Depression: the drugs don't work

Photo: Getty Images
Photo: Getty Images

Mike Crawl reviews Lost Connections: Uncovering the Real Causes of Depression - and the Unexpected Results, by Johann Hari. Published by Bloomsbury

Hari's book might be considered the popular science approach to the well-researched subject of depression. He has a knack of presenting the material in layman's language, with strong stories, and the book is all the better for that.

His theory is that depression is not primarily a problem with the brain being chemically out of whack, and therefore anti-depressant tablets (which he took for 18 years) do little good.

In fact, he has evidence to show they work for only a very few people. The vast majority of people suffering depression need a different ``medicine'' they are rarely offered. Tablets are the easy option.

He does not deny depression, but finds its causes come from a wide variety of sources. Yet most are treated in the same way. For example, grief, which used to be treated separately from depression, is now lumped under the same umbrella.

For Hari, depression is not caused by the body going wrong, but by life going wrong.

This may be a result of trauma, grief, disconnection from meaningful work, loneliness, a sense of having no hope or the realisation that being able to have more and more of the good things in life is not satisfying.

Having laid out all these, he offers some solutions. Few are quick fixes, but overall they are more effective in the long term.

Much of our depression comes from a sense of disconnection. The mantra ``you should be yourself'' is actually harmful; we need to focus not on ourselves but on others. Helping others, being involved in community, having a common purpose are all far better than spending time on your own self-esteem, the author says.

In the second half of the book, Hari gives several stories about how people have changed through just such approaches, and some doctors are learning to listen to people who come to them with depression and show them a different path.

One clinic in the East End of London gathered a group of depressed people together (with their permission) and gave them the task of making a garden out of a desolate piece of land. It took time, education and working together, but depression was left behind and new challenges adopted.

A traumatic experience can bring on depression years later. Hari shows that even having someone who will listen to your story is enough to begin the reversal of the depression.

Hari's research is based on information given to him by a large number of scientists, some of whom have been studying depression for many years.

The book's value lies in encouraging us to look beyond the pills dished out in their millions and see how much of our healing can come from alternative sources.

 - Mike Crowl is a Dunedin author, musician and composer

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