY ALL FUCKING MATTER! you can have fucked up genetics that give you a bigger amygdala, which makes you more prone to fear and anxiety and thus stress, which then can lead to greater susceptibility to stress related disease. You can be born on a high latitude so you lack CRUCIAL SUN EXPOSURE while living most of your time indoors, leading to cognitive impairment that's the result of light deprivation. You can come from a broken home having had shit parents who have left you inadequately socialized, which is the reason you don't have friends or have trouble maintaining them. As a result of your lack of social status you're constantly in a state of depression, making you impulsive and prone to alcohol and drug abuse. Which in turn ruins your health even more, besides the shit diet you're eating consisting of junkfood. Because you live a depraved perverted crap life and you engage in no meaningful endeavours whatsoever, so you stay up late gaming or bingewatching netflix till there's no more soul left in you and you pass out from the sheer stench of degeneracy and depravity. The next morning you wake up, you get up and you take your dose of citalopram and wonder if this is the day it will finally work for you. The problem with western thought is that we treat knowledge in a reductionist manner, when we should look at things holistically. If you think you've tried everything then guess again. I'll repeat myself by saying everything you do matters. The way you eat, sleep, spend your time etc. The big clou is that we evolved to behave in a specific way in relation to a specific environment. Any deviation from it causes drastic, often negative, consequences. You can't even be born via c section without having a weaker immune system for the rest of your life. You can't even be bottlefed without having a weakened immune system. We think we know better then nature but we are fools. Focussing on depression alone means missing the bigger picture. If you're looking for solutions focus on these things: sun exposure(or heliotherapy), circadian rhythm, sleep, social status, diet(look into paleo/weston price), exercise.

    16. The idea of depression is that you feel awful regardless of your circumstances. I'm happy for him, but he has managed to completely miss the mark here. Yes if you are sad due to your circumstances then changing your circumstances is much more effective than medication. But that would mean that you felt depressed. Not that you had clinical depressing. Which is very different. Even if everything is going perfectly, people truly suffering from depression will still have all their symptoms and feelings that go along with the illness. This video is very misleading and could do real damage to those suffering who might think it's their fault for how they've gotten to their current state of mental health and current life situation.

    17. What about people who have great lives and still feel depressed ? loving families, physical health, good income and still feel shit. Feeling depressed because you lost a limb can't work without pain and have hesitation to go back to the place of the trauma is a totally rational feeling, that's why it was justified, that's not depression. Depression is irrational or illogical.

    18. Thanks for that, but it's not about how we are living today, it's about how we perceive how we are living today. Reality is about perception and how your subconscious controls the habits of perception. Original Buhddist teaching know this well

    19. I was depressed a big part of my life. Then i began to eat D3-vitamin, 4000 ie a day during vinter. Life still sucks but i don´t care about it anymore. My brain became stable. Suicide-toughts is d-vitamin deficiensy (?). Really easy to fix!

    20. Depression grows from the loss of hope! If someone believes that there is hope they can fight depression

    21. I will try to give a simple analogy here,
      If someone suffers from a chronic heart disease for a long time , that does make him a cardiologist no matter how much research he/she does on the matter. It will still take a medical doctor to diagnose and treat the condition. Mental health conditions are no exception. Having suffered with anxiety and depression for a prolonged period and having read 100 books on the topic does not make one an expert. It will still take a psychologist/ psychiatrist to diagnose and treat the condition chemical / therapeutical based on the knowledge from more than a century of scientific medical research.
      So when some one person says that he has found some radical cure to these mental health issues which no has been able to think of ….. scepticism is warranted.

    22. What if you are depressed about the fact that our fellow earthlings like cows are systematically enslaved and killed?

    23. Thank you. This is what I've always said. It's an emotional response that's quite normal. I had extreme anxiety as a child, now circumstances have changed, I have not ha anxiety for a very long time. Circumstantial.

    24. Uggh this culture is so fucking backwards. We're force-fed this systematic fear of not making the grade, in some form or fashion. And that fear perpetuates big business initiatives and fuels the economy, while all of us are dissatisfied with ourselves. We're left with this gigantic void to fill, and we can't even pinpoint the source of it. This creates a dog-eat-dog mentality that fills us with a deep-seated apprehension that eats away at our self-worth and makes us form unhealthy conceptions of who we are. Once recognized, one can detect this malady in almost of every facet of our day-to-day lives. And there's really no palpable solution in sight..

    25. Access for all walks of life to mental health care allowing people to work through issues gaining tools to help resolve bouts of depression.

    26. We need to fix the problems that's plaguing our society/world in order to stop people from getting depressed/sad. A LOT needs to change.

    27. Very simplistic. Been depressed since 12 years old, and have relatives with depression – it's at least partially heredity. SSRIs make me suicidal.

    28. People as a community and their attitude towards those who has suffered depression or are suffering depression needs to change. There’s still a culture of shame towards people affected by a mental illness. Communities need to learn empathy towards people who suffers mental illnesses and contribute to a more loving and cooperative solution. If a person is suffering from mental illness, it’s not because they’re weak. In fact, they’re strong if they go to seek medical help because it’s one step towards recovery. Depression and anxiety can be healed, and it also requires the help of solving issues that drugs can not alleviate. Communities have the responsibility to their own society to reach out to those in need.

    29. Lmfao… It took you over a decade to research that there is a difference between depression as a chemical imbalance and psychological depression? You're dumb.

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