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Johann Hari: To Treat Depression, Provide Meaningful Work, Housing & a Basic Income, Not Just Drugs

Web ExclusiveFebruary 02, 2018
Media Options

Extended conversation with Johann Hari, author of a controversial new book, “Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions.”

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman, with Nermeen Shaikh, in Part 2 of our discussion with Johann Hari, the journalist and author, whose new book on depression is called Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions, his previous book on addiction called Chasing the Scream: The First and Last Days of the War on Drugs.

Johann, you very powerfully talk about your own life experience. Explain when you were first diagnosed antidepressants, how old you were, what it meant for you, and then what you came to understand.

JOHANN HARI: Yeah. So, I was—I was a teenager when I went to my doctor. And I explained, you know, I had this—sorry, this is not an easy thing to talk about. I had this feeling like pain was kind of leaking out of me, and I couldn’t control it, I couldn’t regulate it. And my doctor told me a story. My doctor said, “Well, we know why people feel this way. There’s this chemical called serotonin in people’s brains. You’re clearly lacking it. We’ll give you these drugs, and you’ll feel better.” And as soon as I started taking the drugs, I felt a tremendous sense of relief and release. Within a couple of months, that sense of pain started to come back, so I went back to the doctor. He gave me a higher dose. Then I felt some relief. Again the pain came back. I was in that cycle until—for the end, I was taking the maximum possible dose you can take for 13 years.

And, you know, at the end of that, there were these two mysteries that were really haunting me, right? One was: Why was I still depressed? I was doing everything I was told to do. I was following the story our culture tells. And the second was: Why are there so many other people like me? You know, one in five Americans will take a psychiatric drug in their lifetime. One in four middle-age women is taking an antidepressant, a chemical antidepressant. And I just thought, “Can it really be that this is just due to some kind of chemical imbalance in people’s brains?” But I was very afraid to look into this. When you have a story about your pain, even when it doesn’t work that well for you, it kind of structures your distress. It’s like putting a leash on a wild animal. At least you know where it is. And the act of challenging that story was initially very disconcerting to me.

But I think the key thing I learned is how wrong I had been in my life. So, until I was a teenager and I went to my doctor, I thought my depression was all in my—and anxiety were all in my head, meaning, you know, it’s just a—I’m being weak, right? I just need to toughen up. And then, for the next 13 years, I thought it was all in my head, meaning it’s a biological malfunction, it’s a, you know, chemical imbalance in your brain. And the main thing I learned is, although there are real biological factors, which we can talk about and I write about in the book, overwhelmingly, it’s not in our heads. It’s in the way we’re living. And there was—you know, there were several aspects of that that I found really, really challenging, and several of the causes of depression and anxiety I found really challenging, because I could see how they had been playing out in my own life and how I had kind of protected myself from that by just clinging to this really simplistic story that it’s just a chemical imbalance.

NERMEEN SHAIKH: Well, you talk about nine causes of depression. Can you lay those out and which ones, in particular, you think are not included in the way that mental illness is diagnosed? And what would happen if they were included? What would the prescription then be?

JOHANN HARI: Yeah. So, it’s a bit like, we were talking about, the Cambodian doctor. I kept thinking, when I learned about these causes, “What’s the cow for these causes? What’s the antidepressant that solves this problem?” Right? So, I’ll tell you about two that I found really challenging, because I felt they played out in my own life, and Amy mentioned this in the intro to the previous part of our conversation.

So, we all know that junk food has taken over our diets and has made loads of us physically sick, right? It’s not that people have become obese because they’re just weak. It’s because there’s been a change in our diets and, in fact, the amount of exercise we can do, that’s made people sick. And I was really struck by the evidence I learned, that there’s something similar has happened with our values. So, for thousands of years philosophers have said, if you think life is about money and status and how you look to other people, you’re going to feel really low, right? But, actually, weirdly, no one had scientifically investigated this, until an incredible professor I got to interview a lot, called Tim Kasser, who’s in Illinois.

Professor Kasser knew there are, broadly, two ways we can motivate ourselves as human beings. So, say that you play the piano in the morning. If you play the piano because you love it and it gives you joy, that’s an intrinsic reason to play the piano, right? You’re not doing it to get anything out of it. You’re doing it because you love it. If you play the piano, though, in a dive bar to make the rent that you can’t stand, or because your parents are really pressuring you to be a piano maestro, that would be an extrinsic reason to play the piano, right? You’re not doing it for the thing itself. You’re doing it for another reason, to get something else out of it. And we’re all a mixture of intrinsic and extrinsic values.

