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Lost Connections

Uncovering the Real Causes of Depression - and the Unexpected Solutions
Narrated by: Johann Hari
Length: 9 hrs and 20 mins
4.5 out of 5 stars (4,020 ratings)

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Publisher's Summary

From the New York Times best-selling author of Chasing the Scream, a radically new way of thinking about depression and anxiety.

What really causes depression and anxiety - and how can we really solve them? Award-winning journalist Johann Hari suffered from depression since he was a child and started taking antidepressants when he was a teenager. He was told that his problems were caused by a chemical imbalance in his brain. As an adult, trained in the social sciences, he began to investigate whether this was true - and he learned that almost everything we have been told about depression and anxiety is wrong.

Across the world, Hari found social scientists who were uncovering evidence that depression and anxiety are not caused by a chemical imbalance in our brains. In fact, they are largely caused by key problems with the way we live today. Hari's journey took him from a mind-blowing series of experiments in Baltimore, to an Amish community in Indiana, to an uprising in Berlin.

Once he had uncovered nine real causes of depression and anxiety, they led him to scientists who are discovering seven very different solutions - ones that work. It is an epic journey that will change how we think about one of the biggest crises in our culture today.

©2018 Johann Hari (P)2017 Audible, Ltd

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Are we turning the corner....

....on the epidemic of depression and anxiety?

With the number of people afflicted by depression and anxiety ever rising, this title really caught my attention. And while the title may raise hopes (and for some, skepticism), it actually provides an interesting account of Johann Hari’s personal story and his exploration of the causes of and solutions for depression. That may be enough for some to make this book worthwhile, but it actually offers a lot more.

Hari’s finding, primarily based on publicly available research and hundreds of interviews, is that depression / anxiety is more a social phenomenon and less a biological / psychological one (using the bio-psycho-social model generally accepted by most mental health professionals / researchers, he doesn’t get into gut micro-biome, etc). He cites a wide range of research in this regard, such as Robert Sapolsky’s long-term study of baboons, Martin Seligman’s study of the Amish and many, many more. Hari goes on to say that many cases of depression / anxiety are a normal reaction to people’s individual situations and that the current ways of diagnosing depression (e.g., the DSM) and prescribing medication need to be reconsidered. But perhaps the broader message is that the increase in depression / anxiety is based on the way our society has changed. Lots of reasons cited / suggested for why this is the case, but generally, we have become disconnected: from people, nature, our work, our values, and others. Probably not a shocker for most, who experience this in some manner on a daily basis.

Hari goes on to highlight many successful programs / strategies where these connections were re-established and how this improved the overall well being of the individual and in many cases, their larger community. He also broaches the big question of what is, or could be, an anti depressant. In other words, why do so many restrict their definition of anti-depressants to pharmaceuticals?

And while his title may be setting a high bar, the book does not in actuality claim to know all of the real causes and solutions to depression. This is a really difficult subject for most individuals, but also for our society at large. If one approaches it with an open mind (I think I did) there is a great deal of information and perspectives in it which many will find useful.

Many will benefit from reading this book and I recommend you do so.

154 of 160 people found this review helpful

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Must read

For those of us who have experienced depression as a personal crisis, and for all of us who need to recognize it as a public health crisis. Hari is a brilliant investigative journalist (see Chasing the Scream, about addiction) who brings his personal experience, taut and engaging research style, and profound empathy to this widespread but yet hidden malady. The medical and pharmaceutical model of depression is just not supported by the research, and Hari discusses 9 other causes/contexts for understanding depression that are backed by scientific evidence. From the treatment perspective, not much mention of CBT, DBT or mindfulness practice might be a flaw in the book to some. Current practices in psychiatry and psychology are not quite as drug reliant as Hari suggests. But almost. For a book about such a weighty and, yes, depressing topic, it trips along like an adventure story as research findings are tracked down and humane and personable scientists are interviewed. The narration is pleasant, earnest but never harping. Well worth the credit on all counts.

133 of 143 people found this review helpful

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Heartfelt, but not convincing

Johann Hari goes in search of why we, as a society, have skyrocketing numbers of people who are depressed or anxious, and are on prescription medication as a result.

The solution is not in medicine, but in restoring our ‘lost connections’. Much if this feels real and commonsensical. But an alarming amount of it seems convenient. He visits a center for obese people and a woman immediately tells him she was raped, and has been obese ever since as a defence mechanism. Another man tells him something very similar. It’s all black and white, cause and effect, and a lot of reads like the worst pop psychology.

