217. mental health book club series: lost connections by johann hari

Apr 10

listen to this episode:

In this week's solo episode, I am sharing one of my absolute favorite mental health books as a part of my new book club series! This week's pick is Lost Connections by Johann Hari, a New York Times bestselling book that explores what truly causes (and fixes!) depression.

In this episode, I break down my favorite quotes and teachings from the book, on topics including:

+ the chemical imbalance theory & why we're over-prescribed anti-depressants

+ a theory that explains why people actually get depressed

+ debunking other theories of depression based on the research

+ the crucial relationship between grief & depression

+ nine disconnections in our lives that can cause depression

+ how loneliness can change our physical & mental health

+ what psychology says about materialism when it comes to depression

+ childhood trauma & its impact on depression

+ modern society's emphasis on status & its impact on mental health

+ how living in a city versus a rural environment affects mental health

+ if some of us are genetically wired to be depressed

+ seven ways to solve your depression

Mentioned In The Episode…

+ Lost Connections

+ Johann Hari interview

+ Hans Schroder interview

+ ACEs criteria

SHOP GUEST RECOMMENDATIONS: https://amzn.to/3A69GOC

About She Persisted (formerly Nevertheless, She Persisted)

After a year and a half of intensive treatment for severe depression and anxiety, 18-year-old Sadie recounts her journey by interviewing family members, professionals, and fellow teens to offer self-improvement tips, DBT education, and personal experiences. She Persisted is the reminder that someone else has been there too and your inspiration to live your life worth living.

a note: this is an automated transcription so please ignore any accidental misspellings!

Sadie: [00:00:00] Welcome to She Persisted, the Gen Z Mental Health Podcast. I'm your host, Sadie Sutton. Let's get into it.

When we think about as a society, why we see more depression, why this is becoming such a common emotional experience, Johan presented a great quote, which is that we're being propagandized to live in a way that doesn't meet our basic psychological needs.

So we're left with a permanent puzzling sense of dissatisfaction. What do we reward as society? It's those external markers. It's those external goals that we all are in pursuit of.

Hello. Hello you guys and welcome back to Sheed. I am really excited you're here today. We are doing a solo, and this is the first of our book club series. We are going to be going through some of my favorite books in the mental health sphere that maybe you don't have time to read, you're not a big reader.

And I'm gonna share with you some of my favorite learnings, quotes, findings from these books. And hopefully you'll be able to implement them in your own life. I'm a huge reader. I have many a favorite book in the mental [00:01:00] health niche and category. So I'm really excited to take you guys through these.

And we're starting with one of my favorites, which you guys have heard me talk about so many times, which is Lost Connections by Johann Hari. This book is really a masterclass in the environmental social factors that cause us to be depressed and really a new way that we can think about and consider depression and how you can really feel hopeful as a result of that and feel like you have a really concrete understanding of things you can work to change and adjust, and how you can set yourself up for success from a preventative perspective.

So to give you guys a little background, yohan Ari is the author of Three New York Times bestselling books. His books have been translated into 40 languages and been praised by a broad range of people. From Oprah to Noam Chomsky, from Elton John to Naomi Klein.

His first book is Chasing the Scream. The second is Lost Connections, which we're talking about today. His third book, stolen Focus, and then he just released Magic Pill this past year and we had him on the podcast to talk about that. So anyways, huge fan of his [00:02:00] work but today we're focusing on lost connections because this is one of my favorite books that I've read about depression. I think he just presents his arguments in such an interesting way. The anecdotes that are included, the research that was done is just really incredible.

And it's a lot of things that aren't like accepted as common knowledge, which is really fascinating. So. Let's dive into Lost Connections, why you're depressed and how to Find Hope by Yohan. So he starts this book with a sentiment, which I really related to in my experiences with depression.

And it's one of the first things I highlighted in annotated, which is that my life was good. Sure I had some problems, but I had no reason to be unhappy. Certainly not this unhappy.

And I think this is a sentiment that a lot of us can relate to, where there wasn't some huge shift that took place or a loss or trauma that resulted in us feeling depressed. So even though you know these feelings are real and they're really debilitating and overwhelming, there's not a cause you can point to which you almost then end up in a cycle of invalidation [00:03:00] about, why am I depressed?

I don't deserve to be depressed. I don't have a reason to feel this way, or There's definitely no reason for me to feel this way to such an extreme.

And not having a cause or a reason you can point to almost increases and exacerbates that distress. And so I think this book does a great job of explaining what those causes are, that we aren't as familiar with like a trauma or a loss or, , a huge shift that took place in our life. And so we can kind of reach that understanding of, okay, here's why I feel this way, here's how I can address that.

, and I think the reasons that Johan presents are really sound and backed in evidence and are things that a lot of you guys will relate to. , so we're gonna start with a little bit of a background on depression as a whole, which is like the misconceptions that we as a society have promoted and embrace, ,

and debunk those a bit. And then we're gonna dive into the actual causes that Johann presents. And then in tandem with that, [00:04:00] the solutions to counteract those.

So in response to Johann's experience of being depressed, struggling with mental health, the solution presented to him by clinicians was medications, antidepressants.

I think this is a really common first string of interventions that a lot of us have experienced. , the stat is that one in five US adults have taken medication for a psychiatric problem. That's 20% of us. That's a really large portion of the population. So these are really widespread intervention. And the messaging here that this sends, that we kind of embrace and internalize is that if you have a broken brain that can't generate the right happiness producing chemicals, what is the point of asking questions about why we're depressed?

Right? It's just the brain. It's a, it's a broken problem related to or internal systems. And so. Johan explains that like it's, it's kind of cruel to ask these questions. You wouldn't ask a dementia patient where they left their keys because they don't know if your brain is the problem. If it's like a broken internal system, [00:05:00] why would we even ask what are the environmental causes of this depression?

And so this is a larger theme that he dives into, especially in the first part of the book, which is like the chemical imbalance theory, right? Like your brain is lacking serotonin and dopamine, something's not working right in the brain. And the alternative, which is depression, is a signal that something in your life isn't going right.

Right? It's a totally valid, normal evolutionary response to something being wrong in your life. And so what can we do to address and figure out and figure out and

Navigate the cause of that depression in our life. And there's been a lot of interesting research on this. We had Dr. Hans Schroder on the podcast. He's a University of Michigan professor. You guys should absolutely listen to that episode because we talk a lot about this idea where the messaging around depression specifically has a really strong relationship with how people go through treatment, right?

So when we tell people that it's a chemical imbalance, they feel less hopeful [00:06:00] about going to therapy and they get worse results because they are like, this is a problem with my brain. It's not a problem with me, it's not a problem with my life. So why would I go to therapy to fix something that is gonna be addressed by medication or that I can't solve by making changes in my day-to-day life?

Similarly, when , we tell people that depression is lifestyle factors, it's something that you are doing. It's a problem with your day to day. It can be really invalidating and people can get defensive and feel overwhelmed. And they're like, I don't wanna feel this way.

What do you mean? I've done this to myself. And so there's a lot of nuance around how do we talk about depression? How do we explain depression to patients?