But Professor Kasser found two really important things. The more your life is driven by extrinsic values, the more you will become depressed and anxious, the more you will have a hollow life. But just as crucially, we have become a society much more dominated by extrinsic values. We are constantly being primed to think that life is about buying, consuming, showing off, demonstrating how we look on the outside. There’s a whole machinery of advertising. More 18-month-old children recognize the McDonald’s M than know their own surname. We are immersed in this from the moment we’re born. And this system, as Professor Kasser puts it, this system is designed to get us to neglect what is good about life, right? Imagine an advert that said, you know, “Amy, Nermeen, you look great today. Your hair looks great. You smell great. You’re amazing!” Right? That would be the worst advert ever, in terms of the advertising industry, because you wouldn’t want to buy anything. So we’re surrounded by this kind of neoliberal machinery that makes us feel bad. And we’ve been fed a kind of KFC for the soul. And Professor Kasser has shown that that is a factor that’s really, you know, driving up this crisis. And that was very challenging to me, because I realized how much of my life was like that.

But the other factor that I found more challenging, and it’s quite difficult to talk about, so I’m going to—I’ll do it as best I can, was something I learned about from an amazing man called Dr. Vincent Felitti in San Diego. And he just made an extraordinary discovery about depression. And to explain how, which at first it will sound a little bit strange, like I’m talking about something else—so, he was commissioned in the mid-1980s to do this research into obesity by Kaiser Permanente, not-for-profit medical provider in California, because they had just hugely increasing costs around obesity. So they said—gave him quite a big budget and said, “Just do blue skies research. Figure out what’s going on here.”

So he starts working with about 350 extremely obese, like more than 400 pounds, people. And one day he had this seemingly stupidly simple idea. He just said, “What would happen if really obese people literally just stopped eating for a while, and we just gave them the vitamins and nutrients they need? Would they just lose loads of weight?” So they started doing this, obviously medically supervised. It turned out it worked. People who were more than 400 pounds went down to like 130 pounds.

But then something happened that no one expected. There’s a woman—I’ll call her Susan to protect her medical confidentiality—who went down from more than 400 pounds to 138 pounds. And one day she just freaked out and put on a huge amount of weight, started compulsively eating again. And Vincent sat with her and said, “Susan, did anything happen that day?” Turned out something had. When she had been very overweight, no men had hit on her. But when she was this—when she lost a lot of weight, a man hit on her for the first time. It completely freaked her out. Vincent said to her, “When did you start to put on weight?” It was actually when she was 11. And he said, “Well, did anything happen when you were 11 that didn’t happen when you were 9, that didn’t happen when you were 13?” She said, “Yeah, that’s when my grandfather started to rape me.” She discovered that 55 percent—sorry, Dr. Felitti discovered 55 percent of the people in the group had been sexually abused and had put on weight in the immediate aftermath. What he realized is, this thing that seemed irrational—extreme weight gain—in fact, performed function. As Susan put it to him, “Overweight is overlooked, and that’s what I need to be.”

Now, the reason this is relevant to depression is it led to this incredible breakthrough. He wanted to do a much more detailed study. So, with funding from the CDC, the Centers for Disease Control, everyone who came to Kaiser Permanente, for any kind of healthcare, over the next year, whether it was a broken leg, headaches, whatever, was given a questionnaire. Just said, “Did any of these 10 traumatic things happen to you when you were a kid?” Different categories. And then it said, “Have you had any of these problems as an adult?” Things like obesity, addiction, and then they end at depression.

When the figures were added up by the CDC, it was just astonishing. For every category of childhood trauma you experienced, you were radically more likely to become depressed. If you had six categories of childhood trauma, you were 3,100 percent more likely to attempt suicide as an adult. What Professor—what Dr. Felitti showed is that childhood trauma is a major cause of all sorts of problems.

And I found that very challenging, because it made me realize one of the reasons I had clung to the chemical imbalance—the simplistic chemical imbalance story for so long, because I had experienced some—when I was a kid, my mother was very ill, my dad was in a different country, I had experienced some very, very extreme acts of violence from an adult in my life. And, you know, I just didn’t want to think about it. I didn’t want to—I didn’t want to think that that was still playing out in my life. I didn’t want to give the power to the individual involved to have done that to me. I didn’t—I just didn’t want to look at any of this. And I found that very challenging.

