Verbinding verbroken

by Johann Hari, Marga Blankestijn (Translator), Monique Eggermont (Translator)

Wat is de echte oorzaak van depressie en wat is een echte oplossing? Johann Hari lijdt al sinds zijn puberteit aan depressies, en begon ook al jong met het nemen van antidepressiva. Hem – en velen met hem – werd verteld dat zijn probleem werd veroorzaakt door een chemische onbalans in zijn hersenen. Eenmaal volwassen, en gewapend met sociaalwetenschappelijke kennis, begon hij zijn onderzoek of dit hele verhaal wel klopt. Hij kwam erachter dat wat ons wordt verteld over depressie en angststoornissen, onwaar is.

Hari legde meer dan 60.000 kilometer af op zijn zoektocht en sprak met wetenschappers die hem duidelijk maakten dat niet een chemische onbalans aan depressie ten grondslag ligt maar fundamentele problemen in onze samenleving. Hij kwam terug met een radicaal ander verhaal over de oorzaken van onze pijn, en over hoe we onze weg terug kunnen vinden.

Toen hij eenmaal negen echte oorzaken van depressie in kaart had, vond hij ook zijn weg naar wetenschappers die echt oplossingen aan konden dragen.

Genres: Nonfiction, Psychology, Self Help, Mental Health, Health, Science, Audiobook

392 pages, Paperback

First published January 11, 2018

About the author

Johann Hari is an award-winning British journalist and playwright. He was a columnist for The Independent and the Huffington Post, and has won awards for his war reporting. His work has also appeared in the New York Times, the Los Angeles Times, The New Republic, The Nation, Le Monde, El Mundo, the Melbourne Age, El Pais, the Sydney Morning Herald, the Irish Times, The Guardian, Ha'aretz, the Times Literary Supplement, Attitude (Britain's main gay magazine), the New Statesman and a wide range of other international newspapers and magazines.

Hari describes himself as a "European social democrat", who believes that markets are "an essential tool to generate wealth" but must be matched by strong democratic governments and strong trade unions or they become "disastrous". He appears regularly as an arts critic on the BBC Two programme Newsnight Review, and he is a book critic for Slate. He has been named by the Daily Telegraph as one of the most influential people on the left in Britain, and by the Dutch magazine Winq as one of the twenty most influential gay people in the world.

After two scandals in 2011 involving plagiarism and malicious editing of Wikipedia pages, Hari was forced to return the prestigious Orwell prize he had won in 2008, and lost his position at The Independent.

Reviews

[Just Plain Neddy · Rating 1 out of 5]

Hoo boy! Where to start? Well Hari starts by saying that everything I know about depression is wrong, which is a bold claim given that I've lived with it, waxing and waning, for most of my life. So what does he say?
Hari: Everyone thinks that depression is simply caused by a chemical imbalance in the brain!
Me: Well, of course depression is caused by chemicals in the brain. Every part of our experience is caused by chemicals in the brain. That's what the brain DOES. Love, rage and that annoying tickle behind your right knee are also caused by chemicals in the brain.
Hari: They think that life experiences and the environment are irrelevant and have no impact on people developing depression! They think it pops up out of nowhere!
Me: Literally nobody thinks that, Johann.
Hari: I've found out that people get sad because they've lost their jobs or have no friends.
Me: No shit.
Hari: A woman could have her newborn baby die, and then go to the GP the next day and be diagnosed with major depressive disorder!
Me: Ooooh, a situation that has never happened, ever, because doctors are not fucking idiots! How exciting!
Hari: Antidepressants don't really work even though Big Pharma insists that they do in order to make money. We should take St John's Wort because it's better, has no risks and no side effects.
Me: The evidence on antidepressants is complicated, and Big Pharma have indeed done some shady stuff which I won't defend. St John's Wort works because it is basically an SSRI. However, unlike substances classified as drugs, it's very badly regulated so dosage and purity are inconsistent. There are side effects. One is that it reduces the effectiveness of hormonal contraceptives, which seems like a pretty big risk to me.
Hari: In all the time I took antidepressants, not one medical professional asked if I had a reason to be sad.
Me: I flat out don't believe you, I'm afraid. If you were ever referred to mental health services, you sure as hell went through a history of your whole life in the hour-long initial appointment. Even GPs generally ask.
Hari: Everyone in medicine just thinks that antidepressants will fix everything without any context!
Me: Really? Because I'm pretty sure that NHS best practice advice on depression includes antidepressants, talking therapy, mindfulness, diet and exercise, and sleep hygiene. They've also become pretty keen on choral singing recently. Of course they don't always have the resources to offer this stuff and GPs have to get you out the door pretty quickly. But that's not because they all think pills are perfect.
Hari: Nobody ever asks about real life stressors!
Me: The last time I was referred to an NHS mental health service I was asked over and over if I had any issues with debt, housing, the police, my non-existent children, isolation, harassment etc. Social workers are a lot cheaper than psychiatrists.
Hari: But the REAL cause of depression is real life stress, not brain chemicals.
Me: This is a ridiculous false dichotomy. It's like saying "the cause of type 2 diabetes isn't having a body that can no longer get the insulin/glucose balance right. The cause is people eating too much and getting fat." There are levels of cause and effect, and interactions between these levels. Life experience affects brain activity. Brain activity then both creates and affects life experience. The problem with depression is often a feedback loop between life and the brain. The reason why antidepressants are needed is to get into this loop and push the brain in a different direction so that life can also be pushed into a different direction.
Hari: Everyone now thinks that depression is caused by too little serotonin.
Me: I don't know what "everyone" thinks, but the current medical consensus is that serotonin is one of several neurotransmitters implicated in a very complex disorder that we still don't fully understand. Because, you know, the brain is complex, similar symptoms can have different causes and different appropriate treatments, and so on.

I mean there's more I could say but this is pretty long now.

I think this book might come across as groundbreaking for people who don't know all that much about depression and the state of science around it. This is clearly what Hari was going for. But what it has actually done is build up a ridiculous straw man. Nobody thinks that depression always springs up, spontaneously, because the brain forgot to put serotonin on the shopping list. What the medical profession actually thinks is that it's a very complex disorder, with a lot of interconnected causes and a bunch of different things that can help. Of these things, there's often an antidepressant which will give the person a bit of a boost in conjunction with sorting out other stuff. But Hari doesn't engage with this. Instead he presents another wildly oversimplistic explanation and then claims credit for Figuring It All Out Unlike Those Actual Scientists And Doctors.

[Emily May]

I have a lot of thoughts about this.

For some background, I've owned this book for a while. I was initially drawn to it because I am personally interested in the causes of, and the science behind, depression, but I was later turned off, both by some of the criticisms and the fact that the UK version of this book has a much stronger self-help vibe than a science-y vibe (I'm all about the technical language, as you can see). The UK subtitle is actually "Why You're Depressed and How to Find Hope".

Still, people raved about this book. I don't care much for celebrities, but even I can appreciate the impressive list of names offering up their praise on the cover and inside. Some people feel this book is a mindblowing exposé, yet others feel it is a waste of paper. Some have called it "dangerous". In the end it was controversy, I guess, that made me curious.

I will start by saying that Hari is, in my opinion, a fantastic nonfiction writer. He employs a technique used by the most-loved pop sci writers, like Malcolm Gladwell, in which he begins his chapters with an emotive anecdote that draws you into the narrative he is spinning. He then goes on to reveal the science and statistics behind the point he is making, often delivered in a deliberately dramatic fashion. It makes for very compelling reading.

There can be no doubt here-- Johann Hari is not a scientist, not a psychiatrist, but a journalist. And he is very good at what he does.

The book is split into three parts. The first attempts to dispel the myths that apparently everyone, including most doctors, believe about depression and antidepressants. The second explains what Hari believes to be the true nine causes of depression and anxiety. The third is what we can do about it, and it is the most self-helpy of the bunch.

The controversy mostly surrounds part one, though I think the criticisms are as overblown as some of Hari's most grandiose claims. Dean Burnett responded to the publication of this book by begging people not to stop taking antidepressants, which heavily implies that Hari suggests you abandon them, which is not the case. In fact, Hari openly states that giving up antidepressants is long and complex and should be done with a doctor's guidance, if at all.

Hari certainly sets up a few Straw Men of his own here, the most obvious being his stance that almost no one in the medical community was willing to acknowledge other causes of depression outside of the "brain chemistry" explanation until he came along, which is ludicrous. I think Hari is one of those people who has a certain set of experiences and then thinks he can apply his own experiences to everyone. It is also telling that most of his sources are dated between the 1970s and 1990s.

He is probably right that SSRIs are overprescribed, but his fuelling of Big Pharma conspiracy theories is extremely reductive. The issue is far more complex than 1) Antidepressants do nothing, 2) Drug companies want to make money so they are prescribed anyway.

