The best science says depression is a social ill, not an individual flaw

Contrary to what we've been told for decades, depression isn't coming from inside our heads. This author and big thinker tells us that it's coming much more from the society we live in.

Johann Hari: I kept learning intellectually about what causes depression and anxiety. 

And that it’s much deeper than the story I’d been told by my doctor—that it’s just a missing chemical in your brain. 

But I think it really emotionally fell into place when I went and met an incredible South African psychiatrist called Derek Summerfield. So Derek was in Cambodia when chemical antidepressants were first introduced there. And the Cambodian doctors didn’t know what they were, right? They’d never heard of it. So he explained it to them and they said, “Oh, we don’t need them. We’ve already got antidepressants.” 

And Derek said what do you mean? 

He thought they were going to talk about some kind of herbal remedy or something. 

Instead they told him a story. There was a farmer in their community who one day, a rice farmer, who one day had stood on a landmine and had his leg blown off. And so they gave him an artificial limb and he went back to work in the fields. But it’s apparently very painful to work in water when you’ve got an artificial limb. And I imagine it was quite traumatic—He’s going back to the fields where he was blown up. 

And he started crying all day. He didn’t want to get out of bed. Classic depression, right? And so they said to Derek, “Well we gave him an antidepressant.” Derek said what did you do? They explained that they sat with him, they listened to his problems, they realized that his pain made sense. He was depressed for perfectly good reasons. They figured if we bought him a cow he could become a dairy farmer then he wouldn’t be so depressed. They bought him a cow. Within a few weeks his crying stopped, he felt fine. 

They said to Derek, “You see, Doctor, that cow was an antidepressant.” Now if you’ve been raised to think about depression the way that we’ve been indoctrinated to, that it’s just the result of – there are real biological factors but it’s just the result of a chemical imbalance in your brain—that sounds like a joke, a bad joke. They gave the guy a cow as an antidepressant and he stopped being depressed?

But what those Cambodian doctors knew intuitively is what the World Health Organization has been trying to tell us for years. Depression is a response to things going wrong deep in our lives and our environments. Our pain makes sense. 

As the World Health Organization put it, mental health is produced socially. It’s a social indicator. It requires social as well as individual solutions. It requires social change, right? 

Now that is a very different way of thinking about depression and anxiety but it happens to fit with the best scientific evidence. 

And it really required me to reassess how I’d felt about my own pain and how I tried to deal it unsuccessfully and open up a whole different way of responding to my depression and anxiety that worked for me. 

And I think as the World Health Organization says and the UN says, if we talk less about chemical imbalances and more about power imbalances we will get more at the heart of depression and anxiety and we’ll find better solutions.

This was a—this was such a personal and difficult journey for me. There were these two mysteries that were really kind of haunting me, and it’s a sign of how afraid I was to look into them. I wanted to start doing this seven years ago and I figured it would actually be easier to do a book that required me to go and spend time with the hitmen for the Mexican drug cartels instead, which I then did. 

And the first was: why was I still depressed? I’d gone to my doctor when I was a teenager and I’d explained I had this feeling like pain was kind of leaking out of me. I didn’t understand it. I couldn’t regulate it. I was very afraid of it. I was very ashamed of it. 

And my doctor said, “We know why you feel this way. There’s a chemical called serotonin in people’s brains and it makes people feel good. Some people naturally lack it. You’re clearly one of them. We’ll give you these drugs. They’ll boost you back to a normal serotonin level.” 

And I felt such relief when I was give that story and even more relief when I was given the drug. And for a few months I felt radically better. 

And then this sense of pain started to kind of bleed back in. So I went back to the doctor and he said, “We didn’t give you a high enough dose.” I took a higher dose. Again—got relief again, and the pain came back. And I was really in that cycle until I was taking the maximum possible dose for 13 years. And at the end of it I still felt terrible. 

The second mystery, and to me the much more important one, is: why are so many other people in our culture feeling such profound despair and anxiety? One in five Americans will take a psychiatric drug. One in four middle-aged women in the United States is taking a chemical antidepressant in any given year. 

And I thought, I began to think, “Could it really be that just so many people are just mysteriously lacking a specific chemical in their brain? Why does it seem to be rising so much if that’s the cause?”

So I forced myself to go on this journey over 40,000 miles for my book Lost Connections. 

I met the leading scientists in the world who studied the causes of depression and anxiety and the solutions. The first thing I learned is that story my doctor told me is not true. 

Professor Andrew Scull at Princeton University says it is deeply misleading and unscientific to say that depression is just caused by low serotonin.

Dr. David Healy in Britain says you can’t even say that idea has been discredited because it was never credited. 

There was never a time when half of the scientists in the field believed that. It doesn’t mean there’s no value to chemical antidepressants. There’s some value, but what I learned is actually I had been wrong about depression all my life. 

Until I went to my doctor when I was a teenager I thought it was “all in my head,” meaning you’re weak, you’re just not tough enough. 

And then for the next 13 years I thought it was “all in my head,” meaning it’s a chemical imbalance. 

What I learned is: it’s largely not in our heads. There are real biological factors that can make it worse, but the main causes of depression and anxiety are in the way we’re living today.