But the next stage of Dr. Felitti’s research I found incredibly empowering. So, if people had indicated that they were—you know, they had experienced this childhood trauma, the next time they went to the doctor, the doctor was asked to say to them something like, “I see that when you were a child, you were sexually abused,” or whatever they had indicated. “I’m really sorry that happened. That should never have happened to you. Would you like to talk about it?” And a lot of people said no, and a lot of people said yes. They would have a five-minute conversation. At the end of that, they’d say, “We can refer you to a therapist, if you want.” What’s so interesting, Dr. Felitti showed, is just that five-minute conversation with someone, a trusted authority figure, led to a really significant fall in depression and anxiety for people. And the people who referred on to a therapist, there was an even bigger fall. One woman wrote to Dr. Felitti—she was in her eighties. She had been sexually abused as a child. She said, “I’m so glad you asked. I thought I was going to die, and nobody would ever know.”

So, I think this shows us again, part of the problem with this—both of those, both the junk values and the childhood trauma, which are two of the nine causes of depression and anxiety I write about in Lost Connections, show us something about why this exclusively biological story we’ve told is so problematic. Right? Because there are biological factors, as I talk about—talk about genes, that are real brain changers, that, once you’ve become depressed, make it harder to get out, but not impossible—and I write about them in the book. But if you tell people this exclusively biological story, it actually disconnects them from finding the sources of this pain, and for the society, together, to fix those problems.

And it’s important to say I’m not saying—because a lot of people hear this, and they think I’m saying, “Well, if it’s not exclusively biological, it’s on you to fix it. You know, it’s on the depressed and anxious individual to fix it.” And I’m talking about a whole other thing, which is completely in fitting with the way Democracy Now! covers the news, which is it’s neither—you know, it’s neither just the biology nor the individual. It’s the society. It’s the way we live together. And we have to solve these problems together. This isn’t a technical glitch. It’s a societal and spiritual crisis. And we have to change the way we live together in order to reduce these deep underlying causes.

NERMEEN SHAIKH: Well, Johann Hari, with respect to one of the factors that you just spoke about, childhood trauma, would you agree that many in the mental health community have taken that into account, which is what accounts for the proliferation of different kinds of talk therapy? That’s precisely the recognition that it—whatever causes depression, it’s by no means only a chemical problem, that it has environmental causes, and that’s why talking about it, like the example that you cited shows, can alleviate the symptoms.

JOHANN HARI: Sure. So my book is full of praise for all the people who are doing this work. And there’s a funny thing here, where there’s been this weird disconnect. You know, there is overwhelming scientific consensus that depression has three—and anxiety have three kinds of cause, right? Biological causes, psychological causes and social causes. And they all play out to some degree in all depressed and anxious people. Even if you think about something like dementia, where there’s obviously a huge biological factor, even there, there are social and psychological factors. People who are isolated develop dementia much more quickly. It becomes much worse. Now, depression, obviously, the biological aspect is real, but it’s nowhere near as big as dementia. So there’s this weird thing where psychiatrists are taught this—right?—in their training, and yet, apart from some really heroic individuals, who I write about in the book, very few doctors explain this to their patients. The vast majority of people I know with depression and anxiety who have gone for help have been told an exclusively biological story and been given—you know, most of them are just off of drugs, which have some limited, but real, value, and a small number are offered like therapy, and none of them are told anything about the social causes, which are actually what the World Health Organization talk about as one of the most important drivers and where some of the most important solutions lie. So, it’s this slightly weird disjunction.

I’m not saying anything on this particularly new. This has been known for a long time. And yet it hasn’t broken through into either the public discussion or, more importantly, a public response, right? We don’t say the job of fixing car accidents lies with people who have just been mangled in car accidents and doctors in A&E, right? In the emergency room, right? We say that actually the whole society has to deal with car accidents. We have driving tests and seat belts and airbags and speed limits, and, you know, we arrest DUIs, right? In a similar way, I think one of the cruelest things we do is we put all of the burden of solving depression and anxiety on people who are already depressed and anxious and their families.

Actually, what we need is a societal response to this. And also, partly because the factors that are making—the nine factors that are making some of those really depressed and anxious are actually making most of us unhappy to some degree, right? Instead of just telling this biological story where there’s this minority of people who have this internal malfunction, actually, when you explain they’re reacting to the same things that everyone watching Democracy Now! is reacting to, to some degree, there will be nobody watching Democracy Now! who is not affected by one of the nine causes of depression and anxiety, that I write about, to some degree. Now, we’re not all depressed and anxious, thank God, but those factors are playing out in everyone. And we need to—it’s a signal.