The truth is that our understanding of depression is still in its infancy, and doctors have to do what they can with the limited, sometimes contradictory, information that is available to them. When thousands of patients are coming to them depressed, many of said patients the poorest members of society, it is not an option for doctors to prescribe them better relationships, a more fulfilling job, a mountain climb. They have to save their lives and help them get through each day in that moment. Often drugs are that first line of defence. Very few people think this is ideal.

Part two is less controversial. In fact, I'd say it's more just... obvious. Hari is very good at writing like he is the first person ever to have had the thoughts he is putting down, then dramatically lifting the curtain on ideas that have been around for decades. Of course having good relationships with family and friends, a rewarding job, a secure future, and time spent wandering the rose garden will decrease your chances of depression. Who could have possibly guessed?

It all culminates in a no-brainer in the final part of the book. Hari has discovered the real answer to everyone's problems, the ultimate cure for depression is the never before seen concept of... socialism. I mean, I think he's right. It's certainly not a cure-all, but in societies where social security is higher and inequality is lower, depression is also lower. Humans have core needs that are not being met by modern capitalism.

Lost Connections is a book of old ideas rebranded as something innovative. It is compulsively readable, flawed, melodramatic and arrogant. Arrogant in the sense that it positions Hari as an oracle of new wisdom at the same time as he regurgitates old studies and other people's ideas.

The worst part of the book is where he falls into a non sequitur, using the results of drug efficacy studies to suggest that most doctors are actively trying to get you on antidepressants. The best parts are the reminders he gives for what really matters in life, backed up by statistics. It's obvious, really, though I think in our day-to-day lives it's also easy to forget.

[Emily · Rating 1 out of 5]

This was a frustrating and infuriating book. I kept wanting to shout “but what about us who HAVE the connections you talk about, have everything going for us, and yet have lifelong depression?” Being told to join a gardening group and make friends is NOT HELPFUL when you have friends and already garden. Being told you need a job you feel is worthwhile, and a living wage, is not the answer when you already have both. It comes off as extraordinarily patronizing to be told “I know you don’t want to hear this, because it’s easier to take a 20 second pill each morning; I didn’t want to either, but here’s the truth.”

It may well be accurate to say that SSRIs are not especially effective on average. It may be true that we don’t have good medical answers for or understanding of depression. But if that’s the case, SAY SO and call for further research. Don’t end by explaining how we all need a universal income so we don’t feel stressed. Ugh. Maddening.

[Sam (Rescue Dog Mom, Writer, Hugger) · Rating 5 out of 5]

I thank the author for writing this book and the person who gifted me a copy. Finally, the truth!!

Every psychiatrist who believes that serotonin chemical imbalance in the brain is the reason for depression and anxiety should read this book! Anyone taking prescribed anti-depressants and not finding relief from their symptoms needs to read this book. Like the author, I was diagnosed with depression and anxiety at a young age and prescribed medication. For years I tried many different drugs including SSRI's, SNRI's, and even NDRI's. From some, I would experience relief for a brief period of time, but it would always wear off and my doctor would increase the dosage, then eventually switch me to a different drug. Some actually worsened my depression and anxiety and even caused difficult health issues that the drug companies like to call "side effects."

I agree with the author on the actual reasons for depression and anxiety. It makes complete sense that having more negative and painful experiences than positive and happy occasions in your life will cause you to be depressed, anxious, and even suicidal. I've seen it happen with family and friends and have experienced it myself. It's not something to be simply dismissed as just a bad day. It's much more than that. It's numerous and severe negative incidents in life that can cause one to retreat and withdraw from society as a mode of self-protection. The cumulative effect can become debilitating for many people and also lead to self-deprecating behavior. Crying so hard and feeling actual physical pain and believing the world would be better off without you is a serious crisis that requires immediate attention. At that point it's extremely difficult, if not impossible, to have the courage to seek social interaction in hopes of obtaining positive and happy social experiences.

If I knew then what I know now, I would not have taken any of these medications and I believe I'd be healthier both mentally and physically. I also wouldn't have wasted so much money, as some of these medications were not covered by insurance and are quite expensive. If you are suffering depression and anxiety and are taking prescribed anti-depressants that are not working for you, I encourage you to read this book with an open mind. If you know of someone who is suffering, I urge you to recommend this book to them. If you don't suffer anxiety or depression, I kindly ask you to try to understand what it's like for those of us that do.

This book was thoroughly researched, is very well-written and easy to read. I sincerely thank you for reading my open and honest review.

[Aisha Smith · Rating 1 out of 5]

This book purports to be groundbreaking but is actually an example of sloppy and unscientific reasoning. The author quotes studies published in the 1990's to critique "modern thinking" about clinical depression and anxiety. However, modern thinking on clinical depression and anxiety has advanced by leaps and bounds just in the time I've been typing this review. At a minimum, a book about science should refer to science published in the New Millennium.

A further example of the author's messiness is his failure to define his terms. How does the author define "depression?" Would he argue that postpartum depression, seasonal affective disorder and grief all have the same root in loneliness and societal alienation? That would be ridiculous. To get around this, the author just lumps everything and everyone together. Pretty irresponsible treatment of such an important subject.

[بثينة العيسى · Rating 5 out of 5]

It’s not seretonin; it’s society.

[The Conspiracy is Capitalism · Rating 4 out of 5]

Can there be any Redemption for Pop Psychology?

--Judging by this book's popularity/stellar ratings in a genre I have avoided, I was preparing a niche review contrasting this book with bad “pop psych”.
…Then, I noticed the top review accuses this book of being another bad “pop psych” book! “Instead he presents another wildly oversimplistic explanation and then claims credit for Figuring It All Out Unlike Those Actual Scientists And Doctors.”
…So, I’ll first unpack the negative review (a useful exercise in salvaging a disagreeable review), then bad “pop psych”, and finally the book.

1) Lost in Communication:
--The top (negative, 1-star) review claims that this book took an obvious claim (depression can have social causes; “no shit”) to build a strawman claim (the understanding and treatment of depression have only focused on chemicals in the brain; “literally nobody thinks that”, “because doctors are not fucking idiots!”).
--It’s always disappointing how messy communication is:
a) I found the author’s reminders of it’s-complicated/there-are-exceptions-including-biochemical-and-genetic/antidepressants-can-be-part-of-helpful-treatments adequate for a popular presentation (and thus even repetitive).
…The core of the book is to explore other treatments beyond relying on antidepressants (while listing sources supporting antidepressants, i.e. Kramer’s Listening to Prozac), and the author frequently adds that antidepressants can be a useful addition in treatment, mirroring the reviewer’s coup de grâce: “there's often an antidepressant which will give the person a bit of a boost in conjunction with sorting out other stuff. But Hari doesn't engage with this.”
…The changing debates and medical practices (i.e. modern Western; the brief contrasts with non-Western is worth exploring elsewhere) on depression are summarized at the start (ex. Irving Kirsch vs. Peter D. Kramer, DSM diagnostic guidelines, etc.). Healthcare changes (look at how DSM classified homosexuality). This book is not an attack on healthcare professionals, who are limited to their institutions and cannot resolve many wider social issues. The author supports the NHS (UK’s National Health Service) as a cornerstone of social services (“well, of course”).
…Social causes are often systemic so this is not (and cannot be) a cheap self-help book. Interactions between social and biological factors (ex. neuroplasticity, snowballing effect) are indeed complex and covered, once again mirroring the reviewer’s counter “There are levels of cause and effect, and interactions between these levels. Life experience affects brain activity. Brain activity then both creates and affects life experience. The problem with depression is often a feedback loop between life and the brain.”

b) Meanwhile, the reviewer’s reaction: “Well Hari starts by saying that everything I know about depression is wrong, which is a bold claim given that I've lived with it, waxing and waning, for most of my life.”. This is an (ironically) “oversimplistic” caricature of a presentation which the reviewer also finds to be mostly obvious (“no shit”). The presentation is clearly for a popular audience and not an academic tome, with all its advantages and limitations.
...Update: for the Guardian article "Is everything Johann Hari knows about depression wrong?" , see my breakdown in Comment #10 below my review. Yet another attempt to critique exaggeration that ends up relying on exaggeration.

