LOST CONNECTIONS-Johann Hari

imbalance in his brain. As an adult trained in the social sciences, he began to investigate whether this was true, and he learned that almost everything we have been told about depression and an anxiety is wrong. Across the world, Harry found social scientists who are uncovering evidence that depression and anxiety are not caused by a chemical imbalance in our brains. In fact, they are largely caused by key

problems with the way we live today. Harry's journey took him from from a mind blowing series of experiments in Baltimore, to an Amish community in Indiana to an uprising in Berlin. Once he had uncovered the nine real causes of depression and anxiety, they led him to scientists who were discovering seven very different solutions, ones that work. It is an epic journey that will change how we think about one

of the biggest crises in our culture today. His Ted talk Everything you Think You Know about Addiction Is Wrong has been viewed more than eight million times and revolutionized the global debate. This book will do the same. The book that we're featuring, the Seething is Lost Connections Uncovering the real causes of depression and the unexpected solutions with my special guest journalist and author Johann Hari. Thank you very much for a Greenness interview and welcome back to

the program. Johann Hari.

started this book three years ago. Take us back to that first time and your experience with antidepressants, and then tell us about the impetus for this book, the reason for this book and where you started and three years ago.

bleeding out of me. I didn't understand it, I didn't I feel quite ashamed of it. I didn't know why this was happening, and my doctor told me a story about why I felt this way. He said, as entirely biological story. He said, well, we scientists have discovered what causes this kind of will, causes depression. There's a chemical called serotonin in people's brains. Some people are naturally lacking it. You're clearly one of them. And the solution is just

that we need to give you these drugs. So I started taking as you say, packed and I felt an immediate and significant boost, and for several months I felt radically better. But after a while this sense of pain started to kind of bleed back through. So I went back to my doctor. He said, clearly I didn't give you a high enough dose. I started taking a higher dose. Again. I felt better again, I started to feel a lot with side effects, so I started putting on a lot

of weight, for example. Again this sense of pain started to bleed back through, and I got a higher dose. And it was kind of in this cycle until I was taking the maximum possible dose for thirteen possible for thirteen years, at the end of which I was still depressed. Right. I had felt some benefits initially, but I was still depressed. So for my bit lost connections, I really want to go on this journey to understand what's to really solve

these two mysteries, what's happening here? Right? So I ended up going traveling, as you say, over forty thousand miles to meet the leading experts in the world about what causes depression and anxiety and what solved them, and to go to places that had very different perspectives on this.

And I think I learned many things for this book but on this but one of the most important to me was I realized that until I went to my doctor when I was a teenager, I thought my depression and anxiety were all in my head, meaning, you know, I was just being weak. I needed to man up, I needed to be tougher, you know, insert whatever stigmatizing

cliche you want there. And then for the next thirteen years, I thought depression was all in my head, meaning it was just a kind of chemical imbalance in my brain. But actually, what I learned on this journey is from the leading experts in the world, there are real biological factors that can make you more sensitive to these problems.

There are real brain changes, your genes, and so on, which are write about in the book, But actually the main causes of these problems, according to for example, the World Health Organization, the leading medical body in the whole world, are largely not in our heads. They're mostly in specific factors in the way we're living. I learned there are nine causes of depression and anxiety for which there is scientific evidence. Two of them are biological, seven of them

are factors in the way we live. And once you understand that, it leads you to a very different set of solutions, ones that are more effective.

in the field believed that. Professor Andrew Scarlett, Princeton University says it is deeply misleading and unscientific to say depression is caused by low serotonin in the brain. One of the leading experts here in Britain, Dr David Healy, said to me, Yeah, you couldn't even call that story discredited because it was never credited. There was never a time when half of the scientists in the field believe it.

The reason we were sold that story that it was about low serotonin in the brain is because that was the story that was most popular with drug company prs. That was the story that made it easiest to sell you drugs because what it tells you is, oh, you've just got a natural chemical imbalance in your brain and these drugs are restoring you to a natural state. Right now,

that's not true. That doesn't mean these drugs have no value mentioned Professor Irvin Kersho's the leading expert on this at Harvard Medical School who's done really important research on this question. And there's many things he discovered, but I think the most important is depression is often measured by something called the Hamilton scale. I've always felt really sorry for whether Hamilton was that we only remember him by

measuring how miserable we are. But the habit of scale goes to give you a sense of it from one where you would be dancing around in ecstasy or maybe on ecstasy, to fifty one, where you would be acutely suicidal, and to give you a sense of what movement on the Hamilton scale looks like. If you improve your sleep patterns, you'll generally gain six points on the Hamilton scale. And if your sleep patterns deteriorates to say, you know, you have a kid or something, have a baby, you'll generally

lose six points on the Hamilton scale. What Professor kersh fan by looking at the data, so there's a very selective. The way it works is everyone knows what if you take selfies to you know, do your Tinder profile, you you know, you take thirty pictures, you get rid of the twenty nine where you look like you've got a double chin or like you're building or whatever, and then you use the thirtieth one as your Tinder profile picture.