You know, one thing, as you can tell from my voice, although I spend a lot of my time here, I’m a European, I’m British. One thing that constantly amazes British people when we come to the United States is the existence of indigestion pills, right? Because when you’re offered them as a British person, you go, “But wait a minute. Indigestion is a signal from your body that something’s—you’re not doing something right. Right? It’s actually a signal to slow down. It’s not a malfunction, it’s a function.” And although this was a very painful thing for me to absorb, I came to think that while obviously depression is infinitely more terrible and the worst thing I’ve ever been through, than indigestion, in a similar way, depression is not a pathology. Depression is a signal that something is not going right in our culture. When one in five people is going to take a psychiatric drug in this society, in this culture, that is a sign that all the alarm bells are going off. Right? And what we’ve done up to now is we’ve pathologized that signal and, I think, kind of insulted it, by just saying, “Oh, it’s just”—

There’s a really interesting illustration of this. It was discovered in the 1970s. So, in the '70s, this really interesting thing was discovered about depression that was so inconvenient, it was kind of shunted aside. So, in the 1970s, psychiatrists—U.S. psychiatrists wrote up, for the first time, a checklist of depression symptoms so that they could standardize the diagnosis of depression across the United States. And, you know, the checklist is pretty obvious. It's what most people would think of, things like feeling worthless, that kind of thing. And there’s 10 of them. And they distributed this to psychiatrists and general doctors across the United States. And they said, “If a patient shows more than five of these symptoms for more than two weeks, diagnose them as mentally ill.” So they start doing it. They send it out. It’s in the DSM, the Diagnostic and Statistical Manual, which is like the Bible for how you diagnose these things.

But after a little while, doctors started to come back with this really inconvenient point. They said, “But if we use these guidelines, we have to diagnose every grieving person as mentally ill, because everyone who’s grieving matches this criteria.” So the psychiatrists got together. Obviously they thought this is not right. So they created something called the grief loophole or the grief exception, which said, “Use these criteria to diagnose someone, unless they’ve lost someone they love in the past year, in which case it doesn’t count, don’t diagnose them as mentally ill.” So, psychiatrists start using that.

But they started begging a really awkward question. Psychiatrists started asking, “Well, wait a minute. We’re being told that depression is just a brain disease that should just be diagnosed with a checklist, except in one unique case where there’s one thing in life that means this is actually a legitimate and understandable response. Why is that the only thing that means that it’s understandable and not insane to react this way? Why just if you lose someone you love? Why not if you lose your job? Why not if you lose your home? Why not if you’re stuck in a job you hate for the next 40 years?” But as Dr. Joanne Cacciatore, an amazing woman who’s one of the leading experts on this debate, explained to me, that requires you to think about context. Right? That requires you to actually admit that depression is, to a large degree, a response to life. It shows—”The fact that you even have to make that point,” Dr. Cacciatore said to me—she lost her own child in childbirth, her daughter Cheyenne—”to me, it’s a sign that we just don’t get human suffering in this culture.”

Anyway, because Dr. Cacciatore and so many other people were raising this difficult debate, saying actually this requires a real system overhaul, the psychiatrists—the psychiatric bodies reacted: They got rid of the grief exception. Doesn’t exist anymore. So, now, if your child dies in the morning, you can be diagnosed that day. In fact, Dr. Cacciatore’s research shows 32 percent of grieving parents are diagnosed in the first 48 hours and drugged. Now, that tells you something about how we don’t understand pain. We grieve because we’ve loved. Grief is not a pathology, right? Grief is a deep human response. And in a similar way, depression is a signal that our deeper needs are not being met. It’s a form of grief for your own life. And now, sadly, when someone dies, there’s nothing we can do about that grief except hold the person who—the survivors and love them.

But with this grief for our own life, there is something we can do. There are these seven scientifically proven ways we can change the way we’re living to reduce some of these deep underlying causes of depression and anxiety. But if all we do is pathologize these feelings—and I have to say, you know, going around speaking to people all across the United States about this, almost everyone I spoke to had been told—not in these exact words—that their depression was a malfunction to be fixed with just a bit of tweaking, chemical tweaking. That’s not true. There’s some value in chemicals taking some of the edge off these symptoms, of course. You know, one of my closest relatives is a struggling single mother who, you know, is working really hard to pay the rent, and gets home at the end of the day and collapses. Right? Now, the idea of saying to her, “It’s your job to fix this society, and it’s your job to democratize your workplace and fight for universal basic income,” would be ridiculous. Of course she wants to take the edge off the symptoms, and she’s right to want to take the edge off the symptoms. And for her, the side effects, which are quite significant for a lot of people, don’t outweigh that benefit, so she’s making the right choice for her. But I think most people watching this can see that is not the solution for the society, right? It’s not for us just to accept that we’re trapped in this depressogenic environment and just take some of the edge off. The solution, in the medium and longer term, as the World Health Organization has been telling us, is to deal—to listen to the signal, listen to the alarm bells that are going off, and respond accordingly.