2) Bad “Pop Psych”:
a) I ended up dropping a star (from 5, which I try to be very finicky giving as to not dilute gems!) given the advertising hype/spin employed in some of Hari's passages (the major limitation of popular writing, as it seems to be treated as a requirement); this definitely detracts from what is otherwise 5-star content and is a misuse of creative writing.
...My go-to for engaging writing on the topic without shortcuts in nuance is medical doctor/epidemiologist/science writer Ben Goldacre (Bad Science: Quacks, Hacks, and Big Pharma Flacks). Goldacre's collection I Think You'll Find It's a Bit More Complicated Than That has numerous articles directly related: "Heroin on Prescription", "Neuro-Realism", "The Least Surrogate Outcome", "The Stigma Gene", "Brain-Imaging Studies Report More Positive Findings Than Their Numbers Can Support. This Is Fishy". Goldacre's medical/research background offer deeper experiences with the realities of "Big Pharma" (whose crimes are more abstract and structural than what is sensationalized by bad media, see later).
...That said, I still think Hari's topic of social addiction is a gem, unlike standard bad “pop psych” extraordinaire Malcolm Gladwell...

b) Why psychology is a mess and heavily criticized in academia: the difficulties quantifying a social science:
-https://www.madinamerica.com/2016/09/...
-http://jaapl.org/content/45/3/278
-https://www.theguardian.com/commentis...
-https://www.badscience.net/2011/10/wh...
-https://www.theguardian.com/commentis...
...plenty of ideological fiends that emerge from this swamp, misusing science's initial reductionist steps of discovery by not re-synthesizing with real-world complexities in making conclusions (esp. considering psychology crosses over so much with social sciences, unlike physical sciences). I'll need to continue reviewing these culprits:
-Jordan B. Peterson: 12 Rules for Life: An Antidote to Chaos
-Steven Pinker: The Better Angels of Our Nature: Why Violence Has Declined
-Sam Harris: The Moral Landscape: How Science Can Determine Human Values

c) “because doctors are not fucking idiots!”: if you read Hari more carefully, you’ll see he reviews the fascinating world of for-profit medical trials (referencing meta-research legend John Ioannidis), which are unpacked here:
-I Think You'll Find It's a Bit More Complicated Than That (“because, you know, the brain is complex”)
-Bad Science: Quacks, Hacks, and Big Pharma Flacks
-Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients: in particular the numerous ways to rig trial results.
…If you’re actually serious about evidence, you’ll realize “the evidence […] is complicated”. Indeed, legend John Ioannidis himself has gotten into controversies in his interpretations of COVID-19 research: https://sciencebasedmedicine.org/what...
…Rigidity in evidence-based-medicine paradigm: https://youtu.be/qYvdhA697jI
...How this applies to COVID research: hierarchy of evidence? https://youtu.be/gNKYMOItsaU Missing social structures? Dead Epidemiologists: On the Origins of COVID-19

3) The book:
--Unpacking the bad review helped contextualize this book, so here’s a quick overview:
a) Lost connections with:
...meaningful work (Yes! Political economy is my interest; check out Bullshit Jobs: A Theory, Democracy at Work: A Cure for Capitalism, The Invisible Heart: Economics and Family Values), other people (loneliness, “self-help” culture)
...meaningful values (intrinsic vs. extrinsic), lack of authenticity from childhood trauma (defensive mechanisms; many references of Gabor Maté (In the Realm of Hungry Ghosts: Close Encounters with Addiction; Maté has since broadened the scope in The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture), status/respect (stress of insecure status/subordination), as well as brain changes (neuroplasticity) and gene changes (environmental activation, stigma)
...nature (Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge, and the Teachings of Plants), and hopeful/secure future (another big topic in political economy, esp. Neoliberal cannibalism of Western post-WWII industrial boom, not to mention existential ecological crises)
...You can see how much “Neoliberalism” plays into lost social connections, symbolized by Thatcher's “There is no society” and “There is no alternative”. This also relates with boogeyman Marx's “alienation”.

b) Re-connections with:
...other people, social prescribing (“what’s the matter with you?” becomes “what matters to you?”), meaningful work, meaningful values, sympathetic joy (vs. envy)/overcome addiction to self (meditation, psychedelics), acknowledge/overcome childhood trauma, and restoring a future.
…The last point (restoring a future) is of course a big political economy topic! The author cites Bregman regarding UBI (Utopia for Realists: How We Can Build the Ideal World) which can be a useful conversation-starter for novices (just as The Shock Doctrine: The Rise of Disaster Capitalism popularized the critique of "Neoliberalism"), but many structural economic issues are unaddressed (let's not forget market fundamentalists like Milton Friedman supported variations of UBI, to help dismantle welfare services).
...I much prefer Varoufakis unpacking the structural crises (Talking to My Daughter About the Economy: or, How Capitalism Works—and How It Fails) and proposing structural alternatives (Another Now: Dispatches from an Alternative Present). In fact, Varoufakis interviews Hari on social alternatives! https://youtu.be/j0EOhF5v48M
...Another excellent pairing, now on the global situation, is Hickel on global inequality (The Divide: A Brief Guide to Global Inequality and its Solutions) and on solutions to the existential ecological crises (Less is More: How Degrowth Will Save the World). Also useful and accessible: Doughnut Economics: Seven Ways to Think Like a 21st-Century Economist
...Once again, this cannot be treated as a cheap self-help book; social problems require social solutions. Hari quoting Jiddu Krishnamurti:
“It is no measure of health to be well-adjusted to a sick society.”

[Argos · Rating 1 out of 5]

Britanya’lı gazeteci Johann Hari uzun yıllar birlikte yaşadığı depresyonunun gerek nedenlerini gerekse çözümlerini deneyimlerinden çıkardığı sonuçlarla okurlara aktarıyor “Kaybolan Bağlar” adlı kitabında. Yorumumu iki şapkamla yapıyorum, bilim insanı tıp doktoru olarak ve “goodreads” okuru olarak. Kitabın girişinde bu kitabı yazma amacını açıkça sergiliyor gazeteci-yazar; antidepresanladan uzak durun, yan etkileri çoktur, bu ilaçlar depresyonda çözüm değildir. Bu düşüncesi için (tezi ya da iddiası demiyorum çünkü bu konu hakkında binlerce makale, yüzlerce kitap yazıldı, ulaşılması kolay kaynaklar halinde duruyor internette) seçilmiş bilimsel veya popüler yayınları özetliyor.

Daha sonra yine kendi deneyimlerine dayanarak saptadığı depresyonun ya da kaygının dokuz nedenini bölümler halinde anlatıyor. Ve şu notu düşüyor: “depresyon ve kaygı konusunda birkaç yıl süren araştırmalarımın ardından bugün dokuz neden belirliyebiliyorum,…. henüz keşfedilmemiş ya da karşıma çıkmamış başka nedenler olacaktır”. İlahi sayın gazeteci yazar J. Hari, bu konudaki çalışmalar on yıllardır çok yoğun bir şekilde yapılmaktadır, 9 değil 99 neden bulmak mümkün, öyle ki günümüzde en yaygın kullanılan antidepresanlardan örneğin SSRI’lar, 1990’lardan beri hallaç pamuğu gibi atılarak incelenmiştir ve incelenmeye devam edilmektedir. Ancak yazarın hakkını verelim bu geniş bölümü okunuşunu kolay kılan iyi bir üslupla yazmış.

Bu kitabı günümüzde yaşadığımız Covid pandemisinde “aşı taraftarları ile aşı karşıtları” arasındaki zıtlaşmaya benzettim. Sonuçta “aşı karşıtları” bilimsel veriler ve geniş çalışma sonuçları ile değil komplo teorileri ve tıp dergilerinde yayınlanan çok kısıtlı sayıda yayınlar ile kendilerini savunma dışında bir şey ortaya koyamamaktadırlar. J. Hari de aynen böyle “antidepresanların yararsızlığı hatta zararlı oldukları” konusunda bilimsel tıp dergilerinde kısıtlı sayıda yayınlanan yayınlar dışında hiçbir inandırıcı kanıt ortaya koy(a)mamaktadır. Kitapta örnek gösterdiği yayınlar da bilimsel olarak doğru oldukları için değil, o tıp dergisinin yayın kurallarına uygun oldukları için, örneğin çalışmanın metodolojisinin doğru, kullanılan istatistiklerin uygun, sonuçların çarpıtılmaması gibi temel kurallara uyduklarından dolayı bu dergilerde yayınlanmışlardır, zaten bu çeşit dergiler bilimsel doğrulukların sorumluluklarını üstlenmezler.

Öyleyse neye inanmalıyız? Bu konuda yapılmış tüm bilimsel çalışmaları tek bir depoda toplayıp inceleyen ve sonuçları geniş meta-analizler ile veren çalışmalara yüzümüzü çevirmeliyiz. Bunun için platformlar vardır örneğin Cochrane Training bazlı kontrollü çalışmalar, Randomize Kontrollü Çalışmalar, PubMed tabanlı yayınlar vb. Bunlar buradaki yorumun konusu olmayacak kadar teknik konular olduğundan burada noktalıyorum.

Sonuçta bir hekim olarak gazeteci yazarın antidepresanlar hakkında yazdıklarını onaylamam mümkün olmadığı gibi haddini aşan ucuz bir pazarlama tekniği olarak da nitelendirmekten kendimi alamıyorum. Buna karşın depresyonun saptadığı dokuz nedenine tabii ki itirazım olamaz, çünkü bunlar yeni şeyler değiller, yıllardır belki farklı başlıklar altında sadece bilimsel ortamlarda değil, aktüel yayınlarda da yazılmaktadırlar. Bu kitabı okuyacak dostlara son olarak şunu söyleyebilirim; günümüzde anksiyete-kaygı ve depresyonun tedavisi “hekim kontrollü antidepresanlar ve psikoterapi (telkin, grup tedavisi, ortam değişikliği, meditasyon vb)” ile sağlanmaktadır, ola ki kitaptan sonra (eğer antidepresan alıyorsanız) ilacınızı kendi başınıza kesmeyin, hekiminize danışın zira konu gelişmelere açıktır. Son bir not da bu konuda yani antidepresanların kullanımlarında ilaç firmalarının olası etik dışı manüplasyonlarına karşı Dünya Sağlık Örgütü (WHO) ve Dünya Psikiyatri Birliği’nin (WPA) rehber bildiri (guideline) ve yayınlarından şaşmamak gerektiğidir.