. And this has a lot of parallels to like the DVT framework of acceptance and change, which was so pivotal in getting people that were really struggling with their mental health to make meaningful shifts and alleviate extreme suffering. And so the idea that if a therapist goes to their patients and says, you just have to accept the situation is the cards you've been dealt, the patient feels really upset and is like, so you're not gonna help me.

You're saying this is my fault. What do you mean? [00:07:00] And then when you tell people, just change the situation. They're like, do you not understand how painful this is? How much I've tried to shift this? It's not working like, well, this isn't helpful either. But when you say like, we have to deeply accept that this is really painful and uncomfortable and not ideal, and also look to see what we can change,

they're a lot more receptive in their responses and willing to change and take steps towards recovery. So we're gonna come back to this idea of like, after all the misconceptions, where are we left? How can we adjust this messaging? But we're gonna start talking about antidepressants there's a huge disconnect between like public understanding and what's actually in the literature.

And I'm sure this will shift in coming years, but for now, I'm gonna give you like a brief overview, which Johan also does in his book because it's something that I don't think we widely understand. Even if you're on a antidepressant or you have a family member or a friend or whatever it is. So. There's a quote here that is really powerful that Johan presents, which is that when you are prescribing someone antidepressant, you're [00:08:00] giving her a drug which will usually have a chemical effect on her body in some way.

And you are giving her a story about how the treatment will affect her. The story you tell is often just as important as the drug itself, as this is what we're talking about, right? Like what does it say to patients? What are we telling patients when we present them with a medical intervention for depression?

It tells them that there's a chemical imbalance, that this is out of their hands. That it's not an environmental thing. And a big piece that's at play here and a big mechanism of change in mental health is the placebo effect. This is the idea that it's not necessarily a result of the chemical intervention within the drug itself, but how we're thinking about the drug, right?

Like so if we expect to not feel depressed from an antidepressant for a lot of people, that belief in itself allows change to take place. And it's not just a change in how we feel, but physical effects happen in our bodies as well. And the placebo effect is fascinating. We have to do an episode at some point about this because it truly knows no [00:09:00] bounds and like how powerful the mind of the body are.

And when we believe things, they do become true. And not just like in a woo woo manifesting way, but like from an intervention standpoint. But basically the TLDR here is that if you expect it to work For many of us it will. And so what that looks like in the research that's been done is that when you give patients antidepressants.

One in four is the natural recovery, right? So like if you didn't give people an intervention, if you didn't prescribe 'em a medication, how would they feel a year from now? How would they feel six weeks from now? What's the natural course that depression takes? So 25% is just naturally, they start to feel better.

two out of four people is the story that you're told, or one in two people, I guess we should say, is a story that you're told that placebo effect, right? You expect it to work. So for many of us, it will. And I love the placebo effect from a mental health perspective. And I think this is something that gets lost in the conversation because when you tell people that yes, you're struggling, and yes, this is totally something that's not normal to experience and you're in pain and you're [00:10:00] distressed, and I see that so much.

Here's a prescription, here's a medication to help you treat this thing, which is really overwhelming and distressing and you shouldn't feel this way. And this will help. The piece that gets lost here is like, okay, we just believe it and then things automatically shift. There's also this element of what environmental changes do we make when we feel like things are getting better or we expect them to shift?

Do you spend more time with friends and family? Are you more consistent with your sleep schedule? Are you eating more balanced? Are you getting more movement in throughout your day? Are you more engaged with work or school or things that you're passionate about? Like what environmental changes do we make as a result of believing that this thing will help us feel better and that we are feeling better?

Right? So it's not just like the belief that things will change, but we also take action based on the belief that we're getting better and we will feel better. And that also in turn helps our mental health. So 25% of the effects is just natural recovery. 50% is that placebo effect the story that we're told.

. So only 25% is that chemical change [00:11:00] that is addressing the serotonin reduction or the lack of dopamine, whatever it's Right. So 75% is not actually due to the intervention itself. And the other piece that is helpful to consider here is that almost all the studies that have been done on antidepressants are done by the companies that produce these medications, right?

Like they have to prove that they're effective to be able to put them on the market. And so there hasn't been a lot of independent research on how well antidepressants work and, what the efficacy is independently.

And the interesting part of this is that a lot of these studies are never published because they don't show results. And I'm not trying to be like, oh my God, we're being lied to. Like the results are shifted. It's just helpful to know, right? Like we don't even have access to all the information. So about 40%, four out of 10 studies that are done by these companies never actually get released or given to the public.

So on top of this idea that the studies that are released, we know that 25% is natural recovery. [00:12:00] 50% is the story you're told in 25% is actually, the chemical reaction or the chemical result that takes place. In addition to that, 40% of the studies have never been released, which we would assume that maybe they don't show the effect that we would want to see, , to support the efficacy of a drug.

the other thing is that to take a drug to market, you have to show that it in a statistically significant way, performs better than the placebo. So if people are given a placebo and mentally think that they're taking the drug or they have their natural recovery, you have to outperform the placebo to be able to take a drug to market.

So that's also helpful context to consider and like how are these drugs studied as being effective? They just have to be better than doing nothing.

So based on this background of like the placebo effect and what the actual medications do, , from an intervention perspective, when we look at all of the research on antidepressants as a whole and all the research that's been done about the chemical imbalance associated with depression, there's no scientific basis to that.

It's just marketing copy [00:13:00] that emerged at the beginning of the production and marketing of antidepressants as an intervention. There's no scientific basis to the chemical imbalance. There is no such thing as your brain not having enough serotonin Or the threshold of serotonin you require to be produced isn't being met, and that's why you're depressed.

There's no scientific or research basis to this idea that a chemical imbalance is what causes depression. And we've done a lot of research on this. We've done a lot of studies independent of these drug companies done by drug companies, and there just is not research that supports this idea, which I'm sure you're listening to this and you're like, this sounds really suicide.

What are you No. Like if you read the research, if you read the articles, if you read the meta analysis, there's not research that supports the chemical imbalance theory. That's not why we're depressed. It truly was marketing copy. That was a great way to explain to people why this intervention would help you being depressed, which is that there's a problem in your brain.

It's not balanced. You don't have enough [00:14:00] chemicals, and this pill will help you get back to that level of equilibrium, will reach that balance again. And here's the intervention that will help your depression. And the thing about this chemical imbalance theory is that it does serve a purpose, right? It's really validating.

It tells us that we're not lazy, we're not wrong, we're not insufficient. It's a biological issue, right? It's not your fault that you're depressed, your brain's doing something wrong, and when you're so overwhelmed and distressed and exhausted from suffering with a mental health issue, hearing that it's not your fault, it's your brain is incredibly validating, right? So it does serve a purpose. It also might help reduce stigma, right? Like it's not the person, it's not the behaviors or the choices they're making or them and who they are, it's their brain.

But this isn't necessarily true when we look at the research.. So Johan presents some really interesting research about how people interact, like how hostile they are towards people with mental illnesses.