When the original applications were being made for antidepressants to be released and they were applying to the drug regulators, it turned out the drug companies did something very similar. They basically selectively released the studies. So only the studies which suggested the drugs had a really powerful effectas were released, were published. So we ended up with a quite distorted picture of how well they did. What professor Kershpound is if you look at the data, all the data, not

just the stuff that they released to the public. But what he showed is, on average, chemical antidepressants moved people one point eight points on the Hamilton scale. So remember, improving your sleep patterns gives you a six point boost on average, chemical anti depressants give you a one point eight point boost. There's a few things that are important to stress about that. Firstly, that's an average, so I initially got more over time, I got less. Important to say,

there's a debate. Some people think it works better with people with severe depression, and it's important to say some scientists think that that Professor Kirsher's figures slightly underestimate it, and that it's more like three points on the Hamilton scale. But once you understand that, what you can see is a few things. Firstly, one point eight points is worth having for some people, right, some people that boost will outweigh the significant side effects, in which case, you know,

I'm glad for them and they should carry on. But you can also see why for most people over time, that boost isn't big enough to solve the problem of

their depression and their anxiety. You need more. And one of the people who really helped me to understand one of the ways we need to think about this differently was a South African psychiatrist called Derek Summerfield, where I went to interview and he explained to me, just by coincidence, Derek was in Cambodia in two thousand and one when chemical and antidepressants were first introduced in that country, and the local doctors, the Cambodian doctors didn't know what these

drugs were. They've never heard of them, so they asked him, well, what are they. I'm sorry, I'm losing my voice, but and he explained he explained what these drugs were, and they said to him, oh, we don't need those, we don't need them, We've already got antidepressants. And he said, what do you mean. He thought they were going to talk about some you know, local herbal remedy or something.

Instead they told him a story. They told them about a farmer in their community who worked in the rice fields and one day he stood on a land line and got his leg blown off, and they gave him an artificial leg. They're good at that in Cambodia, as I saw myself when I was there, and they he went back to work in the fields. But apparently it's very painful to work underwater when you've got an artificial limb.

For obvious reasons. I'm imagining it was pretty traumatic for this guy to be back in the fields where he got blown up, and he started to cry all day. He didn't want to get out of bed, kind of classic depression, they said to Derek, So we gave him an antidepressant. Derek said, what was it. They explained that they went and sat with him, they listened to him. They realized that his pain made sense, that he wasn't some irrational malfunction. It was being caused by the way

he was being made to live. They figured if they bought him a cow, he could become a dairy farmer. He wouldn't have to be in this situation that was causing him so much distress. So they brought him a cow. Within a month, he stopped crying. His depression went away, they said to Derek, So that cow was an antidepressant. Right,

that's what you mean. What those Cambodian doctors knew, intuitively is what the World Health Organization, the leading medical body in the world, has been trying to tell us for years. If you're depressed, if you're anxious, you're not crazy. You're not a machine with broken parts. You're a human being with unmet needs, and you need support and help to get those needs met. And this is one of the things that really united not all, but most of the

causes of depression and anxiety that I learned about. Everyone listening to your showdown knows that they have natural physical needs. Right. You need food, you need water, you need cleaner, you need shelter. If I took them away from you, you would be in real trouble, real fast. Right. There's equally strong evidence that human beings have natural psychological needs. You need to feel you belong, You need to feel your life has meaning and purpose. You need to feel that

people see you and value you. You need to feel you've got a secure future. And our culture is good at many things, but we've been getting less and less good at meeting these underlying psychological needs but very large numbers of people. And that is one is not the only one, but that's one of the key reasons why we have a growing depression and anxiety crisis.

recommended they'd not be given to teenager. One thing it was shocking as one of them was the drug that I was in fact given as a teenager PASO, And it was quite shocking as well to see some of the leaked memos from the drug company that produced these

drugs saying they didn't work for teenagers. But I think one of the other names for the drug is peroxetine, and I think the wording of the memo was that it would be commercially unacceptable for the profile of peroxetine to release that information, so they didn't, So they carried on giving out We know this partly because there was a big court case taken by Elliot Spitzer when he was the Attorney General of New York State against the drug companies and they had to make a big payout

in court because of the court found they had in fact misled people about giving antidepressants to teenagers. So I think again what that shows is I'm not arguing that we should take chemicalanty depressants off the menu. They do give some relief to some people. What I'm arguing is we need to radically expand the menu because they're not solving the problem for extremely large numbers of people. It doesn't mean they have no value, but it does mean

we need a lot more options. And one of the things that was so fascinating to me was meeting all over the world with people who were acting on this insight. So I'll talk about one of the causes of depression anxiety, and then someone who decided to effectively do the equivalent of what those Cambodian doctors want to do, which is bind a cow for the problem. Right, So we are the loneliest that has ever existed. There's a study that asks Americans how many close friends do you have who

you can call on in a crisis? And when they started doing this study years ago, the most common answer was five. Today the most common answer is none. It's not the average, but it's the most. There were more people who say none than any other option, which is

kind of startling, right. And I remember I thought about this a lot because I interviewed extensively the leading expert on loneliness in the world, a man who sadly actually died this week, a wonderful guy called Professor John Cassiopo, who did really groundbreaking research on this, and Professor Cassiopo discovered what he discovered many things. One's shocking one. He showed, so when we're stressed, we release a hormone called corssol.

