Come Together: A New Kind of Antidepressant
"The proportion of people who continue to be depressed [whilst on antidepressants] is found to be between 65 and 80 percent." Hari
What if, like the adjective definition for 'antidepressant', we removed the precursor in which antidepressants are defined by their usual constitution as a drug? What if 'antidepressants' could be redefined as anything which can effectively 'alleviate depression'?
This is author of Lost Connections, Johann Hari's, theory anyway. After discovering that the cause of depression lies not in our brains but in the way we are living today (see previous blog post for an outline of the first half of Lost Connections), it makes sense that Hari dedicates the second half of Lost Connections to rethinking the solutions for depression.
Hari concludes the first half of Lost Connections with a nod to neuroplasticity (the ability of the brain to restructure itself based on lived experience). He highlights that although experiential factors (e.g. disconnection from meaningful work, meaningful values, nature and each other) hold the capacity to stimulate our brains to be restructured in a way that feeds on depression and anxiety, through reconnection we can reverse this.
1. Problem: disconnection from meaningful work Solutions: universal basic income + better working conditions
Studies have shown that 63% of workers are not engaged in their jobs. Those in low-level, monotonous, stress-free jobs are particularly depressed. It would be ignorant to suggest that people simply avoid these jobs. Sometimes we find ourselves stuck in these avenues, and more importantly, these jobs need doing. So instead, Hari explores several solutions to this issue, one of which is a universal basic income. This concept was once tested in Canada, where "instead of using a net to catch people when they fall, they proposed to raise the floor on which everyone stands." In the city of Dauphin, citizens were given $19,000 to live on each year. This meant they could work less, and spend more time with their families, learning or working on projects that really fulfilled them. Although this experiment was abruptly shut down after three years, the results from just that short period of time showed that the decrease in stress provided by the universal income meant there was a 9% reduction in rates of severe depression. There is a marvellous catch to this theory: in order to ensure those monotonous, but necessary, jobs are still done, wages and working conditions have to improve. Meaning, "in one swoop, the worst jobs, the ones that cause the most depression and anxiety, will have to radically improve, to attract workers." Win, win, right?
Obama seemed to understand. Before his presidency ended *cry*, he suggested a basic universal income could be the next big change needed:
“It’s not just money that a job provides, [...] it provides dignity and structure and a sense of place and a sense of purpose. So we’re going to have to consider new ways of thinking about these problems, like a universal income...” Barack Obama
2. Problem: disconnection from people Solution: making the private public
"What you are supposed to think of as home is your own four walls and the space within them [...] But as these protests erupted, their sense of home expanded [...] to cover the whole housing project and the dense network of people who lived there." Hari
Whilst we are seemingly more connected than ever through technology, for the last 50 years we have entered a loneliness epidemic, and this is having a detrimental effect on both our mental and physical health. In a housing project in Kotti, Berlin, people were being evicted for not being able to pay their rising rents. In an unexpected turn of events, they found a solution to not only this, but a sense of disconnection they didn't even realise was afflicting them, too. After one woman was driven by the threats of eviction to put up a note in her window saying she was going to kill herself, a few residents decided to begin a protest by creating a makeshift camp blocking the street. In a plea to create enough impact that their rent fees would be frozen, they created a timetable to ensure there would always be at least two people manning the camp. This is where the magic began as strangers, antithetical in nature, who had previously avoided each other in the street, spent hours together united in this mission to save this housing project. Theists and atheists, immigrants and Berliners, young and old, white and black, communists and reformists, gays and homophobes, conservatives and liberals; over time, through conversation and a shared goal, all of these previously heterogeneous individuals became one homogenous unit. Whilst the residents' goal of freezing their rents was successful, many declared they had gained something even more valuable: in allowing their once private lives to become public, they had become a neighbourhood, a community, a family. They realised, "how weird it is- the idea that we should all sit apart from one another, pursuing our own little story, watching our own little TV, and ignoring everyone around us."
I read this chapter whilst sitting on my window seat, and it prompted me to stare out at the world beyond the four walls of my home, at my 'community'. As I gazed into the flats across the road from me I tried to imagine the lives going on within them. I wondered how many people were struggling, or feeling lonely; how many lives could be bettered if we gathered together and became a proper community who looked out for and supported one another?
3. Problem: disconnection from meaningful values Solution: collectivism
What do you see in this photo? According to Hari and many social scientists, Westerners will first notice and describe the man addressing the crowd, and then the crowd, whereas Easterners will describe the crowd, and, as an afterthought, mention the man separate from the crowd.
This simple test epitomises the difference between individualistic (UK and USA) and collective (Japan, China and Russia) cultures. According to research, being individualistic or collective has a significant impact on how we pursue happiness. As part of an individualistic culture, it is suggested we generally seek happiness for ourselves, whereas in collective cultures, happiness is sought and defined in relation to others. Hari suggests the Westernised idea of curating happiness doesn't work: turning inwards when we feel down, seeking to feel better by examining and treating only ourselves. The latest crazes in mental health and wellbeing generally are self-care, self-help and self-love, but what Hari is suggesting here upturns all of that. The solution, then, comes not from fixating on the self, but instead "from dismantling our ego walls - from letting yourself flow into other people's stories and letting their stories flow into yours; from pooling your identity, from realising that you were never you - alone, heroic, sad - all along."
"An antidepressant [...] isn't just a pill. It's anything that lifts your despair."
What if these kinds of solutions to depression were promoted, as opposed to the act of being shunned away with a pill to swallow each day?
Hari likens the social change necessary for the movement of reshaping solutions to mental illness to the fight for race, gender and LGBT equality. All of these things which are now normal once appeared to be distant and unachievable fantasies. The pharmaceutical industry, which drives the affluence of drugs as a solution to mental illness, is so powerful that redefining what constitutes antidepressants seems similarly unreachable. But, like Hari, I believe that through the spreading of this information that so many people have been made blind to, the revolution that we so desperately require can be realised.
We must listen to our bodies and our minds. The depression and anxiety that so many of us are suffering from is a sign that something is not right. If that something is sociocultural, like Hari suggests and the research indicates, a drug will not fix it. We need to take responsibility and we need to make an active change in our lives; we need to come together and reconnect.