It’s very pleasing that Mr Hari appears to have found a solution to his own depression and anxiety. But I was yearning for him to acknowledge that this issue is incredibly complex and won’t necessarily be resolved by people talking to their neighbors or climbing a mountain. That didn’t happen.

170 of 186 people found this review helpful

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good start to untilmately disappointing finish

this book started with all the right ingredients. beginning with a healthy skepticism for the earlier narrative on depression that deserves to be challenged. However, the author then decided to move from one simple answer to yet another simple answer. And, no surprise, simple answers that he is now totally convinced of happen to align with all of his personal politics. Meanwhile he ignores all the other evidence for other social structures that already exist that provide exactly the kind of relief that he claims we need to follow his political recommendations in order to achieve. though he did research for this project, his search did not go far enough, nor was he open enough to find the truths that were already sitting there in plain sight.

17 of 18 people found this review helpful

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Interesting Perspective

The author has an interesting perspective on depression. As someone who has been working with people who struggle with the disorder for years, there was not much new. At times, he would discuss his own frustration with the treatment he received and it seemed as if he wrote the book to say he received bad treatment (which he did). This became tiresome at times.

18 of 20 people found this review helpful

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This book is about more than just depression.

this book is full of great information about the causes of depression. But it's also a book with a bigger idea; an idea about changing our society, changing our culture, changing the way we think about the things that we need as human beings and some ideas about how we might be able to put them back into our lives.

41 of 47 people found this review helpful

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Pretty good until the last couple of chapters

The author offers some interesting theories as to the causes of depression and what to do about it. Many of them seem to be valid, however I would caution anyone who reads or listens to this book to keep in mind that this information is just one source of information on a very complex subject. Hari feels that antidepressants have been over-prescribed, and that may well be the case. But it should be noted that for some individuals, medication is absolutely necessary and in some cases life-saving. The recommendations that Hari makes with regard to reconnecting with your outside world are all very good suggestions. Where I had the problem was when he started to push his social agenda toward the end of the book stating that if we could just give everybody a guaranteed income that that would somehow solve the depression problem. Seriously?!? That simplistic utopian view was where I felt he went off the rails. He should have kept his social/political views separate from this issue. We already have too much political divide in our lives, and politics may well be a contributor to our overall depressive state these days. Skip the last couple of chapters - the rest of it is ok.

77 of 89 people found this review helpful

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I cried

What did you love best about Lost Connections?

How personally familiar I felt with the Author's story. In so many ways we are all the same.

What was one of the most memorable moments of Lost Connections?

When Johann Hari walks us through his experience with losing a child. I've lost twin boys who were very premature and my wife and I three years later still weep on occasion. Hari goes on to ensure us that pain is our connection to their life. We don't want to lose that connection. We don't want to forget their names and their faces. It's human nature to feel sadness after experiencing loss many years after the occurrence despite what DSM thinks.

What about Johann Hari’s performance did you like?

When Johann shares his experience with loss you can almost hear the pain in his voice. It helped me connect with him. Also his narrating voice is spot on and he speaks clearly.

If you were to make a film of this book, what would the tag line be?

Human Nature-A closer look into the human experience

Any additional comments?

Incredible. The words can't describe how thankful I am for Johann to share his story. To share insight. To ask questions and show his findings. And thank you for your podcast with Joe Rogan. Very informative. Thank you.

27 of 31 people found this review helpful

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World-changing ideas

This book is a long overdue shift in the beliefs that we have about depression. Bottom line: Anxiety and depression are vital messages to show us what's wrong in our lives. It's not caused by our "faulty brain chemistry". It's caused by our collective denial of basic human needs. Thank you for writing this book.

25 of 29 people found this review helpful

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Good book. Too much personal story for the topic.

There is a great deal to be learned from this book. Especially regarding the insane modern approach to depression. But he strays well into neo-Luddism with some of his stories. Especially the, "noble savage" segment about the native Americans, whose war mortality rate was upward of 25%. Depression is a real problem, but a little perspective is in order. With starvation, war and murder all at all time lows in human history, a return to the bloody past is hardly a recipe for success. But if you ignore this, and focus on the facts, you will learn a lot.

33 of 39 people found this review helpful

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  • Amazon Customer
  • 10-16-18

Let down by a very poor last third

I bought this on the recent Audible Deal and thought that it might help with my anxiety and depression.

