The Rich Roll Podcast - Addiction & Depression: Johann Hari On Lost Connections

Episode Date: January 15, 2019

Why are we seeing unprecedented rates of depressions? What's behind our current opioid epidemic? And what can be done about it? Journalist and author Johann Hari suggests that everything we think we know about addiction and depression is wrong. Johann has written for The New York Times, The Los Angeles Times, and many other outlets. He was named ‘Newspaper Journalist of the Year' by Amnesty International UK and his TED Talk, aptly titled  “Everything You Think You Know About Addiction Is Wrong”, was viral hit, with over 25 million views. Pertinent to today's discussion, Johann is the author of Chasing The Scream*, which chronicles his 3-year investigation and research into the war on drugs and the nature of addiction. And his more recent book, Lost Connections* is a compelling deep dive into the nature of depression, its underlying causes and unexpected solutions. As many of you know, addiction and mental health are subjects of great personal importance. Better understanding that nature of these conditions is the motivating force behind this conversation, which is is everything I hoped it would be. This is an incredibly powerful, educational — and at times controversial — exploration into what drives these malignancies, why they are so difficult to overcome, and how a new approach can plot a more hopeful and solution-based course forward. Many see Johann’s ideas as radical. And although I don't entirely agree with everything Johann prescribes, there is great wisdom in much of his findings. If you suffer from addiction or depression, this is a must listen. If you don't, chances are someone you care for does. This conversation can provide the insight and tools for better understanding the struggle — because mental health truly impacts everyone. For the visually inclined, you can watch our entire conversation on YouTube at bit.ly/johannhari416 and the podcast is now available on Spotify. Peace + Plants, Rich

Once you acknowledge that depression can be largely a response to life, that just challenges the whole system we've built. The system we've built is not designed to talk about context. It's not designed to talk about how do we sit with you and hold you and love you and help you change your life, right? We all live in a machine that is designed to get us to neglect what is important in life. Nobody thinks they're going to lie on their deathbed and think about all the things they bought, right? They will lie on their deathbed and think about moments of love and connection and meaning in their lives. And yet we've created a culture that is designed to get us to neglect those things. You have a natural human need to seek meaning in your life.

have a natural human need to seek meaning in your life. And if you're doing something that's controlled by someone else, almost all of your waking hours, that disrupts your ability to create meaning out of it. That's Johan Hari, this week on The Rich Roll Podcast. The Rich Roll Podcast. Hey, everybody. How you guys doing? What's happening? My name is Rich Roll. I am your host. Welcome to the show, to the podcast. Good to have you here. journalist Johan Hari. Johan has written for the New York Times, the Los Angeles Times, and many other outlets. He is also the author of two quite profound books, Chasing the Scream, which chronicles his three-year investigation and research into the war on drugs and the nature of addiction,

and his more recent book, Lost Connections, which is a compelling deep dive into the nature of depression and its underlying causes. As many of you know, these two subjects, addiction and depression, mental health in general, are quite important to me personally, and they are the motivating force behind my desire to connect with and share Johan's experience and wisdom with all of you. And this conversation is everything that I hoped it would be. That's coming up in a couple of few, but first let's take care of a little business. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety.

And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because unfortunately, not all treatment resources adhere to ethical practices. It's a real problem. A problem I'm now happy and proud to share has been solved by the people at recovery.com who created an online support portal designed to guide, to support, and empower you to find the ideal level of care tailored to your personal needs. They've partnered with the best global behavioral health providers to cover the full spectrum of behavioral health disorders, including substance use disorders, depression,

anxiety, eating disorders, gambling addictions, and more. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself, I feel you. I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful, and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find

the best treatment option for you or a loved one, again, go to recovery.com. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because, unfortunately, not all treatment resources adhere to ethical practices. It's a real problem. A problem I'm now happy and proud to share has been solved by the people at recovery.com who created an online support portal designed to guide, to support, and empower you to find the ideal level of care tailored to your personal needs.

They've partnered with the best global behavioral health providers to cover the full spectrum of behavioral health disorders, including substance use disorders, depression, anxiety, eating disorders, gambling addictions, and more. depression, anxiety, eating disorders, gambling addictions, and more. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself, I feel you.

I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. Okay, Johan Hari, mental health, addiction, depression, anxiety. This is a super interesting exploration into the causes, the reasons, the cultural drivers behind these mental conditions, what contributes to their malignancy, what compels so many in this unhealthy direction,

and why they are so difficult to overcome. On the subject of addiction, Johan proffers a fairly controversial perspective that everything you think you know about addiction is wrong. It's the subject of his viral TED Talk, which I think has about 25 million views at this point. And although I don't agree with Johan on this point entirely, there's plenty of merit in his perspective on the curative impact of building deeper connections with nature and with each other, basically deeper connectivity, more intimacy. And with respect to depression and anxiety, the question really is, why are these things now at epidemic levels? And it's Johan's assertion that it's not entirely, but in large part,

attributable to the manner in which we live our modern lives, our misplaced values, which prioritize things like money, status, and materialism over, once again, deep human connection, love, intimacy, and purpose. A lot of people see Johan's ideas as relatively radical. Han's ideas as relatively radical. I see them, at least many of them, as basic common sense fueled by an honest desire to really understand the root drivers behind mental and emotional well-being. So we can plot a more helpful and hopeful solution-based course forward. Again, this is a fascinating conversation, one of particular interest, of course, if you happen to suffer from addiction or depression. But this is something that impacts all of us because chances are there is somebody in your life, somebody that you care for deeply who does suffer or struggles. So, with that being said, here's Johan.

Well, delighted to have you here. Thank you for coming up. I've been looking forward to this conversation for a long time as we just sort of spoke a moment ago. Everything that you're about, the work that you do is definitely right in the sweet spot of the things that I love to talk about. I think the work you're doing is important and I'm excited to dig into it with you today. Hooray. Love to be with you, Rich. Thanks so much. What are you doing here in LA? Well, I'm here for one reason that I'm not allowed to talk it with you today. Hooray. Love to be with you, Rich. Thanks so much. What are you doing here in LA?

Well, I'm here for one reason that I'm not allowed to talk about because it's not been announced yet, so I have to be slightly mysterious. But also, I was here to do, I was at Politicon, you know, the kind of weird political convention that happens here. So I was debating addiction with Chris Christie, the disgusting former governor of New Jersey, and Dr. Drew. So that was, I wouldn't exactly call it fun, but it was intriguing. That's interesting. I'm familiar with Dr. Drew's opinions on addiction,

but where does Chris Christie fall? Well, Christie pretends to be in favor of destigmatization. But he got very angry when I asked him. So he keeps saying, you know, I'm against stigma against people with addiction problems, but he's not in favor of changing the laws. And I said, well, the laws criminalize drug use and drug addiction. Yeah, that's the genesis of the stigma. Exactly.

It's at least a significant expression of the stigma. So I kind of said to him, do you see any contradiction there? How do you reconcile them? And he just did his kind of sub-soprano shtick, where he starts going, buddy, I'm from New Jersey. You don't get to bully me. He just didn't want to have a serious discussion about it. And what about Dr. Drew?

Honestly, I just didn't think he understood quite basic things about addiction. He seemed like a fairly nice person, but he didn't really understand. You know, the debate about the opioid crisis, we were discussing the opioid crisis. The debate about the opioid crisis in the US is so removed from really basic facts about even what addiction is. I'm not critical of people for that. Before I started doing the research for my book, Chasing the Scream, which is about addiction and the drug war, I don't think I didn't understand many of these basic things as well. I don't think Dr. Drew really, I think both Chris Christie and Dr. Drew were making the mistake. I don't want to over-describe this to Dr. Drew. I think he's a bit more sophisticated. He's certainly more sophisticated than Chris Christie. bit more sophisticated than he's certainly more sophisticated than chris christie but just making a basic mistake about what why this crisis is happening right so if you'd asked me

when i started doing the research for chasing the scream whenever it was eight years ago now what causes addiction let's say heroin addiction because that played out in people i love and i would have looked at you like you're an idiot and i would have said well obviously heroin causes heroin addiction right we've been told this story for a hundred years about addiction. That's become totally part of our common sense. One of my earliest memories is of trying to wake up one of my relatives and not being able to, I didn't understand why then, but as I got older, I realized we have drug addiction in my family. And, um, and so when I thought about saying like heroin addiction, obviously I thought, you know, we're sitting here in Los Angeles.

We think if I grabbed the next 20 people to walk past your house and I injected them all with heroin every day for a month, like a villain in a Saw movie, at the end of that month, they'd all be heroin addicts. For a simple reason, there's chemical hooks in heroin that bodies would start to desperately physically need. They'd have this desperate physical craving. They'd be hooked. This is where we get the phrase hooked from. And that's what addiction is, right? That's what I thought had happened in my family. That's what I thought I'd seen happen in front of me. And I only learned that while there's some truth in that story, it's actually a small part of the story. And that there's something much bigger and more, it's actually a small part of the story, and that there's something much bigger and more important going on. When I went to Vancouver and interviewed this amazing man called Professor Bruce Alexander. So Professor Alexander explained to me, this story we've got in our heads, addiction is caused primarily by the chemical

hooks in the drug, comes from a series of experiments that were done earlier in the 20th century. They're really simple experiments. Your listeners can try them at home if they feel a little bit sadistic. You take a rat, you put it in a cage, and you give it two water bottles. One is just water, and the other is water laced with either heroin or cocaine. If you do that, the rat will almost always prefer the drugged water and almost always kill itself quite quickly. So there you go, right?

That's our story. But in the 70s professor alexander came along and said well hang on a minute you put the rat alone in an empty cage which got nothing that makes life meaningful for rats what would happen if we did this differently so he built a cage that he called rat park which is basically like paradise for rats right they've got loads of friends they can have loads of sex they've got loads of cheese and colored balls and wheels of anything that makes life meaningful to rats, it's there in Rat Park. And they've got both the water bottles, the normal water and the drugged

water. But this is the fascinating thing. In Rat Park, they don't like the drugged water. They almost never use it. None of them ever use it compulsively. None of them ever overdose. So you go from almost 100% compulsive use and overdose when they don't have the things that make Life meaningful to none when they do there's loads of human examples we can talk about this But to me the core lesson of this is the opposite of addiction is not sobriety important though that is to many people the opposite of addiction is connection and Having your psychological needs met and and I think we need to understand the opioid crisis in that context, right? It's not a coincidence that the opioid crisis is at its most intense in the place where the non-opioid-based

suicide rate is highest, where antidepressant prescriptions are highest. That tells us something. Despair clusters together, right? There's a leading economist who's called opioid deaths despair deaths whereas it seemed to me dr drew and chris christie were chris christie exclusively and dr drew way too much we're focusing on the drug itself right now the drug itself plays a role there are chemical hooks they do they can cause physical dependence but and neglecting much more so for example you know i think think the core of addiction is about not wanting to be present in your life

because your life is too painful a place to be. Once you understand that, you can see why the drug war imposing more pain and more punishment on people is such a disaster, right? Because it causes more pain. It actually deepens the addiction. So I was very disturbed both that Chris Christie is a supporter of the drug war.