AMY GOODMAN: Johann, just as your book came out, Yale University offered a course called “Happiness.” A quarter of the undergraduate student body signed up. It’s the most popular course in the history of Yale. Twelve hundred people signed up. Can you talk about the examples you found, for example, the Amish people here in the United States, and why you chose to look at them?

JOHANN HARI: Yeah. So, this was really challenging to me, right? So, there’s really interesting scientific evidence that the Amish have the lowest level of depression in the United States. And, you know, I’m a kind of gay, left-wing atheist, so I was like this is—what’s going on here, right? So I went to spend some time in an Amish community. It’s called Elkhart-LaGrange. It’s outside Fort Wayne in Indiana. And, you know, I have to admit, although there’s still a lot I disagree with the Amish about, obviously, and I’m not suggesting we all convert to the Amish, not least because I just rewatched Witness, there are nonetheless things they have that we don’t have, right? They have very—they’re constant—they are living in a way that is much more compatible with some underlying human needs, like, for example, they are living tribe—we evolved to live in tribes. Bees need a hive. Humans need a tribe. And the Amish live in ways that are much closer to that constant communal contact that human beings evolved to have. They have a very deep sense of meaning and purpose, which is lacking so deeply for the rest of us. They’re extremely equal. The richest Amish is as wealthy as the poorest Amish. And there’s all this really interesting evidence that inequality massively drives up depression and anxiety, because it creates a sense of humiliation and defeat in huge numbers of people.

Actually, I had a really interesting conversation with one of them, Lauron Beachey. It’s on the book’s website, TheLostConnections.com. I had a really interesting conversation with this guy, Lauron Beachey, because they have this interesting thing where they’ve lived in our world, right? Because when they’re 16, the Amish have to leave—it’s called going on Rumspringa—for two years and live in our world, and then they have to decide whether they want to come back. It’s one of the reasons why nobody classes the Amish as a cult. A cult would never do that. And talking about why they chose to come back, you know, Lauron said to me, “Well, there are things I had to give up, right? And I miss them.” He missed That ’70s Show. He missed trucking and driving. But he said to me, “If I still had those things, I wouldn’t have the much more meaningful things in life. I wouldn’t be spending time with my family, with my kids, with my neighbors, with my church. I would be constantly distracted.” They, of course, don’t have electronics. And he said this really interesting thing to me. He said, “You know”—he said, “You know Weight Watchers?” And I said, “Yeah.” And he said, “Well, with Weight Watchers, you find that you can give up—you know, you can reduce your food intake, in a group, in a way that you wouldn’t be able to on your own.” And I was like, “Right.” And I said, “Wait. Are you saying that the Amish is like Weight Watchers for the problems of Western civilization?” And he said, “Yeah.”

Now, of course, I don’t want us to become as, you know, hardcore as the Amish. There are lots of ways we can integrate these insights into our own lives. One way, actually, is really challenging for me, as well. I went to California to interview someone called Dr. Brett Ford, who’s at Berkeley. She’s actually in Toronto now, but she was at Berkeley at the time. And she did this really interesting piece of research. It was very simple. Looked at if you, Amy, you, Nermeen, decided you were going to spend a dedicated amount, more of your time, trying to become happier, would you actually become happier? And they did this research in four countries. It was the U.S., Russia, Taiwan and China. Right? And what they found was really fascinating. In the United States, if you try consciously to become happier, you do not become happier. In the other countries, if you choose consciously to become happier, you do.

And they were like, “What’s going on here?” So they looked in more detail, and what they discovered is, in the United States, if we try consciously to become happier, what we do, generally, is do something for you, right? You buy something for yourself. You big yourself up. You work harder to buy something more. So, we have an implicitly individualistic conception of happiness, right? In the other countries, most of the time, if you try to make yourself happier, you try to do something for someone else. You do something for your family, your friends, your community. They have an instinctively collectivist vision of happiness.