If they're told it's like a biological issue, it's their brain versus if it's like a social issue, something happened to [00:15:00] them, they were traumatized, right? So like is it something they went through or is it a biological issue? Is it a chemical imbalance? And what they found is that when people are told that the reason someone is struggling from a mental illness is because of a disease, you're more hostile.

People are more hostile to people where it's like it's a chemical imbalance, it's a problem with the brain. So it doesn't necessarily increase stigma, even though we might think that it would, if we understand that it's not your fault, it's just something internal. But it doesn't change in a meaningful way how we treat people.

And so we end up with this question, right? So is it a, is it a moral failing that we just as people are making ourselves depressed? Or is it a brain disease, right? Like, is it not our fault if something's going wrong internally and there's this new kind of perspective that we can come at it with?

And there's been a lot of research that's been done on this, and we talk about Tom Schroeder work. We talk about you Hari's work that he presents in this book. It's a signal, it's a sign that something in our life is not going the way it should be. And we are responding in a completely [00:16:00] evolutionarily, emotionally, socially proportionate way by feeling depressed.

And some people will say, our needs aren't being met. The way Johann frames this is that we are experiencing disconnection on different levels. And we'll get through all those different areas of disconnection and what they mean and the examples he presents. But this is an interesting idea when we think about depression has a signal because it suggests that as humans, we universally are vulnerable to this, right?

Like, if we don't get these needs met, we will feel depressed and we'll all feel that way if we are not living our lives in a way that gets these basic needs met.

, and then the last piece that we're gonna talk about, about this chemical imbalance, copy and idea is that it can be really disempowering, right? So when we are told that your distress has no meaning, right? So you're feeling depressed because of swimming in your brain. It's not your relationships, it's not your job, it's not the school you're at, it's not any of those things.

It's just your brain that can be really disempowering. And again, like Johann says, it sends the message that your distress has no meaning. [00:17:00] So even though it can be somewhat validating, being like, it's not your fault. I know you're trying and this is happening, despite that, it also can be really disempowering and invalidating to say it's actually not your life.

You should feel fine based on the life you're living. It's just a disease. It's just a chemical imbalance, just your brain. And so when we say no, your distress does have meaning. It makes sense. You feel this way, you are not getting these needs met. That can be really empowering. In turn, when we truly listen to and value and take meaning from that signal that we're getting with regard to feeling depressed.

So again, you're probably like, okay, like I'm buying into this whole signal thing. I get it. It's a better way to frame depression. It makes more sense, but you're like, but all I've heard my entire life is depression is a chemical imbalance. I'm not buying this thing that there's no evidence to support that.

Sadie, give me more because there's no way That's true. That's all I've ever heard. So there is been extensive studies, like I've said. And there's no direct relationship [00:18:00] between serotonin levels and depression. It just doesn't exist. No matter how many times we study it.

No matter how many populations, we look at the relationship between depression and serotonin, which most antidepressants that you take are selective serotonin, re-uptake inhibitors. So what they do is they inhibit the re-uptake of serotonin. So if you think about like a hose and serotonin is coming through the hose, and if you're spraying a hose on grass, the grass will absorb the water, right, so then you can keep spraying water.

The water will keep being absorbed by the grass. What selective serotonin reuptake inhibitors do? Is that they kind of turn the grass into concrete. So instead of absorbing the serotonin, they're not allowed to be reuptake. So as you spray your hose onto the water, it starts to pool it, sit there. There's more serotonin in that neurosynaptic gap, right in the neurosynaptic left.

I think it might actually be called. I took like one cognitive neuroscience class in college. , [00:19:00] so basically what selective serotonin re-uptake inhibitors do is that they make serotonin harder to be absorbed. So there's more floating around in your brain. The concentration increases, it doesn't absorb it as much as it used to.

And so instead of being re-uptake, it inhibits the re-uptake and more serotonin is present.

So they've done research on this. And again, there's no statistical relationship. There's no connection between your level of serotonin and depression. It just doesn't exist. And you might be like, well, it's, maybe it's dopamine, maybe it's norepinephrine, like maybe it's cortisol, maybe it's these other things.

Nope. When they study the level of dopamine in the brain and depression, no relationship. When they study the relationship of norepinephrine and depression, no relationship. the caveat that I will give here, we talked about placebo effect. We talked about natural recovery.

The studies that have been done on antidepressants, they do show that the magnitude of benefit when compared to placebo is better in severely depressed individuals. So when you take someone who is [00:20:00] like subclinical or moderate depression, they don't benefit as much from the antidepressants as severely depressed individuals.

But the bulk of the relationship, the bulk of the effect size is not from the intervention of antidepressants, but there's more effect in this population. So I do wanna give that caveat, right? It's not like antidepressants 100% don't work. They don't work for anyone. It's a huge hoax. There is a small effect size.

It does work better in severely depressed populations. There are other mechanisms through which antidepressants can cause change and promote hope and agency. But I do wanna add that caveat that we know antidepressants don't really work for subclinical depression, moderate depression. It really isn't effective as an intervention for severely depressed.

The effect is more

significant. and then another important piece of data that Johan presents is that 65 to 80% of people that go on antidepressants continue to be depressed. And this isn't like totally, completely insane within the mental health world of interventions, right? Like when we look at [00:21:00] all the effect sizes of talk therapy or psychotherapy, going to see a therapist and talking through your problems, it's about a 50% chance of that works, right?

So like one in two people, it'll work for most people see a huge number of therapists before they find ones that work. So the idea that. People that are receiving this intervention as a first line intervention or , maybe as a second thing, they've tried the idea that 65 to 80% of them continue to be depressed.

I wouldn't say that that's crazy, but when you are hearing that, it might be like, wow, that's a little bit fascinating. And then the other thing that I'll mention here while we're talking about effect sizes and , things that we see in the research is that the side effects are really, really real. And Johan mentions this, , in the book as something that people also should consider, , which is that while the chemical effects of antidepressants are murky in some context and not totally solidified and not totally established as a correlational relationship,

we do know that the side effects that people experience from antidepressants are really real and can add additional distress. And so it's also something to consider [00:22:00] when using this as an intervention.

So. Why don't we just throw this out the window, right? Like, why don't we just completely abandon this and ignore this? Why is this something that we're using as an intervention and in such a widespread context, right? Like why are one in five adults taking psychological medications for mental illnesses if the effect sizes are really misunderstood or misconstrued or unknown?

And Johan has a really beautiful quote that encapsulates this, and I think, again, adds nuance to this, this story, which is that giving a person a story about why they're in pain is one of the most powerful things that you can ever do. And hearing this quote, I'm like, yes, absolutely, 100%. And this is one of the reasons why we're doing this episode, but it's also one of the reasons why I do the podcast, which is that I'm really incredibly passionate about explaining these things and helping you guys understand why these things happen in our mental health and why we feel the way that we do.

And that there are explanations and there are ways to understand this. And then in turn, shift these behaviors and adjust our lived experiences and build our life worth living. [00:23:00] And so my goal with the podcast, but also in this episode in particular, is can we explain why these things happen when we're depressed?

