But Hari points to research showing that things actually become more stigmatised when they are thought to result from unchangeable biological characteristics rather than development. I hear this kind of language from people sometimes, and one of the motivations for saying this, I gather, is that if people think of mental illnesses in much the same way they do, say, cancer, then there wouldn’t be such a stigma surrounding it. Another is that depression is “just” like a physical illness and should be treated as such. One is that it is caused purely by one’s thoughts in a way that is entirely divorced from the physical world – this is the naive view Hari attributes to most doctors in the past. There are two extreme ways of looking at depression. Something can be considered psychological insofar as it’s more parsimonious to consider it with respect to the mind/consciousness level of reality, rather than the cells/biology level of reality. For instance, atoms are real, and presumably chairs are real too. It means something like this: there are multiple emergent levels of reality. What it means to call something ‘psychological’ is actually quite philosophically complex. So, in a trivial sense everything is equally physical.
Of course, the brain is physical, and its behaviour is completely determined by the laws of physics. Another is about the extent to which depression is psychological vs. So that’s one confusion about depression. This seems like a strawman and I can’t find evidence of it ever being widely believed. Some claim that psychiatrists used to believe in the “chemical imbalance” theory but have since moved on. Also, tianeptine is a common antidepressant in Europe which works by lowering your serotonin. Also, while serotonin is known to have something to do with depression, it’s not a straightforward relationship: if you give a chemical cocktail to normal people which lowers their serotonin, they don’t get depressed. It’s unclear what it would even mean for the brain to be in a state of “chemical imbalance”. One of the things people say about depression is that it’s a “chemical imbalance” – usually, a lack of serotonin. There are parts of the book that I liked, but I have some problems with it.
Lost Connections is about how antidepressants are wildly overprescribed, and how Big Pharma has marketed them as a panacea using dodgy science while ignoring the complex social and economic roots of depression and anxiety. If I were to summarise my main takeaway from this book, it would be this: people are mostly depressed because their lives are bad. The actual content of Lost Connections: Why You’re Depressed and How to Find Hopeby Johann Hari is significantly less self-help-y than the title would suggest.
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