By Johann Hari. Bloomsbury, 336 pp, hardcover
With 2015’s Chasing the Scream, British journalist Johann Hari laid out a compelling case against the war on drugs. Prohibition is more harmful than the drugs themselves, he argued. Core to that thesis is what Hari describes as a deeply entrenched misunderstanding of drug-use disorder.
“Everything you think you know about addiction is wrong,” Hari has said in many interviews since the book’s release. “The opposite of addiction is not sobriety, it’s connection.”
Three years later, Hari has delved deeper, beneath addiction, into mental health. The result is Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions.
It begins with a personal story of Hari’s own struggle with depression.
“There are some people who naturally have depleted levels of serotonin in their brains,” Hari recounts his doctor telling him when he was a teenager. “This is what causes depression.
“Fortunately, just in time for my adulthood, there was a new generation of drugs—Selective Serotonin Reuptake Inhibitors (SSRIs)—that restore your serotonin to the level of a normal person’s,” he continues.
Hari took the pills and they worked, for a short time. Then they didn’t work and he was prescribed a higher dose. Again and again.
Of course, Hari’s doctor was not alone in his enthusiastic embrace of drugs like Paxil, Zoloft, and Prozac.
“Today they are all around us,” Hari writes. “Some one in five U.S. adults are taking at least one drug for a psychiatric problem.…Without talking about it much, we’ve accepted that a huge number of the people around us are so distressed that they feel they need to take a powerful chemical every day to keep themselves together.”
In Lost Connections, Hari challenges the primary narrative of our mental-health-care systems. He dissects our understanding of serotonin deficiencies and rejects the idea that depression is primarily the result of chemical imbalances in the brain. Then he takes the next step. If a chemical imbalance is not the problem, a pill correcting that imbalance cannot be the answer. Hari sets off in search of alternative remedies.
“Because you have been given the wrong explanation for why your depression and anxiety are happening, you are seeking the wrong solution,” he writes.
“You are not suffering from a chemical imbalance in your brain. You are suffering from a social and spiritual imbalance in how we live. Much more than you’ve been told up to now, it’s not serotonin; it’s society.”
Hari emphasizes that he only arrived at these conclusions reluctantly. The book is exhaustively researched. Hari waded through countless academic papers and traipsed the globe investigating mental-health challenges and enduring solutions. Easily digestible anecdotes take readers along on that journey.
In Berlin, Hari visits a housing complex where low-income residents formed a guerrilla occupation to prevent evictions. In Baltimore, he stops by a bicycle shop where employees established a collective that gives each member authority as a partial owner of the company. At the University of British Columbia, he speaks with Michael Chandler, a professor emeritus in the psychology department, who explains colonialization’s effects on Indigenous populations and how those groups’ different levels of self-determination correlate with suicide rates.
The common threads are community and empowerment. Depressed and anxious people who were isolated or marginalized forged connections and took control of their lives. As a result, their mental-health improved. Forming a protest movement for housing rights or a business collective at a bike shop might be more work than swallowing a pill, but, Hari shows us, western society has arrived at a place where it needs more than a quick fix.