Can we increase our understanding collectively and can we create that story, right? Can we give ourselves a story for why we're in pain and give ourselves that power back to make changes that are lasting and meaningful and really profound and there's some interesting kind of other things that Johan presents within the first part of the book, which I wanna go through before we dive into the causes of depression.

One is the grief exception. So when the DSM was created, there was this exception written in for depression, which is that if you lost a loved one a year ago, you cannot be classified as depressed because there's a reason. Right? So you're allowed to exhibit the symptoms of depression, which colloquially most of us are aware of, but in case you're not, it changes in sleep.

Appetite, energy, loss of interest, and things you used to enjoy, disrupted sleep. , being more tearful, emotional like, I'm not giving you a full [00:24:00] comprehensive list there, but that some of the DSM criteria for being depressed, and it has to be for at least two weeks. But when the DSM was first created, they were like.

People who are grieving experience those symptoms of depression. Their sleep changes, their appetite, changes. They're less interested in things they used to enjoy. They're sad, they're tearful. So they wrote the DSM and said, if you lost a loved one a year before, you're not depressed.

There's an exception. And then when they did the next version of the DSM, it was one month. If you lost a loved one within a month, even though you experienced the symptoms of depression, you're not depressed. It's grief. Then it was two weeks. If you lost a loved one within the last two weeks, you were allowed to experience depression.

But it's grief is not depression. You're not diagnosed. The most recent version of the DSM removed this grief exception. So. Even if you lost a loved one, those symptoms, those experiences still can be classified in diagnosed as depression. And this is really fascinating because what this tells us in the messaging that this gives, how we can kind of conclude and interpret this, is [00:25:00] that it's reasonable to be depressed after a loss in that context, right?

So like this is kind of segueing into the losses that we've experienced disconnections, the causes of depression. But the idea here is that we know and we understand in some context it makes sense and it's a normal response and it's quote unquote okay to feel depressed. One of those examples being grief.

And so if it's okay to feel depressed after a loss, what other losses are we potentially experiencing that would cause a normal proportionate evolutionary sound response of depression in our lives?

And so Johan presents this question based on this grief exemption and this being, added to the DSM and the way that we understand mental illnesses, which is that grief and depression have identical symptoms. So what if depression is a form of grief? What if it's a response to a loss? And not all these other stories and things that we've been told, but what if that is truly what's happening is that we've lost something [00:26:00] and we are in response grieving that loss in our life.

if that's the understanding we take that means that our depression is a response to our circumstances. It means that human distress cannot be assessed separate from our lives.

Sadie: We can't just say it's a chemical imbalance. It's the way your brain is processing things. It's your life. It's the way that you're living your life. It's things in your life, and that's why you feel this way. And there's this other piece, , which we're again, going back to this chemical imbalance thing because it is such common messaging surrounding depression.

We're told this all the time. It's a really common, , response to coming into a doctor's office or a therapist's office or a psychiatrist's office and being depressed, and what are the potential consequences of that messaging is that when we're told our pain is a result of our malfunctioning brain, we're disconnected from ourselves and therefore disconnected from others.

And that's kind of what Johan presents is like, why we should embrace this new way of thinking about and treating depression. So instead what we do is we listen to our pain, we pay attention to it. What is it trying to tell us? And like we said at the [00:27:00] beginning of this episode, our depression acts is a signal.

And so we end part one of lost connections with an amazing quote from Johan where he says, depression is in fact, to a significant degree, a problem not with your brain, but with your life. So if we're depressed because of our life, what are these causes? What are these needs not being met?

What are we grieving? What are the losses that have occurred? And that gets us into part two, which is that there are nine disconnections that we experience that lead to feelings of depression and grief. So the first one we're gonna dive into is meaningful work.

And so the question that we ask ourselves when trying to evaluate if this is a loss that has occurred in our life, if we're disconnected from this, is do we feel like we made a difference in anyone's life today? And maybe it's as a student, maybe it's through your relationships, maybe it's through your actual job.

If you're at that point in your career, maybe it's through volunteer work, maybe it's through sharing your story, whatever it is. But when we don't feel like we've made a difference in anyone's life, we feel depressed. That's a [00:28:00] cause that takes place. And this also lines up with something we talked about on the podcast before, which is positive psychology research, where we research not people that are struggling, not people that are like below the average, but people that are above the average, people that are thriving and doing great.

So what are the happiest people do that allows them to be effective and successful with their wellbeing? And there's a framework for this that Dr. Salman created called perma. And so PERMA stands for positive emotions, engagement, relationships, meaning and achievements. And when we have these things in our life, we have good wellbeing and we find that we do mentally and physically and generally well.

But getting back to what is meaningful work? How do we understand this concept? It's important that we're challenged in a healthy way and that we feel valued. So when we look at research on people in the workforce, 13% of people are engaged in their jobs. 63% are not engaged and 24% are actively disengaged.

So when it comes to us as a society doing meaningful work and feeling like we have a purpose and are really tapped [00:29:00] into our day to day, that's not great stats. Another one is that twice as many people hate their jobs as love them again, really challenging to feel like we are engaged in meaningful work when that is kind of as a society, how we feel about these roles.

and another thing related to what we talked about on the podcast before is the sense of agency, right? So do we feel like our actions have a meaningful impact on our lives and on outcomes and on, things changing. And we can feel disconnection from meaningful work when we feel really out of control.

And that really diminishes our sense of agency, which is really important for our mental health. And the other piece , of having meaningful work that's important is when our work life is enriching, our life is fuller. And that extends to our life outside our work, right?

Like you have the best day, you come home, you talk to your partner or your friends or your family, you have energy, you wanna see people, you wanna engage in your hobbies, go out, do all these other things, versus coming home from work and being burnt out. You don't wanna do anything. So you not only are having like this [00:30:00] negative experience in the workplace, but it really trickles out into these other areas and really impacts your ability to maybe bounce back or continue to maintain or even improve your mental health outside of work.

And so the quote that you Johann presents here in this part is that disempowerment is at the heart of poor health. And he gives a really fascinating anecdote about tax return workers. I wanna say it was in the uk, but I might be wrong. And suicide rates. And so there was a really high rate of suicide in this specific department and this specific role, which was tax return workers.

And when they looked into it, the reason why was that these workers never felt like they got their head above water. Every time they finished a tax return, there was like 65 more on their inbox, on their desk. Like the work never ended. They never felt like their head was above water. There was always more to do.

They felt like they had no control over that fact. There was that lack of control, and no matter how hard they worked, they were still behind and there was also never thank you or any recognition. so when you're [00:31:00] thinking about the roles that you engage in, the jobs that you have, your career that you go into, making sure that you feel like you are able to get your head above water, that there's a point where you're like, okay, I did that.

I killed that project. There's like that sense of completion, not like an never ending cycle, that you have a sense of control and that when you work hard, you're not always behind. And then you have that thank you. You have that recognition. People see that you're trying hard and doing well and making an impact.

And so the, the last way that we'll kind of explain this, , lack of meaning phenomenon is that despair is when there's a lack of balance between effort and rewards.. And the societal messaging that accompanies that is that you're irrelevant. And so meaningful work helps us feel like we matter and we have a sense of meaning and that people need us and rely on us.