And, you know, our story about happiness just doesn’t work. We’re not that species. The reason that you and I exist, the reason we’re able to have this conversation, is because our ancestors on the savannas of Africa were incredibly good at one thing. They were incredibly good at cooperating. They weren’t bigger than the animals they took down, but they were much better at working together. And as a culture, we’ve started telling this story. So, a very extreme version would be like, I don’t know, lunacy of someone like Ayn Rand, but this—you know, which was just, you know, doing something for other people is actually wrong. But we’ve told this increasingly individualistic story about who we are. And it turns out we’re just not that species. Right? And if we try to live like that, we’ll be really, acutely unhappy.

And what we’ve had as a culture—and I think people intuitively know this—is, yeah, we’ve had a big and rising depression and anxiety crisis. And there are many reasons, but the deepest reasons, I think, are—and I think this is demonstrated by many of the scientists that I write about in Lost Connections—is we’ve got an increasingly lonely and isolated society, where we’ve been told that what matters and what you should build your life around is accumulating money and stuff, and you should spend your spare time screaming at people through screens, and if any of that is making you feel bad, it’s because your brain is broken and there’s a chemical imbalance. You know, we can carry on with that, if we want. And it’s given us a terrible depression and anxiety crisis. It’s given us an extraordinary addiction crisis. It’s given us President Donald Trump. Or we can acknowledge what the World Health Organization is telling us, what some of the world’s leading scientists is telling us, which is actually there are social causes to this. We’ve got to understand them.

AMY GOODMAN: I wanted to ask, before we go, about the role of corporations in the development of drugs like antidepressants, what gets approved, what doesn’t, who gets what.

JOHANN HARI: Yeah. So there’s a few things about that. One is, so we know how much effect chemical antidepressants have. There’s something called the Hamilton scale, which measures it. I’ve always felt sorry for whoever Hamilton was, that this is the only way we remember him, by how miserable people are. It goes from one, which is where you would be dancing around on ecstasy or in ecstasy, to 51, where you would be acutely suicidal. To give you a sense of movement on that, if you improve your sleep patterns, you’ll gain six points on the Hamilton scale. On average, according to the best research by Professor Irving Kirsch, who’s at Harvard Medical School, chemical antidepressants move you 1.8 points on the Hamilton scale. It’s important to say a few things. That’s on average, so some people get more, some people get less. But—and it—you know, that is also important to say. That is a real effect. Right? That’s more than a placebo. One-point-eight points is—you know, is something. And it takes the edge off it for some people. But it doesn’t solve the problem of depression for most of us, right? It gives people a lift, but it doesn’t take them over the threshold.

Now, what happened when the drug companies began marketing these drugs was a kind of effect. You know, we all know, when we take selfies, you take, you know, 30 selfies, you throw away, in my case, the 29 where you look like you’ve got a big double chin, and then the 30th one is the one that becomes your Tinder profile picture, right? A very similar thing happened with the scientific studies the drug companies commissioned. They commissioned enormous numbers of studies. They junked all the ones where the drugs showed no or low effect. And they only published the ones which showed a really strong effect. There was one study I cite in the book where I think they gave the drug to 247 people, and they only published the results for 27 of them, who happened to be the ones who had a really powerful effect. So what happened is they hugely exaggerated the effect of the drugs. They hugely exaggerated the amount it moved people on the Hamilton scale.

People might remember when these drugs first came out in the '90s, when I started taking them. We were told they would make people better than well, right? No one says that now. And this was then established in court. Eliot Spitzer, when he was the attorney general of New York state, who deserves a lot of credit for this, took a really important court case against the drug companies, which just established that they had lied, and they had to make a big payout, about a lot of the effects of the drugs, not least the effect on teenagers. There was a leaked memo of actually the drug that I started taking when I was a teenager, Paxil, in which the company admitted it just didn't work for teenagers, but they said—I think the phrase was—”It would be commercially unacceptable to the profile of paroxetine,” which is the other name for it, “to kind of release this result,” so they didn’t. Right? Now, I want to stress, that doesn’t mean there’s no effect of the drugs. There is a real effect. There is some real value. But they were massively oversold.

