Raaid Reads - Lost Connections

What is it?

Lost Connections (opens in a new tab) by Johann Hari is oversold and smacks of "I'm writing about something I don't have expertise in". He makes bold claims about why you are depressed and why SSRIs don't work (he's wrong if scientific consensus is your barometer, and the NHS page on it (opens in a new tab) provides a wonderful overview of what we know). Don't get me wrong, he's clearly a talented writer and brings forth stories that many of us can relate to. Intuitively, a lot of the external causes of depression he highlights feel right, and often are a part of the cause. But to portray it as "society is bad, drugs don't work, it's a mystery that I have solved" is pretty reckless.

Why don't I like it?

A few years ago, Bloomberg came out with a story called The Big Hack (opens in a new tab). It got lots of traction. People in my (software) tech-y circles were reading it and amazed, and believed it. Me? Not so much. I (please don't read this as bragging of any kind, it's really just context that is necessary) have a degree in Electrical Engineering and worked at a robotics company for a year designing and prototyping circuit boards. I have used lots of different integrated circuits (ICs) in my designs, and have a general understanding of what is feasible. I was immediately skeptical of what the authors were outlining. But it was no use. My peers found it convincing, and of course Apple and the U.S. government were going to say that it isn't true.

I admire and respect journalists at large, I think they have a very difficult job. Hold truth to power, tell me when the politician is lying. Shed light on important things that we might otherwise not ever know. But this? I know about this. Your understanding of this fairly complicated space is lacking, and your confident explanation is reckless. I imagine this is how most any medical professional feels when reading Lost Connections.

My gripes

Hari highlights things like "disconnection from nature" and "disconnection from people" as true causes of depression. He cites research to back it up. Unfortunately, he exhibits rigor in the face of medication, but lacks this rigor entirely when discussing "disconnection". He dives into numbers for drugs, but takes statements (and even makes them) at face value when discussing "disconnection". He makes you feel, he humanizes, he hooks into your intuition, then misdirects you.

Do I feel lower when I go all day in my apartment, with no interaction, without seeing a tree, without moving my body? I do. To say that this is all novel, that it's a conspiracy to keep you hooked to pills, feels fairly conspiratorial to me. In my own experience (which isn't reflective of everyone's), my therapist asked about my support network, about diet, exercise, and sleep, about how much time I spend outside. The context does matter, and this professional made that very clear. For what it's worth, my doctor did prescribe pills pretty readily, but he did so knowing I was in therapy and my therapist and I agreed to try out medication at a particularly low point.

A lot of the research he cites about these "disconnections" isn't new, and is in large part accepted by the medical community. Again, the NHS has a great overview page (opens in a new tab) and mentions a variety of causes (from life-changing events to nothing at all) as well as treatments (exercise, therapy, medication).

Anyway, there is plenty of skewering of this book online already, as I learned after I finished reading it. Some of the experts he brings in have earned the ire of their peers for spreading views that aren't in line with evidence based scientific consensus. He was also fired from the Independent for various wrongdoings. As one last writing-based note, to call all of the environmental factors he lists "connections" is weak wordplay to tie together very disparate things that make up life. It feels forced, unnecessary, and incomplete.

The good bits

The societal phenomena he highlights are indeed important. he cites widely accepted research about how childhood trauma increases the likelihood of developing depression, anxiety, and other hurts. For people who haven't been made aware of the fact that their situation impacts how they feel, these are useful things to learn.

The stories told are also quite powerful. I particularly enjoyed the story about the folks in Germany who banded together to prevent their neighbors from eviction and how it turned into a beautiful transformation of a whole neighborhood and communities. These are beautiful anecdotes that arguably demonstrate something about how our context shapes our mental well being.

And despite the overstated bashing of antidepressants, I do think it is a good thing to not treat them like magic. They can have side effects, sometimes quite severe. They might not work for you. To look at their benefits as well as their drawbacks can only help us.

Why should you read it?

You probably don't need to bother at all. If you're interested in the stories he highlights of people finding meaning, of coming together, then go for it. Just remember to keep a skeptical eye over all the evidence provided, since much of it (even from the Harvard guy) is questionable or ill-sourced. Instead, I suggest The Mindful Way through Depression (opens in a new tab) which is written by 4 experts who are generally well regarded in their fields. Please don't take my word for it and look it up yourself if you'd like, but from what I have read mindfulness and meditation actually seem to have pretty good clinical results in helping some people with their depression (just like drugs). It sure helps me, at least.