He's in favor of punishment. I mean, he says, oh, we'll make the prisons nice treatment centers for some people rather than just brutal prisons. But that's still a criminal, you're still criminalizing people, stigmatizing them. And the drug treatment centers he wants to put in the prisons are not so impressive either. And Dr. Drew was still saying things like, well, we need to impose negative consequences. You know, that can be helpful for some people. That is not helpful. There is nowhere in the world that has reduced addiction through imposing negative consequences. As your friend of mine, Dr. Gabor Marte said, it said to me once, if negative consequences stopped addiction, there wouldn't be a single addict anywhere in the world because what negative consequences

have they not experienced? Yeah. I mean, mean listen I agree with everything that you're saying certainly I think to be fair to dr. Drew He's not gonna be on Chris Christie's punitive page like he's he's been very I mean Rehabilitation over punitive measures, but he was saying that there should be he did say that with some of his I was this is what? Surprised because I thought well the negative consequences for your behavior I think is I think we're where where where he's kind of the space where he's dancing around is is something that I can relate to, which is when you I've heard that, you know, I know about that rat study. And I think it's super informative in terms of getting people to kind of rethink the paradigm. It's very powerful in that regard. But I also think it's more complicated

than that. It is indeed certainly true that the compulsion to use that the addict is coming from a place of being uncomfortable in their own skin, in their own life, whether that's the result of childhood trauma or some kind of psychological miswiring, which we can get into. It's a complex matrix of many factors that I think contribute to somebody becoming an addict versus somebody who's just a casual user in the case of your heroin example. And genetics probably plays a small role in that, some role. But in terms of unpacking that, like, I know for myself, longtime sober guy, when, you know, my loved ones fled, that was not, you know, that was not lost on me. Like, that was definitely a motivating factor in me finally reckoning with the damage

that I had created and ultimately starting to walk the path towards sobriety. So I think there is some wisdom in this idea of not being complicit and, as they say, codependent in an addict's behavior. And I thought one thing that was striking in your amazing TED talk, which I loved, was this idea of moving towards the addict as opposed to away from them. This idea that we should sing love songs, not war songs with respect to them, that we should bring the addict closer and let them know that we love them. I think that's important. But I also think it's important to use discernment so that the addict understands this is not acceptable, that there is some conditional aspect to the relationship that if they do X, Y, and Z, that not necessarily that you're retracting your love, but that you can't make yourself available to be a punching bag for

that person's errant ways. Yeah. I mean, love doesn't mean, I think you're making important points. Love doesn't mean giving someone everything they want in any situation right you don't love your children by giving your child candy all the time um no loving relationship involves just 100 giving the person what they want and that goes for people with addictions and people without addictions that's obviously true um i think one of the reasons why the debate about the war on drugs is so charged is because it runs through the hearts of all of us, right? Everyone, I feel this, even now after all the research I did for Chasing the Scream, everyone who has someone they love who's got an addiction problem, you know, has a part of them that thinks, God, someone should just stop you. Why are you being so stupid? Why are you being so destructive?

being so stupid? Why are you being so destructive? And then there's another part that most people have that is compassionate and sees, oh, wait a minute, this is someone trying to deal with a very profound sense of pain. They're anesthetizing themselves. Actually, we need to deal with the causes of their pain. Yeah, because the drug is the solution, not the, it's not the cause. It's not the problem itself. The problem is the person you're left with when you take the drugs away. I think it's not just the person you're left with, it's the environment, the cage you're left with. I mean, there's a very challenging line in Marianne Faithfull's memoir, you know, the great British rock star. She says at one point, something like, so she had heroin addiction in the 60s when she was homeless. She said, heroin saved my life because if it wasn't for heroin i would have killed myself at that point that's a very challenging thing to hear

for a lot of people it was challenging for me when i read it now obviously marianne faithful is not saying heroin is a good solution to despair but i do think it's very important to understand why but let's think about the opioid crisis right right? Why is this happening? Why are so many vectors of despair? I mean, so think of- It's serving a need that is so profound that it outweighs the negative ramifications of the behavior. That's a really good way of putting it. Everyone listening to your show knows that they have natural physical needs, right? Obviously, you need food, you need water, you need shelter, you need clean air. If I took those things away from you, you'd be in real trouble real fast. But there's equally

strong evidence that all human beings have natural psychological needs. You need to feel you belong. You need to feel your life has meaning and purpose. You need to feel that people see you and value you. You need to feel you've got a future that makes sense. Our culture is good at lots of things. I'm glad to be alive today. I love dentistry. I love gay marriage, a whole range of things. But we've been getting less and less good at meeting these deep underlying psychological needs. And this is manifesting in just an enormous range of problems, right? Think about, and this is one of the subjects of my more recent book, Lost Connections. You know, one in three middle aged women in the United States at any given time is taking a chemical antidepressant even more are depressed and not

taking drugs and the suicide rate combined with opioid deaths is now so high that white male life expectancy has fallen for the first time in the entire peacetime history of the united states teenage girls according to professor george tw, who's done really good research on this, now have the same anxiety. And the average American teenage girl now has the same average anxiety level as a mental patient had in the 1950s, right? So we've got this whole vector of despair, these different forms of despair. I would argue the political situation we're in is a manifestation of profound despair and anger. We need to understand why this is happening. And at the moment, I think we're being offered stories that are too simplistic. So when it comes to the opioid crisis, we're being offered a story that's not false. The drug companies did do terrible things, that they do bear some responsibility.

I'm in favor of the criminal prosecution of Purdue and various other things for mis-selling their drugs. But that's not the core of why this is happening, right? That if we think, a better analogy to help us to understand it, if you think about something that happened in Britain in the 18th, obviously I'm British, Britain in the 18th century. So at that time, huge numbers of people were driven out of the countryside into these disgusting urban slums in places like London and Manchester.

They lost everything that had made life meaningful to them. And they're suddenly totally disorientated in this place they don't understand. And there was a huge outbreak of alcoholism. It was known as the gin craze. And it really did happen, right? There's a famous painting from the time called Gin Lane of a mother downing a bottle of gin while her baby falls over some steps Right and there really was this this crisis really did happen And if you look at what people said at the time what they said is look at this evil drug gin

Look at what it's done to us. If only we could get rid of this evil drug gin. We wouldn't have this problem Now when we look back, we know it can't be gin that caused it because anyone in Britain who's over the age of 18 can go and buy gin. It's easier to get gin now than it was then. And while we still have some alcoholism, of course, we don't have mass alcoholism in the streets. We don't have babies falling out of windows. What changed? What changed is not the availability of the drug. What changed is the amount of despair and pain in the society. If you want to understand why people are turning to painkillers in? Such enormous numbers we have to understand why they're in such pain, right? I mean people on the faculty at Harvard have much easier access to opiate based painkillers than people in West Virginia who disproportionately don't have

their medical insurance and yet West Virginia has a Drastically higher level of opioid addiction than the faculty at Harvard. What's going on? It's not access to the drug, right? It's terrible, terrible, deep pain. We've created a culture which for many people, it's not bearable to be present in, right? So you think about one false narrative is the, or false is the wrong word, one limited narrative is the opioid crisis is simply the result of opioids. And if only we got rid of the opioids, we'd all be okay again. When in fact, what would happen is think about Marianne Faithfull's quote or what you're saying. It would be in some ways better. Fewer people

would overdose, but there would be profound despair, right? Or think about depression. So when I was a teenager, I went to my doctor and I explained that I had this feeling like pain was leaking out of me and I couldn't control it. I couldn't regulate it. And my doctor told me a story that again, I now realize was really oversimplified. My doctor said, well, we know why people feel this way. There's a chemical called serotonin in people's brains. Some people are just naturally lacking it. You're clearly one of them. All you need to do is take this drug. In this case, he gave me an antidepressant called Paxil. You're going to feel, you're going to be fine, right? So I started taking this antidepressant. I felt significantly better for a few months, real boost. And then this feeling of pain started to come back.

So I went back to my doctor. Again, I felt better. Again, this feeling of pain came back, and I was really locked in this cycle of taking higher and higher doses, until for 13 years, I was taking the maximum dose, at the end of which I was still profoundly depressed, and I really felt haunted by these two mysteries, one is really related to what we're talking about, you know, I'm nearly 40, every year that I've been alive, depression and anxiety have increased in the United States and across the Western world. I'm thinking, well, why, right? If it was just a problem inside our brains, which I think is simplistic in the way the chemical hook story is simplistic about drugs, if it was just a problem

in our brains, why would it be rising so much? It can't just be that all our brains start to malfunction at the same time. There must be something deeper, deeper going on. And so I ended up going on this big journey all over the world for Lost Connections, as you know, and I learned that there's kind of scientific evidence for nine causes of depression and anxiety, two of which are biological, but most of which are factors in the way we live now. Yeah, it's interesting that the work that you've done in addiction and in that first book really boils down to an assessment of how we're living culturally. This lack of connectivity that we have that is fueling, in large part, this increase in substance addiction across the board.

And then how you've now extended that to look at mental disorders, specifically depression and anxiety, and it's really the same thing. And in order to really kind of understand this, as we begin to look at these nine reasons, which we're gonna get into, we have to like step back and look at these nine reasons, which we're going to get into, we have to look, we have to

like step back and look at society. You know, it's like to echo Henry David Thoreau, you know, the mass of men lead lives of quiet desperation. And it's more true now than ever. People are more disconnected from their fellow man. I know you have that statistic where, I don't know how long ago it was that if you ask somebody how many good friends do you have that would come to your aid it was somewhere in the in the range of five and now for a lot of people it's zero the most common answer now when you ask people how many close friends do you have you could turn to in a crisis is none right so there's been this enormous and this is one of many pieces of evidence shows there's been in it we are the loneliest society there's ever been right there's been this enormous explosion in loneliness ironic

given the connectivity that the devices we all carry around in our back pocket you know provide us with but it's elusive illusory compared to real connectivity with another human being. And I think laid on top of this is a system, a cultural priority, this engine that is driving us to distance ourselves further and further away from each other. Because the mandate is to succeed, to get as much as you can for yourself, to live this life of luxury, of convenience. And we have lost sight of what it is that truly makes us human in the most beautiful way, which is our relationship with each other, with our families, the networks that we create,

the connectivity, the cooperation that allowed this species that, if you ask Yuval Noah Harari, should have never survived, yet we were able to do so simply because of this genetic predisposition that we have to be connected with each other. And that's what we've lost. And I think we're now seeing on a mass epidemic scale, the results of what happens when the human being is removed from that basic requirement that we have in order to feel contented, fulfilled, purposeful, engaged with life, and the sense that the lives that we're pursuing have meaning. It is a crisis

of consciousness. It's a spiritual crisis as much as anything else. And it really boils down to the way that we've structured the society in which we live. I think there's a lot of things in what you just said that are totally right. So I learned a lot about this from a man called Professor John Cassioppo, who sadly just died, but he was the leading expert on loneliness in the world. He was at the University of Chicago. And he explained a few things to me that were really important that touch on what you said. So he talked about, I remember him saying to me,

why are we alive? Why do we exist? One key reason is that our ancestors on the savannas of Africa were really good at one thing. They usually were not faster than the animals they tracked down. They usually weren't bigger than the animals they tracked down. What they were was much better at banding together into groups and cooperating. So just like bees evolved to need a hive, are banding together into groups and cooperating. So just like bees evolved to need a hive, humans evolved to need a tribe. In fact, humans who had wandered off on their own would have died out, right? A species inclined to do that would not have continued to exist. And actually, if you think about those circumstances, if you were separated from the tribe in the circumstances where we evolved, you would be depressed and anxious for a really good reason. You were

probably about to die. Those are the instincts we have, right? If you separate a bee from its hive, it will go crazy. Look at it. It will lose its mind, right? It will panic. It will freak out. It'll be profoundly distressed. And eventually it will just give up. In a similar way, we are the first humans to ever try to disband our tribes, to try to live alone. And this is a disaster for us, a real disaster. And one of the things I wanted to think about is, given that there's overwhelming evidence that is a cause of depression, what is the antidepressant for that, right? And I learned one of the heroes in my book, Lost Connections, is this amazing man called Dr. Sam Everington, who's a doctor in East London, a poor part of East London where I lived for a long time.

And Sam was really uncomfortable because, like me, he thinks there's some role for chemical antidepressants. But he was just very conscious of two things. Firstly, most of the people he was giving chemical antidepressants to were becoming depressed again. It was giving a bit of relief. And secondly, they were depressed for perfectly good reasons. So, you know, one of the nine causes that we're talking about here is loss connection, sorry, is loneliness. So one day he decided to pioneer a different approach. A woman came to see him who I got to know quite well called Lisa Cunningham. And Lisa had been shut away in her home with just crippling

depression and anxiety for seven years. And Sam said to Lisa, don't worry, I'm going to carry on giving you this drug. I'm also going to prescribe something else. There was an area behind the doctor's surgery that was known as Dog Shit Alley, which gives you a sense of what it was like. It's just kind of scrub land. And Sam said to Lisa, what I'd like you to do is come and turn out a couple of times a week. I'm going to come too because I've been quite anxious. And with a group of other depressed and anxious people, we're going to turn Dogshit Alley into something nice, right? The first time the group met, Lisa was literally physically sick with

anxiety. But they decided, this group, that they were going to learn gardening, right? They were inner city East London people like me. They didn't know anything about gardening, right? They started to get their fingers in the soil. They started to learn the rhythms of the seasons. But even more important things started to happen. They began to, oh, by the way, I should say about that, there's loads of evidence that exposure to the natural world is a really powerful antidepressant. Connection with nature and connection with others.