Bu tür kitapların faydalarını her zaman şüpheyle karşılamaktayım.

[Arani Satgunaseelan · Rating 2 out of 5]

Just not for me. I found that this book unnecessarily portrayed psychiatrists and anti-depressants negatively. I was presented with plenty of studies related to other causes but the idea of anti-depressant studies was quickly dismissed as being biased because of ‘Big Pharma’ funding - which I think is an insult to the men and women scientists working for companies conducting this research.

For me, the causes and ‘reconnections’ highlighted are all part of ‘psychiatric treatment’ in conjunction with anti-depressants. At the end of the day if you go to your GP saying you can’t stop crying, they’ll prescribe meds, but also set up counselling, encourage regular exercise and removing yourself from any negative life situation.

It’s a comprehensive model.

Whilst I completely agree with all the disconnections that the author described in leading to mental health issues, I just think going out there and saying anti-depressants are a conspiracy is dangerous and unnecessary. For many people, getting a prescription is the first step to seeking the support they need.

[Heather · Rating 5 out of 5]

"We need to move from 'focusing on chemical imbalances to focusing on power imbalances.'"

You are not suffering from a chemical imbalance in your brain. You are suffering from a social and spiritual imbalance in how we live. Much more than you've been told up to now, it's not serotonin; it's society. It's not your brain; it's your pain. Your biology can make your distress worse, for sure. But it's not the cause. It's not the driver. It's not the place to look for the main explanation, or the main solution.
Because you have been given the wrong explanation for why your depression and anxiety are happening, you are seeking the wrong solution. Because you are being told depression and anxiety are misfirings of brain chemicals, you will stop looking for answers in your life and your psyche and your environment and how you might change them. You will become sealed off in a serotonin story. You will try to get rid of the depressed feelings in your head. But that won't work unless you get rid of the causes of the depressed feelings in your life."

"You aren't a machine with broken parts. You are an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you've been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated."

”All these depressed and anxious people, all over the world - they are giving us a message. They are telling us something has gone wrong with the way we live. We need to stop trying to muffle or silence or pathologize that pain. Instead, we need to listen to it, and honor it. It is only when we listen to our pain that we can follow it back to its source - and only there, when we can see its true causes, can we begin to overcome it."

I included these quotes because I simply don't possess the ability - or quite frankly the desire - to express this better than Hari did in the conclusion of this book.

I read Chasing the Scream: The First and Last Days of the War on Drugs and was mind-blown by it. It challenged everything I thought I believed about drug addiction, and made an extremely compelling argument, with solid proof. This book did exactly the same thing - it challenged what I thought I knew about depression and anxiety and detailed the ways he believes we, as a society, can and must change that, and it makes SO MUCH SENSE.

I will most certainly, without a doubt, read anything Johann Hari writes. Anything. Not only is his research extremely extensive, he presents his findings - and opinions - in a way that is so easy to understand. So easy that I often found myself wondering how I didn't realize it myself, how it isn't common knowledge.

PLEASE , read this. It will really challenge you, and it will most certainly help you, and the world around you. We, as a society, are handling depression and anxiety all wrong.

[Lisa · Rating 3 out of 5]

3.5
I'd recommend just listening to Hari's episode on the Joe Rogan Experience podcast, episode #1077, because you'll hear the most important points of his book and Joe Rogan is a pretty good person to hear responding to it. I thought the book was unnecessarily lengthy, I guess he wanted to show off his journalistic skills because he had a few deep experiences talking to people about this.

He divided his book into two parts: what causes depression and then how we can solve it. I found the first part immeasurably more valuable than the second, which mostly called for social transformation. And fair enough, but it depressed me a little (haha) because well yeah the world is messed up but what can I do about it right now in my own life? Nonetheless I guess it needed to be said, despite there not being a clear path to utopia yet.

The nine causes he came up with included disconnection from: meaningful work, other people, meaningful values (basically don't be materialistic), childhood trauma, status and respect (something about the social hierarchy and being bullied), the natural world and a hopeful or secure future. Finally he discusses the role genes and your brain (neuroplasticity).
All of this made sense to me but I sensed an excessive amount of bashing of antidepressants (in one study he reports that getting better sleep is on average 3 times more effective than taking antidepressants). I get this, especially considering that he lives in America and had a profoundly terrible experience himself - but I think it's simplistic to say that antidepressants are always bad. (I don't think he means to say that, but hey, that's the vibe you get).

Some gems I really appreciated hearing: (and I'm paraphrasing)
- You need your pain, it has something to tell you about what's wrong in your life.
- Grieving has the same symptoms of depression, but we see grieving as rational in its context - what if depression is a form of grief for how our own lives aren't going as they should?
- Having no friends or supportive partner when a negative life event occurs increases your chances to get depressed by 75%
- Sometimes addiction, like to food in the case of obesity, is a solution to a problem most people just can't see?I.e. What if addiction isn't the fire, but the smoke. (in the chapter about childhood trauma)
- Being in nature helps with depression because realising you're "just protein" gives "release form self-enclosure in your own ego". Go hiking!
- On neuroplasticity: a brain scan is a snapshot of a moving picture. Your brain changes to meet your needs and is always related to your life and personal circumstances. "You can't figure out the plot of Breaking Bad by dismantling your TV set"
- Statistically it's been found that thinking depression is a disease vs a lifestyle defect is more likely to make you stigmatise the depressed person. This is because when you know that could just as well be you in a few years makes you more empathetic.
- Consciously trying to make yourself happy only works if you see being happy as being more connected to others, I.e. Helping other people
- Everything he said about sympathetic joy and loving-kindness meditation!

Okay I'm tired of writing

[Zora · Rating 3 out of 5]

At his best, Hari writes with real compassion and insight, advancing an important argument that we need to expand our understanding of both depression and of anti depressants. Popping pills to solve a chemical imbalance is not the answer, but rather identifying what it is that you/ we are disconnected from - including with the help of mental health professionals, but not exclusively. He consults experts, showcases innovative approaches and research and thinks about things ‘for a long time’ as he says more than once. It’s hard to disagree with large chunks of this - much of it sensible and attentive to the complexities of human existence - and he covers a lot of ground while maintaining the pace of a page turner. He thinks big too, indicting contemporary neoliberalism in the depression epidemic. But sometimes the tone was too proselytising & verged on condescending while the space allocated to particular issues over others was sometimes curious (pages and pages to a single LSD experiment while childhood trauma is smashed out in one of the smallest chapters). Towards the end, huge topics like the universal basic income were introduced with great fanfare only to capsize on another walk on part for a celebrity friend of his. And while he made attempts to give biology its due, once it was established that the chemical imbalance theory is basically bunk, other biological factors - most notably hormones which is a huge issue for many women suffering various forms of depression - barely got a look in. Still, I am glad he wrote it and that I read it. We do need to listen to our own pain, and to the pain of others, and to expand the possibilities of how we deal with it. In that broader sense, this is a hopeful and helpful book.

[Ashley Peterson · Rating 1 out of 5]

As a mental health professional and person living with major depressive disorder, I was fairly certain going in that I wasn’t going to agree with this book, which argues against any sort of biological causation for depression. What I wasn’t prepared for was the amount of absurdity and apparently deliberate misunderstanding/misinterpretation that I found.

From my perspective, the absurdity began when the author wrote the he had an “epiphany” at age 18: “I’m not happy, I’m not weak - I’m depressed! … There is a term for feeling like this! It is a medical condition, like diabetes or irritable bowel syndrome! I had been hearing this, as a message bouncing through the culture, for years, of course, but now it suddenly clicked into place. They meant me! And there is, I suddenly recalled at that moment, a solution to depression: antidepressants. So that’s what I need! … I knew about the cure [Prozac], because it had been announced by the global media just a few years before.” Years later his therapist observed that he seemed depressed, and he insisted that couldn’t possibly be the case, because his antidepressant was boosting his serotonin levels. This does not in any way sound like anyone I’ve ever encountered who suffers from a serious mental illness, and cast serious doubts on the author’s judgment.

Hari cites a number of researchers that are proponents of the stance that he takes, but his interpretation of their findings demonstrates a fundamental lack of understanding of the principles of scientific research. He held up as a credential for one scientist the fact that he’d been deemed one of the most influential scientists alive by a social commentary-oriented magazine, as if this somehow backed up the validity of this scientist’s arguments. He also makes misleading statements about how the Diagnostic and Statistical Manual (DSM) deals with bereavement.