I enjoyed Part 1 (why anti depressants shouldn't be given as much as they are and don't actually appear to have benefits for most people, but do have side effects) and Part 2 (what are the causes of depression if its not a chemical imbalance and what can we do that might work better). Both parts had scientific research and experts quoted. However, Part 3 (lost connections?) was a pretty rambling, unfocused waffle which went on at great length about a German housing group's issues and other tales (like using psychedelics) which had little - if any - scientific backing for the conclusions he came to. He would tend to have someone say "this could be of benefit" and run with that as though it was the greatest cure even though it was one person's opinion on (usually) one and only one example, the efficacy of which was frequently subjective. By the end of Part 3, I was fed up of listening to Johann and could understand a previous comment about him having a leftist agenda as it felt to me that this part was using very sketchy at best evidence to support his beliefs and world view.

Pros:
Part 1 provided interesting information as to how drug companies have manipulated trial information and the system to get their drugs on the market when they show little benefit but have been shown to cause harm. I found this enlightening.

Part 2 provided a good list of possible social and environmental causes and what you can do to improve your symptoms. I think I will listen to this again.

Part 2 had a lot of direct references by the people he'd interviewed and a lot of facts and figures (as did part 1)
Parts 1 & 2 had a lot of quoted scientific evidence

Cons:
Narrator: Johann Hari shouldn't have narrated this himself. He's not a professional and it shows. At times he was poor and by the end I was sick of his melancholy voice.

Swearing. There wasn't a lot, but why was it needed at all? It might be quoting someone, but it was jarring and really put me off.

Mealtimes: I don't want to know what Johann was eating when he was interviewing someone. Might be his "chummy" writing style but I really don't care about it and it's not why I got the book. He was always saying what he was eating.

Overly Personalised: Some elements (most of Part 3 was guilty of this) were much too personalised and his own journey with AD's coloured his perception too much and biased his opinions too clearly. For instance, there are many side effects to AD's, but he focused on weight gain as it was the major one for him. Not a mention of suicidal or angry mood swings for instance which are much more devastating. I also read this book with no idea who the author was. Part way through Part 3 I was asking myself "what has any of this stuff about a gay bar have to do with depression?" and later wondered what the tale about the guy who wanted gay marriage had to do with it. I now know that he is gay and I guess that's why he felt I needed to know what the gay bar owner's other clubs were called in a book on depression.

CBT: In part 3 in just one sentence he dismisses CBT saying "there isn't any evidence that it is of benefit to people with depression" (or words to that effect), which a very quick and cursory Google shows is utter nonsense. If that was the case, then why does the NHS advocate it? I've just spent a month studying the efficacy of CBT and I know his flippant claim to be untrue and it makes me concerned about the rest of his claims.

Metaphors: At times the metaphors he used made me cringe.

Bookending: The first chapter struck me as irrelevant and I wondered why it was included. I found out at the end of the book it was so he could refer back to a single line in that chapter (listen to your body and don't mask it) at the end. It felt contrived... like too much of the book.

In summary, had I stopped reading the book at the end of part 2, then I would have rated it much higher. Part 3 seemed to be a waste of my life and a fairly desperate attempt to make the points he wanted despite the lack of compelling evidence for his views.

35 of 38 people found this review helpful

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  • Bailey Jayne
  • 03-15-18

Don't buy if you have depression and no support.

Very interesting read, possibly for people trying to understand the disease. But this book has made me more depressed.
The author talks about how you need a support system to help you manage your mental health, so as someone who has no one this book made me feel like I will never recover.

137 of 154 people found this review helpful

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  • Andy T
  • 10-04-18

One mans story

Although a lot of hard graft has gone into this book. And we’re all looking for a simple solution. This book, if taken seriously, will cause some truly ill people a false sense of hope.

It’s concerning that those in a dark period may adhere to the subjective advice and ruin their life.

It’s true, doctors to hand out pills to too many who are not clinically disabled through depression.

Having witnessed a family member commit suicide and her father fighting depression, his medication is keeping him balanced and alive.

One time he had a church tell him he was cured through their prayer meeting. The very next day he was in a police cell due to the consequences of not taking his medication for depression.

The change from the original diagnosis after taking medication enabled him to live a full life. Due to stopping his meds’ he lost his home, wife and children.

Read the book, but please do not put blind faith into one mans misdiagnosis. It’s not an exact science, though it is a life saving one. My brother is still alive today, only because of medical intervention.