He showed that feeling acutely lonely is as stressful for human beings as being punched in the face by a stranger. And he explained to me, you know, if you think about why are you and I able to have this conversation, Dan, it's partly because our ancestors on the savannahs of Africa were really good at one thing, right. They weren't bigger than the animals they took down, they weren't faster than the animals they took down, but they were incredibly good

at banding together into tribes and cooperating. Every human instinct is to live in a tribe. Bes need to hive, Humans need a tribe. If you think about the circumstances where we evolve, if you were separated from the tribe, you were frightened and anxious and depressed for a really good reason. You were probably about to die, right, you know, And those are the impulses we have. We are the

first humans to ever try to live without tribes. It's contrary to our human nature, and especially because one of the heroes of my book Lost Connections is someone who really absorbed this insight in this research and began to act on it. So, as you can tell from my weird down to Abbey accent, I'm British, or though I spent life in the US and here in London at the moment. In East London there's an extraordinary doctor called Sam Everington. So Sam is a general practitioner in a

poor part of East London. It's actually where I lived for a long time, although sadly he was never my doctor. And Sam was really uncomfortable because like me, he's not blanket the opposed to chemical antidepressants. But he could just see he had loads of patients coming to him who, for example, were really lonely, and he could just see that this wasn't solving their problem, you know that for most of them. So he decided to try something different.

One day, a woman came to him called Lisa Cunningham. Lisa had been shut away in her home with crippling depression and anxiety for seven years. She'd barely left her house and Sam said to Lisa, don't worry, I'll carry. I'm giving you the drugs. I'm also going to prescribe something else. I'm going to prescribe for you to take part in a group. So there was an area behind the doctor's surgery that was just kind of like scrubland, right, And he said to Lisa, what I'd like you to

do is to turn up twice a week. I'll come and support you. And the group of other depressed and anxious people were going to turn this scrubland into a beautiful garden. The first meeting of the group, Lisa was literally physically sick with anxiety, but she kept going. And several things happened in this group. One is these were inner city East London people don't know anything about the natural world, right. They started to put their fingers in

the soil. They started to teach themselves gardening, and they started to you know, they didn't know anything about any of this stuff. And there's a lot of evidence that interacting with the natural world is a very powerful antidepressant for reasons we can talk about if you want. They also started to do what human beings do when we form tribes. They started to solve each other's problems. There was one person, this is an extreme example in the

group who was sleeping on the local public bus. Right the drivers would just let him sleep on the night bus. Everyone else in the group was like, well, of course you're depressed if you're sleeping on the bus. They started pressuring the local authority to get this guy a home, and they succeeded. It was the first time done something for someone else in years, and it made them feel great.

Over the weeks and months and then years, the garden began to grow, the way Lisa put it to me, as the garden began to bloom, we began to bloom. There was a study in Norway that found a very similar program prescribing people to take part in gardening was more than twice as effective as chemical antidepressants. I think for a kind of obvious reason, right, it's dealing with the reasons, some of the reasons why they were depressed in actions in the first place, and everywhere away in

the world. I write about seven different kind of alternative antidepressants because I think anything that reduces depressions should be regarded as an antidepressant. That program is an antidepressant. But why do we hear all the time about the drugs which have some value, and not about, for example, this program,

which was shown to be twice as effective. It's because there's a ten billion dollar industry in drugging Lisa, and there's a zero billion dollar industry in getting her to learn gardening with other depressed and anxious people and bonding with other people. So we've ended up with a very distorted picture what explains depression and anxiety. It's not that the biological stories. There are real biological explanations for depression

anxiety which do contribute to it. There are real brain changes that happen when you become depressed, and there are obviously real your genes can make you significantly more sensitive to these problems. But what we've been told is a story that focuses almost entirely on those factors and barely all on the wider factors which the World Health Organization says are the main drivers of this crisis.

It's just outside Spokane in Washington State. And then the woman who runs it co founded it, is called Dr Hillary Cash's a really extraordinary person, and she became a kind of accidental expert on this because she happened to have an office near the Microsoft officers in the nineties, so she saw the first wave of Internet addiction that later becomes a kind of TSUN army. And it was I've got a bit. When I arrived at this Internet

rehab center. My first thing I did, absolutely instinctively get out of the car's clearing in the woods, was I glanced at my phone and felt really irritated though I didn't have any self overception and couldn't check my email, and I was like, oh wait, you're in an Internet

rehab center. You're in the right place, right And what's fascinating is they get all kinds of people that restart Washington, but one of the biggest group, the biggest kind of demographic group they get, is young men who've often become obsessed with these multiplayer role player games like World of Warcraft and Doctor Cash said to me, what do these young men get out of these games? They get the things they used to get from the culture but no

longer get. They get a sense of tribe, they get a sense of identity, They get a way to rise, to gain points, to gain status. These are things that culture doesn't give to these young men, anyway to give to many people anymore. You know, there's a study in Britain that found the average British child now spends less time outdoors than the average maximum security prisoner because by law, a maximum security prisoner has to have seventy minutes a day,

and most kids don't get that. So you think about the profoundly strange environment in which these kids have grown have grown up. So what it is is an attempt to fill the whole that's been left by the connections we've lost. Now it's not a good way to fill that hole. And I think as I spent a lot of time there speaking to people that came to think that the relationship between social media and social life, I think is a bit like the relationship between pornography and sex. Right.

