When you are depressed and anxious, you get hit by two kinds of stigma. People will often say that you’re being weak or self-indulgent and just need to snap out of it.
But there’s a stigma that’s even worse than that: You tell yourself the same message. When I first became depressed, as a teenager, I felt that pain was leaking out of me and I couldn’t stop it. I explained this to my doctor in a state of crouched shame. I thought the problem was “all in my head” — meaning it was imaginary.
In Western society, we’ve been trying to fight this crippling stigma in one way. We tell depressed and anxious people: This isn’t happening to you because you are weak. It is happening to you mainly because there is a problem inside your brain.
Three decades after this approach began, where are we? Now 1 in 5 Americans has taken a psychiatric drug and every year, the depression and anxiety crisis gets worse, while the stigma isn’t shrinking. I spent three years researching this subject to find out why — and to see if there is a better way to find our way out of the stigma, and out of depression.
According to some of the most distinguished scientists in the field, depression is not caused by a chemical imbalance in our brains. The World Health Organization, in fact, finds that the causes are largely “social.” They are not primarily in our heads, but instead largely in the way we are living today. I found evidence playing out all around us.
For example, if you have no control over your work, you are far more likely to become depressed. If you are lonely, you are far more likely to become anxious. If you go through a traumatic childhood, you are 3,100 percent more likely to attempt suicide as an adult. This points to a very different way out of depression.
A South African psychiatrist named Dr. Derek Summerfield was carrying out some research in Cambodia when chemical antidepressants were first introduced there in 2000. He explained to the doctors what they were, and they replied that they didn’t need them because they already had antidepressants. Puzzled, he asked what they meant. They told him about a local rice farmer who one day stood on a land mine and had his leg blown off. They gave him an artificial limb and he went back to work in the fields, but he began to weep all day and became depressed.
They went to talk to him. They saw that he was in a lot of pain, walking on an artificial limb in water and presumably traumatized to return to the fields. But if they bought him a cow, they realized, he could become a dairy farmer. So they did — and within a few weeks, his depression went away. “You see, doctor,” they told him, the cow was an “antidepressant.” To them, finding an antidepressant didn’t mean finding a way to change your brain chemistry. It meant finding a way to solve the problem that was causing the depression in the first place.
Is this more effective when it comes to reducing stigma? Professor Sheila Mehta at the University of Alabama set up an experiment to find out. Participants were taken into a room and seated with a person, who was an actor, pretending to be another participant. Half the time, the actor would mention he was depressed because he had a problem with his brain, and half the time he would say he was depressed because of things that had happened to him. Participants were then taken into a room and told to give the actor/participant a painful electric shock every time he failed to memorize a pattern. It turned out that participants who thought the actor’s depression was caused by a problem with his brain gave him significantly more electric shocks.
To find our way out of the stigma we inflict upon depressed and anxious people, we need to radically change how we think about them. A society of lonely people who have been trained to think life is about status, shopping and screaming at each other through screens will only continue to be more and more depressed. We need to all learn the lesson of the cow — and begin to deal with the deep underlying reasons for why so many of us are depressed in the first place.
Johann Hari’s book “Lost Connections: Uncovering The Real Causes of Depression — and the Unexpected Solutions” (Bloomsbury USA) is out Tuesday.