Exactly. They started to form a tribe. They started to form a group. They started to care about each other. They started to solve each other's problems. They started to notice if one of them didn't show up and go and check on them. The way Lisa put it to me, as the garden began to bloom, we began to bloom. There was a study in Norway of a very similar program that found it was more than twice as effective as chemical antidepressants. I think for an obvious reason, it was dealing with some of the reasons

why they were depressed and anxious in the first place. This is something I saw all over the world from Sao Paulo to Sydney to San Francisco. The best strategies for dealing with this epidemic of despair, this depression, this anxiety, this addiction are the ones that deal with the reasons why we feel like this in the first place. Yeah. It's interesting that I feel like we're seeing this trend of people like yourself that are coming out and looking at problems that we're experiencing as a culture, as human beings, that we have traditionally treated in a certain way. and that way being kind of part and parcel of the gestalt of the scientific method, producing less and less beneficial results. And then now we're kind of looking in the rearview mirror and saying, hold on, I know we all think this is working, but it's actually not working so well. Why don't we look back through history and see how we've

dealt with these problems as a species in the past and realizing that there's a lot of wisdom there that we've overlooked. We like to think that we've transcended these primal needs, that we can live in these hermetically sealed environments, that we can drive around in air conditioning and we can do what we do and be perfectly fine and pop a pill if we feel less than stellar. And that's the end of the story. When in fact, in order to really fully redress this, we need to look at it holistically and understand that it's not one thing. It's not a constant or a variable that we can just tweak, but we need to really reassess how we're fundamentally living in every aspect of that. I think that's a really good way of putting

it. The Indian philosopher Krishnamurti said, it's no sign of good health to be well-adjusted to a sick society. And if you are uncomfortable and distressed in a world where donald trump is the most powerful person that's not a sign that you're crazy that's a sign that you're sane and i think it's important for us to think about this so there's there's there's extremely strong scientific evidence that there are three kinds of cause of depression and anxiety and to some degree they play out in in fact all forms of um mental and emotional problems so there's biological causes like your genes like real brain changes that happen when you become depressed that can make it somewhat harder to get out those are real right

there are people who deny them they are definitely wrong the evidence is very clear on that there are psychological causes which are how you think about yourself and there are social causes which are how we live together and these are all real but what we've done is we've largely as a culture told a story that focuses exclusively on the biology right think about what my doctor told me there's just a problem in your brain the problem with that well the first problem with that is it's not true right but the second problem with that is what it tells people is your distress doesn't mean anything it's like a glitch in a computer program and somebody really helped me to think a bit differently about this i went to interview this south african psychiatrist called derek summerfield who's a wonderful man and he happened to be in cambodia in 2001 when they introduced

chemical antidepressants for the first time for the people in that country. And the local doctors, the Cambodian doctors, had never heard of these drugs. So they were like, what are they? And he explained. And they said, oh, we don't need them. We've already got antidepressants. And he said, what do you mean? He thought they were going to talk about some kind of herbal remedy, like St. John's water or something. Instead, they told him a story. There was a farmer in their community who one day stood on a landmine and got his leg blown off. He worked in the rice fields. So they gave him an artificial limb and he went back to work in the rice fields after, I forget

what it was, some months. But apparently it's very painful to work underwater with an artificial leg. I'm guessing it was traumatic for obvious reasons. The guy started to cry all day, didn't want to get out of bed, developed classic depression. They said to Dr. Summerfield, well, that's when we gave him an antidepressant. And he said, what? They explained that they went and sat with him. They listened to him.

They realized that his pain made sense. They figured if they bought him a cow, he could become a dairy farmer. He wouldn't be in this position that was screwing him up so much. So they bought him a cow. Within a couple of weeks, his crying stopped. Within a month a month his depression was gone They said to dr. Summerfield. So that cow that was an antidepressant. That's what you mean, right? Now if you've been raised to think about this the way we have that sounds like a joke

I went to my doctor for an antidepressant. He gave me a cow But what those Cambodian doctors knew intuitively is what the leading medical body in the world The World Health Organization, has been trying to tell us for years. If you're depressed, if you're anxious, you're not crazy, you're not a machine with broken parts, you're a human being with unmet needs, and what you need is practical love and support from the people around you to get those deeper needs met. It's a very different way of talking about these problems. It explains to people that pain is a signal. It means something. It evolved for a reason.

It's telling you your needs aren't being met. Or some other things, obviously reference to a biology. Or there's some psychological event that occurred that you haven't really fully processed or worked through. There's some hitch in your operating system that requires redress. So I wouldn't say, I wouldn't call it a hitch in an operating system. I would say it's a signal. Well, if you're experiencing grief in the loss of a loved one or something like that, like, yes, there are natural reactions that, you know, we've kind of been told we should

just get over that kind of stuff rather than really just embrace them for what they are, because that is what it is to be human and that's certainly fine and to stigmatize that or just to to kind of pathologize that is certain is certainly wrong but their messages their wake-up calls that their signals yeah exactly yeah To go back to the cultural piece, you know, if someone's grieving the loss of a loved one, and they're uncomfortable sitting with that grief, we have a system that's set up to help you and say, you don't need to feel this way. Like take this, take this pill, right? Because we've gotten to a place where it's almost understood that we never need to feel bored or uncomfortable or ill at ease, right? That we can, that we can just medicate all of that.

And, and implicit in that is this idea that we should all beate all of that. And implicit in that is this idea that we should all be happy all the time. I think people are right to want to be happy and satisfied in their lives. The question is, it's a deeper thing I think you're getting at, which is, so let's think about grief, for example. There was this thing that happened in the 1970s that I think is really revealing. So in the 1970s, the APA, revealing so in the 1970s the apa the american psychiatric association who are the obviously the main body of psychiatrists in the us and psychologists decided to do a kind of basic kind of obvious thing they decided they were going to standardize how depression was diagnosed across the us so up to then doctors were just basically deciding for themselves oh what what depression meant so the the APA drew up a simple checklist of 10 symptoms,

kind of obvious things, crying a lot, you know, you could guess them. And there's 10 list of 10 symptoms and they send it to doctors all over the United States. And they say, if your patient shows more than five of these 10 symptoms for more than two weeks, diagnose them as mentally ill and do what you can. So they send this out. But within quite a short period afterwards, psychiatrists start to come back and go, we've got a bit of a problem here. If we use this checklist in the way you're telling us to, we're going to have to diagnose every grieving person in the United States as depressed because these are also the symptoms of grief. And the APA got together and they said, well, that's not what we meant. Clearly we didn't intend that. So they

invented something that became known as the grief loophole, where they said, okay, if your patients come to you and they've got more than five of these 10 symptoms for more than two weeks, diagnose them as mentally ill, unless someone they love has died in the last year, in which case it doesn't count. They're not crazy exception they're not crazy well exactly so they started doing this but this began to beg the question hang on a minute why is someone you love dying what we're saying is what we're meant to tell doctors and tell people is so if you feel this way it's just a problem in your brain that just needs to be drugged into submission except there is one circumstance in life where it's an understandable response well why is that the only circumstance why if my mother dies i'm allowed to feel like that, but not if I lose my job. Why not if I

become homeless? Why not if I'm stuck in a job I hate for the next 40 years, right? But what that does is a wonderful woman called Dr. Joanne Cassiotore, who's the leading expert on traumatic grief in the United States, has really done amazing work on this, asking, well, once you acknowledge that depression can be largely a response to life, that just challenges the whole system we've built. The system we've built is not designed to talk about context. It's not designed to talk about how do we sit with you and hold you and love you and help you change your life, right? As she puts it, we just don't understand pain in this culture. We've developed a bizarre way of talking about pain. It's so bizarre that I did

an interview recently on a radio show where I was talking about, we were talking before in a similar way to the way we were talking before about loneliness causing depression. And the interviewer said to me, well, this is an extremely controversial theory. And I thought, how did we get to the point where it was regarded as controversial to point out the most banal and obvious thing, this is an extremely controversial theory. And I thought, how did we get to the point where it was regarded as controversial to point out the most banal and obvious thing, which is if you're lonely, you're going to be much more likely to be acutely unhappy. So I think the grief exception debate

reveals something really deep about how we have misunderstood pain. And so Joanne, Dr. Cassia Torre, who'd be a great person for you to talk to and give an intro to, she's an extraordinary woman. Her baby died during birth, her daughter Cheyenne.

And she was devastated. And she was horrified to be, to see how many other grieving parents were very rapidly being diagnosed as mentally ill and drugged, right? Because the APA was so uncomfortable with this debate about the grief loophole, they just got rid of it. It doesn't exist anymore, right?

So now you can be diagnosed almost immediately after your child dies. In fact, 9% of parents who lose a baby in the United States are diagnosed and drugged in the first 48 hours, right? And as Dr. Cassia Toye puts it, we grieve because we've hours, right? And as Dr. Cassia Toye puts it, we grieve because we've loved, right? Grief is a testament to our love. It's not a glitch. It's not a pathology. It's a profound form of love. If someone you love dies, it is natural and necessary to grieve. If you interrupt that process, if you pathologize the pain, if you say, you know, it's a sign of, so for example, one of Joanne's clients, she now

treats people who've gone through terrible traumatic grief. You know, one of her parents, one of the parents she worked with mentioned to a psychiatrist that she, when she would lie there at night, she would sometimes hear her son's voice talking to her. Not in a distressing way, in fact, soothed her, entirely natural form of grieving. She was diagnosed as psychotic and prescribed loads of antipsychotics. You can see what are, ironically, what a crazy system that is that's telling us we're crazy for having perfectly natural human responses. Yeah, it's interesting that somebody would say that these ideas are controversial. I mean, there is a little controversy around your book. And I read a couple of those articles trying to understand what exactly that controversy is. And it seems to me to

be a misreading of what you actually say in the book. It's this perspective that you're saying everything we know about SSRIs and these drugs that we're over-prescribing to people is wrong. We shouldn't be doing this at all. And here's the real reason when in fact, you're saying, listen, let's look at these SSRIs, let's look at these drugs, let's look at the system and the history behind how we got to this point so that we can fully understand the context of the world that we're talking about. And nowhere in the book do you say these things should be gotten rid of. You say, look, if this is working for you, you should do it. I've been on and off them. And for certain people, they do work. And you're also not saying that any of these ideas are new or your own, or that they aren't already part of the literature and the protocols

that a lot of well-intentioned psychologists and psychiatrists are putting into practice with their patients. It's just that it's not enough, right? You're zeroing in on the scenario in which, the overplayed scenario in which the person goes to their shrink or doctor. And because of the healthcare system that we have, they have 15 minutes to diagnose this person and prescribe them something. And more often than not, people leave those appointments with a script that they go and they fill. And that's the end of the story. There isn't that aftercare. There isn't the functional medicine sort of rubric established that gives the well-intentioned medical practitioner the time and the bandwidth to really have the kind of conversations that are required in order to provide the person with the optimal care that they need. So I think there's loads of things in what you said. I think you're right that, I mean,

so the people who responded to the book in the way that you mentioned, I mean, to be fair to them, they admit they hadn't read it. Yeah, there was a bunch of people who, they were like, they got little snippets of it or whatever and were we're writing reviews. Yeah. So it's not even a misreading. It's a non-reading, but the, but no, I think in terms of, but I do understand why some people, when they hear some of these things, find it deeply challenging because I found it really challenging, right? For 13 years, I was very committed to the idea that my depression was just a problem with my brain chemistry. And I found that relieving in all sorts of ways I'm happy to talk about. But

I think there's a few things in what you said that are worth bringing up. So one is, you're absolutely right. I'm not against chemical antidepressants. I just think we need to have a nuanced conversation about them. So the two most important facts about chemical antidepressants that I learned from the leading scientists in the world who've studied this are, one is, so depression is generally measured by something called the Hamilton scale. I've always felt really sorry for whoever Hamilton was that we only remember him by how miserable we are. But anyway, this is the one to 51. Yeah. So it goes from one where you would be dancing around in ecstasy or maybe on ecstasy to 51 where you would be acutely suicidal.

And to give you a sense of movement on the Hamilton scale, if you improve your sleep patterns, you'll generally gain six points on the Hamilton scale. And if your sleep patterns deteriorate, you'll generally go six points the other way. I can definitely validate that. Yeah, you've had children so i could yeah um but um so according to the leading expert harvard medical school who's looked at the data all the data including the data the drug companies didn't publish but he managed to get a hold of um on average over time chemical antidepressants will move people 1.8 points on the hamilton scale it's important to say a few things firstly that's an average so i initially got much more than that over time i got less it's important to say a few things. Firstly, that's an average. So I initially got much more than that. Over time, I got less.