I'm not opposed to pornography. Sometimes I look at it, but if your entire sex life consisted just of looking at pornography, you would go around constantly frustrated and irritated. Because we didn't evolve to look at images of sexual images, just we evolved to have sex, right, and no one spends an hour looking at porn and feels valued and held and satisfied the way you do worce. You've had sex if it goes right, you know, not every time, obviously,

and in a similar way, you know. It also made me think about the moment in history when the Internet arrives, right, so the internet arrives in our lives for most of us in the late nineties the early two thousands, when a lot of the factors that are driving up depression and anxiety that I write about in Lost Connections had already massively been supercharged. Right. I go through nine courses, most of them had risen by them or had all

remained high. And actually what's interesting is the Internet arrives and it looks a lot like the things we've lost. Right, We've lost our friends, so it looks like it Facebook friends, We've lost our status officers, status updates. Right, But actually it's a parody of the thing we've lost. Now, this is not to say, of course, and doctor Cash, who runs the start Washington, said this very clearly. You know, it's not to say that the Internet is a bad thing,

or that would be ludicrous. Right, she's on Facebook, I'm on Facebook. But if it dominates too much of your life evolve to interact through screens, it doesn't meet our deeper needs. Right. The deeper communication we need is this face to face communication where we see it into each other's eyes. We send these forms of communication, those are the forms of communication that meet out deeper needs.

you end up making lots of comparisons. And one of the things we know is one of the things that makes people much more depressed is thinking about your life externally and looking at other people's lives externally rather than thinking about what you actually value, makes you more depressed. There's kind of a lot of things going on there.

And I was like okay, and he went back, you know, behind the ovens and everything, and he brought out a massive Christmas card they'd brought me, the entire staff had brought me, and it said to our best customer. My heart sank, partly because I thought, this is even the fried chicken store I come to the most right. So we all know how jung food appeals to the part of us that evolved to need food, but it doesn't give us nutrition. It doesn't give us, you know, the

things we need. A very similar thing has happened to our values. So the thousands of years, philosophers have said, if you think life is about money and status, you and you know how you look to other people, you're much more like it's become depressed and unhappy. But weirdly, no one had actually scientifically investigated this until an extraordinary man I got to know, called professor Tim Kasser who's

at Knox College in Illinois, and Professor Casson Knu. You'd already been discovered that there are basically two ways human beings motivate each other motivate ourselves. To put it crudely, so, imagine you play the piano in the morning because you love it.

You know, maybe there's some piano fetishist out there. Right, that would be an extrinsic reason to play the piano. You're not doing it because you love it. You're doing it to get something else out of it. Right now. Of course, we're all a mixture of intrinsic and extrinsic motivations. Every human being is. But what Professor Kassa showed is several things that are really important. As a culture. We have become much more driven by these junk values, by

these extrinsic values, than we were before. And the more you are driven by these junk values, these extrinsic values, the more you will become depressed and anxious by quite a significant effect. There's now been more than two dozen studies that have shown this across the world, and there's several reasons for us. Professor Kassa has discovered lots of reasons why living this way makes us so depressed. I'll

just give you two examples. One is one of the things that makes human beings feel really good is what are called flow states. So there are moments when you're doing something you love. So for me it's writing, for someone else it might be running or singing or whatever, and you're just in the zone and you feel you're flowing in the moment and time seems to just melt away. That's called the flow state, right. They make people feel

really good. We need them as human beings. And what Professor Cassa showed is the more you are driven by junk values, by how you look to other people, the less you get into these flow states. So you imagine when you're playing the piano and because you love it. And now imagine you suddenly stop you in the middle of playing the piano because you love it, and suddenly you think, how do I look to all the other people in this room? Am I the best piano player

in the United States today? How much am I going to be paid for playing this piano? You can see how that would jolt you out of the flow state right more we were driven by junk values. The more

that happens, you can see this. I mean the other day I went to a music concert, right, amazing concert, and you just see people who are in the moment, you know, listening to this great performer, and suddenly they get out their phones and they want to show off on Facebook that they're at this thing, right, and you can see how it jolts them out of the experience out at the moment, we are all being jolted out of these blowstates much more because we've all become driven

much more by junk values. Another example would be Professor Kassa found that the more we're driven by junk values, the more the worse our relationship has become. So I'll give you a concrete example. This is going to sound like a little bit of a dig, but I don't mean it as a dig. In two thousand and nine, Milania Trump went to speak at NYU, this is long before the political stuff happened, and a student asked hers something like, would you have married Donald Trump if he

wasn't rich? And she replied, do you think he would have married me if I wasn't beautiful? And what that shows is how much their relationship is driven by these extrinsic values. So what Millennia and Trump knows is if she got fat is over. What Donald Trump knows is if he lost his status and money is over. Right, Now, you can see why that would be a more insecure anxious relationship than say someone who'd say, you know what, I love my husband whether he's rich or poor. I

love my wife whether she's fat or thin. Right, it's the difference between everything being contingent and things being secure. Now, as a culture, we have become much more like Dol than Milania Trump, and much less like people who have more secure relationships. So those are just two of some of the reasons why these junk values are making us feel so much worse. And again that shows all this evidence.

Professor Casser and other people have found shows you can see why it's way too simplistic to just say to someone it's just a chemical imbalance in your brain. Of course things are happening in your brain. I don't think a chemical imbalance is the right way to describe that. But there are real things happening in your brain. But you can see why it's too simplistic. Your your brain changes in line with the way you live, right in the same way that if I start lifting weights my

arms will get bigger. Doesn't mean I've got on disease. I mean I'm using my arms differently. And so we've been told the story that's too simplistical. We need to have a much more complex conversation about what causes the depression of anxiety and how to solve them.

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talk about e classist. I'm mispronounced that. Sorry us a little bit about this, tell us a little bit about status and respect and this alpha baboon named Solomon.