And this is part of the problem that—and this is one thing that I kept stumbling across, right? There’s all this evidence for these different ways of dealing with depression and anxiety. I’ll give you one more example, just quickly. There’s a huge amount of evidence that exposure to the natural world is a really powerful antidepressant. There’s a state prison in Michigan where, just by coincidence, big—one big part of the prison looks out over just concrete, and another part of the prison looks out over kind of lush greenery. Turns out it’s random where you end up in the prison, but the people who look out over lush greenery were 23 percent less likely to develop mental health problems. You know, as a species, we evolved in that kind of environment. When animals are deprived of that kind of environment in zoos, when they’re deprived of their habitat, they go crazy. Parrots rip out their feathers. Horses start swaying obsessively. Elephants will grind their tusks down to nothing. If you’re—if an animal is deprived of its habitat, as Dr. Isabel Behncke taught me for the book, they’ll go crazy. We’ve been deprived of our habitat. There’s all this evidence that nature exposure really significantly reduces depression and anxiety. And an amazing program, that I alluded to in the interview at the top of the show, that has—gets people to work in gardens, and massively reduces their depression.

Now, why has no one been told about that? Because there’s a $10 billion industry in telling a depressed person that the only solution is drugs, and there’s a zero billion-dollar industry in the gardening programs that have been piloted in East London, which is shown to have twice as an effect—twice as big an effect moving people on the Hamilton scale as chemical antidepressants. So I think it’s one of the—and you guys document this so well in Democracy Now! almost every day—the distortions of neoliberalism, right? And it’s not that there isn’t—these are not good scientists. They are. But what it does is it constantly pushes people towards focusing on just one very narrow part of the solution, which is the one that can be monetized.

I had a weird experience, exactly at this time last year, actually, almost, where I was invited—you know Peter Thiel, the disgusting PayPal gazillionaire who funded the Trump campaign. I was invited by him to a conference, which was looking at—in Silicon Valley, that was looking at how to develop apps to deal with depression, anxiety and addiction. And because of my previous book, Chasing the Scream, which is about addiction, I got invited to speak there. And it was this really fascinating illustration about the relationship between neoliberalism and these exclusively biological stories. So there were these amazing scientists there, people who were really smart and really good people. And the whole day—I was the last person to speak, I think by coincidence. The whole day, if all you had known about depression, anxiety and addiction was from this conference, you would have thought they were just spontaneous brain problems, right? All they did was spend time looking at pictures of brains. And what they were looking at was incredibly good and important and thrilling science.

But when I tried to speak to them afterwards, when I gave my speech, I was trying to think, “What can I say about this?” And I just said, “To me, it’s like you could explain the plot of Romeo and Juliet using Newtonian physics, right? It would all be true. But you wouldn’t understand anything about why Romeo and Juliet do anything, right?” We happened to be very close to the Tenderloin district, where there’s a lot of people with addiction problems who are homeless. And I said to them, “Let’s just all go out of here, talk to the first homeless person with addiction problems we hear—we meet, listen to their life story, and then come back and tell me that the main problem going on there is a malfunctioning amygdala.” It’s bizarre to speak in these reductively biological terms about what are clearly problems in people’s lives.

Now, the biology is really important. I’m strongly in favor of neuroscience and—as I talk about in the book. And I was taught by an amazing professor of neuroscience, Professor Marc Lewis. There are—when you become depressed, there are changes in the brain that make it harder to get out, and the solution for that is for you to have more love and more support, not less. But what you see is—the reason why I mentioned it’s Peter Thiel is, I don’t think it’s a coincidence—I’m not implying there’s any conspiracy or there’s any conscious agency in this; there absolutely isn’t—but I don’t think it’s a coincidence you’ve got, you know, the 1 percent of the 1 percent funding the Trump campaign, actively funding the spreading of neoliberalism and loads of the factors that are causing depression, and that that overlaps with a narrative that just says to people, actually, all this pain, caused in part by this system, is just due to a biological malfunction, and the solution, by the way, is to create more things that we sell people. I think you can see that there’s a kind of unconscious relationship there. We’ve created a system that only looks for solutions that can be monetized, and that neglects, actually, the more meaningful human solutions that are all around us and, at some level, we all intuitively know are more necessary.

AMY GOODMAN: Johann Hari, talk about your experience in Berlin.

JOHANN HARI: Oh, right, OK. I’m going to try to do this without tearing up. I learned intellectually loads of the things that we’re talking about, but only really felt it in my heart in Berlin.

So, in the summer of 2001, a woman called Nuriye Cengiz, who lived on a big, anonymous housing project in Berlin, put a sign in her window. She lives on the ground floor. And it just said something like “I got my eviction notice today. I’m going to be thrown out next week. So, next Thursday night, I’m going to kill myself.”