It's important to say 1.8 points isn't nothing, right? That's a real effect. If a good night of sleep gets you six points. Yeah. I mean, some people will get more than that. But I think that fits also with the... And by the way, some people say he slightly underestimates the effect of looking at the same data.

They say it's three points on the Hamilton scale, but no one says it's more than three points or so more than half of improving your sleep patterns. But that fits with, I think, the even more important piece of research, which is that the only good long-term research we have on the effects of chemical antidepressants when it comes to depression is something called the STAR-D trial. It's really simple. People go to their doctor. They say, I'm depressed.

And they follow, the study follows them over two years to see, or 18 months to their doctor, they say, I'm depressed. And they follow, the study follows them over two years to see, or 18 months to two years, to see, well, do they stop being depressed? What I found is the vast majority of people taking chemical antidepressants do become depressed again. Now, that doesn't mean they don't get some relief. They do get some relief, a lot of them. But what we can see is it's not solving the problem. And in a way, I think this is a rather banal insight. It actually, in certain cases, can prevent you from solving the actual problem because you think that you've solved it when actually you're just treating a symptom without actually getting at the rationale, the reason behind what's driving the depressive emotion.

I think there's several things going on there. I think you're right to raise that. So one is some people benefit and get a benefit which outweighs the side effects it's true some of my closest relatives some people get a benefit and enormous side effects like a lot of people i gained a huge amount of weight 70 percent of men affects their sexual functioning all sorts of problems so some people gain a benefit but the side effects outweigh the benefit some people don't get a benefit and get horrendous side effects but i think you've gone to them i think in a way the more important thing which is if you are told a story that your depression is simply a biological problem and can only be treated with drugs it comes back to what we're saying that just tells

people there's no meaning to their pain it actually cuts them off from finding the causes of their pain in their life and it cuts us off as a society but i would just say just a second thought about what you said before and it's worth saying this is not my view this is the view of the leading medical body in the world the world health organization but when you said you know so part of the problem is that your doctors only have 15 minutes and so when it's actually seven minutes now is the average but the that's true and it's an even deeper thing if we think about road accidents right car accidents it's now is the average but the that's true and it's an even deeper thing if we think about road accidents right car accidents it's still the single biggest cause of death although opioids are coming up close behind it in our society um when you think about how do we prevent road

accidents right one of the or deaths in car crashes one of the things we do is we have doctors in emergency rooms and they do heroic jobs when someone's already been horrifically mauled. And the doctors are heroes and they're amazing, but they are not the people who save the most lives, right? What do we do? As a society, we have driving tests. So we make sure you can drive before you get onto the road. We have speed limits. We have seatbelts.

We have airbags. We send the cops out to chase down people driving chaotically to see if they're duis or drug driving environmental control exactly precisely because it's a social problem we have an enormous social response of which one part which is amazing and heroic is the biomedical response of doctors patching you back together But that's one thing on a big long list, right? In the same way, the evidence is overwhelming that depression and anxiety have huge social and psychological causes alongside the biological causes, right? Very few people will dispute that, although it's rarely explained to the public. That needs a social response, right? So there are lots of

things that the evidence shows very clearly can reduce this epidemic that are much earlier down the chain, if you like, than by the time the person becomes acutely depressed and goes to the doctor. So I'll give you an example. I noticed that lots of the people I know who are depressed and anxious, their depression, anxiety focuses around their work. So I started to think, well, are the people I know unusual? I started to look at the evidence for this. So Gallup did the best research, enormous study, three-year study, that figured out how do people feel about their jobs in the United States.

What they found was 13% of us like our jobs most of the time, 1-3%. 63% of people... That's actually pretty high. That's higher than I would have thought. You're a pessimist. Oh, my God. 63% are what they call sleep working. You don't like it. You don't hate it.

You just kind of get through the day. And 24% of people hate and fear their jobs. I was quite struck when I saw that. That means 87% of people don't like the thing they're doing most of their waking lives. And jobs, you know, most jobs these days are not nine to five. They're, you know, from the minute you wake up in the morning and check your phone to the last, you know, check on the phone before you go to bed and constantly we're, you know, we're all on call 24-7. If you don't like what you do, it's academic that this is going to lead to psychological issues well i think that's right and i started to look for the evidence well how to

is there any evidence about depression and work i discovered this is an amazing man australian social scientist i went to go and see called professor michael marmot um who made a real breakthrough about this in the 1970s. So he discovered the key factor, not the only one, but the key factor that causes depression at work. If you go to work tomorrow and you are controlled, so you have low or no control over your work, you are much more likely to become depressed and anxious. And at first, when I was looking at this evidence,

and I went to interview Professor Marmot a few times, I kept misunderstanding it. So I thought the lesson of this was, okay, you've got this elite 13% at the top who get to have nice jobs where they control it and they're going to be fine. And then you've got everyone else who's condemned to this shitty life.

And I thought, wow, my brother's an Uber driver. My dad was a bus driver. My grandmother's job was to clean toilets. Are we saying that like these people I love are condemned? And Professor Marmot kept explaining, it's not the work that makes you depressed. It's a lack of control over the work. And there's something we can do about that,

which I think is the equivalent of your seat bags and your DUI arrest, right? So I went to Baltimore and went to interview a wonderful person called Meredith Keogh. Meredith used to go to bed every Sunday night, just sick with anxiety. She had an office job. As she would tell you, it wasn't the worst office job in the world.

She wasn't being bullied or harassed or anything, but it was monotonous, low control. She couldn't bear the thought this was going to be the next 40 years of her life. So one day with her husband, Josh, Meredith did this quite bold thing. And at first when people hear this, they're going to think I'm saying, you should do this too. And you're going to think I can't do that. And it's true, most people can't. It leads to a different insight. So Josh worked in a bike store in Baltimore. And he'd done it since he was a teenager. And as you can imagine, that's insecure work. It's controlled. You don't even have any vacation, paid vacation, or paid sick pay, unless your boss happens to be generous. And one day, Josh and his colleagues were in their bike store,

and they just asked themselves, what does our boss actually do? They liked their boss, he wasn't a terrible guy, but they were like, we seem to fix all the bikes, and he seems to make all the money. Could this work out differently here? And they decided they were going to set up a bike store of their own that worked on a different principle.

So the place they'd worked before was a corporation, right? Most people listening to your show work in corporations. You know how it works. You've got a boss at the top who's like the dictator and we're all the little serfs and sometimes the dictator chooses to be nice and sometimes they don't, but you don't have much say over that.

Josh and his friends and colleagues and Meredith decided they were going to set up a bike store that works on a different principle, an older American principle. It's a democratic cooperative. They don't have a boss. They take the decisions about the business together by voting. In practice, they agree almost all the time, but they vote once every couple of weeks. They share the profits, obviously. They share out the good tasks and the shitty tasks, so no one gets stuck with the shitty tasks. And one of the things that was fascinating spending time with them at Baltimore Bicycle Works, which is their store, is how many of them talked about having been depressed and anxious in this previous way of working,

but were not depressed and anxious in this different way of working. And it totally fits with what Professor Marmot had taught me. It's not like they quit their jobs fixing bikes and went off to become Beyonce's backing singers, right? They fixed bikes before, they fixed bikes now. The difference is now they've got control over their work. And when you control your work, you can create meaning out of it, right? If you have an idea, you can try to persuade the people around you. You can try to put it into practice. You don't feel humiliated. You don't feel subordinated. There's no reason why we should be structuring our society so most of us are spending time in institutions that make us feel like shit, right? It's a sense of agency.

Exactly. Right? I mean, it's multifaceted because you have ownership, you have decision-making control, you have some sense of decision-making power over your hours. I would imagine there's a whole variety of things that get played into that. But fundamentally, it's about agency over your life. And when people lack that, whether it's in their job or other areas of their life, that's going to lead to a sense of disempowerment that I think will quickly cascade into despair. That's a really good way to put it. You have a natural human need to seek meaning in your life.

And if you're doing something that's controlled by someone else almost all of your waking hours, that disrupts your ability to create meaning out of it, right? I think the idea of meaning gets confused. If you say, well, does your life have meaning or are you living a meaningful life? That can get misconstrued into this idea that you're on a grand quest to answer some universal question or something like that. But I think at its core, you know what I mean? Yeah, you're searching for the ring or you're trying to find God. But it's really just, I think, some sense of these fields where now jobs become so regimented into performing these very specific tasks.

You see it in medicine. It used to be the family doctor who paid house calls. Now, every doctor has a very specific specialty that allows them to be very good at that one thing, but they lack a general understanding or not. Like we lose sight of the bigger picture. And I think when we're being funneled in that direction of greater and greater specificity, with that comes a loss of that level of agency as well. This is one of the causes of depression and anxiety that I write about in Lost Connections that I found quite challenging, actually. So everyone knows that junk food has taken over our diets and made us physically sick. But there's equally strong

evidence that a kind of junk values have taken over our minds and made us mentally sick. No question about it. Yeah. For thousands of years, philosophers have said, you know, from Confucius to Socrates on down, if you think life is about money and status and showing off, you're going to feel like shit, right? That's not an exact quote from Confucius, but that is the gist of what he said. We all think we're going to be the exemption to that rule, though. You know what I mean? Yeah. We're like, yeah, yeah yeah yeah yeah i get it but well this is what was fascinating because although people have thought that for a long time no one had actually scientifically investigated it until i got

until an incredible man i got to know called professor tim casser who's at knox college in illinois started to do amazing research into this professor Professor Cass had discovered some really important things. One of the things he discovered is the more you think life is about money and status and showing off, the more likely you are to become depressed and anxious because that's not a way of living that meets your deeper needs. He also found as a society, as a culture, we've become much more driven by these junk values. They've really begun to dominate the culture over time. And it's making us feel terrible. There's a little experiment, this wasn't done by Professor Kasser, it was done just before he started his work, but I think it's kind of a revealing one. It's done in 1978. It's very simple. They've got a

bunch of five-year-olds and they split them into two groups. And the first group was shown an advertisement, two advertisements for a specific toy, whatever the equivalent of Dora the Explorer or the Teletubbies was in 1978. Second group was shown no advertisements. Then they say to all the kids, okay kids, you've got a choice now. You can either play with a nice boy who doesn't have the toy that was in the ad, or you can play with a nasty boy who's got the toy that was in the ad. The kids who have not seen the advert, choose the nice boy. The kids who haven't, sorry, the kids who haven't seen the advert, choose the nice boy. The kids who have seen the advertisement, choose the nasty boy who's got the toy. Just two advertisements primed those kids

to choose an inanimate lump of plastic over the possibility of connection and fun and friendship, right? Everyone sees more than two adverts a day, right? We're just bombarded with it. Oh, my goodness. I mean, I don't know what the number is, but it's got to be in the hundreds, if not thousands, every single day, depending upon where you live and your media habits. Well, as Professor Kasser put it to me,

you know, we all live in a machine that is designed to get us to neglect what is important in life, right? Nobody listening to your show thinks they're going to lie on their deathbed and think about all the things they bought, right? They will lie on their deathbed and think about moments of love and connection and meaning in their lives. And yet we've created a culture that is designed to get us to neglect those things. And Professor Kasser proposes two kinds of solutions to this. So one is we need to just get these contaminants out of the environment, right? Analogous to getting rid of environmental contaminants, you know.

So I went to Sao Paulo in Brazil where they just banned outdoor advertising, right? That's one thing we can do. We should much more tightly regulate advertising. Advertising is the ultimate frenemy right imagine an advert that said to you hey rich you look great today you smell great you're doing fine you don't need anything more save your money that would be the worst advert ever right from the perspective of the advertising industry advertise only advertising industry talks about this openly in their documents. It's about creating manufactured wants, manufactured needs, creating feelings of inadequacy that they then have to keep selling the solution to over and over again. There was a kind of example a few years ago that was a nice illustrated rare moment when people pushed back where a cosmetics company started to sell a product that said,

are you embarrassed by how wrinkly and disgusting your armpits are? Compassionately, we've created this beautiful solution. Of course, no one was worried about how their armpits look because no sane person thinks about that, right? Of course, what it's subtly saying is, you're like the ultimate frenemy. Oh, babe, I really care about you.