So one of people he's made a really big breakthrough in understanding depression is a guy called Professor Robert Sapolski who's at Stanford University, and when he was in his early twenties, he went to go and live with a troop of baboons in Kenya and the savannahs of Kenya, and his job was to find out when are baboons most stressed, right, And so when baboons are stressed, like human beings, they release a hormone called cortisol. So what Rober's job was party to do is just dart these

baboons and then take blood samples from them. And baboons live, male baboons, interestingly, not the women, but the male baboons live in a very strict hierarchy. So so there's forty men in the baboon troop. Number one knows he's above number two. Number two knows he's above number three all

the way down to number fourteen. And where you are in the hierarchy determines what you get to eat, who you get to have sex with, you know, so the top baboon gets to have sex with all the women in the bottom baboon doesn't get to have sex with anyone, right, and suppressor Suposki lives with this this group, and baboons move through the hierarchy, right, So sometimes you rise to become the top baboon, the king of the swingers, and

then you can get knocked down from your position. As you get older and you get weaker, some younger guy is going to come up and start having sex with the women in front of you and eventually drive you out right. And what Professor Sepolski found was two things the baboons are most There are two circumstances where baboons are most stressed. One is when their status is insecure, So the top baboon when the young men are circling,

is insecure about whether he can keep his position. And the second is when you're at the bottom of the hierarchy. That the baboons at the bottom were stressed constantly. And what happens is the baboons that are at the bottom, that are stressed constantly, look a lot like depressed human beings. They withdraw, they don't want to get up. They keep their bodies low, their heads low, they keep their heads down. They show what's called a submission response. It's basically a

way of saying, okay, you beat me, just leave me alone. Stop, stop stop harassing and attacking me. Right, are you okay? You got me right? That's called the submission response. And what Professor Sepolski and quite a lot of other social scientists have argued is that modern human depression is part

of what's going on there. Is basically, if you are stressed and insecure too much about your status, or you feel you're at the bottom of the pile too much, you experienced these physical sensations which are a bit like the ancient forms of the submission response, the kind of what baboons experience of submission response, and what's into One of the ways we know this is that so baboons always live in a hierarchy, right, but humans don't always

live in strict hierarchies. Our hierarchy is mary. So, for example, Norway is a very equal country. So the richest Norwegian is not that much richer than the poorest Norwegian. The United States today is a massively unequal society.

big middle, right. And what we know, and Professor Kate Pickett and Professor Richard Wilkinson have shown this really powerful along with other people is the more a society becomes unequal, the more people feel humiliated, the more people feel defeated, the more depression and anyis al grows up, grows up. Right. So one of the things that's happening is we live in an environment that makes us feel Jesus, I'm being

defeated here, right. If you're constantly being bombarded with images of people who are so much richer than you, and there is no way you're ever going to get up to being to joining the of it. This is tiny early at the top, and everyone else is constantly stressed and harassed and humiliated that produces more depression and anxiety. This is one of the nine causes a depression and anxiety that are about lost connections. It's a disconnection from a sense that you are respected and have a status.

told this is what this is depression. You can see the brain is very different to a non depressed person's brain in all sorts of ways. This shows depression is a brain disease and it's an inherent problem, right, And lots of people have debunked this, but one of the people who really helped me to understand This is a wonderful guy called Professor Mark Lewis. So Professor Lewis has has shown and explained your brain changes as many other

scientists shims as well. Your brain changes according to how you use it. Right, Like I mentioned before, we all know this about other parts of our body. If I started lifting weights, which I tragically don't, but if I started lifting weights, my arms would become much bigger. It doesn't mean I've got an arm disease. It means using my arms differently, a very similar process happens with our brains.

So London taxi drivers famously have to sit a really difficult examination to get their license to be a London taxi driver. It's really hard to get this license. You have to memorize the map of London. It takes on average three years to do it. It's called the knowledge. If you do brain scans of London taxi drivers, their brains look very different to your brain and my brain. The part of the brain that relates to spatial awareness

is called hippercampus, is much bigger and more developed. Right now, that doesn't mean that being a London taxi driver is a brain disease. Obviously, right now, The danger with the story we tell about brains is it's true, as you become depressed, your brain changes. Now you're usually you're becoming depressed because of these wider factors that we're talking about and many of the others we haven't talked about yet. Your brain changes. Your brain changes in ways that do

make it harder to get out of that state. But it's important to stress. When you are given the support and love and the interventions that we know work to reduce depression and anxiety, your brain will change out of that state of depression. So this is called neuroplasticity. The brain restructures itself according to how you use it right, and so the danger what we do when we tell people these stories about people's brains. If we tell a static story about the brain, first of it, it's not true,

but secondly that actually traps people. It makes them, you know, it makes them think, oh, JESU, weal, I'm just biologically different, and to me, one of the worst things we do. One of the biggest problems about the story we tell about depression just being a chemical imbalance or just being some other problem in the brain is it tells people that their pain is meaningless. It's just a malfunction. Right, And one of the most important things I learned is

that our pain is not meaningless. Right. It is a signal is telling us something. It's telling us that are same has moved in a direction that does not meet our underlying needs. It tells us that we've got to change some of the ways we live together. Right, that's a really important signal if we pathologize that. You know,

an analogy that kept coming to me. This is a trivial analogy, but you know, I spend a lot of my time in the US, and it always amazes me the existence of indigestion pills, right, things like pepto bismal, and whenever I'm offered them, I always want to say to people, for wait a minute, Indigestion isn't a malfunction. Indigestion is a signal from your body that you're eating too fast. Right. You don't want to get rid of

that signal. That's a really important signal. If you don't listen to it, you're gonna hurt your stomach, give yourself stomach ache, you're gonna put on weight, you're gonna make yourself unwell.