He holds up the disproven hypothesis that depression is due to a lack of the neurotransmitter serotonin as evidence that depression is not biologically caused. This hypothesis was originally developed to try to explain why medications that inhibited the reuptake of serotonin were helpful for people with depression, and at the time there weren’t the scientific techniques available to verify whether this was accurate. It has since been found that depression is not correlated with a deficiency in the absolute amount of serotonin, but it is utterly illogical to say that because scientists came up with an inaccurate explanation decades ago we should throw the baby out with the bathwater and say biology and neurotransmitters are simply not involved.

The author comes up with a list of 9 causes for depression, although he has no formal training in psychiatry or psychology. These causes involve various social/environmental factors, entirely overlooking that many people who develop mental illness (including myself) may experience none of these. The author isn’t arguing that some people’s depression is related to situational stressors (which is absolutely true) or that broader societal existential malaise is attributable to social/environmental factors (which is quite possibly true); he is saying that all depressive illnesses fit into his narrow box, which is incredibly insulting to those of us living with serious mental illness.

So what can I conclude personally from this book?  Apparently to get better from my severe illness that has caused multiple hospitalizations and suicide attempts, I'm supposed to engage in local activism, participate in a community garden, start a co-op, hang out in nature, and get laid. Forget meds, according to the author sex is the best antidepressant.  The author writes about depression involving various disconnects, but by the end of the book I could only conclude that the author was well and firmly disconnected from the reality of mental illness.


This review first appeared on https://mentalhealthathome.org/2018/0...

[Lisa Vegan · Rating 5 out of 5]

The book’s description field at Goodreads (https://www.goodreads.com/book/show/3...) gives a more than adequate summary of its contents so I won’t make a point here of giving any further details here.

As usual, it’s hardest for me to write reviews for books I love the most. This might be the best book I’ve ever read about depression and anxiety, and I’ve read dozens, maybe hundreds, over many decades.

It’s a book that I wish I could own. I might borrow it from the library again at some point.

I can recommend this to everyone (including several specific people I know) particularly those who have experienced depression/anxiety, those who work with sufferers to alleviate those conditions, and those who know or have known people with depression and/or anxiety, and most people living in our modern world; in other words, most readers. The book’s subtitle refers to depression but throughout the book both depression and anxiety are explored, and I appreciated that.

I should probably feel perturbed that none of the buzz on the book jacket is from professionals in the field, but I ended up not caring. This is not a pop psych book, and I hope that mental health professionals will read it. I wish this information had been published and publicized many decades ago, and accepted by those in the field. To me it’s ridiculous that this information could be considered groundbreaking but some of it feels that way given the accepted current treatment modalities for depression and for anxiety.

The book is entertaining and informative, and well structured and well written. Most of what is related is or should be common sense but I found much of what was presented thought provoking. Perhaps there was nothing earth-shatteringly new but it felt good getting validation and more to consider, and I did learn some things. The author is an engaging writer and storyteller. The account has a good mix of his personal story, others’ stories, and (scientific and informal) research results. He interviews people from around the world, people working in various disciplines, and about various organized and spontaneous social experiments that have occurred. The personal stories make the hard data even more interesting.

When I read the Contents pages before I started the book I thought I’d have an issue with the specific numbers of reasons for and solutions for these mental health issues, but I didn’t. The author is not dogmatic and the sections were useful and made sense.

I’ve never been a person especially attracted to drug use, but after reading this book I’d love to try the ingredients in mushrooms, at the high dose, under strict medical supervision, even though I suspect I might be among the 25% of users who have negative experiences when under the influence of psilocybin. I’m really curious though and I’d be willing to take the risk because I think there would be an opportunity for a special, positive experience.

I do wish that the sections on traumatic childhoods were much longer and had more details and examples.

What is said about disconnection in modern life really resonated with me, and the conclusions the author reaches about its impact on how we feel are ones with which I mostly agree. Finishing the book I feel that it can be helpful to many, and somewhat empowering, but as is made clear, many of the needed changes must happen not just by individuals but also at the societal, cultural, group, organizational-governmental level, and accomplishing this in the big way that will be required for large populations feels like a daunting goal. So I’m not sure how optimistic or pessimistic I feel regarding this epidemic, but ideas are given that individuals and small groups can implement.

The notes are worth reading, preferably at the same time as their corresponding chapters. There is an index, though when I went to look up things I didn’t always find the book’s contents there where I’d expected to find it.

One quote I really liked that is a good summary of the book’s thesis is: “You aren’t a machine with broken parts. You are an animal whose needs aren’t being met.”

[Nina (ninjasbooks) · Rating 5 out of 5]

This is simply the best book I’ve ever read. It asks all the right questions and it also provides many possible answers. I hope this will be a book that ultimately will change our society and the way we think about mental illness. Working as a psychologist myself, it felt like somebody finally provided solutions that will work for us.

[Yara Yu · Rating 4 out of 5]

الاكتئاب ليست كلمة سهله تقال ، أي شعور بالحزن ليس اكتئاب
بل هو مرض نفسي ، سرطان الروح الذي ينهش كيان المصاب به ويجعله يكره حياته وكل ما حاوله
هو مرض لا يشعر بثقله الا من أصيب به وهو مرض خبيث لا يسخر من وجوده
كتاب رائع من افضل الكتب التي تناولت الاكتئاب كمرض نفسي بشكل تفصيلي

[Leo Robertson · Rating 5 out of 5]

I was gonna set this to 4* but Mr Hari does leave me feeling ever so empowered :)

And seems to provide me with new reasons to criticise Russell Brand! Which I love doing anyway ;) Because unfortunately for Mr Hari I'd argue, he seems trapped into calling for revolutions.
"Hey!" his publishers say. "Do that calling-for-revolution thing you do. Really gets books flying off shelves!"
The last book I read of Hari's, Chasing the Scream, I did so when a bit younger and looking for "THE answer", so his revolution-calling got in. This time, I'm reading this book in conjunction with Jordan Peterson's 12 Rules For Life (which isn't on my GR shelves because I like to have unique experiences with books. When I add percentage read, or "currently reading", and someone likes it, it's like when you're in a shop and the salesperson goes, "Great choice! Pairs well with our new range of patterned cotton t-shirts." I know that's not how it is. GR people have no marketing-style incentive to encourage me with my reading, but of things that should be private, experiences with books are way up there. Someone just showed me a Facebook video of an alcoholic woman screaming because the government were taking away her child. I'm sure it was offered with the incentive of inducing some sort of change, but no matter the motivation, some things just need to remain private, even if they don't "technically have to" anymore. Now that we can record everything, doesn't mean we should. Look at that whole Logan Paul thing, or that prankster vlogging couple that broke up and feel like they "sold their relationship to YouTube." Privacy is a human need like water and food. So that's that!)
One of Peterson's points is that dominance hierarchies are ingrained in us, not in our culture. They can't be dismantled. I'm sure Hari would agree, but he doesn't make that explicit. He just makes the point that hierarchies in certain countries are ramped up to the extreme in a way that is massively detrimental, and advocates flattening those hierarchies as they do in Norway (omg if one more person who doesn't live here tells me how great it is...!!)
Well, read that in conjunction with this School of Life article:
http://www.thebookoflife.org/countrie...
Because I can't be bothered yet again to explain why no one country, and perhaps especially not Norway, has all the answers.

And the knowledge of this book is not as hidden as he makes it sound. Go into nature, for example: well, there's the whole Japanese "forest bathing" practice etc... I mean I guess I've never seen these solutions collected in this way before, and that's enough. Just something about the "woooww" tone of it was, like... Yeah, certain technological advancements and new modes of living have us lonelier than ever. I don't think that's news to anyone. The pernicious effect of advertising: yes. We're all talking about this stuff. You're not ripping our blinkers off. But thanks for providing some new thoughts on the urgency of stemming those influences. As for advocating for laws that prevent advertising that makes people feel bad?! Are you nuts? That sounds like Brave New World territory to me. Though I appreciate the sincerity of its intent, sure.

But, fine: I kinda think the point of all this reading we do is to develop our own personal philosophy.
I had a discussion with a friend about it yesterday. He was of the opinion (or was playing Devil's Advocate just to rile me, as is sometimes his wont :P) that everything has been done before.
I said it depends on the level at which you look at something. No one like him has ever existed, and what he claimed was the equivalent of saying, we're all molecules, or we're all just fleshbags or something. That, as we even know scientifically, is looking at the problem at the wrong order of magnitude.
(I often do the hard graft of beefing up other people's weak arguments for them, just so that when they know I blast those arguments to shreds that I had reason to do so. I have to provide points A and B and C and D so that I don't just refute point A, then they come back in a week and go, "Aha! I've been thinking about it! Have you considered: point B?! Gotcha!!"
Ugh. People!! I know we need them, but maybe we allow ourselves to be depressed because the monumental task of locating a network of decent friends is even more depressing!)
What makes us unique is DNA, and each of us have genomes that have never existed before—no matter how much of that code we share with others. Each of us is a discrete object, with a unique collection of experiences, experiencing life differently.
He either didn't like or understand that, so, exasperatedly, I said, "Cavemen didn't have iPads!"
That shut him up for a few seconds but he still had this look on his face. Again, while being arrogant, he couldn't express to me exactly why he thought he'd bested me, so I helped him out again. I think what it transpired that he was getting at was that, we're not the beginning or ending of anything ourselves. Okay sure. We're participating in life, which is bigger than ourselves. We're part of a fabric. Nice!
Two of my favourite aphorisms are, "Better than nothing" and "Take what works for you and let the rest go." This is how I get out of bed and go about my business and develop. Okay, so I'm not the most well-read, best engineer, greatest husband etc. Does that absolve me of responsibilities in any of those regards? No. Because worse than me doing anything to better myself would be to do nothing. Any attempt at improvement is better than nothing. That's really all I ask of myself. And then, okay, the point of my reading is almost never to agree with the writer. If I do, it's an easier task; if I don't, I have to work out why I don't. I take what works for me and let the rest go. I look at what my parents did and how they went about life. I mimic those parts of them that I appreciated and look for areas of improvement—which there always are. They're only human. And so am I.

