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Lost Connections

Uncovering the Real Causes of Depression – and the Unexpected Solutions

By Johann Hari
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Lost Connections by Johann Hari

Lost Connections (2018) takes you on a historical and scientific journey that dispels many of the lingering myths surrounding depression and the reasons it touches so many of us. Along the way, author Johann Hari introduces readers to the cutting-edge advancements being made by those looking into new solutions for depression and anxiety.

Key idea 1 of 13

Contrary to claims made by pharmaceutical corporations, depression is not the result of a chemical imbalance.

The author, Johann Hari, was 18 years old when he took his first antidepressant medication, but by this time he’d already had years of experience with depression.

Even as a young child, Hari had his fair share of moments alone in a room, weeping uncontrollably. He came to understand that he was experiencing the symptoms of depression. When he went to his doctor for treatment, his doctor explained that the cause of depression is a chemical imbalance in the brain, which can be alleviated with prescription antidepressants.

For Hari, this meant taking Paxil, one of many drugs on the market classified as selective serotonin reuptake inhibitors (SSRIs), which claim to raise a person’s serotonin levels to that of a “normal,” non-depressed person.

Like many patients taking SSRIs for the first time, Hari experienced some initial relief, but it didn’t last long. So his doctor upped the dosage, leading to another period of relief followed by a relapse into depression and yet another increase in the dosage.

One thing Hari could be sure about was that Paxil was causing him to gain weight and sweat more than usual. Eventually, in his 30s, Hari was faced with the truth: After over a decade of Paxil, he was still depressed. Following this realization, he embarked on an extensive period of research on the topic of depression and antidepressants, and what he discovered was truly shocking.

After speaking to a number of researchers, Hari found that there was little evidence to support the claim that a chemical imbalance causes depression, or that SSRIs are an effective treatment for everyone suffering with depression.

In the mid-90s, Harvard professor Irving Kirsch began taking a close look at the research on antidepressants. What he found was that the clinical tests being published by pharmaceutical companies were routinely skewed in order to get their medications released.

During the clinical testing for Prozac, for example, 245 patients were tested. But in the published results, only the 27 patients that experienced positive results were mentioned. As for Paxil, the unedited results of one clinical test showed that patients responded better to the placebo than to the actual medication.

Kirsch also researched the claims of a link between depression and the neurochemical serotonin. He found the connection to be an “accident of history” whereby scientists had misinterpreted findings and pharmaceutical companies had latched onto this misinformation to sell drugs.

As the University of London professor Joanna Moncrieff told Hari, when it comes to anxious and depressed brains, “There’s no evidence that there’s a chemical imbalance.”

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