I too wrote off big pharma as snake oil. Yet here in England the research by NICE and the university’s is deep and thorough.

The book could cause unintentional and unneeded suffering.

A good support network, though great as it is, everyone has an opinion, everyone reads the latest on the internet, the latest greatest book of the moment. Meanwhile the poor person suffering from depression gets more confused and being vulnerable will try to pleasing everyone’s opinion whilst in internal agony.

It’s an enjoyable read but one mans misdiagnosis has to be seen as a subjective opinion of what the authors bias is.

78 of 88 people found this review helpful

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  • A. M. Costa Correa
  • 03-25-18

Ok but not life changing

Starts off well but meanders. It won’t change your life or clear your depression but it’ll pass a few hours telling you what you suspected all along.

6 of 6 people found this review helpful

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  • dc
  • 08-02-18

Well Argued.

In comparison to Chasing the Scream it’s not as interesting a story. However, Johann makes an eloquent argument for changing the way we see and treat depression. Although nothing in this book is particularly new to me (I’m in the healthcare field) he does a good job of pulling the strands together. My only real criticism is he spends too little time directly quoting his interviewees and too much time on his analysis of what they have said. I think it would have been stronger to let their statements speak for themselves the the listener draw their own conclusions.

3 of 3 people found this review helpful

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  • Annie crabtree
  • 02-04-18

Highly recommended.

I was wary of listening to this book as I am always wary of simplistic “answers” to depression and anxiety. But this was not that. It is a beautifully put together, well researched, considerate and open minded look at anxiety and depression. I found it interesting from an intellectual perspective, enlightening and reassuring from a personal perspective. Highly recommended.

23 of 28 people found this review helpful

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  • Gillian
  • 02-13-18

#lifechanger 🙏🏻💗🙏🏻💗

After winning my first ever award from Audible (listening to the most books) for my ongoing search to quieten my constant internal chatter by having audible play through the night consistently for the past 1 1/2 years I have finally found the answer to my misery! This book is a must for anyone with a busy & beautiful mind.

38 of 47 people found this review helpful

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  • Suswati
  • 03-19-18

Sentiment is worthy but not cohesive

Johann Hari has delved into the world of depression and psychiatry, revealing his own battles with the condition and attempting to debunk approaches towards mental health. His intentions are worthy as it is a dense topic of discussion, and absolutely essential, but unfortunately Hari only focuses on one side.

His views on overprescription are completely accurate as many mental health professionals have a tendency to equate behaviour as a science, therefore looking towards traditional methods of treatment. However, his views that depression is totally reactive to environment is incorrect as many with other serious conditions such as schizophrenia and bipolar, would have "endogenous" depression ie. where something goes wrong in the brain.

Much of this book concentrates on the disconnection from vital human requirements such as neighbourliness, professional fulfillment, acknowledgement of trauma and so on. His approach suggests that reconnecting may help the malaise. While I agree with half of his argument, others may find it oversimplified. But no doubt we do need a more compassionate attitude towards mental health.

6 of 7 people found this review helpful

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  • Liz Tucker
  • 01-29-18

Brilliant

Well worth a read / listen if you suffer from or have suffered with anxiety and or depression. At some points I felt somewhat despondent because my parameters to change are narrow but I'm glad I perservered. This book gives you hope, a new perspective and something to work with. Fantastic work.

14 of 18 people found this review helpful

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  • Amazon Customer
  • 05-07-19

Journalist explores his own psychological pain

An interesting attempt to identify some of the economic and social contexts of psychological distress, and to think through ways of creating a world less toxic to our well-being.

However, he does this by setting up straw men to knock down. He makes much of medicine’s belief in a chemical imbalance theory of depression (which will seem alien to most of those who work in the field), whilst also reporting that psychiatrists have for decades proposed alternative models which attend to the person’s social, psychological, and physical situations.

There is a clear association between housing, jobs, environments, politics and mental ill health, but these aren’t things that are easily changed in the surgery or therapy room.

I thought the early section on medication was dreadful. Quite shockingly bad. I can’t see his footnotes on Audible, but he appears to rely entirely on two very critical writers, both interesting and challenging though they are, but without any effort to explore other researchers, other evidence, or other conclusions. That’s polemic, not journalism. He doesn’t even describe the critical literature on the distorting role of drug companies research, not that all research is undertaken by Big Pharma.

Considering this is a book about anxiety and depression, it seems odd that he doesn’t actually define what these highly complicated things might be, except in so far as they may relate to our evolutionary history.