I'm on your side. Just so you know, people are kind of saying your armpits look gross. You can see how it works, right? That was a moment where people really kicked back.'s another good moment in london um i guess two years ago now where um a company that did i think there were protein shakes launched a huge ad campaign all over the london subway system that said um are you beach body ready and had a picture of an impossibly buff man or woman right uh? The implication being, if you don't look like these people,

you're not ready and you better start drinking our protein shakes, right? And there was a huge backlash to get people vandalized. And in the end, they took them down from the subway system. I think the mayor actually, Mayor of London, Sadiq Khan, actually banned them. Because of course, we could see the, occasionally they go too far and we see the implicit message, right? But most of the time, we're just soaking this up. so part of the solution is get the contaminants out of the environment just get rid of most advertising extremely tightly regulate what remains but professor how likely is

that a lot more likely than gay marriage seemed 50 years ago you think wow you know a lot more likely than a black president seemed 50 years ago a lot more likely than a black president seemed 50 years ago, a lot more likely than president Trump seemed five years ago. Right. Go either way. But the, um, we're all the beneficiaries of things that seem completely impossible. Right.

I mean, my grandmothers were not allowed to have a bank account once they got married. Right. Of their own. That's not so long ago. Right. The weekend was a crazy radical idea when American trade unionists

proposed it for the first time. Now we take it for granted, know so um we're all the beneficiaries of impossible seeming things that people fought for and didn't give up and demanded um but professor casso also said there's another another set of solutions which are actually more immediately achievable which are um about how we inculcate these more meaningful values in ourselves. So he did this interesting experiment with a guy called Nathan Dungan, who I interviewed. So Nathan came back in a kind of slightly funny way. Nathan was a financial advisor in Minneapolis to adults, help them do budgeting, things like that. And one day he got contacted by this school in a middle-class class neighborhood not particularly fancy neighborhood

saying look we've got a problem the kids in their school were demanding really expensive consumer objects like nike sneakers and they were getting extremely distressed when they didn't get them and it was freaking out the school is freaking out out the parents they're like what can we do and they asked him to come in and do what he did which was give budgeting advice so he comes in to advise the kids on budgeting and quite quickly realizes this ain't a budgeting issue right there's something deeper going on here so he starts to work with the he did this interesting experiment that was then monitored that so set up with professor casso that was monitored so what they did is they would get teenagers and their parents to come they would meet in groups i think it was once a fortnight for six months something like that and at first the first day

the very first session the teenagers and parents had to write down what they thought they had to have right and of course people would initially say food and shelter and perfectly sensible things and quite quickly the teenagers would say i gotta have you know whatever the latest designer object was and and then they would say tell me what you would feel if you got those objects if you got that thing and quite quickly the teenage quite quickly it was clearly not about an inherent property of the consumer object so So, for example, when I was a teenager, I remember craving Nike sneakers. You could not have had a child who was further away from playing basketball like Michael Jordan than me, right? Why did I want it? You know, why did these kids

want it? They would say things like, well, I would feel accepted by the group. Yeah, it's social acceptance. It's where you fall in the social pecking order. And I think at that age, the social dynamics feel like life and death. It's very acute at that age. And it didn't take long for the kids to articulate what you're saying, for them to go, huh, why do I think that? Right? They didn't need much prompting as the sessions went on.

So where did you get the idea that you will have value as an individual if you have this lump of shitty... Right, from the 8,000 commercials and billboards that I've seen in the last 24 hours. Exactly. So they would, firstly, what they did was work on seeing, well, where did those junk values come from? They would look at the ads. Everyone likes to think they're smarter than the ad. And everyone began to realize, oh, shit, the ad got me, right? But then they did what I thought was the more interesting bit. They began to say, okay, well, set that stuff aside. What do you actually value?

What do you think is actually important in life? And they started writing about that. They started discussing it in groups. We don't really have those conversations very often in our culture, certainly much less than we have conversations about shopping. And they started talking about what they actually thought was important, what actually gave them joy in their life. Some of them talked about playing music, some of them talked about just love, there was a whole range of things, some talked about being in the natural world. And they started talking about, well, how could you build more of that stuff into your life and less of the junk? And they started to do it, and this was monitored over time. And what it found was just this intervention and meeting once a fortnight led to a really significant shift in people's values

what this tells us professor casser argues i think persuasively is these insights are just below the surface right and this is not like explaining quantum physics or complex linguistics or something in some ways these are almost banal insights and yet the reason they have to be stated and argued for is because we created a culture that's all about getting us to not see them it's a machine that in fact faces real challenges if we stop buying crap right the problem is if we carry on buying the crap and thinking that's what life is about we have the crisis not that system so i think it's about and you can see again and we touched on a few of the causes obviously that i talk about lost connections but you can see again this is a very different story than telling someone there's just a chemical missing in your brain and all you need to do is

drug yourself right it leads to a different set of attempted solutions. And I believe very strongly in antidepressants in the sense that people are really depressed. They're not making it up. They're not imagining it. They are terribly depressed and anxious. They need solutions to that. But what I argue is we need to expand our concept of what antidepressants are. For some people, one of the things on the menu should remain chemical antidepressants they have value but we need a much broader range of antidepressants on the cow model right that group that nathan and professor casa led where they got people to talk about their values and it shifted their values over time that's an antidepressant that gardening program in east

london that was an antidepressant obviously the last third of the book is about these different kinds of antidepressants they are just as real and just as important easily as the kind of chemical solutions because they're tending to some of the other causes. Yeah, yeah, yeah. And I think we're seeing some interesting cultural movements at the moment that are kind of incarnations of what you're talking about. I mean, this whole minimalism thing that a lot of young people are super all about and keen on, that didn't really exist even, I don't know, five or ten years ago. Now there's movies about it. There's movements. There's YouTube channels.

There's people with podcasts about this who are basically speaking to Gen Z and saying, listen, everything that you see all around you every single day is promising you a lie. The answers that you seek will not be found in this material way. And in truth, that which we seek the most will be found through connectivity, through getting back to nature, to these things that you're talking about and it requires like a material shedding as much as it does kind of a psychological rebooting of your software to really understand that you need to look at the world through a different pair of glasses i think that's true and i think it's interesting this is playing out with teenagers so much because the figures for teenage distress are really shocking. Yeah, I mean, what are they? They're super high. They're exceptionally high.

Part of the problem is it's difficult to measure distress over time because some of the figures that show astronomical increases i think are slightly misleading because there's been a decline in stigma of talking about it so that would mean that more people for example my grandmother i'm sure from having discussed this with her while she was alive um was terribly depressed in her 30s and 40s if anyone had ever asked her are you depressed she would have said no and she would never have dreamed of going to the doctor so there's been whereas it would you know if um you know a relative of mine the same age now does, they would say yes and they would get help. They would go to the doctor for help.

So I think the kind of stratospheric figures for increase are misleading, but I do think there's good evidence there has been a significant increase. We know teenage suicide, for example, has gone up, which is obviously a very relatively easy way of measuring extreme distress. But I want to think about, obviously, one of the factors we think about when we talk about teenagers is social media and so on. I want to think about this.

One of the places that really helped me to understand it is I went to the first ever internet rehab center in the United States. Oh, wow. There's something like that exists. I'm glad it does. It should exist. It's in Spokane. It's just outside Spokane in Washington. yes i'm glad it does it should exist it's in spokane it's just outside spokane in washington and i remember when i arrived there i remember getting out the car and absolutely instinctively looking at my phone and being really pissed off there was no reception to check my email and i was like all right you're in the right place exactly what is this place um and we're going in there no wi-fi it was hell what can i say but i remember going in there. No Wi-Fi. It was hell. What can I say? But I remember going in there and talking to these. So they get all kinds of people at Restart Washington,

but they disproportionately get young men who become obsessed with these multiplayer role-player games like World of Warcraft or Fortnite. Although Fortnite didn't exist at the time that I was there. It's become an issue for them since I'm sure. And speaking to these young men, I felt like I was getting, it's become an issue for them since I'm sure. And speaking to these young men, I felt like I was getting this kind of insight. And then I spoke to Dr. Hilary Cash, who runs, co-runs the place. It was a great person. She really helped me to understand it. So she said to me something like, you've got to ask yourself, what are these young men getting out of these

games? They're getting the things they used to get from the culture, but they no longer get. So what do they get? They get a sense of tribe and identity. They get a sense of status and a way they can gain status, that they can feel they're good at something. They get a sense they're physically roaming around. The average child in Britain now spends less time outdoors than the average maximum security prisoner, because by law, a maximum security prisoner has to have 70 minutes a day. And most of our kids don't get that. But what they're getting is like a kind of parody of those things, right? I began to think as I was speaking to her and the young men there there the relationship between social media and social life is a bit like the relationship between porn and sex right i'm not anti-porn

but if your entire sex life consists of looking at porn you're going to be going around pissed off and irritated the whole time because you didn't evolve to masturbate over a screen you evolved to have sex in the same way um there's a place for screen-based interaction of course i'm not some weird luddite but that's not what we evolved to have. If you and I were having this conversation over Skype, I wouldn't feel you were hearing me and you wouldn't feel you were hearing the other way around in the way that we feel we're hearing and seeing each other now, right? And that led me to think about, well, you've got to think about when did the internet arrive right because you can get into a simplistic dialogue where you say this is just the internet's for the internet's this horror show but if you think about it and you look at the evidence on

this the internet arrives for most of us in the late 90s the early 2000s i sent my first email in the year 2000 and a lot not all but a lot of the causes of depression and anxiety that i write about in lost connections had actually already been supercharged by that point so we've talked about a couple of the loneliness meaningless work um but junk values and what happens is the internet arrives and it looks a lot like the things we've lost, right? You've lost friends. Here's a whole range of Facebook friends. You've lost status. Do as many status updates as you want, right? But again, it's like a parody of the thing we've lost. And the expert on loneliness, Professor John Cassiopos said to me, gave me a good kind of rule of thumb, which is if you're turning to the

internet as a way station to meet people offline, great. If it's the last destination on the line, generally something's gone wrong. Yeah. It's a tricky thing because this is the lexicon. thing because this is the lexicon. This is how more and more people are communicating. And the solution isn't to completely put the phone away and never use it and become a Luddite. But these devices are specifically designed to create that addictive response. I mean, I think this is a perfect example of where the work that you've done in addiction and depression dovetail directly into each other because you have a highly addictive device

in the hands of an undeveloped young mind with apps on it that are specifically created to create that serotonin response that makes it almost impossible for that kid to put that phone away. So short of completely putting it away, how do we as a parent, like this is something I think about all the time, like how do we create structures around it to foster a healthy relationship with the best of what it can do, which is, you know, like they communicate with their friends and they see their friends at school.

So there is that offline component to it, but it very easily, if left unchecked, can devolve. And I think it does and has with thousands, if not millions of teenagers into a compulsive behavior pattern that is truly an addiction that, you know, leads these young people to a very, very dark place. And it's not necessarily just young people. I think that's true. And I think we've also got to look at a bit like going back to Rat Park, that addiction occurs in a context, right? And I think it's worth explaining to people the way we are raising our children is deeply weird and has never been tried by any group of human beings before we have no idea the long-term implications i don't mean just with our phones if you think about the nuclear family right where the child remains indoors with two two adults or if they're

lucky or one adult if they're not um that's not a model of child that's ever been tried by human beings right human beings have always been raised by villages by groups by tribes right it's a very recent thing that we would imprison our children in the home and get them try to get them to get all their emotional or most of their emotional needs from just one or two adults who by the way are working 50 hours a week or whatever it is. So we've got this, I think the cell phone addiction occurs rather like the heroin addiction in the rats occurred in the circumstances of isolation and imprisonment. The cell phone addiction is an unmet psychological needs. The cell phone addiction is happening in a context where the children's basic needs are not being met there's

a wonderful guy called professor peter gray who i was speaking to about this recently in boston so just children have a need to run around they have a need to play an unsupervised play there's a lot of evidence unsupervised play is an absolutely essential part of child development there's been i think the figure is something like a 20 decline at least in unsupervised play is an absolutely essential part of child development. There's been, I think the figure is something like a 20% decline at least in unsupervised play in the last 10 years, right? Parents are afraid to let their kids go outside at all. Yeah. Or when they do play, they've got to be constantly referencing back to the adult for what do I do now? What do I do now?