And that's really important as humans to have that in our lives. Okay, loneliness. Really fascinating thing about loneliness. We know it's bad, right? Like being lonely isn't good. When we've done studies where people [00:32:00] are isolated, there's always adverse consequences, physically, psychologically, like we know loneliness isn't great.

We're in a loneliness, epidemic. The surgeon General has talked about it, all the things. But an interesting thing that Johan presents here is that loneliness is correlated with high cortisol and stress. So being acutely lonely. So being really, really lonely is as much stress as high cortisol as getting punched in the face by a stranger.

They've done studies that compare cortisol levels of being really lonely, chronically lonely, acutely lonely, and the cortisol that results from being punched in the face by a stranger. And the amount of stress experienced is the same. We also know that lonely people are three times more likely to get sick with a cold.

There's a lot of fascinating research in the positive psychology world on like how much more likely, pessimists are to get sick, how their outcomes after surgery are worse, like how we think about things and how we feel really matters from a physical standpoint. But being lonely, again, that level of stress, it impacts our immune function.

We know that people that are [00:33:00] acutely lonely are more likely to die over a nine year period. So mortality rates are impacted. And what we can conclude from this is that loneliness is deadly, not only from a psychological standpoint that we know that people are lonely, are more likely to, , commit suicide, but we also know that physiologically our physical health is really impacted by how connected we are and if we're engaged in our relationships.

We also know that there's a lot of psychological impacts. Lonely people are anxious. They have lower self-esteem, they're more pessimistic, they're more scared that other people will dislike them. And there's a studied correlation. There's a established link that loneliness leads to depression. So when we're lonely, when we're isolated, when we're not around people, when we don't feel seen by our community, we get depressed.

So again, it's this disconnection, it's this loss, it's this grief of not being in relationship that causes this experience of depression. And there's a great evolutionary cause of this, and one that completely makes sense. So when we think back to caveman [00:34:00] days, if we were surrounded by a tribe, we survived.

If we were alone in the middle of the desert, a line would take us out instantly. So being connected, being in a tribe, being needed, feeling like you mattered, was literally what led to survival. And so our bodies responded to that. It realized if we're not together, we're not gonna stay around. We're not gonna stick around, we're not gonna survive to the next generation.

So it gave us a biological response to being alone, which is depression and loneliness, and this really negative emotional experience that then drives us to find other people and be in relationship and connect because if we didn't connect, the adverse consequences were extreme. So it makes sense that when we aren't with people, we have this adverse emotional experience which is loneliness.

And in a long-term way, depression. But a lot of people are more lonely, even though we arguably are more connected than we have ever been, and we have to do another episode Diving into this, we've talked about it with people on the podcast before. There's a lot of different theories of why this [00:35:00] is, but I think that when we think about why we evolved to have this loneliness response, it meant that we were in a community, a tribe, right?

A number of people. We had these close relationships with this key community, and today our societal social landscape looks like that we have less one-to-one relationships. So our tribe really no longer exists, but we also have an extremely larger, broader network. So like both sides of the social equation are kind of blown out of proportion and not being set up for success.

. And so these emotional responses that we've developed over hundreds of thousands of years. Really aren't fitting with this modern day environment. And as a response, we see loneliness and depression pop up at a much more alarming rate.

So the way that evolution helped us stay connected as Johan explains us is that when we're with people, when we're connected, we feel secure. When we're not with people, we not only feel bad when we're isolated, but we also feel insecure.

Like we have this internal [00:36:00] gut feeling of like, I'm not protected, I'm not safe, I don't have my community. There is now a threat to me. So we're not only feeling bad and negative and depressed, but we also feel insecure in our life as a whole, which is also, we know like change and uncertainty psychologically is not fun in a negative experience.

And so this is another layer that gets added onto this loneliness puzzle and this piece of disconnection, this grief, this loss that we've experienced of social relationships. So there was a really interesting study that was done that Johan talks about, which is over many decades, Scientists ask people, how many confidants do you have? Right? Like, how many close people do you have that you can tell your deepest, darkest secrets to how many people can you go to for advice and support?

The most frequent response that people gave was three confidants in their life. By 2004, the most common response that people gave was none. The most common experience in US society that this study looked at was [00:37:00] that people didn't have any confidants in their life. They didn't have any people that were really in their corner there to support them and help them navigate challenging situations.

So we see this being more and more widespread, more and more of a common experience, and we also see more and more people becoming depressed. And so we talked about, insecurity as a feature of loneliness, right? Like from an evolutionary perspective, we evolve so that when we're alone, we also feel insecure.

And the catch 22 here that Johan talks about, which adds a whole other layer to this, is that we start to become afraid of the very thing we need most. And this is what social anxiety is. So when we're lonely, ideally we would feel like, okay, I feel negative, but I have this drive to go and find people and build relationships, and I'm super motivated to go and solve this problem.

That's not what happens when we are isolated, when we are not in relationships, when we're lonely, we become more suspicious [00:38:00] of social contact. We are hypervigilant and we're constantly scanning for threats. So we're not only feeling depressed, we're not only feeling bad, we're not only lonely and insecure, but we're also really suspicious of everyone around us.

, and so what happens because of this is that we need more love, more reassurance than you would have initially when you're lonely. So if we think about like the average person at being net zero, right? Like their needs are met, they're fine, they don't need that much reassurance. , they have healthy relationships. Once we start being lonely, we creep down into the negative numbers.

And so then we not only just need a relationship, which would fill that need of being lonely, but we need more love and more reassurance because we're insecure, we're isolated, and we are hypervigilant, suspicious and fearful of threats in our relationships. And the other thing that we have to mention here, which I'm sure you guys have experienced, is that feeling lonely isn't necessarily related to being alone.

We can be in relationships, we can be in classes, we can be in [00:39:00] family context and feel really unseen and misunderstood and really lonely despite being surrounded by others. So what we're grieving here, what we're missing here is a two-way relationship. We need a sense of mutual aid. We both need to be doing things for each other.

It has to go both ways, and we have to feel protected. Again, this goes back to our evolutionary roots, right? Like if you were kind of just following everyone else around, you never contributed to the tribe. They don't want you there like you're dead weight. And similarly, if you weren't protecting your tribe, your dead weight, we don't want you.

And so what we need to get this need met and to not feel lonely is a two-way relationship. That sense of mutual aid. We're both helping each other and we feel protected. We feel like we have each other's backs, and if something happens, it's gonna be okay. We've got each other. So our third disconnection is meaningful values.

diving into what Johann presents here, we know from research that materialistic people have higher levels of depression, anxiety. They generally just have a [00:40:00] worse time in life, and they feel sicker. Like physically, they experience more sickness and they have more anger.

And we've experienced a really fascinating shift in society, especially in the western world, in these really individualistic cultures where we celebrate achievement. And we talked about in the disconnection from meeting section, this perma framework for positive psychology like achievement and feeling like what you're doing matters and that you're appreciated and valued.