any more than you should just sit with indigestion. It means that it's a signal that's telling us the direction in which we need to change.

if you understand this. So in the mid nineteen eighties, a wonderful scientist I got to know called Dr Vincent Feliti was working in San Diego and he was approached by kinds of Permanente, who are one of the not for profit medical providers in California, and they said, look, we've got this really big problem. Obesity was massively rising in California like in the rest of the country, and everything they were trying just wasn't working, like giving people

nutritional advice that kind of thing. And they were like, look, this is really screwing with people's health and with our budget. So they gave Vincent a really big budget to just do Blue Sky's research to figure out what the hell was going on. Right, So Vincent starts to work initially with a group of three hundred and fifty extremely obese people. These were people who weighed more than four hundred pounds, and one day he had this, well, seems like a

really stupid idea. He just said, what would happen if they literally just stopped eating and we gave them the vitamin supplements that they would need so they wouldn't get like scurvy and whatever. And so they decided to do it, obviously with like massive medical supervision and lots of doctors monitoring it. And the crazy thing is in one sense

it worked. They did, in fact lose loads of weight. Right, So there was one woman in the program, so I'm going to call Susan to protect her medical confidentiality, who went down from more than four hundred pounds to one hundred and thirty eight pounds. Everyone was celebrating, you know, her life has been saved. And one day something happens that no one expected. She freaked the hell out. She

goes to KFC or wherever it was. She starts obsessively eating, and quite quickly she's back at was not quite where she was, but a really high weight Vincent called her in and said, Susan, what happened? She said, I don't know, I don't know. She was really ashamed, and he said, well, tell me about the day that you cracked. What happened. It turned out that day something had happened to her that never happened to her when she was obese. A man had hit on her and it really freaked her out.

And Lynda started to ask, well, that's interesting. When did you start to put on weight? In her case, it was when she was eleven. He said, well, what happened when you were eleven? That didn't happen when you were you know, ten or fourteen, and she looked down and she said, well, that's when my grandfather started to rape me. Vincent started to talk to everyone in the program. He discovered that fifty five percent of them had put on their extreme weight in the way of being sexually abused,

which really startled him. He began to realize this thing that seemed like it was just an irrational pathology putting on loads of weight, which is of course extremely dangerous, in fact, was performing a function for these people. It was protecting them from sexual attention. As Susan put it, overweights overlooked, and that's what I needed to be. And

so this was still quite a small study. So Vincent got a load of funding from the Center for Disease Control, obviously one of the most important bodies in the US, and they start and they gave him a load of money so that every single patient it came to Kus of Permanente in the next year for anything, whether it was headaches, broken legs, schizophrenia, anything, was given a questionnaire and the questionnaire asked, firstly, did any of these ten bad things happen to you when you were a child?

Things like you know, sexual abuse, dosical abuse, and then it asked have you had any of these problems as an adult? Things like obesit, addiction, And then at the last minute they added depression and suicide attempts. When the CDC added up the figures, they were absolutely stunned. For every category of childhood trauma you experienced, you were radically

more likely to become depressed and anxious. If you had had six of those categories of childhood trauma, you were three thousand, one hundred percent more likely to have attempted suicide as an adult than somebody who had none of those categories. Right, you don't get figures like this in

science very often. One of the reasons I found this really hard was because and I actually was very resistant to this, And it made me realize why I had stayed this simplistic idea that depression is just a chemical imbalance in our brains, because you know, even quite early on, I had suspicions that this story couldn't be right. I'm not an idiot, right, if it was just a problem in people's brains, why would it be rising so much? Right?

But I think one of the reasons I stayed with that story is when I was a child, my mother had been very ill, and my dad had been in a different country, and I had experienced some very extreme acts of abuse from an adult in my life. I didn't want to think about that. I don't want to think that was still playing out in my life. I didn't want to reckon with it. I didn't want to think about the shame I felt about that. But one of the reasons I stayed with this is because of

what doctor Feliti discovered. Next. So, if you'd gone to a doctor and you've filled in this questionnaire, as everyone in San Diego had who was with Kus of Permanente, your doctor was told the next time you come in, say to the patient something like, I see that when you were a child you were sexually abused. I'm really sorry that happened to you. That should never have happened. Would you like to talk about it? And a significant minority of people said, I don't want to talk about it,

but most people did. On average, the conversation lasted five minutes, and then some of those people were told, I can refer you to a therapist to talk about it more. What they found was just that five minute conversation and nothing else led to a really significant falling depression of anxiety, and the people who referred on to a therapist haven't even bigger falling depression of anxiety. What that tells us, it's with a much wider body of knowledge that we have,

is that shane is catastrophic for human beings. It's devastating. For example, we know that in the age crisis, openly gay men died on average two years later than closetive gay men, even when they got medical care at the same time. Shame destroys you, and giving people ways to release shame is very powerful. After in that experiment, one of the a woman in her eighties, wrote to her doctor after they had this conversation. She'd been sexually abused.