Or it's all super organized. Exactly. You go from structured event to a structured event. Exactly. That's good for children in some, of course, as part of a balanced diet, that's a healthy thing. But if that's most of what the kid is getting, they're not able to develop in a healthy way. And so you've got this context of a very weird form of toxic childhood and weird child rearing, often tragically motivated by love, not motivated by desire to hurt the child quite the opposite a desire to protect the child um that has led to uh so in that context

the if the one thing that gives you any sense of relief or pleasure is the phone fortnight whatever it is you're going to it's not to dispute there are things about the game these games are designed by some of the cleverest people in the world to keep you hooked at the point you're making absolutely right but like all addiction you need to look at the object of the addiction and then the context in which the addiction occurs and i think both those things are really important and the factors that are causing depression and anxiety in adults through unmet needs are even more heartbreaking when you see them playing out in children and we're doing the same over biologization i think one of the great scandals in this country is 30 percent of children in the foster care system

are being given at least one psychiatric drug i mean think about that it is not that 30 percent of children in the foster care system happen to have defective brains, right? These are profoundly distressed children and as a culture, what are we doing rather than dealing with their distress loving them? Caring for them looking after them. We're drugging them into submission. That's 30% by the way at any given time So it's actually gonna be more over over the span of their time in foster care That's an obscenity. One in 10 American, 13-year-old American boys has been given a stimulant drug at any time. Don't tell me that one in 10 American boys

has some kind of defective, broken, diseased brain. This is bullshit, right? These are kids who need to, you know, need love. They need to have their needs met. They need to run around. They need to play. There's all sorts of things going on here that are being boiled down

in this extraordinarily simplistic way to, you know, a brain disease that needs to be drugged. Not to say that some of them don't have some problems in their brains. Of course they do. But this is a, we've ended up with a grossly simplistic narrative about our distress from childhood,

where they're drugged into submission to when you're in an old people's home and half of them are given antipsychotics to shut them up, you know, right the way through their lives. This is not a sensible way. We need to think in a much deeper, more honest, more loving and complex way about our distress. We need to listen to the signals that it's giving us. what are the statistics on uh the diagnosis of adhd with kids i haven't written about this i don't want to i don't want to oh it's i know it's enormous super high right and I often wonder, like, are we over diagnosing these people? Certainly, we're over medicating them. And we've created this syndrome or disease. And look, I'm not a doctor. I'm not going to say it doesn't exist. But there is an argument that a hyperactive kid or a slightly

active kid who has trouble sitting in a classroom and focusing there's an argument to be made that that's perfectly normal a child of that age and to pathologize that and say we need to medicate this kid because he can't pay attention i think is really problematic well you get rid of recess and gym and kids can't sit still and you go what a mysterious thing. These children have developed brain diseases. What a funny coincidence, right? It's not to say there aren't some children who, for a complex range of reasons, genuinely have problems focusing and need help.

Certainly there are, yeah. But this connects to another thing that it was the hardest cause of depression and anxiety for me to write about. And it has a manifestation in very related to what you're what you're saying so um if i tell you the story of how it was discovered for a minute you're going to think why is he telling me this what's it got to anything but i think it's only possible to really understand it we got to tell the story so um not so far from here in san diego um in the mid-1980s a doctor called dr vincent felitti was given a quite difficult task.

He was approached by Kaiser Permanente, the big not-for-profit medical provider in San Diego and here in California. And they said to him, look, we've got a big problem. Every year, obesity is rising. And everything we're trying, like giving people diet advice, all that stuff, none of it's working. What can we do? So they gave him quite a big budget and they said, look, just do blue skies research, figure out what the hell we can do. So Dr. Falidi started to work with 250 extremely obese people, people who weighed more than 400 pounds. And one day he's interviewing one of them and he has this idea, which seems like an insult. I mean, it actually is a kind of dumb idea. He asked himself, what would happen if really

obese people literally just stopped eating and we gave them like vitamin C shots so they didn't get scurvy and all of those things. Would they just burn through the fat stores in their body and get down to a normal weight? So obviously with a huge amount of medical supervision, they start doing this. And in one sense, it worked. So there's a woman who I'm going to call Susan to protect her medical confidentiality, who went down from being more than 400 pounds to 138 pounds. Incredible, right? Her family are telling Dr. Felitti he saved her life.

She's rejoicing. He's rejoicing. And then one day something happened they didn't expect. Susan cracked. She starts obsessively eating at kfc or wherever it was and quite soon she's back at a dangerous weight and she comes in to see dr flutie calls her in and he says susan what happened and she looks down she's really ashamed she says i don't know i don't know and after a while he said well tell me about the day you cracked. What happened that day? It turns out something had happened that day that had never happened

to Susan. She'd been in a bar and a man had hit on her, not in like a predatory or awful way, but expressed sexual interest in her. She felt really frightened. She went and started eating. He thought it was interesting. He said to her, Dr. Felicity thought this was interesting. He said to her, when did you start to put on weight? In her case, it was when she was 11. He said, did anything happen when you were 11 that didn't happen when you were 5 or 9 or 14, anything that year? And she looked down and she said, yeah, that's when my grandfather started to rape me. He started to interview everyone in the program. He discovered that 55% of them are put on their extreme weight

in the aftermath of being sexually abused. He was really puzzled by this, like what's going on here? Susan explained it to him. She said, overweight is overlooked and that's what I want to be. He realized this thing that seems pathological and of course is bad for you, obesity,

was performing a function, right? It had a rational function. It was protecting them from sexual attack. It was a defense mechanism for dealing? It had a rational function. It was protecting them from sexual attention. It was a defense mechanism for dealing with unhealed childhood trauma. You know, it makes perfect sense. It's very much in the vein of what Gabor Mate talks about, unhealed childhood trauma fueling addiction

or unhealthy behavior patterns. It's so interesting that all it took was this person asking the right questions to get to the bottom of what was fueling this entire problem for this woman. It's interesting because this was a relatively small study. So Dr. Falidi, it's hard to draw conclusions from a group of 250 people. So Dr. Falidi went to the CDC, the Center for Disease Control, the main body that funds medical research in the United States. And he got a huge amount of funding to do this, to do a massive study. So everyone who came to San Diego, everyone in San Diego who came for medical care for an entire

year was given, it didn't matter what for headaches broken legs schizophrenia anything was given a questionnaire had two parts first part said did any of these bad things happen to you when you were a kid things like sexual abuse physical abuse neglect the second part asked have you had any of these problems as an adult things like obesity addiction suicide, suicide attempts, depression. And at first when they calculated it out, the CDC thought they'd made a mistake because the figures were so extreme. For every category of childhood trauma you experienced, you were two to four times more likely to become depressed and anxious. But it was when you got into the multiple categories, the figures just exploded

If you'd had six categories of childhood trauma You were three thousand one hundred percent more likely to attempted suicide and four thousand six hundred percent to have an addiction problem It's I mean you just don't get figures like that very often and it's funny when I remember But the first day first time I interviewed dr. Felitti, I went to see him down in San Diego. And he's a wonderful, wonderful man. And if you met him, you would really admire him. And I remember leaving and like shaking with anger. Being so angry, I actually thought I might hit him, which is really, I was like, why am I reacting this way?

This is so weird. And I had experienced as a child some very extreme acts from an adult in my life. And I remember thinking that day, you know, I'd never thought about that in relation to my depression, which seems ludicrous now looking back at it. Was it a repressed memory or just something you were dismissive of? No, no, no. It means I was dismissive of it. It's something I'd always remembered. I just never... You were dismissive of or...

Yeah. I mean, so I was dismissive of it. It's just, it was in one silo in my head, you know, under stuff that happened then. And I didn't really think of it as related to the silo that was about depression and anxiety and why I might feel that way. I think it's one of the reasons actually why I clung to this very simplistic story my doctor told me about serotonin for so long. Because then you don't really have to go look at that. Yeah, I didn't want to, exactly. I didn't want to think about, I didn't want to give this individual power over me now. I didn't want to think about these things. But one of the reasons I'm glad that I did stay with this insight and I did go and see Dr. Valuti

again was because of what he discovered next, right? So once they'd done this study and people all over San Diego, a lot of them had indicated they'd experienced childhood trauma, their doctor was told, don't call them back, but next time they come in, say to them something like this. I see that when you were a child you were sexually abused, or whatever the nature of the abuse was. I'm really sorry that happened to you. That should never have happened. Would you like to talk about it? 40% of people said I don't want to talk about it, but 60% of people you like to talk about it? 40% of people said, I don't want to talk about it,

but 60% of people did want to talk about it. And they want to talk about it on average for five minutes. What was extraordinary was just those five minutes of an authority figure saying, I'm so sorry, that should never have happened. That alone led to a significant fall in depression and anxiety. And then it was randomly, some of them were randomly assigned to a therapist

to talk about it more, and they had an even bigger fall. And the reason is, I think, it fits with a much wider body of research into shame. There's a guy called Professor James Pennebaker at Florida State University who's done interesting work on this. So we know that shame destroys you, right?

Physically, mentally destroys you. During the AIDS crisis, openly gay men died on average two years later than closeted gay men, even when they got healthcare at the same time, right? Shame is desperately physically destructive and mentally destructive. And those things, of course, are not entirely separate as you've done lots of work on. are not entirely separate as you've done lots of work on and giving people a way to release their shame is profoundly physically healing and mentally healing it in fact should be regarded as an antidepressant and you know it was after one of the other scientists who worked on that program um a man called dr robert anda said to me it made him realize when we see someone who's behaving with an apparent pathology

whether it's obesity, addiction, depression we need to stop asking what's wrong with you and start asking what happened to you and I think it was that more than any other causes of depression and anxiety that I learned about, although the other eight are really important, that made me realize how mistaken what my doctor did was when I was a teenager, right? So I'd gone to my doctor.

I'd been profoundly distressed. I'm not sure. I suspected the doctor had said to me, has anything happened to you that made you feel this way i would not have been able to talk about it anyway so i don't want to be simplistic about this but the fact that i was given a story i was given a story that diverted me from these real causes that wasn't the only cause of my depression but i think it was really significant. The story I was told diverted me from that story. Now, with my complicity, for sure, and I think I would have been able to deal with my depression much earlier

had I been told a more truthful, complex and nuanced story and given a more complex menu of options for how to respond to it um that's not a criticism of that individual doctor who had seven minutes to see each patient is and i'm sure was saying what he honestly thought was true but it is a criticism of a society that's put us in this position that's responding to distressed children and distressed adults with this remarkably simplistic story that we know isn't right. Yeah. I mean, there is, I mean, there are plenty of people, like what would have happened had you been directed to therapy instead, right?

And told, listen, you're going to get, you know, six one-hour sessions and you can sit there and not answer any of the questions, but you're going to have to show up for them. Like if your parent or somebody in your family had said, look, we can see you're suffering, let's try this, perhaps that would have led you in a different direction. I think part of the problem is that most of the therapy that people are assigned to is cognitive behavioral therapy, which does have some value, so people might not know. are assigned to is cognitive behavioral therapy right which does have some value so people might not know cognitive behavior therapy descends from the ideas of a psychologist called aaron beck who basically argued i'm slightly caricaturing him but i think most of his followers slightly caricature him as well um that that um most of our problems certainly depression come from defective thought patterns right there's some truth in this this is not untrue right we all know people for example i saw someone but not so too many details

about this but i recently here in la saw an old friend whose life is going great and is miserable as hell and just is one of those people who just looks at all their benefits in life where they're kind of looking for the worst in everything, right? Welcome to Los Angeles. Exactly. It's true. It's true. But the, it's true actually, all my British friends here with one exception,