That's important, but solely focusing on extrinsic goals and solely pursuing those is really adverse for our mental health. And what research shows is that when we achieve our extrinsic goals, so when we get that grade, we get into that school, we get that job.

We don't experience any increase in our day-to-day happiness. You guys might be like, yeah, dove, of course, but like, let's really think about this. If you're in high school right now and you have worked hand and foot for a certain GPA and that certain grade on that test, in your letter of Rex. When you get into that school, that dream school that you've been working for your whole life, you're not gonna experience any more happiness on a day-to-day [00:41:00] basis.

Similarly, if you get in, get that job, you get that offer, you land that role, your day-to-day happiness isn't increased from meeting that extrinsic goal. So people that pursue these intrinsic goals, ones that are guided by our values and , they're fulfilled because, , they're really important to us, not just externally, what we get from them.

Those people are happier and they become less depressed and anxious. And there's been 22 studies at the time that this book came out that were done on people that were materialistic and focused on extrinsic goals. And again, it doesn't have to be materialistic, right? Like extrinsic could be a grade in a class, how you're perceived by others.

going to a. Certain school getting a certain job, right? Like it doesn't just have to be like I buy things. It's just pursuing things for external purposes. So 22 studies have been done on this, and there is a studied relationship between focusing on materialistic things, pursuing extrinsic goals and depression.[00:42:00]

When we do that, we become depressed. And why this happens is that materialism, and again, we're defining that as anything that we're doing for an external reason, that leaves us really, really vulnerable to the world that's beyond our control. not only is the outcome outside of our own doing, right, it's dependent on the test that your teacher writes or how your friend responds to your text, or if you get into that school or get that job.

So it's not only completely dependent on external factors that you can't control, no matter how hard you try.

But it's also kind of like never good enough, right? Like there's always gonna be another test. There's always gonna be another thing to get into. There's always gonna be another friend you're trying to impress. There's always gonna be that job you want, so you're never able to be like, I did it. I got that thing.

I have that need met. Because the bar is always shifting. And we know we talked about this in the last section, right? Like not having things in our control is a really distressing experience as humans.

So, what Johan says in this section, which I think is so important to drive home and [00:43:00] make sure that we all remember, which is that when we focus on the external, we don't meet our internal needs. And those internal needs are feeling connected, feeling valued, feeling secure, feeling like we make a difference in the world, feeling like we have autonomy and feeling like we're good at something.

Those are the internal needs that we all, as humans, need to have met. And when we focus on the external, there's a chance that as a byproduct, those needs might get met. But it's really not a guarantee and it's really not a great way to go about it because again, it doesn't impact our day day happiness all, and we're not getting those internal needs met and in turn leads to depression.

. Which if you've been depressed, you're like, oh my God, I was missing all those things.

like that's really what depression feels like when we describe it is like not feeling connected, not feeling valued, not feeling secure, not feeling like you make a difference, not feeling like you have control and not feeling good at anything. It sucks. It's really painful. And so when we think about as a society, why we see more depression, why this is becoming such a common emotional experience, Johan presented a great [00:44:00] quote, which is that we're being propagandized to live in a way that doesn't meet our basic psychological needs.

So we're left with a permanent puzzling sense of dissatisfaction. What do we reward as society? It's not really those internal needs we just mentioned. It's those external markers. It's those external goals that we all are in pursuit of. And it's really, really heartbreaking when we think about this, like even high schoolers,

the goals they're pursuing and the markers that they see as important, which is like GPA and SAT scores and trying to get into college and finding an internship and all these jobs, like it's not those other internal needs that we know are really important psychologically to get met.

The next one is disconnection from childhood trauma. So this anecdote that Joanne presents in this chapter has stuck with me for years. I read this book a number of years ago, and I still think about this to this day, which is that there was a study that was done where they took morbidly obese patients and they were like, what if we just like don't give them any food at all?

Like what if to solve this obesity [00:45:00] issue? We literally don't feed them anything, but like obviously people would die. So they're like, we're gonna hydrate them, we'll give them ID IVs. We're gonna give them supplements So that they don't suffer vitamin deficiencies, but like literally, what if they just live off their fat stores?

And it worked. The people in the study, they became healthy, they lost weight. They went back to being a, a normal healthy weight.

But the people that lost the most weight throughout this study, they either panicked, they were enraged or they were suicidal. And it was because they felt really, really, really vulnerable in this new state. And this quote that's in this chapter is just absolutely heartbreaking. But it's that overweight is overlooked and that's the way I need it to be.

And the solution to this obesity problem wasn't not eating. , it wasn't. What they were doing in their life that was causing this behavior. It was why they ate it was why they were binge eating or why they had put on all this weight so that they were invisible. And a lot of these people had gone through really traumatic childhood [00:46:00] experiences, a lot of sexual assault things where they felt really unsafe and vulnerable and threatened in their day-to-day lives.

And being overweight and being overlooked that emotionally was a lot safer than being in a body or in a position where there was a lot of attention and eyes on them. And I just, I still keep going back to this because it's such a crazy study idea, but also what they learned from it was so diving more into childhood trauma. ACE scores, you guys might have heard of these because they are becoming like a more common phenomenon, , and something that we're aware of. But ACE stands for adverse childhood Experiences and basically the studies on ACE scores have showed that for every traumatic event you experience as a kid, you are radically more likely to be depressed as an adult.

And there are like so many different things that a scores impact. , it could be rates of diabetes, obesity, how well you sleep, like lots of physical health markers, but also lots of mental health markers and the things that they describe as c trauma. It could be like parents being divorced, [00:47:00] physically, being abused, mentally, being abused, going through, , like a natural disaster.

so for every one of those traumatic things that you experienced in your childhood and you can look up the list of all the ACE criteria, you are radically more likely to be depressed as an adult. And another really interesting thing here that Johan talked about is that emotional abuse is a much more significant driver of depression than even like a physical assault or abuse. And beyond that, not just emotional abuse, but being treated cruelly by parents was by far the biggest driver of depression.

And this is where we go back to this idea that depression isn't a disease, it's a normal response to abnormal life experiences.

And so another quote from this section before we get into our next area of disconnection, which I loved, is that if you believe depression is solely due to a broken brain, you don't have to think about your life or what anyone might have done to you.

The belief that it all comes down to biology protects you in a way for a while. If you absorb this different story though, [00:48:00] you have to think about those things and that hurts. And that's really true, right? Like if we just say it's our brain, it's how our processing thing, it's not my life. We don't have to look at these painful experiences.

We don't have to ask ourselves if our jobs are not meaningful, if we're chronically lonely and unseen, we can just blame it on this other factor. And so it's painful, it's challenging. We don't have that cop out of like, it's my brain, it's not my fault. And we can really, truly get to the root of the issue and then in turn, solve that.

. Our next section is disconnection from status and respect. So when we think about how we describe depression, a lot of language around this is like feeling down, right? Like, I, I feel down, I feel depressed. And so this like status and respect thing is really interesting when we think about how we frame depression as a concept.

