Over the next few months, I'll be co-hosting a monthly book group with my friends Gaia Kile and Dr. Beth Barclay to discuss Lost Connections by New York Times bestselling author Johann Hari. In this book, Hari shares his firsthand experience of living with depression and his research on the underlying physical, emotional and societal components of depression and anxiety. Through interviews with experts in medicine and neuroscience, engaging conversation with members of diverse communities, and thorough journalistic research, Hari explores nine causes of depression - all related to disconnection - and lays out possible paths for reconnection.
Part I of Lost Connections tackles some of the biggest controversy about depression and conventional treatments, digging into the shortcomings of the monoamine theory of depression and low statistical efficacy of antidepressant medication. This material has been revealed in previous publications such as Robert Whittaker's Anatomy of an Epidemic, The Emperor's New Drugs by Harvard Director of Placebo Research Irving Kirsch, and Dr. Kelly Brogan's A Mind of Your Own. It's important to note that Hari, and our discussion cohort, are not disputing a biophysiologic component to depression, but rather are eager to dig into what is known about the causes of depression that are not currently being incorporated into conventional treatment, or being addressed on a preventive basis. These causes include societal factors which lead us to consider the rising incidence of depression as a societal problem, rather than exclusively an individual problem.
In The New Mind-Body Science of Depression, a tome of research analysis written by psychiatrists Vladimir Maletic and Charles Raison, the authors state that "...in fact, we already know more about the cause(s) of depression than we generally acknowledge. Thus, we can say with confidence that gene-environment interactions are at the heart of depressive causality." That much is agreed upon; but where exactly to pinpoint on the gene-environment continuum (GEC) as the 'real cause' of depression is not. Maletic and Raison argue that the answer depends upon what you consider to be 'inside' and the 'outside,' and that lies in the eye of the beholder. For example, a geneticist would consider everything above the level of the gene the 'outside;' neuroscientists draw the line at the brain; psychologists, at the level of the individual patterns and behaviors; systems theorists, between interactions in the family; sociologists at the level of society or culture. Part II of Hari's book explores nine causes of depression and anxiety, located at several points along the GEC: the genetic (epigenetics), body/brain (neuroplasticity), individual behavior (disconnection from meaningful work and from other people), family of origin (adverse childhood experiences [ACES], trauma) and societal factors (disconnection from nature, societal hierarchies and systems of oppression). Though Hari's scope is pretty wide along the GEC spectrum, his primary focus and critique is at the societal level.
Section III deals with routes to 'reconnection' and social prescriptions for shifting toward meaningful values, meaningful work, and repairing our connection to the natural world. It speaks of the need to acknowledge and heal trauma, both on a personal level and a societal level, and to dismantle the dysfunctional systems in place that contribute to intergenerational and cultural trauma. It speaks of the need to reconnect to one another, and take care of one another, in new ways. Hari shows us that the societal end of the GEC spectrum is rich with opportunity for creating a more favorable environment for human connection and mental health.
Our first meeting is May 24th at 7:15 pm at downtown AADL library. Hope to see you there!
Copies of Lost Connection are available at a 20% discount to book club members at Bookbound independent community bookstore.