 

For almost the past 100 years, some mental health professionals have told us that depression is purely caused by a chemical imbalance in the brain. However, there's a much more realistic theory that depression happens due to an imbalance happening outside of your cranium. Journalist and author Johann Hari believes that while for some people it is a chemical imbalance, for many people suffering from depression, the cause stems from societal issues. Hari offers some staggering statistics showing that antidepressants seem to be doing much more harm than good — among them, that one out of every four middle-aged women in the United States is taking a chemical antidepressant in any given year. If we want to get rid of modern-day depression, he says, we have to change society. Johann Hari's new book is Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions.

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Image source: Christian Zimmerman/USGS/Big Think
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The Barry Glacier gives its name to Alaska's Barry Arm Fjord, and a new open letter forecasts trouble ahead.

Thanks to global warming, the glacier has been retreating, so far removing two-thirds of its support for a steep mile-long slope, or scarp, containing perhaps 500 million cubic meters of material. (Think the Hoover Dam times several hundred.) The slope has been moving slowly since 1957, but scientists say it's become an avalanche waiting to happen, maybe within the next year, and likely within 20. When it does come crashing down into the fjord, it could set in motion a frightening tsunami overwhelming the fjord's normally peaceful waters .

"It could happen anytime, but the risk just goes way up as this glacier recedes," says hydrologist Anna Liljedahl of Woods Hole, one of the signatories to the letter.

The Barry Arm Fjord

Camping on the fjord's Black Sand Beach

Image source: Matt Zimmerman

The Barry Arm Fjord is a stretch of water between the Harriman Fjord and the Port Wills Fjord, located at the northwest corner of the well-known Prince William Sound. It's a beautiful area, home to a few hundred people supporting the local fishing industry, and it's also a popular destination for tourists — its Black Sand Beach is one of Alaska's most scenic — and cruise ships.

Not Alaska’s first watery rodeo, but likely the biggest

Image source: whrc.org

There have been at least two similar events in the state's recent history, though not on such a massive scale. On July 9, 1958, an earthquake nearby caused 40 million cubic yards of rock to suddenly slide 2,000 feet down into Lituya Bay, producing a tsunami whose peak waves reportedly reached 1,720 feet in height. By the time the wall of water reached the mouth of the bay, it was still 75 feet high. At Taan Fjord in 2015, a landslide caused a tsunami that crested at 600 feet. Both of these events thankfully occurred in sparsely populated areas, so few fatalities occurred.

The Barry Arm event will be larger than either of these by far.

"This is an enormous slope — the mass that could fail weighs over a billion tonnes," said geologist Dave Petley, speaking to Earther. "The internal structure of that rock mass, which will determine whether it collapses, is very complex. At the moment we don't know enough about it to be able to forecast its future behavior."

Outside of Alaska, on the west coast of Greenland, a landslide-produced tsunami towered 300 feet high, obliterating a fishing village in its path.

What the letter predicts for Barry Arm Fjord

Moving slowly at first...

Image source: whrc.org

"The effects would be especially severe near where the landslide enters the water at the head of Barry Arm. Additionally, areas of shallow water, or low-lying land near the shore, would be in danger even further from the source. A minor failure may not produce significant impacts beyond the inner parts of the fiord, while a complete failure could be destructive throughout Barry Arm, Harriman Fiord, and parts of Port Wells. Our initial results show complex impacts further from the landslide than Barry Arm, with over 30 foot waves in some distant bays, including Whittier."

The discovery of the impeding landslide began with an observation by the sister of geologist Hig Higman of Ground Truth, an organization in Seldovia, Alaska. Artist Valisa Higman was vacationing in the area and sent her brother some photos of worrying fractures she noticed in the slope, taken while she was on a boat cruising the fjord.

Higman confirmed his sister's hunch via available satellite imagery and, digging deeper, found that between 2009 and 2015 the slope had moved 600 feet downhill, leaving a prominent scar.

Ohio State's Chunli Dai unearthed a connection between the movement and the receding of the Barry Glacier. Comparison of the Barry Arm slope with other similar areas, combined with computer modeling of the possible resulting tsunamis, led to the publication of the group's letter.

While the full group of signatories from 14 organizations and institutions has only been working on the situation for a month, the implications were immediately clear. The signers include experts from Ohio State University, the University of Southern California, and the Anchorage and Fairbanks campuses of the University of Alaska.

Once informed of the open letter's contents, the Alaska's Department of Natural Resources immediately released a warning that "an increasingly likely landslide could generate a wave with devastating effects on fishermen and recreationalists."

How do you prepare for something like this?

Image source: whrc.org

The obvious question is what can be done to prepare for the landslide and tsunami? For one thing, there's more to understand about the upcoming event, and the researchers lay out their plan in the letter:

"To inform and refine hazard mitigation efforts, we would like to pursue several lines of investigation: Detect changes in the slope that might forewarn of a landslide, better understand what could trigger a landslide, and refine tsunami model projections. By mapping the landslide and nearby terrain, both above and below sea level, we can more accurately determine the basic physical dimensions of the landslide. This can be paired with GPS and seismic measurements made over time to see how the slope responds to changes in the glacier and to events like rainstorms and earthquakes. Field and satellite data can support near-real time hazard monitoring, while computer models of landslide and tsunami scenarios can help identify specific places that are most at risk."

In the letter, the authors reached out to those living in and visiting the area, asking, "What specific questions are most important to you?" and "What could be done to reduce the danger to people who want to visit or work in Barry Arm?" They also invited locals to let them know about any changes, including even small rock-falls and landslides.

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