She said, thank you so much for asking. I thought I was gonna die and nobody would ever know. And again, it was in the childhood trauma. It was when I was researching this child too traumahich is one of the nine causes I write that in Lost Connections of Depression and Anxiety. It was there that I really got a sense of howp unethical it was that I was told that it was just a chemical imbalance. You know a

thirteen years I was given chemical ancy depressants. Never once did any doctor say to me, is that any reason you might feel this way? And I think this is really it's not that. You know, doctors are very overstressed and they have very little time to spend with their patients and have a lot of sympathy for them, and as a society, we've only given them one lever to pull right, which is chemical anity depressants, I mean, and

a little bit of therapy in some cases. So I'm not so much anger with the doctor, but as a society and as a culture, we have to reckon with the scientific evidence about what is actually causing this crisis of depression and anxiety, and we have to look at the best solutions, and we have to offer more than just drugs. Drug should remain on the table. Of course, I'm arguing for expanding the menu of options, not for taking anything off the menu. But we have to do a much better job with this.

to make myself happy. Would you actually become happier? And they looked at this in four countries the United States, Russia, China, and Japan, and what they discovered was totally fascinating. In the United States, if you try deliberately to make yourself happier, you do not become happier. But in the other places, if you tried to make yourself happier, you do become happier.

They were like, what's going on why? And what they discovered was in the United States and Canada and Britain, I'm pretty sure if you try to make yourself happier, generally what you do is something for yourself, you try to get promotion, you buy something for yourself, you show off on Instagram, whatever it is. Generally, in the other countries Russia, China, and Japan, if you tried to make

yourself happier, you generally did something for someone else. You do something for your friends, your family, and your community. So we have an individualistic idea of what it means to be happy, and they have a collective idea of what it means to be happy. And it turns out our model of happiness just doesn't work very well. Right, It's just not very effective. It's not the species we are.

In fact, if human beings had been individualists from the start, you and I wouldn't be having this conversation because the species would have died out because they wouldn't have been able to cooperate enough to survive. Right, Their theory of

happiness and more collective theory of happiness does work. And I've tried to very deliberately move myself and I realized that in the past, not every time, but a lot of the time when I felt these painful feelings coming, generally, what I would do would be something for myself, right, I would try to dig myself up in some way now. When I feel those painful feelings coming, generally, what I try to do is do something for someone else. And I don't mean, you know, I'm not like, oh for it.

I don't turn up with a free car for someone. I just leave my phone at home and try to go and sit with them and listen to them. We live in a culture where people are so isolated, with so few people are heard and seen that just turning up and being present with people it's one of the most and really being present is one of the most powerful things we can do. So there are lots of things I go through in lost connections, lots of things

that people can do. Some of them are individualistic things, some of them are bigger things we need to fight for collectively. But there are these solutions waiting for us, and there is evidence that they work.

So on Wednesday night, I'm going to kill myself. And you know, this was a housing project and slightly weird it's It was a quite poor part of Berlin for a long time, and basically people who lived there were either recent Muslim immigrants, gay people, or punk squatters who, as you can imagine, looked at each other with a lot of you know, incomprehension, right, and no one knew

Nuria on this housing project. But people saw this sign in her window and they started to knock on her door, and she was like, They were like, do you need any help, and she was like, screw you, I don't

want an help. I'm going to kill myself. And some people started talking in the kind of outside her apartment and they were like, you know, there's this big thoroughfare that runs into the center of Berlin that goes through this this project is called Kotti, And they were like, maybe if we just blocked the road for a day and we protested because a lot of them were really angry that their rents were going up so much as well.

We just protested and we wheeled Nuria out. Maybe there'll be some media coverage, you know, maybe they'll you know, let her stay in her apartment. So they decided to do it. So one Saturday, they blocked the road and they wheeled Nuria out. She was like, well, I'm going to kill myself anywhere, and may as well do this.

And they did get quite a lot of media coverage that day in Berlin, you know, the local news came and at the end of the day the police turned up and they basically said, okay, you've had your fun, take it down. And the people there said, well, hang on a minute. You haven't told Nuria she can stay here, and actually we want a rent freeze for all of us, right, so we'll take this down when we've been guaranteed that. But they knew that the minute they left this barricade

the police would just tear it down anyway. So there was one of the people who live in Cottie, one of my favorite people there, called Tanya Gartner, who she's one of the punks there. She wears tiny mini skirts even in Berlin winters, which shows real dedication Tanya. Tanya had in her apartment one of those things that makes a really loud noise for soccer matches or clackson. So she went and got it and she put it down

and she said, Okay, what we're going to do. We're going to draw up a timetable to man this barricade and if the police come to take it down, let off the clackson. We'll all come out of our apartments and we'll stop them, right, So people who don't know each other all over COTTI start signing up to do the night shift. Right, Tanya and Nuria were paired together to do the night shift. You cannot imagine what a likely combination of people. Nuria, as I say, is a

very religious Muslim and a headscarf. Tanya is the opposite, right, and they're paired. I think they had the Thursday night shift, if I remember rightly. And the first few nights they sit together, it's just super awkward. They don't know what to say. They think they've got nothing in common. Then they started talking about their lives. Turns out they had something extraordinary in common. Nuria had come to Berlin when she was seventeen years old from her village in Turkey.