Now, maybe almost none of this had anything to do with this book in particular, and that's on me. I always end up spilling when I relinquish journalling.

Whatever. Let's end on this note:
HEY! YOU! YOU DESERVE TO BE HERE, motherfucker. You are worthy of love, and fun, and silliness, and the beautiful mistakes you'll keep making.
Go you!

[Petra · Rating 4 out of 5]

"You aren’t a machine with broken parts. You are an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you’ve been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated."

[Xe_maria · Rating 3 out of 5]

I have mixed feelings about this book. On the one hand, it raises really important topics and there is a lot of very interesting data in there. There were bits of this book that I found helpful and insightful.

On the other hand, there is a lot of oversimplification in this book. I have been particularly annoyed with the oversimplifications around biology/psychopharmacology and almost dropped the book after the first few chapters and then I reminded myself that this is the area that I know a lot about, so I need to exercise some discretion. But on childhood trauma I also felt that there is a massive topic of how your experience as a child teaches you to interact with reality in certain ways that is completely omitted. And I am fairly sure that on sociology and economics there is also a lot of simplification but I just don’t know enough about these disciplines to pick up on that.

I also think that the book that mostly talks about the cultural, social and economic interactions is completely oblivious to how the modern world expects people to be constantly happy. This is another big topic that is worth exploring.

[Saranya ⋆☕︎ ˖ [hibernating] · Rating 4 out of 5]

This was quite provocative and deep.
The author used to believe that depression was only caused by problems in the brain, but after traveling and talking to experts, he learned that there’s much more to it.

🌱
Hari says that depression often comes from being disconnected—from friends, family, nature, meaningful work and even our own values. He believes that fixing these connections can help people feel better.

The author tells us stories from his own life and from people around the world, which makes the book interesting and easy to follow. His pharmaceutical solutions are both courageous and well-researched. He looks at the bigger picture—like how jobs, relationships and society affect our mental health. He shares his own struggles with depression, making the book feel intimate and authentic.

[Alan · Rating 4 out of 5]

A common occurrence for me: getting bogged down in discussions about food. I never instigate. Ever. I don’t really care about what people eat because I’m no saint myself. It’s also not my job to “save” people from their big bad diets or whatever. But I get asked about food habits all the time. I will answer. What I eat should not be of much interest here, so I won’t list it, but suffice it to say that the magnitude of the reaction is always much more in your face than it would be with other conversations. People immediately want to know more, convert themselves, admonish me, convert me, shill for specific products, quote studies, pity themselves, etc. etc. etc. Clearly, food is much closer to people’s hearts and minds and beings than other abstract issues. I have had people try to tell me that the Red Hot Chili Peppers are overrated when I tell them that I like them, but not with any great conviction. At the end of the day, why would you care if I listen to Dani California on repeat? But tell people that I don’t eat until 5 PM on a regular day and boom. That’s a half hour. At the very least.

So why say all that I’ve just said? Well, obviously food is near and dear to people’s entire beings. In many ways, it is the key pillar to many cultures (sorry England!) and what brings people together, lends narrative to their lives and creates a connection to their past and their future. You know what else is near and dear to people’s entire beings, their hearts and their minds? Their literal minds.

Mental health and illness cannot be classified in a satisfactory way, one that will have experts agreeing with the definitions and categories across the board. Books that have implications about these topics feel deeply personal for readers, as they are checking each and every single word against their own personal experience. If something is off with what the book says in comparison to their own personal experience, then the content of the book is seen as pernicious and dangerous, misrepresenting the field and not representative of reality.

A cursory glance at the front page of the reviews for this book will show you that. Lots of 1- and 2-star reviews across the board. Lots of anger. I get it. Who the hell is he to talk to me about me? This review by Emily feels like a personal plea. Does it strawman everything in the book? Absolutely. Emmy’s review is sassy, but sincere. It betrays a sense of trust in the Western medical system that (without sounding condescending) is naïve at best, negligent at worst. She privileges her own experience with depression to knock down overly-reductionist representations of the arguments that Hari puts forth, using a dialogue format that always seems to come back to “me, me, me”. Some people are calling her out, but I am too tired to do so and have far too little energy. I will do it passively here instead. But hey, that comment section is a war zone. Aisha’s review is also fairly popular, but it seems like she used two brief “pointers” from a scientific reasoning pamphlet and applied it poorly, those being: 1) Make sure to check the recency and relevance of sources cited, and 2) Make sure the author is setting out his/her parameters accurately. Yes, some of the sources here are 20-30 years old. So? If there is no issue with it and there is nothing to update on, why are we tossing it out? Just to add some flavour, I did look up the research (journal articles, not Google, don’t worry), and research as recent as 2020 corroborates the work Hari has presented. And Hari fails in defining “depression”? Yes, that’s his point, I think. That’s like reading a meta-analysis of philosophical papers that attempted to define “the good life” and complaining that the authors compiling the research failed to define “the good life” – it’s circular. It makes no sense. One more - Arani complained that Hari “unnecessarily portrayed psychiatrists and anti-depressants negatively”. Let me take advantage of all the logical fallacies and poor debate form on display here to appeal to my authority. Reader – let me assure you of one thing: Hari went easy on mental health professionals. Really, really easy. Probably, I assume, because he wants to be granted interviews and access for future books.

I don’t know the truth. Almost all clients I have seen have depression. It’s a vague, foggy, hazy, indefinable beast that ruins lives in its own way. Our current confused sentiments are not, honestly, much better than Burton’s 1000 page + musings on melancholy. Anti-depressants work, in their own way. They have saved many lives. As do, by the way, socially reconnecting, finding meaningful hobbies, starting to see the future better, changing your values, all of the things that Hari talks about. But the basics also work, and they are the most important: sleep and diet. But then we get dicey again. Where does that moment happen? Does depression lead to poor sleep and diet, or the other way around? What about the ones that sleep well and eat well but are still chronically depressed? You pose one thing in this field and you’re sliding down a vortex. Pitchforks are out by readers, academics, and practitioners. As they should be! This is an important topic.

I think a fair review of this book, one that is well reasoned out and lists all the strengths and issues with the book, is Emily May’s. I will point you to that instead, because she has done it superbly already.

I think it’s good that we are engaging in dialogue here, because that will ultimately get us closer to helping those that need it. This is a great book in explicating some key issues in the field, but does get a tiny bit out of hand when he is diving deep into Big Pharma territory, or when Hari is waxing poetic and pathetic by saying things like how we should overcome the issues of social status and biological hierarchy “because we’re humans”. None of my issues with the book were left untouched by the author – he did provide caveats to most of his arguments, and they felt like more than just lip service. There is not too much controversy, in my opinion, by saying that anti-depressants are not the only answer (key word: only, though how he presents his arguments sounds like he is waging war on them at times). He gets a bit Paulo Coelho when he is posing ways to overcome depression. Again, nothing wrong with what he is saying: if you live a lifestyle that follows his path, I can almost guarantee that you will not have depression. Can most people live such a life? No. Is it realistic? No. Is our society set up to ease that way of living? No. Are the systems around us contributing to a healthy life? No. He does mention this here and there, but I just want to underline it.

Ultimately, the narratives we have about ourselves and our lives are important in propelling us on. One of those narratives is about how we are doing, why we are or are not healthy, and how to fix that. One of the ways in which anti-depressants help, as is well-documented in the literature, is by allowing us to have a handle on the fact that our brains aren’t just randomly going haywire, that there is a tangible cause. This is a key portion in healing. Another key part, however, that should be done in tandem, is looking at patterns of living, the systems we are embedded in, the things we do from the moment we open our eyes until the moment we close them every 24 hours. This part is far more difficult, will require help, and takes much, much longer.

[Ayse_ · Rating 5 out of 5]

This is such a beautiful book that lays out the real reasons behind depression, the lies of pharmaceutical industry, the indecency of the so called scientist; and also shows us, providing real-life evidence on why people get depressed and how to deal with it.