Now, this area is called Kotti. It’s a big, anonymous housing project, and it basically had three groups of people living there: Turkish-German immigrants, gay people and kind of punks who are often squatters. And these three groups looked at each other with a lot of kind of puzzlement. It was big project. You know, people didn’t really know each other. Imagine a housing project in the United States. It would be similar. But, actually, lots of people started to knock on Nuriye’s door. They were like, “Are you OK? Do you need any help?” And she was like, “No, don’t want any help. Go away.”

And people on this housing project were angry because their rents had been rising, too. There had been a lot of evictions. And this was, you might remember, it was the summer of the Tahrir Square uprising in Egypt. It was about to be the fall of the Occupy Wall Street. And some people who live there just had this thought. They just said—so there’s this big thoroughfare that goes into the center of Berlin, that runs through this housing project. And they were like, “You know, if we just blocked the road for one day and we wheeled Nuriye out, probably the media would come. Probably they’ll let her stay in her apartment. We might get a bit of pressure for our rents to come down or at least be frozen.” So they did it. They blocked the road, and they wheeled Nuriye out. And Nuriye was like, “Well, I’m going to kill myself anyway. I may as well do this.” And they sit there, and they protest. And the media did come, and there was some news coverage. And at the end of the day, the police said, “OK, you’e had your fun. Take it away.” Right? But the people who live there said, “Well, hang on a minute. You haven’t told Nuriye she can stay. And actually, we want a rent freeze.”

And there was someone who works there, one of my favorite people at Kotti, she’s called Taina Gartner. Taina, she came as a kind of punk squatter, and she wears tiny miniskirts even in the Berlin winter, which, believe me, is hardcore. And Taina had—she lived in one of the blocks. She had a loud klaxon. And she said, “What I’m going to do, I’m going to get my klaxon. We’re going to all sign up to man this barricade. And if the police come to take it down, let off the klaxon. We’ll all hear it, and we’ll all come down and stop them.”

So what happened is, people who had never met each other, who didn’t know each other, started to sign up to man this barricade to protest against the rents. Nuriye, who’s a very religious Muslim in a headscarf, was paired with Taina in her miniskirt. And they sit—these pairings happened all over Kotti. They sit there all through the night together, and they have this really awkward conversation the first few nights. But as the days went on and the nights went on, they started to talk to each other. They actually realized they had a lot in common. Nuriye had—they had both been runaways to Kotti. Nuriye had come to Berlin when she was 17 with her two children. She left her husband behind in Turkey. She was there to raise the money to send home for her husband. But after she had been there for a year, she discovered her husband had died. She told Taina something she had never told anyone. She’d always tell people her husband died of a heart attack. He had actually—he had actually died of tuberculosis, which she was ashamed of because it was seen as a disease of poverty. Taina started telling her about her own life. Taina had been thrown out by her middle-class family when she was 15. She came to Kotti to squat there. She got pregnant when she was really young. They realized they had both been alone in this alienated place with children. They realized they had a lot in common, even though, at first glance, they seemed to have nothing in common.

AMY GOODMAN: Johann, we just have 30 seconds left on the satellite.

JOHANN HARI: Sure. There was this incredible reconnection that happened all over Kotti, this coming together, this reduction in depression and anxiety because they came together to fight for something better. There was a woman there who told me that, you know, when she had grown up in Turkey, she called her—she called her village “home.” And she came to the Western world, and she realized you’re meant to call “home” just your apartment. And then this protest happened, and she started to call this whole place “home.” She said that she realized that she had been homeless all the time she had been living in the Western world. So many of us are homeless. Our sense of belonging—our sense of home is not big enough to meet our deep sense of belonging. Those people in Kotti didn’t need to be drugged, most of them. They needed to be together.

We need to be together. We need to deeply reconnect, with each other, with meaning, with purpose, with meaningful work. These are the paths out of the very deep depression and anxiety crisis. We need antidepressants. Most of the antidepressants we need are social, psychological, in the way we live.

AMY GOODMAN: Johann Hari, we want to thank you so much for being with us, writer, journalist, has just written a new book. It’s called Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions.

JOHANN HARI: Oh, Amy, I should just say, the website is www.TheLostConnections.com, where people can take a quiz to see how much they know about depression. They can see what loads of people, from Hillary Clinton to Glenn Greenwald to Naomi Klein to Elton John, have said about the book. And thank you so much for everything you do at Democracy Now!

AMY GOODMAN: Well, thank you, Johann. And if you want to see Part 1 of our discussion with Johann Hari, go to democracynow.org. I’m Amy Goodman, with Nermeen Shaikh. Thanks so much for joining us.

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