She came with her two kids, and the idea was that she would make enough money so she could then send back the money to her husband, who would come and join her. After she'd been in Berlin for a short time, she received word that her husband had died. She'd always told people that her husband had died of a heart attack. She told Tanya something she'd never told anyone, that actually her husband had dieded tuberculosis, which was seen

as a disease of poverty. She'd been really ashamed as that, so she'd found herself alone in Germany, not knowing anyone to young children. Tanya told Nui or something about her life. She'd been thrown out at home when she was fifteen. She found her way to live in a squat for punks in Kotti. She got pregnant when she was fifteen. They'd both been alone in this frightening place with young children. When they were still teenagers themselves. They realized they had

so much in common. All over Kotti there were these pairings of people who would never have spoken to each other. There was a young Turkish German lad called Mehmet who was seventeen, loved hip hop, kept being nearly thrown out of school because they said he had ADHD. Got paired with a seventy year old, grumpy white German guy who loved stalin right. The old German guy started helping him with his homework when they did their shift right. And

this was happening all over Kotty. Opposite the housing project, there's a gay club called Zudblock, which run by guy I love called Rickard Stein and to give you a sense of the previous club that Rickard owned was called Cafe Anal. So these are pretty cop guys, right. And when they first opened the club, you can imagine there's a lot of religious Muslims who live there. They'd smashed the windows. There've been a lot of opposition to this club.

The zudblock. The gay club started saying. When the protests began, they gave loads of their furniture to the protest. They said, after a while, they said, you know, you guys could come and have your meetings for free, and we'll give you food and drinks in this gay club. And at first even the kind of lefties in Kotti were like, look, we're not going to get these Muslims to come and sit under posters for fifting like Claub, but you know,

meetings about our protests. But actually everyone took these small steps to begin to understand each other. After the protest had been going on for about six months, a guy turned up one day at the protest camp called tun Kai and Tunkai has he's in his early fifties, was in his early fifties at the time. He has kind of cognitive difficulties, as you can tell when you meet him. He'd been living homeless. Then he started saying, can I

help out, and everyone in the camp loved him. Tunkai has this great energy about him, and he was really popular with all three groups, the Muslims, the gays and the punks. And he began living. You know, they'd actually turned this barricade into a permanent structure, and they said to him, you know, you could start sleeping here if you want. You know, he wanted to be sleeping on the street, especially in Berlin it gets really cold, so he started sleeping there. He became one of the great

fixtures of the protest movement. And after he'd been there for about six months, one day the police came. They would do these inspections and Tunkai doesn't like it when people argue. He thought the police were arguing, so he went to hug one of them. They thought he was attacking them, so they arrested him. That was when they discovered Tung Kai had been shut away in a psychiatric hospital for twenty years, often in a literal padded cell. He'd escaped and he'd found his way to Kotti, so

they took him back. The police took him back to this psychiatric hospital, and suddenly the whole of the Kotti protest movement turned into a kind of free Tung Kai movement. They descended on this psychiatric hospital in the suburbs of Berlin, and the psychiatrists they are like, what the hell is this. They suddenly got all these Muslims, gaze and punks demanding the release of this person who they'd kept shut away for twenty years. And I remember Uli, one of the protesters.

They're saying to them, you know, but he doesn't belong with you, He belongs with us. We loved him, we want him back. It took him a long time, but they got tun Kai released. He now lives in Koti. Many things happened at Koti. The kind of most important headline I guess is they got a rent freeze, not just for their entire housing project, but they launched a referendum initiative that got the largest number overwritten signatures in

the history of the city of Berlin. But the last time I went to see Nuria, the woman who had been suicidal, had put this notice in her window, had started this whole protest. Nuria said to me, you know, I'm really glad I got to stay in my apartment. That's a great thing, but I gained so much more than that. I was surrounded all along by these amazing people. And I never knew another. One of the Turkish Gairman

women in there. A woman called Nehreman said to me that when she was a kid and she grew up in Turkey, she learned that what you call home is just your what you call home is your whole village, right, that the village is home. But then she came to live in Germany and she realized that what you're meant to call home is just your four walls in the Western world, right. And then this whole protest began, and she said, we got to know each other, and this

whole place became my home. And she said she realized that all this time she'd been living in the Western world, she had been in some sense homeless. That we need to feel we belong and our sense of home in the West is too small to meet our sense of belonging, right, And I kept thinking about I mean, I learned so many things in Kotti. I think they think I'm crazy because I would just turn up every few months to listen to them and just cry because I felt it

so moving. But one of the things is those people didn't need to be drugged. They needed to be together. That so many problems that seem insoluble when you are an isolated individual becomes soluble when you have a when you have a group. You know, Nuria was suicidal, Tonguai was shut away in an actual padded cell. That young lad of Memet kept being nearly thrown out of school

because they said he had ADHD. Right, all these problems they've been insoluble when they were alone, were perfectly soluble when they were part of a tribe of people who cared about them and wanted to help them solve their problems. And to me, that's one of the most important things I learned that if we carry on just being broken up and isolated, you know, we might we'll find some patchwork solutions here and there, But the key is we need to reconnect. We need to build a sense of

home together. We need to because I guarantee anyone listening to this who is depressed and anxious, you are surrounded by people who are depressed and anxious, and they have the same longings for connection, for reconnection, for meaning to be seen and heard that you have, and we've got

to begin that process of a deep reconnection. So obviously there are many solutions to depression and anxiety that I talk about Lost Connections, but to me, that's the beating emotional heart of the most important one.

different people. And also if you want to take a quiz to see how much you know about the real causes of depression of anxiety, go to the Lost Connections dot com. You can also hear audio interviews with loads of the people we've been talking about, and some of the best experts in the world, all those people in Cottie and a load of other other great people who spoke to me said the book.

do a lot of things to promote my work. I draw any thirty nine year old man on Snapchat is probably a pedophile, right, you should be very suspicious of them. So fortunately you did not ask with my snaptat because I would have had to give a horrified answer.