What the best science really says about depression | Johann Hari | Big Think

I kept learning intellectually about what causes depression and anxiety. And that it’s much deeper than the story I’d been told by my doctor—that it’s just a missing chemical in your brain. But I think it really emotionally fell into place when I went and met an incredible South African psychiatrist called Derek Summerfield.

So Derek was in Cambodia when chemical antidepressants were first introduced there. And the Cambodian doctors didn’t know what they were, right? They’d never heard of it. So he explained it to them and they said, “Oh, we don’t need them. We’ve already got antidepressants.”

And Derek said, “What do you mean?” He thought they were going to talk about some kind of herbal remedy or something. Instead, they told him a story. There was a farmer in their community who one day, a rice farmer, who one day had stood on a landmine and had his leg blown off. And so they gave him an artificial limb and he went back to work in the fields. But it’s apparently very painful to work in water when you’ve got an artificial limb. And I imagine it was quite traumatic—he’s going back to the fields where he was blown up.

And he started crying all day. He didn’t want to get out of bed. Classic depression, right? And so they said to Derek, “Well, we gave him an antidepressant.” Derek said, “What did you do?” They explained that they sat with him, they listened to his problems, they realized that his pain made sense. He was depressed for perfectly good reasons.

They figured if we bought him a cow, he could become a dairy farmer; then he wouldn’t be so depressed. They bought him a cow. Within a few weeks, his crying stopped; he felt fine. They said to Derek, “You see, Doctor, that cow was an antidepressant.”

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

But what those Cambodian doctors knew intuitively is what the World Health Organization has been trying to tell us for years. Depression is a response to things going wrong deep in our lives and our environments. Our pain makes sense. As the World Health Organization put it, mental health is produced socially. It’s a social indicator. It requires social as well as individual solutions. It requires social change, right?

Now that is a very different way of thinking about depression and anxiety, but it happens to fit with the best scientific evidence. And it really required me to reassess how I’d felt about my own pain and how I tried to deal with it unsuccessfully, and open up a whole different way of responding to my depression and anxiety that worked for me.

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

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

And the first was: why was I still depressed? I’d gone to my doctor when I was a teenager and I’d explained I had this feeling like pain was kind of leaking out of me. I didn’t understand it. I couldn’t regulate it. I was very afraid of it. I was very ashamed of it. And my doctor said, “We know why you feel this way. There’s a chemical called serotonin in people’s brains, and it makes people feel good. Some people naturally lack it. You’re clearly one of them. We’ll give you these drugs. They’ll boost you back to a normal serotonin level.” And I felt such rel...