I like that. But the, that is poor cognitive skills, right? Partly, and there's lots of other things going on in that individual's life. Obviously, I don't want to be simplistic, but that person has poor cognitive skills. Their thought patterns tend them to look for the worst. And I believe this individual would benefit from CBT. So I'm not saying there's no role for CBT. But I also think CBT is really limited, right? Now, there are lots of CBT practitioners who go beyond the limits of CBT

and are actually complex and so on. But it's limited because this explanation of human distress is really limited and Think about that farmer in the field in Cambodia, you know who's having to you know, um With a artificial leg is having to work in the rice fields right now the CBT treatment for him would be to say We've got a hell of mom. Oh, no wouldn't it wouldn't even, let's talk about your mother. That's the Freudian thing, right? It'd be even worse than that. That maybe it would bring up trauma about his mother. It, what they would say is we've got to think about the thought patterns that

elite. I mean, if they were to adhere strictly to the simplistic edicts of this, I suspect most CBT practitioners would be more sophisticated, but it would be to say, let's think about how we can alter your thought patterns and your habits of mind so you will be less distressed right that guy didn't need cbt that guy needed a cow he needed a practical intervention to change his environment right

there are some people who will benefit from cbt i'm in favor of it for some people i in fact recommended it to my friend um but that's not most of what's going on right it's not attending to most of what's going on which is why the evidence shows rather like with chemical antidepressants for most people cbt has a real effect that diminishes quite rapidly over time right so i think part of the problem is we there's a reason by the way why cbt is very popular with neoliberal governments whether it's in britain massively championed by david cameron in florida governor rick scott there's a whole range of places that champion it because it's basically a kind of get back to work right come on now come on now enough of this silly thinking we're going to get you back to work i

mean that's again i'm caricaturing but there is an aspect of it that's like that right rather than say joanne cassia torre who's the amazing woman who did that work on grief which is about you know you're not wrong to feel terrible your thought patterns in for many people you're not wrong to be angry and distressed and hostile in fact you should be angry distressed and hostile in this situation let's use that anger and hostility to change your environment and i think the most important places i saw were places where they had, they acted on those insights,

which is not to say CBT doesn't have some useful insights because it does. Yeah, it's interesting. Well, I love the idea of how powerful it can be to change your environment. And when I look at, you know, like we go through the causes that you talk about in your book that are contributing to this epidemic of anxiety and depression. And they all kind of fall under this rubric of disconnection and the solutions are all about reconnection. And when I hear you talking about changing your environment to make the

environment more conducive to the solution, it reminds me of the work that Dan Buettner has done with Blue Zones. Do you know? I don't know about this. Tell me about it. So Dan is an amazing guy. And he spent many years traveling all over the world to find the people, the cultures that live the longest, the highest concentration per capita of centenarians. He found these, I don't know, there's six or nine of them or something like that. They're called blue zones. They're in places that have been sort of removed from modern progress, for lack of a better phrase, like Icaria and the Nicoya Peninsula in Costa Rica. There's various pockets around the world. And there's one in just outside of Los Angeles

with the Seventh-day Adventist faith community. And it's super interesting what he's discovered. And then he kind of- That's fascinating. Yeah, it's super interesting. I'm getting to the more interesting, relevant part for you. But then he then did it again to say, okay, I want to find the happiest people. And there was some overlap between these happiness blue zones and the centenarian blue zones. And then he was able to extract from this experience and all the time that he spent with these people to kind of divine the principles that are contributing to longevity and happiness. And these overlap as well. And they're very similar to yours. Like it's almost a blueprint here that's emerging if you were to

synthesize his work and your work. And so much of it is about connection. And from his perspective, And so much of it is about connection. And from his perspective, connection, it's about maintaining households with your elders and keeping the extended family around. It's about your faith community. It's about always moving your body gently throughout the day. It's all of these things that we have done historically throughout the ages of human evolution that it's only recently that we've been disconnected from. So I think that's super interesting. And now he has this program where he goes to cities

who have high incidences of obesity and, you know, lots of unhealthy people and, you know, insurance companies that, you know, corporations that are paying high premiums, that want to get their premiums down. And he helps consult with governments and corporations to create systems and structures that will contribute to a healthier population that will live longer. And ultimately, through this experience, he will say to you, look, you can give people, you can have them read self-help books, you can give them this diet or that diet or tell them they need to do this, that, or the other thing. But ultimately, for the most part, these things don't really work or they don't stick over the long haul. What does work is when you change the environment to make the environment conducive to the healthy choice, whether that healthy choice is emotional, mental,

physical, nutrition-related, whatever it is, the healthy choice has to be at arm's reach. You have to create bike paths and make bikes available, make it easy for people to ride their bikes to work, is a simple example. You need to get the soda machines out of the schools, very simple things so that doing the unhealthy thing becomes harder, right? And when I look at your work and I think about how that applies to depression, anxiety, mental illness, even addiction in certain respects, like I see a lot of overlap. Yeah, I think that's true. There's an a academic i interviewed called brett for dr brett ford who did up in berkeley who did this really interesting research i think is very relevant to what you just said

it's kind of simple she did with her colleagues they did it in four countries um they want to figure out if you decided you were going to spend more time consciously trying to be happier, would you actually become happier? They did this research in the United States, in Taiwan, in Russia, and in Japan. What they found at first was really odd. In the United States, if you try consciously to make yourself happier, you do not become happier. In the other countries, if you try to make yourself consciously become happier, you do. And at first they were like, what's going on here? How can that be be what they discovered was in the united states if you try to make yourself happier generally what we do is do something for yourself right i go shopping i

treat myself i indulge myself i eat whatever it is but it's me me me it's an individualistic vision of happiness exactly in the other countries generally and of course there were exceptions on both sides but generally if you try to make yourself happier you do something for someone else you're saying for your friends your family your community so while we have an instinctively individualistic idea of happiness they have an instinctively collective idea of happiness it turns out our vision of happiness just doesn't work right like we said before species that thought like that would have died out on the savannas of africa and it was striking to me i spent some time in an amish village in indiana and you know

the amish are not congenial to me in many ways right and yet i went there because as you can imagine right i'm a they just they were not welcoming of you no they were very nice but they you know look i'm a left-wing gay atheist right like and you know they're not having any pride parades in the amish village anytime soon right and yet there's all this evidence that the amish have exceptionally low levels of depression and anxiety as do generally groups who live like them like the the hudderites um i could kind of see why right they they which is not to say there are not serious problems with the amish and the way they live because there are but the it was very striking to me and and I think you know I was thinking as you were talking obviously I learned a huge amount of the stuff that I talk about in Lost Connections

I'm rather but chasing the screen from scientists and experts and so on but actually one of the places that taught me the most about what you're saying is um a totally different place i'll just tell you the story of it if you want because i think about it every day so in the summer of 2011 on a big anonymous housing project in berlin a woman called nuria chengis climbed out of her wheelchair and she put a sign in her window she lived on a ground lived in a ground floor apartment. And the sign said something like, I got a notice saying I'm going to be evicted from my apartment next Friday. So next Thursday night,

I'm going to kill myself. Now this is a kind of housing project in a slightly strange place. It's in the middle of Berlin. And when they threw up the Berlin wall, they built it very quickly. Obviously this was the bit of West Berlin that kind of jutted into East Berlin, right? When they did the war. So it's like a fang, right?

So if the Soviets had invaded, it would have been the front line. So no one wanted to live there. So the only people who lived there when the wall was there were three groups. Recent Muslim immigrants like this woman, Nuria, gay men and punk squatters, right? And as you can imagine, these three groups looked at each other with some that's a party well no one really knew anyone right and and then the wall came down and suddenly they've got like this prime real estate in the middle of berlin so everyone's rent was going up loads of people were being evicted anyway no one knew this woman people start to knock on

her door and they're like do you need any help she said screw you i don't want any help i'm going to kill myself and And outside the apartment, some of the people who lived there didn't know each other, started chatting. And one of them had this idea. There's a big thoroughfare that goes into the center of Berlin that runs through this project.

It's called Kotti. And I had the idea, if we just block the street for a day, on a Saturday, there'll probably be a fuss. The media will probably come. They'll probably let Nuria stay in her apartment. Saturday there'll probably be a fuss the media will probably come they'll probably let Nuria stay in her apartment maybe there'll be some pressure for us to you know um our rents to be kept down too in this disaster to stop so they decided to do it they went and built a barricade

in the middle of the road uh and Nuria was like well I'm going to kill myself anyway I may as well let them wheel me out there they wheel her't matter. They wheel her out there. And the media did come. And they interviewed Nuria and the other residents. A bit of a fuss. And it gets to the end of the day and the police say, okay, you've had your fun. Take it down. But the people who lived in Kotti said,

well, hang on a minute. You haven't told Nuria she gets to stay. And actually, we want a rent freeze for our entire block, this whole housing project. So when you give us that, we'll take it down. But of course they knew the minute they left the barricade, the police would just tear it down. So one of my favorite people at Cotia, one of the punk squatters, her name's Tanya Gartner. She wears tiny mini skirts, even in Berlin winter, she's hardcore. Tanya had this, in her apartment, she had a klaxon, you know, those things that make a loud noise at football matches. She went and got it.

She came down and she said, okay, everyone, what we're going to do is we could drop a timetable to man this barricade 24 hours a day uh until we get what we want if the police come to take it down let off the klaxon and we'll all come down from our apartments and we'll all stop them right so people start to sign up to man the barricade right don't know't know each other. Tanya, in her tiny little mini skirt, was paired with Nuria in her full hijab, right? And these kind of pairings were happening all over Kotti. And first, I think they had the Thursday night shift. Tanya and Nuria are like,

we've got nothing to talk about, right? What are we going to talk about? It couldn't be more unlikely. So they sit there through the night, barely speaking, first few times. the nights went on and they started to talk they realized had something incredibly powerful in common and Nuria told Tanya something she'd never told anyone so she had come to Berlin when she was 16 from a village in Turkey with her two young children and she was sent to raise enough

money to send back for her husband to come and join her. After she'd been in Berlin for a year she got word from home that her husband had died and she told Tanya that she'd always told people that he died of a heart attack. Actually he died of tuberculosis which was seen as like a disease of poverty. So when Tanya told Nuri something she didn't talk about very often she had come to koti when she was 15 she'd been thrown out by her middle-class family she found her way to a squat she'd lived there for a little while she got pregnant they realized they had both been kind of children with children themselves in this place that they were very that where they've been very frightened they realized they're saying really powerful and common these kind of pairings were happening all over koti there was a young lad

called memet who kept being, they kept nearly throwing him out of school. They said he had ADHD. He was paired with this grumpy old white guy who said he didn't believe in direct action because he loved Stalin, but in this case he'd make an exception. They did a shift together. The old white guy started helping Mehmet with his homework.

Mehmet started doing a lot better. Directly opposite this housing project, there's a gay club called zood block that opened four years before the protest began and um it's run by a guy i love called rick karlstein who they're pretty uncompromising to give you a sense of it the previous place he owned was called cafe anal right so as you can imagine there's a lot of muslim immigrants in this and muslim germans in this in this um in this housing project when they first opened the club there was a lot of muslim immigrants in this and muslim germans in this in this um in this housing project when they first opened the club there was a lot of people who were really pissed off in fact their

windows got smashed but after the protest had been going for a little while in fact very early on the gay club gave all their furniture to the protest they were like they gave free drinks they were like you know after a while they said you know you guys should have your meetings in our club we but even the lefties at kotti were like we're not going to get these very religious muslims to come and you know have their meetings underneath posters for fisting night right it's not going to happen right but actually it did start as one of the muslim women there said to me we all realized we had to take these small steps to understand each other after the protest to be going on for about a year one day um a man arrived at koti he was in

his early 50s he was called he's called tung kai and it's um clear when you meet tung kai he's got some kind of cognitive difficulties he'd been living homeless but he also has an amazing energy about him everyone immediately liked him and after he was there for two or three days that by this time they'd actually turned their barricade into a permanent structure in the street and they with a roof and everything and they said you know you should start living here we don't want you to be homeless he started living there he became a much-loved part of the koti protest nine months later one day the police came to inspect they become an inspector every now and then and tung kai doesn't like it when people argue he thought the police were arguing so he went to try to hug one of the officers they thought he was attacking

them so they they arrested him that was when it was discovered that tung kai had been shut away in a psychiatric hospital a psychiatric hospital often in a padded cell for 20 years he'd escaped one day lived on the streets for a few months and then he found his way to koti so the police took him back to the psychiatric hospital and he's put back in his cell at which point the entire koti housing project turned into a kind of free tung kai movement right they descend on this psychiatric hospital and the psychiatrists are like what is this they've got all these like muslim women in hijabs these game very camp gay men and these punks demanding the release of this person they had shut away for 20 years they don't understand it but i remember uli um carton born one of the protesters saying to them you know you don't love him he doesn't

belong with you we love him he belongs with us i remember thinking you know how many of us if someone carted us away would have hundreds of people descending saying no we love this person right anyway many things happened at cottie i mean that's at Kotti. I mean, that's like a movie. That's like a movie you'd see at Sundance or something like that. I think they think that I'm slightly crazy to people at Kotti because I would turn up every, you know, four or five months, talk to them and just burst into tears. I felt it was so moving. I remember one of them said to me once,

Johan, I think maybe you have allergies because my eyes were in water so much. Anyway. So did she get to keep her apartment and she didn't commit suicide? They got Tung Kai back. They got, Nuria got to stay in her neighborhood. They got a rent freeze for their entire housing project.