And there was an evolutionary purpose of status, which like a lot of these areas we had evolutionary purposes. And now in modern day, our lives don't fit the way we're wired. And so then things go awry and we get depressed. Depression is in part a response to the sense [00:49:00] of humiliation that the modern world inflict on us. And so today, in our modern world status is something that can be taken away at any moment.

We are pervasively insecure and we know that being insecure in your status, not knowing if you're gonna have it from one day to the next, is more distressing than knowing that you're at the bottom of the pyramid. So like if we think of the dance moms period, the people at the bottom, they're distressed because they're at the bottom of the pyramid, but they know that they're there.

The people in the middle who like might be at the bottom at any point, maybe they'll move up. It's kind of uncertain. They're more distressed because their status is insecure and could change at any point. So again, insecurity changed, not knowing what's gonna happen next psychologically. Lots of adverse outcomes.

And this is kind of a common theme between these things of disconnection. And so another piece of data that also backs this like disconnection from status and respect thing is that the more unequal society, the more prevalent mental illness rates

so the United States is like a fascinating, , case study in the wealth gap and our status gap that exists within our [00:50:00] society despite being in like modern day. Whereas when we compare that to Norway where the status gap is much smaller, , and doesn't exist in such a pervasive way, they have lower mental illness rates.

So we do see this correlational relationship between how equal societies are and how much mental illness they have within their populations. And the other piece of like, things are changing in society at large, and we also see depression rates changing at large.

When we look historically. The status gap that exists today is larger than it's ever been before,

next form of disconnection is the natural world. There's been really fascinating research done on mental illnesses in cities versus rural areas, and not just like how many people have mental illnesses in cities because obviously the population is denser. But like when we look at a percentage basis, , what percentage of people struggle more in urban areas versus rural areas.

And mental health conditions like psychosis and schizophrenia are much worse in cities than they are in rural areas. [00:51:00] We also see in research that people that move to green area see a reduction in depression and vice versa. , if they go from a really green area to a more.

Urban area, they experience more depression. We also see that when green spaces are implemented in cities, research supports the levels of despair that, , citizens experience decreases. And they did this other really great study where they had people who were depressed take a walk in nature. So they lived in cities, but they were like, your prescription is to do a walk in nature every day.

And they did this with depressed and non-depressed people. And the non-depressed people saw a benefit, right? Like who wouldn't benefit from taking a walk in nature? But the people that were depressed saw five times the amount of improvement compared to the non-depressed people. And another kind of like anecdotal piece that Johan presents from one of the interviews he does in the book is that when we see natural landscapes, when we're in like a national park or we're on a mountain and we're in these like really wide open areas.

We feel that us and our problems are really small and the world is really big [00:52:00] and not in an invalidating way, but like that test I have coming up or that fight I just had with my friend. When we think about how big the world is and how many things are going on, we're so small in a good way and this too will pass and it's all gonna be okay.

And then our last little stat here, which was fun, which I marked down, is that when we see the natural world, when we are in environments that consistently have us engaging with nature, we're 24% less likely to get sick. So physical and mental benefits. Our last cause of disconnection, before we quickly go over our solutions, 'cause I know this episode is long, you guys, it's a great book.

I have so much to say is genes and brain changes. So we started this episode talking a lot about like how our genetics and our brain like. Antidepressants Really, there's not a lot of research backing that. The chemical imbalance theory isn't really based in science. It's not totally something that we can rely on, , as far as understanding why we're depressed.

But there are a lot of genetic [00:53:00] factors and brain changes that occur that make depression worse. And so we're gonna dive into those a little bit. So the first thing is that our brains change based on how we use them. We have incredible brains that have this thing called neuroplasticity where they rewire based on how we use our brains.

So there's is really fascinating thing when we're born, we can hear the linguistic differences between our language and other languages. We're born with that. So like these really similar sounds we can differentiate as babies, but we only really speak one language for the most part when we're born. And so within a couple of months, a couple of years, we lose that ability to distinguish between those really similar sounds.

It's like use it or lose it. We don't use it, we lose it.

Similarly, again, I took a lot of linguistic classes in high school and it's in college, and it's a great way to explain neuroplasticity. So these, the examples you're getting when we don't develop language, those language areas become dormant and we never recover after that critical period. So if you're not exposed to any linguistic input before, like say 15 [00:54:00] years of age, you're never gonna be able to fluently speak a language.

So our brains change a lot. They are very responsive to our environment. And we also see this in depressed populations. So our brains change based on how we use them. And so depressed people, when we look at them in brain scanners, they have more active areas related to risk and unhappiness. And so literally, despite the fact that that might not be the cause, the way that we're using our brains is exacerbating the issue.

So when our brain assumes a state of chronic pain and stress, we lose those relationships and those pathways and those synapses that relate to pleasure, joy, connection, and healthy habits. So like we're really strongly wiring these,

pathways related to risk related to unhappiness, related to intense emotional experiences. And because we're not using them, we lose them. Those pathways that are related to pleasure, joy, connection, and healthy habits, those are less solidified and they're harder to use [00:55:00] when we then wanna try and make things better for ourselves, build our life worth living, try to invoke those positive experiences.

So even if the original reason that we were depressed, like we talked about grief. So even if it's been months since you lost a loved one, the depression itself persists because the way that we are. Living our life on a day-to-day basis, the way that we process information, the way that we interact with our environment causes that depression and that depressive experience to persist despite the environment, no longer being the problem. to kind of relate this all to what we talked about in the episode as a whole, the origin isn't necessarily in the brain, but the brain can absolutely make it worse when it comes to maintaining this depressive mood and experience.

And then the gene piece of this is also fascinating, which is that depression is 37% inherited. So it is related to genes, and it's this thing called five HTT. And basically these genes turn on or off. It's dependent on your environment. So if you're born with a five HTT gene, you might never be [00:56:00] depressed.

But if you have a stressful event that you go through, or a childhood trauma, an experience that's really depressing. That five HTT gene turns on, it's activated by the environment, and then you have that genetic susceptibility to being depressed. So the quote here that Johan gives, which I'm absolutely obsessed with, and I hope you all remember and internalize, is that your genes can make you more vulnerable, but they don't write your destiny.

So we can be more susceptible to depression, but it doesn't mean that we're predetermined to be depressed regardless of what happens in our life. We have a lot of power in agency. So now that we know these causes, giving you a little like recap, transition here is that if all these things are signals that something's not going right.

We as a society have a really distorted sense of our distress. , the way that we are responding to these signals, the way that we're normalizing these experiences, the way that we're all embracing these day-to-day things, despite the fact that we're disconnected from these things that are really important to our functioning is [00:57:00] really distorted.

And so again, when we go back to this narrative, which we've really embraced of biological malfunction. We feel disempowered. We feel like our brain isn't good enough. There's nothing that we can do. We're told that our distress has no meaning. And the reason why it's so important for us to push back on this and kind of embrace this other way of thinking is this quote that Johan gives, which is incredible, which is that it's no measure of health to be well adjusted to a sick society.

So if we're seeing that at large as society, we're disconnected from meaning, we're disconnected from each other. We're disconnected from values that lead to better lives. We're disconnected from working through our childhood trauma. We're disconnected from status and respect. We're disconnected from the natural world.

