Feb 20

“Lost Connections”: Johann Hari on Depression & Anxiety

Through a breath-taking journey across the world, Johann Hari exposes us to extraordinary people and concepts that will change the way we see depression forever. It is a brave, moving, brilliant, simple and earth-shattering book that must be read by everyone and anyone who is longing for a life of meaning and connection. Eve Ensler, on Lost Connections by Johann Hari

In journalist Johann Hari’s Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, he tells readers his own long-term depression has been blamed on a chemical imbalance in the brain. However, at some point in his therapeutic process “…he began to investigate whether this was true – and he learned that almost everything we have been told about depression and anxiety is wrong.”

Hari’s research led him to this basic conclusion (HuffPost): “I learned that there are in fact nine major causes of depression and anxiety that are unfolding all around us. Two are biological, and seven are out in here in the world, rather than sealed away inside our skulls in the way my doctor told me…I was even more startled to discover this isn’t some fringe position – the World Health Organization has been warning for years that we need to start dealing with the deeper causes of depression in this way.”

According to Fiona Sturges, The Guardian, the factors cited by Hari that contribute to reactive depression “include hardship, trauma, loneliness, lack of fulfilment, absence of status and disconnection from nature.”

Particularly salient is what Hari gleaned about one of these from physician and researcher Vincent Felitti‘s work (HuffPost): “Childhood trauma caused the risk of adult depression to explode. If you had seven categories of traumatic event as a child, you were 3,100 percent more likely to attempt to commit suicide as an adult, and more than 4,000 percent more likely to be an injecting drug user.”

Felitti, in fact, is “co-principal investigator of the internationally recognized Adverse Childhood Experiences (ACE) Study, a long-term, in-depth, analysis of over 17,000 adults…(T)he ACE study shows that humans convert childhood traumatic emotional experiences into organic disease later in life” (Big Think).

Hari, furthermore, makes this helpful point:

One day, one of Dr. Vincent Felitti’s colleagues, Dr. Robert Anda, told me something I have been thinking about ever since.
When people are behaving in apparently self-destructive ways, ‘it’s time to stop asking what’s wrong with them,’ he said, ‘and time to start asking what happened to them.’

In the case of more endogenous depression, or the biologically based type, Hari now believes Big Pharma and prescribers take advantage of the popularized but not necessarily accurate notion of the brain having a chemical imbalance. There is a significant body of research that disputes both this theory and the efficacy of the prevailing remedy, antidepressant medications.

Take the brief depression quiz on his website and be prepared to learn some other things that may be surprising.

If meds aren’t always effective, what other kinds of solutions to depression/anxiety did Hari find and thus present in Lost Connections? Kirkus Reviews reports the author’s view that there are “immense (natural) antidepressive benefits of meaningful work, social interaction, and selflessness.”

For further details we have to read the book.

Apr 12

“This Close to Happy” By Daphne Merkin: Severe Recurrent Depression

The opposite of depression is not a state of unimaginable happiness…but a state of relative all-right-ness. Daphne Merkin, author of This Close to Happy

I think the experience of depression that I most think remains true throughout the years is it’s very isolating. That to me is its strongest quality. That you’re alone in a room, that you’re cut off, you’re just sort of stuck with it. It puts up a wall. Maybe other people are more hopeful for you when you’re depressed when you’re young. Daphne Merkin (Boston Globe)

As introduced by the publisher of Daphne Merkin‘s This Close to Happy: A Reckoning with Depression (2017):

Daphne Merkin has been hospitalized three times: first, in grade school, for childhood depression; years later, after her daughter was born, for severe postpartum depression; and later still, after her mother died, for obsessive suicidal thinking. Recounting this series of hospitalizations, as well as her visits to myriad therapists and psychopharmacologists, Merkin fearlessly offers what the child psychiatrist Harold Koplewicz calls ‘the inside view of navigating a chronic psychiatric illness to a realistic outcome.’ The arc of Merkin’s affliction is lifelong, beginning in a childhood largely bereft of love and stretching into the present, where Merkin lives a high-functioning life and her depression is manageable, if not ‘cured.’

Publishers Weekly on Merkin’s past and its possible effects on her mood disorder:

Merkin arrives at no easy conclusions about childhood trauma or biological circumstances. She writes candidly about her lonely childhood with Holocaust survivor parents who were forced to fight their own demons. Despite her family’s wealth, Merkin and her siblings were subjected to austerity and abusive caretakers, and their mother was emotionally absent. Merkin’s exploration into her complicated yet unconditional devotion to her mother is rendered with compassion and profound perception.

Andrew Solomon, another who’s written eloquently about personal depression (The Noonday Demon), praises This Close to Happy (New York Times), noting that “(t)his is not a how-to-get-better book, but we hardly need another one of those; it is a how-to-be-desolate book, which is an altogether more crucial manual.”

Which is not to say that Merkin doesn’t tell readers about her struggles to get better, which have included medication and therapy. Kirkus Reviews:

She believes in the benefits of decades of therapy and medication, without which it’s doubtful she would have been able to write this book…Hospital stays (the last was eight years ago) have provided respite and occasionally companionship, but circumstances have been rarely much better upon her exit. Merkin has deeply ambivalent feelings about electroshock treatment, resisting a doctor’s suggestion of how much she would benefit and then regretting her refusal.

Selected Praise

Glen O. Gabbard, MD: “This beautifully written tale of Daphne Merkin’s depressive demons is by far the most accurate and human account of depression and its impact that I have ever read. I highly recommend it, both to those in the mental health professions and to those who care about the suffering of their loved ones.”

Adam Phillips, therapist: “D. W. Winnicott wrote that depression is the fog over the battlefield. In this extraordinarily lucid and moving book, Daphne Merkin illuminates the dark and desperate battle that depression can be. This is a book for all those who know nothing about depression and for those who know too much.”

Carol Gilligan: “This Close to Happy belongs on the shelf with William Styron’s Darkness, Visible and Andrew Solomon’s The Noonday Demon. It brings a stunningly perceptive voice to the forefront of the conversation about depression, one that is both reassuring and revelatory.”