They then launched a referendum initiative to keep rents down across Berlin. Got the largest number of written signatures in the history of the city of Berlin. But the last time I saw Nuria, she said to me, you know, I'm really glad I got to stay in my neighborhood. That's wonderful. I gained so much more than that. You know, um, she said, you know, I was surrounded by these amazing people all along and I never knew. And I remember I'm thinking then, you know, one of Nuria's friends, another one of the women who took part in the protest is this woman called Neriman Manker, who's a Turkish-German woman. And she said to me,

you know, when I grew up in Turkey, I grew up in a village and I called my whole village home. And I came to live in the Western world. And I learned that what we're meant to call home is just our four walls. And then this protest began. And I started to think of this whole place and all these people as my home. And I realized talking to her that in some sense, in this culture, we are homeless. You need to feel you belong. The sense of home we've built is not big enough

for that sense of belonging. The Bosnian writer, Alexander Heyman said, home is where people notice when you're not there, right? Lots of people are homeless in that sense um and i remember thinking so clearly in koti think about how distressed these people were nuria was about to kill herself memak kept being nearly thrown out of school they said he had adhd tung kai was shut away in a padded cell loads of them were depressed and anxious these people did not need to be drugged most of them they. They needed to be together. They needed to have a sense of meaning and purpose. They needed a home. And I remember one

time sitting with Tanya outside Zoot Block, the gay club, and her saying to me, you know, when you're at home and when you're in your house and you're all alone and you feel like shit, you think there's something wrong with you. But what we did is we came out of our corner fighting and we realized we were surrounded by people who felt like this. And we realized how strong we could be. And to me, it was such an important lesson about what's gone wrong. And, you know, the people at people at cotty i love those people they are amazing people but in one sense they are not exceptional people right they are ordinary people this was just beneath the surface it did not take much

for them to see how powerful this could be. And this is just beneath the surface everywhere. This is, you know, I remember in the run-up to the 2016 election, being in West Cleveland with a group of people who were doing get-out-the-vote work, I was following for a different book I'm writing. And we were on one of those streets in West Cleveland where a third of the houses had been demolished, a third had been abandoned, a third still had people living in them, often behind actual barbed wire. And we knocked on one door and there was a woman who I would have guessed from looking at her

was 60. I realized she was actually the same. She said she was the same age as me. I was 37 at the time. I was amazed. She had a really hard life she was very articulate extremely angry absolutely refusing to vote for hillary and um she made this this verbal slip that really stayed with me she she was talking about the area used to be like her parents and grandparents and she meant to say when i was young what she actually said is when i was alive and it really knocked me back and And I remember looking at her street and all these people hiding behind barbed wire with all these cameras in front of the house. They have no money, but they've got enough to buy a camera. Right. And I thought the solution to what

you need is all around you. And you've been cut off by this culture from seeing it. Right. You've literally put barbed wire between you and the people next to you um and i thought about cottie and i thought about what this woman needed and i and i thought about the the sickness in this culture that we've been so we've been we've been driven away from seeing the solution that's right in front of us. Do you know what I mean? It's haunting, that story about the woman. But I think that that story about Kati perfectly encapsulates essentially every facet of what you talk about. It's like this amazing drama that plays out that elucidates not only the problem, but also the solution and the simplicity of the solution. And we have to

wind this down because we've got to get you to Santa Monica, but I want to leave it on a little bit of a solution-oriented, optimistic note. Understanding the cultural drives that are compelling so many of us in this unhealthy direction that's contributing to all of these disorders that we're seeing, and intellectually understanding that the solution is within arm's reach, it's still so difficult for people to access. And we can tell these stories and you can inspire people, but there's that person who's listening who's like, you don't understand my pain. That's great, but I got three kids and I'm super depressed. I can barely get out of bed and I'm just trying to make it through the day. I don't live in an apartment building where we can block off the street and

have a protest. So what are some of the things that, like where can somebody begin to try to build community and connection with others, with nature, so that they can find that hopeful thread that they can pull on that will shine some light so i would say two things about that the first is one of my closest relatives is a struggling single mom who works every hour she can to keep her kids in their apartment and when she gets home she collapses and is too tired to watch television most nights the idea that i would say to her well your job now is to democratize your workplace fight for universal basic income it would be grotesque to say that to her, right? We don't approach most problems like this. We don't, when we have a discussion about car accidents, we don't say,

well, we can't solve the problem of car accidents. What do you say to this person who's just been mangled on the I-95 and is bleeding in the wreckage, right? Well, I'd say, I don't want to talk to that person. I mean, I'll call them an ambulance. I very much want to help them. Let's talk about how we can change things like by having speed limits and seatbelts and airbags so that it doesn't get to the point

where so many people are mangled on the i-95, right? So the first thing I would say is, in a sense, I think the, it's a totally natural and right question, I wouldn't start at that point. I would say mostly my message to the person I love in my family who's in that position is, firstly, your pain makes sense. You're not crazy to feel this way. You have been given a really rough deal. And I will try to love you and be present with you

and help you change your life um and i will try to change the culture so you are set free to make more of the changes that you need to make right so what the person you're talking about who's trapped in this look we live in a culture where huge numbers of people are trapped half of americans have less than 500 for if a happens, right? Through no fault of their own, because that money has been transferred to the rich, right? The six heirs to the Walmart fortune, who are heirs, they have done nothing to earn that money, own more and have more money than the bottom 100 million Americans, right? Where did your money go? What happened, right? So we created a culture where lots of people are trapped. I want to fight to change the culture so they are no longer trapped. I don't want to give people a false kind of bromide, which is, you know, I go through in the book, lots of things people can do. Some of them are coming together and fighting for collective solutions. And some of the things people can do on their own. there's a particular kind of meditation

called loving kindness meditation that's been proven to really help i go through other examples but i don't want to be misleading about this i don't think there are very good individualistic solutions in a society that's falling apart where donald trump is the most powerful person where people are profoundly lonely where they've been taught to value the wrong things, where inequality is going off the scale, where they are humiliated and controlled at work. I don't want to be saying to an individual person, hey, here's my little solution for you. It needs a big solution, right? Now, there are smaller things that people can do. Even if you're in solitary confinement, in a prison for the rest of your life, there are things you can do. Of course, I don't want to belittle the possibility of individuals to do things because

there are individuals they can do, but the most important thing we can do is come together. And that's happening, right? The, the, the, there are amazing struggles and they're not privileged people, right? Think about the fight for 15, the fight for a higher minimum wage. And may, you know, workers who work in, you know, McDonald's and Burger King and Jack in the Box, you know, coming together to fight for a higher minimum wage. A great example, which gives you more time, which gives you more, more, more of everything, right? There's a whole range of campaigns happening. So I would say the single most important thing is if you possibly can and i appreciate some people who can't do this but if you possibly can get to a group of people who feel like you who can see that they're upset who can see they've been that

they're wounded and are seeking a solution together because partly what i learned at cotty is the struggle is the solution, right? The act of coming together and saying, we've been made to feel like this through no fault of our own, and we can fight for a solution together. And sometimes they're long fights, right? I'm gay. The first people to fight for gay rights in the 1870s, that's a long journey from 1870 to, you know, the Supreme Court decision in 2015, you know,, granting equal marriage rights, right? That's a long fight. But the act of coming together

and fighting for their own dignity, even in 1870, when they were really early in the fight and they didn't live to see much progress, other than the dignity that they stood up and said, the problem here isn't with me, right? There is a dignity in asserting that, in showing it to other people, in standing with other people. So I would say wherever possible, and there is nowhere in the United States where this is not the case, where you are not surrounded by people who feel

in a similar way, find those people, right? We have tools to find those people. Even if all you can do is sit with them for half an hour a week, sit with them if you possibly can. And if you're so wounded, you can't do that. Okay. Then help is on the way. The rest of us are going to understand this problem differently. And if you can't fight for yourself, we will try to fight for you. That's powerful. It is. No, it's great. You know, I mean, look, we could spend another five hours talking about this stuff and we could talk about all manner of things that people can do to try to, you know, alleviate some of this pain. But I think that's very practical and powerful advice. I mean, that's, look, essentially that's the premise of 12-step, right, which i'm a member of and it's it's all it's all about getting

together with people that share a common uh dilemma and share a common solution and the struggle is the solution it is the community that is created around a shared interest that is fundamentally, you know, it's not about arriving at a future place that is in and of itself the salve to the wound, I think, and a great place to start. So we got to let you go. Oh, I should just say, can my publishers always tell me off if I don't say this? If you would like any more information about the book, if you would like to know where to get the book, the audio book,

if you would like to take a quiz to see how much you know about the causes of depression and anxiety, if you would like to listen to audio of lots of the people we've talked about, what's the other thing they always tell me to say? If you would like to know what a range of people have said about the book, from Elton John to Hillary Clinton to Tucker Carlson to Ariana Huffington.

Russell Brand. Russell Brand. You got great blurbs. I don't know what's going on in your life, but you got the coolest people to blurb your books. And by the way, I was going to do all that for you, but continue, please. If you want to know any of those things, I always feel like I'm doing some 1950s advert, but here we go uh if you go to www.thelostconnections.com it's not lost

connections.com because it turns out there's a fucking band called lost connections that no one told me about when i was uh playing the book although they no longer exist uh they seem very good i listened to one of their songs um yeah go to www.thelostconnections.com you can also find out where to follow me on twitter facebook and instagram although i was asked in an interview recently they said what's your twitter what's your facebook and then they said what's your snapchat and i said i am a 39 year old man the only 39 year olds on snapchat are certainly pedophiles right so you cannot find me on snapchat it had its moment but that moment has passed exactly um and also uh chasing the scream which is your book on addiction

and chasing the scream.com where you get chasing scream.com and other people said nice things about that as well yeah what i love about both of these websites and your books is that as you mentioned you could go to the sites and you literally have all of these audio of all of these interviews that you've done with all these people that so you can listen to the people at Cotty, the people at Cotty, the audio, you can hear how much choked I get talking to them. Uh, yeah, yeah. You could listen to audio with all the experts and all these people. I thought that'd be a good thing to put out there and kind of resource people. And how's the depression now? How do you feel? You look happy. You're smiling. Yeah, no, I feel I'm not depressed at all. Um, I haven't been for quite some time,

although I am always capable to caveat that, which is that I was in the privileged position that I could change my life. And in a way, what I'm fighting for is for everyone to have the opportunity to do that rather than just going in a kind of simplistic way. Hey, I did this and you can too. Because like my closest relative can't do that at the moment, right? But I'm fighting so that we can change the culture so far more people can be set free to make the changes that would release them from depression and anxiety. All right. Well, thank you, my friend. Hooray. Totally my pleasure. How do you feel?

Good. Happy. Yeah, it was great. I really enjoyed that. Thank you so much. Thank you. Come back and talk to me anytime. Hooray, I will. All right. Excellent. Delightful. Thanks.

Thank you. All right. Peace. Bye. Some amazing insights there. I found that quite compelling. I could talk to Johan for hours. I hope you enjoyed it. Please be sure to pick up his latest book, Lost Connections, as well as Chasing the Scream. And also, don't forget to check out his TED Talk, all of which I'll put links in the show notes too on the episode page at richroll.com. Do me a favor. Let Johan know how this one landed for you by sharing your thoughts with him directly.

You can find him on Twitter at JohanH how this one landed for you by sharing your thoughts with him directly. You can find him on Twitter at Johan Hari 101. Plus, don't forget to hit me and DK up with thoughts on his 2019 goals with the hashtag DK goals. If you're looking for additional nutritional guidance to dial in your health goals for 2019, I can't stress enough how helpful our Plant Power Meal Planner can be. Go to meals.richroll.com and there you will find thousands of plant-based recipes, all totally customized based on your personal preferences with unlimited grocery lists. We have grocery delivery integrated into the system in most metropolitan areas. We have incredible customer support from a team of expert health coaches available to you seven days a week. And it's all for just $1.90 a week when you sign up for a year. So to learn more and to sign up, go to meals.richroll.com or click on Meal Planner on

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take care of yourselves, invest in one another, create and cultivate that connection that we talked about today. Peace. Plants. Namaste. Thank you.