In our day, the amount of scientific data that is published but cannot be replicated, has reached to the level of 80-85%. And the real ratio can be even worse than this. We see these kind of lies and schemes in all areas of medicine from cardiovascular to women`s health.

The other issue is the systems that treat people like cogs in the mill. Unless the people find a way to unite for what is good and true and fight for their rights as we see in the examples of Kotti and the Mitchells, this misuse and abuse of power will continue to augment and accelerate; and we will continue this sleepwalking supported by the media, tabloids and companies.

Written from a journalist/reporter`s point of view and life-long experience with depression, this book is a must read for psychiatrists, social workers, psychologists, leaders and anyone who has the courage to see what the misinformation clouds are hiding in this business.

It is also a very uplifting and humanitarian book, highlighting the fact that we are very similar in basics, and indeed semi-divine when we can unite and focus on real values.

[Margarita Garova · Rating 4 out of 5]

Откривам, че ми е по-лесно да слушам нехудожествени аудиокниги, отколкото художествени такива. Тази обаче е достатъчно важна, за да си я има човек и на хартия. Вероятно ще изненада мнозина с изброяване на причините за депресията, сред които биологията и генетичната предразположеност имат много малка роля. Социалната среда, безмислената работа, липсата на пълноценно общуване и културата на материализма допринасят за това твърде много хора да се чувстват тревожни, изгубени и потиснатни. Част от решението, разбира се, не е връщане към някаква отминала златна епоха с нейните къде реални, къде имагинерни ценности, а изисква колективни усилия, намирането на смисъл в това да си полезен за другите и общността, доколкото самовглъбяването не е помогнало на никой никъде никога.

[صان · Rating 4 out of 5]

کتاب خیلی فوق‌العاده‌ای نیست، اما خوندنش رو تقریبا به همه پیشنهاد می‌کنم؛ اما چرا؟

در این زمانه همه یا افسرده‌ایم یا مضطرب. کلی آدم می‌شناسیم که داروهای ضد این‌ها رو مصرف می‌کنن. خود من تا به حال دو دوره در زندگیم این داروها رو مصرف می‌کردم.
ایده‌ی کلی این کتاب اینه که اثربخشی داروهای ضدافسردگی، اونقدری که فکر می‌کنیم نیست. معمولا توی مطالعات بالینی دارویی، اثربخشی دارونما -پلاسیبو- به اندازه‌ی دارو بوده. از طرفی فاندینگ این مطالعات هم معمولا شرکت‌های دارویی بودن. برای همین نمی‌شه خیلی روی اثربخشی‌شون حساب کرد؛ البته که اثر بخشی دارن، مخصوصا در کیس‌های شدید، اما حرف کتاب اینه که حالا بیایم جز دارو، به چیزهای دیگه‌ای که می‌تونن کمک‌کننده باشن در درمان فکر کنیم.

کتاب میاد می‌گه عوامل روانشناختی و اجتماعی‌ای وجود دارن که می‌تونن موجب به هم ریختن تعادل نوروترنسمیترهای مغز بشن که بعدش افسرده یا مضطرب شیم. طبعا با خوردن دارو می‌تونیم اون تعادل رو برگردونیم و حال بهتری داشته باشیم، ولی چون اون عامل اولیه رو درمان نکردیم، این درمان واقعی نیست و مثل یک مسکن می‌مونه.
کتاب به دنبال اون عوامله! ارتباطاتی که از دست دادیم و از دست دادنشون باعث شده افسرده بشیم و دارو به تنهایی نمی‌تونه ردیفمون کنه. باید توی سبک زندگیمون هم تغییر بدیم و به انتخاب‌های دیگه‌مون هم فکر کنیم.
نقطه‌ی قوت کتاب، استنادش به تحقیقات علمیه. هر پاراگرافی که میاره، یه لینک داده به یه مطالعه و بر اساس اون نتیجه‌گیری کرده. تنها نکته‌ای که باعث می‌شه این کتاب ارزش خوندن داشته باشه هم همین مستند بودنشه. البته بعضی از این مطالعات کمی قدیمی هستن و این ماجرا خیلی خوب نیست، اما تعداد زیادی‌شون هم قدیمی نیستن و بهتر می‌شه روشون حساب کرد.

تا اینجا خوبی‌های کتاب رو گفتم. ایده اصلیش و این که چرا خوندنش مفیده. اما حالا بدی‌هاش.

لحن کتاب خیلی شعاری و زرده. هر لحظه ممکن با خودتون بگین این چه کوفتیه که دارم می‌خونم. (حالا نه انقدر اغراق‌آمیز :))) ) اما ناامید و دلسرد نشین. من فکر می‌کنم که نویسنده خیلی قلم قوی‌ای نداشته و نتونسته کتابشو جذاب بنویسه، اما چیز مهم اینه که این اغراق‌ها و کلی‌گویی‌هاش، مطالعاتشو مخدوش نکردن. یعنی هر حرفی زده، سندش رو اورده و چیزهای مهم رو روی هوا نگفته. چیزهای چرتی رو روی هوا گفته، اما اون چیزهای چرت تاثیری توی مطالب علمی کتاب ندارن و به شیوه‌ی دید نویسنده مربوط می‌شن. مثلا این که می‌گه دکترها به حرف بیمارا گوش نمی‌دن و فقط دارو می‌دن. خب غلطه. یا حرف‌هاشو یه جوری می‌زنه که هیجان‌‌انگیز باشن و در راستای این یه درام اضافی‌ای به کتاب تزریق می‌کنه. حرف من اینه که تمام این لفاظی‌ها، ارزش مطالب اصلی کتاب رو دارن.

اما ترجمه‌ی آقای قراچه داغی و نشر پیکان.
بزرگ‌ترین آسیب این ترجمه، اینه که تمام پانویس‌ها و ارجاعات کتاب حذف شده. در ترجمه‌ی کتاب، هیچ لینکی نمی‌بینیم. هیچ مقاله‌ای نمی‌بینیم. این خیلی بده، چون تنها نکته‌ی مهم کتاب هم همین مقاله‌ها و مستند بودن‌هان. وقتی به چیزی آدم شک می‌کنه، می‌تونه بره و مقاله‌ای که پیوست شده رو سرچ کنه و بخونه و خیالش راحت شه که نویسنده این حرف رو از خودش در نیورده یا تصور نویسنده رو از نتایج یه تحقیق راستی‌آزمایی کنه.
نمی‌دونم چرا حذف کردن.

در ترجمه، بخش‌هایی از کتاب هم حذف شدن. البته قسمت‌های آسیب‌زنی نبودن، ینی از حرف‌های کتاب چیزی حذف نشده و فکر کنم برای این بوده که مثلا حجم کتاب خیلی نشه.

و در نهایت کتاب پره از غلط‌های ویرایشی. عدم تطابق فعل، گم شدن یه جمله، یا چنین چیزهایی. منظورم از پر این نیست که توی هر صفحه غلط می‌بینید، اما به نسبت یک کتاب زیاده. فکر کنم علت اینه که وقتی بی‌پلاس می‌خواسته این کتاب رو معرفی کنه، این نشر تصمیم می‌گیره ترجمه‌ش کنه و مجبور می‌شن سریع این کار رو انجام بدن و روی ویرایش وقت نذارن و نتیجه بشه این.
امیدوارم در چاپ‌های مجدد این کتاب، هم ارجاعات زیباش اضافه بشن و هم این غلط‌ها کمتر.

حرف‌هام تموم شد.

[Holly Loucks · Rating 2 out of 5]

Hari’s attempt to brainwash people into thinking socialism is the cure for depression, completely taints the rest of what-would-be legitimate arguments. I wanted to give Lost Connections one star because of how infuriating it is that Hari politisizes depression.

BUT, when I reflected at the end of this book - it did connect some dots in my own struggles.

I did like the point that Hari conclusively makes that “pain is our ally.” We NEED the painful emotions as symptoms & signal to show us that something is wrong. It’s a warning.

As well as the idea that minimizing grief to a short timeline minimizes the love we had for a loved one now gone.

Who would I recommend this book to? Employers. There’s a wealth of information & research that an employer could apply to work environment.

[Cindy Rollins · Rating 2 out of 5]

At times I almost liked this book. There are a couple good takeaways about materialism and our egos in an ago if social media, but the pseudoscience undoes most of that. The author seems to think “I thought about it a lot” is some sort of scientific evidence. Finally, he reveals a political agenda which is based on these “thoughts.” This is the future. Emotionalism parading as science.

[Петър Стойков · Rating 4 out of 5]

Както съм казвал многократно, има някои идеи, които са толкова глупави, че само много умни хора могат да вярват в тях - защото умните хора далеч не са по-рационални от всички останали, просто имат много повече умствен капацитет, с който да успяват да се самозаблуждават и да убеждават останалите, че са прави и да крият както от тях, така и от себе си грешките в мисленето си.

Една такава идея е, че депресията е болест на мозъка, която изисква третиране с лекарства, продължаващо с години или дори цял живот.