What a mixed up, interesting, disappointing book.

1 of 1 people found this review helpful

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  • Anonymous User
  • 02-19-18

Fantastic concepts

I loved it, a great overview of the research and literature investigating depression and anxiety. As someone who has suffered from multiple mental health issues over time this was refreshing to hear. Highly recommend.

12 of 15 people found this review helpful

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  • Anonymous User
  • 01-26-19

Interesting

I found this book quite helpful in simple ways like pointing out some obvious points. I enjoyed all the scientific studies he uses to back up his claim - however, like all biased books, please remember that they have been cherry picked.
Overall, I love that this book has come out to say what it has and it is important for people to realise that depression is a symptom, not a disease (in my opinion/research into the matter).
Well done.

2 of 2 people found this review helpful

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  • Amfo
  • 03-17-19

Interesting to begin with but went off the rails..

Author started well with the narrative constructed around carefully selected scientific studies. However, as the book progressed the author's political views started to replace academic sources as the basis upon which the narrative was based. By the end I'd had enough of the socialism cures depression line being pushed. Antidepressants sure don't cure depression but neither does repressive government intervention into every aspect of people's lives which is what the author idealistically advocates.

7 of 9 people found this review helpful

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  • Sharon
  • 02-08-18

Amazing insight into depression and anxiety

Amazing insight to how we can help people with depression. Lots of info about studies done in this area. We need the whole community to help. Thanks Johann for looking into this area with much thought and research.
I couldn't stop listening this this book.

7 of 9 people found this review helpful

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  • Michael H
  • 06-17-19

Some good ideas, a lot of incomplete science.

There is no doubt that many of the ideas in this book will be really helpful to a lot of people. People who have low to moderate depression will really benefit from this book. Sadly this book will not be helpful to people with severe depression or complex trauma. There are far too many places where Harri offers an oversimplified approach, for example he says if you have experienced childhood trauma, name it and you can move on. In reality trauma is much more complicated than this, it often requires medication to get people to a place where they can do the things he says. In some cases it requires months or even years of specialist treatment to get well. See The Body Keeps the Score by Bessel van der Kolk.

I am also concerned that a book like this would have the glaring omission of not talking about the importance of sleep, we have countless studies that show how poor sleep can trigger mental illness.

He says the Armish do the things he says and they are well. Yet a simple Google search will show that they do experience depression. Mental illness is immensely complicated and sadly this book offers fairly simple answers.

1 of 1 people found this review helpful

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  • Mike
  • 01-25-18

Johann Does it again

Love the book so much that i will buy it as a paperback too. The content is awesome, great stories. Johanns voice is way too soothing and hard to pay attention to specially when in a noisy environment. sorry johann, i loved your ted talk and interviews but your narration was a bit quiet. That is the only critique i have. Otherwise another masterpiece.

2 of 3 people found this review helpful

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  • Sue Svensen
  • 04-18-19

Angry

This book left me angry because it stigmatises the use of antidepressants. It should have a more balanced view and more research behind it.

4 of 7 people found this review helpful

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  • Elissa
  • 08-15-19

This is a book for anyone who is actually depresse

Brilliant description and thoroughly researched book about the causes of depression and how to fix them for yourself. No long descriptions about his own depression, which is a nice change. This is actually a book for anyone who is actually drepressed.

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  • Quentin Andrews
  • 08-12-19

Should have been two books

This was a good book, except that like some others have said it did go off the rails towards the end, without giving spoilers once a book starts deviating from ideas about how society is ill as as whole in it's functioning which causes some/many types of depression, and goes directly away from science into spirituality it should probably have been split into another book. One other issue is the use of genders to refer to generalised cases of victims of abuse, if the author isn't specifically referring to a particular person of a particular gender, they should have generalised the gender as "this person" rather than she, as this ostracizes other genders that may have identified with a particular narrative. It was a good book, but the last few chapters lost some steam by being repetitive and not scientifically grounded by a body of supporting literature.

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  • Earnest
  • 08-10-19

Hard to respond without feeling trite

Every story about people told by Johann , shook with resonance. The research was reassuring, but the stories..they live.
It’s not often that one visual image-that of the gentleman writing what he thought was to be his last book- and telling him what that book helped world thinking lead to - and not burst into tears for the truth.
And when “I” occurred in a list of the demeaned and enslaved, women, even now, it’s hard to stay sensible or unmoved.
I know now that we will all do what has to be done in our small way.