We're disconnected from feeling hope and having a secure future. And our challenges are being exacerbated by genetics and brain changes that occur as a result of being depressed. It's not a good sign if we're well adjusted and normalized to this disconnection that we're experiencing at large. So how do [00:58:00] we respond?

How do we solve this? What are the solutions that we can implement? And we're gonna go through these quickly because a lot of these things we talked about in the causes, right? Like if you're disconnected from relationships, what should you do? Build more relationships. If you're disconnected from meaningful work, what should you do?

Find work that has more meaning. , but I did wanna give you a couple little bits and pieces here. So the seven solutions presented in lost connections. The first is people. so there was a study that was done on. If people tried to consciously make themselves happier, did it make them happier?

They're like, okay, we want you to go into the world. We want you to try and be happy. Like consciously make an effort to try and make yourself happier and we're gonna study if it works. And they found in that Russia, China, and Japan, it worked. When people went out into the world and tried to be happier, they felt happier.

And these are like collectivist society, right? They're more rooted in community, they're more rooted in others. In the US it was not the case. So when people intentionally went out and tried to make themselves happier based on like the values we embrace in the lives we live, they weren't [00:59:00] happier. , and so thinking about this, like individualist versus collectivist societies, that's definitely something at play.

But like, are we being set up for success in the way our society is set up and run? And if we just kind of fall into those patterns and those values and those ideals, like are we being set up for success? Will we feel happier as a result? Not really. And so, , , the finding from the study, which Johan kind of presents is that the more you think happiness is a social thing, the better off you are.

So that might not necessarily be the norm within US communities. It might not necessarily be the norm. We just go on autopilot into our society. But the more that we emphasize social and happiness being synonymous, the better off we are from a wellbeing perspective. The other piece here, , which I hope you guys kind of internalize, is that if we return to seeing our distress and joy is something we share with a network of people around us, we will feel different.

So yes, it's an internal experience to feel distress. Yes, it's an internal [01:00:00] experience to feel joy, but if we know that, like when we feel distressed, we talk to others, we get support, we make sure people are in our corner. And similarly, when things go well, we tell our friends, we celebrate together, we, embrace others' accomplishments.

We feel differently. So leaning into others throughout these emotional experiences, , as like a collective experience rather than individual one is huge. so not focusing on ourselves, focusing on others, and you guys have heard me say this a number of times, but when you do studies on like what short term, one thing that people do will cause the longest and biggest amount of happiness in them, and act of kindness for someone else is what makes that difference.

Like literally takes two seconds, but you not only feel super happy in the moment, but the amount of time that that happiness lasts biggest bang for your buck when it comes to doing something to help your mood. So focusing others is huge. And then the other here, again, a theme that we've found on the podcast but is so, so important, and I love the way that Johann presented this, which is that even if you are in pain, you can always make [01:01:00] someone else feel a little bit better, even if you're depressed, even if you're suffering, even if you're overwhelmed, there's always some little thing that you can do.

To help someone else's day go a little bit better. And that in turn, selfishly will help your mood. , and then a really interesting piece of data that, , is related to society at large is that the Amish population has much lower rates of depression than the average American, despite being in this same geographic environment.

Their rates of depression are dramatically different from ours in the general world outside of those communities. So how are they leaning into that sense of community, sharing those experiences, focusing on others, having a sense of meaning and purpose, all those things that we mentioned. The next thing that Johan talks about that I wanted to touch on is social prescribing.

So this is the next solution. And so he talks to a clinician who explains that patients are depressed. Because their lives have been stripped of the things that make life worth living. We talk about this on the podcast all the time as DVT framework as well of, [01:02:00] of life worth living. Like your life isn't worth living because it doesn't have these things that would make it meaningful.

, and so the questions we should ask ourselves is not what's the matter with you, but what matters to you? What would make our lives worth living? What can we do to increase those things in our life and find a tiny bit of hope based on those things that matter to us? Next solution, meaningful work. , and the kind of unlock here is choosing it like , that sense of autonomy is really important.

So you choose the position, you see a difference that it makes where maybe you are working directly with a population or maybe it really to your own experience, you can see the change and shift that's happening and that you directly benefit from it, right? Like, so for me, I think, and I hope that working in a career in psychology, knowing that I struggled and also like learning all these things about mental health helps my own experience.

I choose it. I see the difference it makes when you guys send me the best messages and listen to the podcast and say that you appreciate, , hearing about all the things and I directly benefited from it, right? Like reading these books, [01:03:00] learning these things I implemented in my own life and feel better as a result.

And then also within meaningful work, reconnecting to a sense of status. So knowing that like , I matter and I have a role in society and I understand what that is, and that won't go away overnight. And then reconnecting to the future. And I absolutely love the anecdote that Johan gives, , in the book, which is that a researcher, went and worked with adolescent patients and psychiatric wards and he worked with anorexic patients and then he worked with depressed patients and they were adolescent teens, and he would ask 'em all these questions and for the most part, mentally they were functioning great, right?

Like they were smart. They could carry a conversation. There wasn't anything that was like super wrong.

. When he asked anorexic patients about their futures, their own futures, like trying to think about what would happen next and happen down the line, they were doing it, it was fine. But when he asked Suicidally depressed teens to talk about what would happen in their future or in his own future and just think about what would happen like weeks and months from now, they weren't able to do it.

Like there truly was this [01:04:00] complete disconnect from today to what would happen down the line. And this is a really interesting phenomenon that takes place in depression. And it's kind of unclear if like, because you're suicidal, do you therefore not identify with and have any attachment towards the future, or do you not have any attachment towards the future and as a result are suicidal and depressed?

Like the relationship there is kind of unclear, but reconnecting to the future and having plans down the line and things you're looking forward to is really important within that meaningful work context. Then values, we talked about focusing on intrinsic things, making sure those internal needs get met.

Sympathetic joy and overcoming addiction to the self. So how can we be more other focused? How can we celebrate others, support them in their experiences, rather than just being so focused on the internal and being really isolated in those emotional experiences. And then healing and working through childhood wounds.

Because again, we know that makes us more predisposed, , to depression because it's a normal response to something that happened to us. So that is our very long, very extensive, but I hope, maybe not [01:05:00] enjoyable, but interesting. summary of Lost Connections by Johann Hari. It's a really fascinating way to look at and unpack and understand why we individually are depressed, but why as a society we're seeing more depression than we ever have before, and how can we think about this differently, especially being more aware of the misinformation that's at play on a larger scale.

So. If you guys are interested in the book, even though I just gave you a full summary, it'll be in the show notes,

so if you guys enjoyed this really long, extensive episode, please review, subscribe, share with a friend or family member, tag me on social media and if you guys have other books that you want me to do for book club, please let me know. , and if you guys like the series or you're like, it's just too much, please don't give us this misinformation, also let me know that.

, but I think it's kind of a, a fun way to distill findings so I really enjoyed it. I hope you guys enjoy as well. And with that, I will talk to you guys later this week for our next episode, but I hope you're having a great week and that you enjoyed the episode and I'll talk to you all soon. .

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