This is a new publication from Johann Hari who questions everything we know about depression in his new book “Lost Connections”.
It makes for interesting reading.
What is Depression?
In the 1970’s a manual was printed for doctors that laid out every single cause and diagnosis for depression. It was called the Diagnostic and Statistical Manual. In the manual is said that there were nine symptoms that would enable a doctor to diagnose that a patient had depression. Symptoms like those we know of today: restlessness, lack of sleep or too much sleep, or persistent low mood. Over a period of several weeks you had to show at least five of these symptoms.
Great – depression solved.
No. After the manual was sent out the doctors found that they had to diagnose every person who came into their offices who was grieving with depression. This wouldn’t do.
The authors of the book got together and wrote out another clause added to the list of symptoms of depression. “None of this applies, they said, if you have lost somebody you loved in the past year. In that situation, all these symptoms are natural, and not a disorder. It was called “the grief exception”, and it seemed to resolve the problem.”
Great – problem solved.
The Grief Exception
Nope again doctors began to ask more questions. They were being told and therefore the general public was being told that depression was due to a lack of serotonin manufactured by the brain. Oh this would work fine if only there was no “grieve exception” in the manual. How do you explain the grief exception with a lack of serotonin manufacture?
The grief exception therefore seriously questioned the claim that the caused of depression are due to a lack of some chemicals not being produced by our brains. It suggested that there are causes out there which needed to be looked into. Psychiatry did not want to have this discussion about causes of depression and the grief exception. So, they with each new manual they produced reduced the period of grief that you were allowed before being mentally ill down to a few months and then nothing as all.
“Dr Joanne Cacciatore, of Arizona State University, became a leading expert on the grief exception after her own baby died during childbirth. She had seen many grieving people being told that they were mentally ill for showing distress. She told me this debate reveals a key problem with how we talk about depression, anxiety and other forms of suffering: we don’t, she said, “consider context”. We act like human distress can be assessed solely on a checklist that can be separated out from our lives, and labelled as brain diseases. If we started to take people’s actual lives into account when we treat depression and anxiety, Joanne explained, it would require “an entire system overhaul”. She told me that when “you have a person with extreme human distress, [we need to] stop treating the symptoms. The symptoms are a messenger of a deeper problem. Let’s get to the deeper problem.””
Finding Answers to Questions about Depression
Johann Hari then traveled the world asking questions about mental illness and finding the best scientific evidence about what really causes depression and anxiety. The people he spoke to taught me that it is not what we have been told it is up to now. and found evidence that seven specific factors in the way we are living today are causing depression and anxiety to rise – alongside two real biological factors (such as your genes) that can combine with these forces to make it worse. Once this was found out a very different set of solutions showed themselves.
Johann Hari then traveled the world looking for answers. He spoke with many different people from many different walks of life. Hari knew that every human being has basic physical needs: for food, for water, for shelter, for clean air. It turns out that, in the same way, all humans have certain basic psychological needs. We need to feel we belong. We need to feel valued. We need to feel we’re good at something. We need to feel we have a secure future. We know there is evidence that our culture isn’t meeting those psychological needs for many people. He kept learning that we have become disconnected from things we really need, and this deep disconnection is driving this epidemic of depression.
A Gallop poll conducted a poll about our waking life and how people felt about the paid work that they do, which takes up most of our time that we are awake. They found that 13% of people say they enjoyed in their work – they find it meaningful and look forward to it. “Some 63% say they are “not engaged”, which is defined as “sleepwalking through their workday”. And 24% are “actively disengaged”: they hate it”.
“Humans have an innate need to feel that what we are doing, day-to-day, is meaningful. When you are controlled, you can’t create meaning out of your work”. This I can relate to after being unemployed for over 12 months I secured a job doing what I do best and I am good at. A job I enjoy. My whole mood was transformed and life looked good. I thought about the antidepressants that I was on and thought that I didn’t need them any more. I was happy. But one month later my job was terminated and I was right back where I started again ready to sleep all day. With determination I have stopped myself from reaching the depths of despair I once felt and have focused on writing this blog and looking for another source of employment.
“If you are depressed and anxious, you are not a machine with malfunctioning parts. You are a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs – for deep connection, to the things that really matter in life”.
If you are affected by depression or suicidal thoughts, there are places you can turn to. In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.
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