Явно мисълта, че когато човек е депресиран, най-вероятно нещо (или много неща) в живота му не са както трябва, е прекалено простичка за за големите учени психиатрични мозъци, поради което те старателно я избягват и опровергават в продължение на десетилетия и тъпчат хората с лекарства без изобщо да им дават каквито и да е съвети, че може би трябва да променят нещо в начина си на живот

Все едно когато някой е дебел да му даваш хапчета за отслабване, без да се интересуваш той яде ли много, спортува ли, има ли някакво ендокринно заболяване и т.н. Резултатът от медикализацията на депресията, разбира се, е ръст на депресивните заболявания в целия "западен" свят в небивали размери, който няма никакво намерение да спада.

Йохан Хари е социолог и самият той страдащ от хронична депресия - затова се захваща да разглежда въпроса не от фармакологична, а от социална и човешка гледна точка. Ако човек е тъжен след загуба на близък или друго трагично събитие, значи може би е тъжен и когато целият му живот е трагичен - ако е самотен, нещастен, ако работата му е ужасно скучна, ако няма смисъл в живота, ако не общува с природата.

В автобиографията си от концентрационните лагери, Виктор Франкъл споделя, че въпреки ужасяващите условия там, хората които са оцелели не са били депресирани - това са тия, които са успели да намерят причина, която да им дава смисъл да се борят и да оцелеят.

Йохан Хари, освен социолог е, както 99% от социлозите, левичар и социалист и това си личи в голяма част от книгата, но не толкова, че да няма смисъл да я прочетете. Идеите му за причините за депресията не знам дали са революционни, но определено са новаторски и казват това, което подозирам повечето мислещи хора си мислят по въпроса.

За съжаление, втората част от книгата, посветена на решенията на гореописаните депресиращи проблеми, далеч не е толкова добра и това е резултат именно от политическите пристрастия на автора, който, според мен, не може да погледне отвъд тях за да прозре, че консерватизмът и традиционализмът имат далеч по-добри решения на поставените от него въпроси, отколкото му се иска да признае. Може би това е една от причините хората с "либерални"(в сащ така наричат левите) възгледи статистически да страдат от значително повече психични заболявания.

[Rebecca · Rating 3 out of 5]

Instead of a personal failing or a chemical imbalance, what if depression is actually a symptom of a sick society? That’s the central question Hari asks here. He pinpoints various ways in which we are fundamentally disconnected from other people and from ourselves: disconnection from meaningful work and values, from a traumatic past that still affects us, from status, from nature, and from hope for the future. He thinks society needs to address these basic human needs rather than just pointing hurting people towards pharmaceuticals.

I appreciated this quote applicable to smartphones: “If your picture of a perfect afterlife is being with the people you love all the time, [an Amish fella] asked me, why wouldn’t you choose today—while you’re still alive—to be truly present with the people you love? Why would you rather be lost in a haze of distractions?”

[Claire Vu]

Đọc xong gần 1 tháng rồi nhưng cứ đắn đo không biết phải cho cuốn sách này mấy sao, thậm chí là có nên giới thiệu nó với mọi người không...

Mình đã có một trải nghiệm tuyệt vời khi đọc sách, thậm chí còn tự tin khẳng định cuốn này sẽ nằm trong top sách của năm nay.

Sách giải đáp những câu hỏi mà mình thắc mắc về trầm cảm, củng cố những điều mình biết, và gợi mở cho mình một góc nhìn khác về một vấn đề cũ. Đặc biệt là, tác giả làm tất cả điều đấy với cách viết dễ hiểu và cuốn hút. Lâu lắm rồi mình mới có cảm giác đọc một cuốn sách và quý mến người viết đến thế.

Đây cũng là cuốn sách hiếm hoi mình thấy ưng cả bản gốc lẫn bản tiếng Việt. Trừ một vài đoạn dịch như hất cùn thì bản Việt khá mượt. Điểm trừ duy nhất của bản dịch là không đánh số thứ tự (endnote) ở các nguồn trích dẫn. Vì vậy rất khó để đối chiếu với reference list dài dằng dặc cuối sách, và gần như bất khả thi để fact check (kiểm chứng).

Sau khi đọc xong sách và tiến hành tìm hiểu về tác giả, mình biết được tác giả từng có nhiều "phốt" trong quá khứ, bao gồm fabrication (bịa đặt thông tin), plagiarism (đạo văn), và đáng buồn nhất, là đặt điều về những người phản đối ông ấy.

Khi biết được những thông tin này, mình buồn tới tận bây giờ. Đương nhiên mình biết là phải tách biệt tác phẩm và tác giả. Nhưng mình thực sự không thể đảm bảo những thông tin trong sách có thật không, hay lại-là-một-sản-phẩm-của-trí-tưởng-tượng. Cuốn sách có vô vàn dẫn chứng là các nghiên cứu khoa học, những cuộc phỏng vấn với các giáo sư đầu ngành về tâm lý. Còn mình thì ko thể fact check tất cả được. Mình cứ nghĩ mãi, liệu có nên giới thiệu về một cuốn sách mà bản thân mình còn chưa chắc chắn? Và mình quyết định, bài viết này sẽ nói tất cả những suy nghĩ, tốt và xấu, của mình về sách.

Trong trường hợp lạc quan nhất: Tác giả đã hoàn lương và tất cả những gì ông viết đều là sự thật to the best of his knowledge, thì đây là một cuốn sách rất ổn áp. Tác giả đặt câu hỏi về các nguyên nhân thực sự của trầm cảm. Trước giờ vẫn có một quan niệm phổ biến nhưng sai lầm, rằng trầm cảm là do sự mất cân bằng các chất hoá học trong não bộ, và cách giải quyết phổ biến nhất là kê thuốc. Nhưng tác giả đã thách thức cả ngành công nghiệp dược phẩm khi nói rằng: Ứ phải, đây chỉ là chiêu trò của công ty dược nhằm thu lợi nhuận từ việc bán thuốc nữa.

Vậy nếu trầm cảm không phải do sự mất cân bằng trong não bộ, thì là do cái gì? Theo tác giả, nguyên nhân thực sự có thể tóm gọn trong 3 từ: Mất kết nối. Và cuốn sách sẽ chỉ ra các loại mất kết nối khác nhau (ví dụ, công việc, thiên nhiên, v.v...), đi kèm với những câu chuyện/buổi phỏng vấn, những nghiên cứu chỉ ra correlation (mối tương quan) giữa sự mất kết nối và trầm cảm.

Ko phải mọi điều tác giả nói cũng mới mẻ với mình. Ví dụ như thông điệp "trầm cảm là cách cơ thể gửi tín hiệu với bạn để báo rằng nó đang ko ổn" mình đã từng biết qua bộ phim tài liệu "The Wisdom of Trauma" (phim rất rất hay - highly recommended).

Nhưng có một góc nhìn tác giả đưa ra đã khiến mình phải dừng lại và suy ngẫm: Trong một thế giới mà trầm cảm vẫn còn chưa được công nhận, người ta nỗ lực nâng cao nhận thức về nó bằng cách nói nó là một bệnh, để từ đó bình thường hoá việc chữa trị. Đấy cũng là cách tiếp cận trước giờ của mình khi truyền thông về trầm cảm. Tuy nhiên, nói cái gì đó là một căn bệnh sẽ dẫn đến việc phải dùng thuốc để chữa bệnh. Vậy nếu thuốc ko phải là cách giải quyết thực sự thì phải làm sao, nhất là khi thuốc đem đến nhiều tác dụng phụ cho người dùng? So sánh là vô cùng, nhưng mình nghĩ giống kiểu bạn bị ho vì không đi tất. Việc uống thuốc có thể giúp dập các triệu chứng, nhưng nếu bạn vẫn không tìm ra được nguyên nhân thực sự để giải quyết nó (ở đây là không đi tất), thì việc dập các triệu chứng chỉ là giải pháp ngắn hạn. Sớm muộn gì bạn cũng sẽ bị cảm lại.

Ko nên coi cuốn sách này như một cái phao cứu sinh. Vì kể cả trong trường hợp tác giả có đang nói thật đi chăng nữa thì những kết luận của ông vẫn còn mang tính sơ khai, rất rất sơ khai, chỉ mang tính tham khảo. Mục đích của tác giả khi viết sách không phải để chứng minh ông đúng và mọi người hãy làm theo những gì ông nói. Ông muốn mở ra một hướng tiếp cận mới, từ đó kêu gọi thêm nhiều nghiên cứu sâu hơn để kiểm chứng, củng cố, hoặc bác bỏ những giả thiết của ông.

Nhưng đâu phải chỉ vì một thứ chưa được kiểm chứng mà chúng ta ngay lập tức ngừng suy nghĩ về nó, đúng ko?

[Juliet Rose · Rating 4 out of 5]

Solid solutions in this book though at times I felt it got sidetracked in stories. The research and time to gather information was apparent and I learned a lot reading it. I think anyone dealing with depression/anxiety should read this and those working in the field should consider this perspective.