The Root Cause of Depression

We all know that every human being has basic physical needs: for food, for water, psychological needs (Maslow’s Hierarchy of Basic Needs).

A great deal of Maslow’s work was devoted to how people got the best from themselves. He researched productive, well-balanced and happy people. Initially he studied the famous – like Lincoln- and later the non-famous. He found common characteristics throughout. These were a love of life, creativity, high energy, a sense of humour and good relationships in their lives. People with these characteristics are self-fulfilled. Maslow called them Self-actualised: that is, they are using their full potential.

Johann Hari a Social Scientist carried out an interview with a number of social scientists all over the world – from São Paulo to Sydney, from Los Angeles to London his findings revealed an unexpected picture emerging.

We need to feel we belong. We need to feel valued. We need to feel we’re good at something. We need to feel we have a secure future. And there is growing evidence that our culture isn’t meeting those psychological needs for many – perhaps most – people. We have somehow become disconnected from things we really need, and this deep disconnection is driving this epidemic of depression and anxiety all around us.

Looking at it from a different perspective, let’s look at one of those causes, and one of the solutions. There is strong evidence that human beings need to feel their lives are meaningful – that they are doing something with purpose that makes a difference. It’s a natural psychological need. But between 2011 and 2012, the polling company Gallup conducted the most detailed study ever carried out of how people feel about the thing we spend most of our waking lives doing – our paid work. They found that 13% of people say they are “engaged” in their work – they find it meaningful and look forward to it. Some 63% say they are “not engaged”, which is defined as “sleepwalking through their workday”. And 24% are “actively disengaged”: they hate it.

From the research most of the depressed and anxious people formed part of the 87% who don’t like their work. A breakthrough had been made in answering this question in the 1970s, by an Australian scientist called Michael Marmot. He wanted to investigate what causes stress in the workplace and believed he’d found the perfect lab in which to discover the answer: the British civil service, based in Whitehall. This small army of bureaucrats was divided into 19 different layers, from the permanent secretary at the top, down to the typists. What he wanted to know, at first, was: who’s more likely to have a stress-related heart attack – the big boss at the top, or somebody below him?

Everybody told him: you’re wasting your time. Obviously, the boss is going to be more stressed because he’s got more responsibility. But when Marmot published his results, he revealed the truth to be the exact opposite. The lower an employee ranked in the hierarchy, the higher their stress levels and likelihood of having a heart attack. Now he wanted to know: why?

Lack of Meaning and Control

And that’s when, after two more years studying civil servants, he discovered the biggest factor. It turns out if you have no control over your work, you are far more likely to become stressed – and, crucially, depressed. Humans have an innate need to feel that what we are doing, day-to-day, that is meaningful.

Suddenly, the depression of many people even those in fancy jobs – who spend most of their waking hours feeling controlled and unappreciated – started to look not like a problem with their brains, but a problem with their environments. Apparently there many causes of depression like this. So how to feel better – how to find real and lasting antidepressants that work for most of us, beyond only the packs of pills we have been offered as often the sole item on the menu for the depressed and anxious. According to Dr Joanne Cacciatore, of Arizona State University, we have to deal with the deeper problems that are causing all this distress.

The Epidemic of Meaningless Work

Case Study: Meredith Mitchell used to wake up every morning with her heart racing with anxiety. She dreaded her office job. So she took a bold step – one that lots of people thought was crazy. Her husband, Josh, and their friends had worked for years in a bike store, where they were ordered around and constantly felt insecure – most of them were depressed. One day, they decided to set up their own bike shop, but they wanted to run it differently. Instead of having one guy at the top giving orders, they would run it as a democratic co-operative. This meant they would make decisions collectively, they would share out the best and worst jobs and they would all, together, be the boss. It would be like a busy democratic tribe. What was discovered at Baltimore Bicycle Works, the staff explained how, in this different environment, their persistent depression and anxiety had largely lifted.

It’s not that their individual tasks had changed much. They fixed bikes before; they fix bikes now. But they had dealt with the unmet psychological needs that were making them feel so bad – by giving themselves autonomy and control over their work. Josh, one of the workers had seen for himself that depressions are very often, as he put it, “rational reactions to the situation, not some kind of biological break”. What he said was there is no need to run businesses anywhere in the old humiliating, depressing way – we could move together, as a culture, to workers controlling our own workplaces.

Professor John Cacioppo of Chicago University who has worked with a number of patients suffering from depression said that being acutely lonely is as stressful as being punched in the face by a stranger – and massively increases your risk of depression. Professor Michael Chandler in Vancouver explained that if a community feels it has no control over the big decisions affecting it, the suicide rate will shoot up.

So, is there a solution to our despair crisis? In the early days of the 21st century, a South African psychiatrist named Derek Summerfeld went to Cambodia, at a time when antidepressants were first being introduced there. He met few doctors who told him they didn’t need these new antidepressants, because they already had anti-depressants that work. He assumed they were talking about some kind of herbal remedy.

He asked them to explain, and they told him about a rice farmer they knew whose left leg was blown off by a landmine. He was fitted with a new limb, but he felt constantly anxious about the future, and was filled with despair. The doctors sat with him, and talked through his troubles. They realised that even with his new artificial limb, his old job—working in the rice paddies—was leaving him constantly stressed and in physical pain, and that was making him want to just stop living. So they had an idea. They believed that if he became a dairy farmer, he could live differently. So they bought him a cow. In the months and years that followed, his life changed. His depression—which had been profound—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 the brain chemistry. It meant finding a way to solve the problem that was causing the depression in the first place. We can do the same. Some of these solutions are things we can do as individuals, in our private lives. Some require bigger social shifts, which we can only achieve together, as citizens. But all of them require us to change our understanding of what depression and anxiety really are.

In its official statement for World Health Day in 2017, the United Nations reviewed the best evidence and concluded that “the dominant biomedical narrative of depression” is based on “biased and selective use of research outcomes” that “must be abandoned”. We need to move from “focusing on chemical imbalances”, they said, to focusing more on “power imbalances”.

I believe we can help our youngsters understand more about depression, and telling them that the pain they are feeling is not a pathology. They are not crazy or going crazy. It is a signal that their natural psychological needs are not being met. But we all need to listen to this signal. We all need to listen to the people around us sending out this signal. It is telling us what is going wrong. It is telling us that we need to be connected in so many deep and stirring ways that we aren’t yet – but we can be, one day.

Being depressed and anxious is not about a machine with malfunctioning parts. It is about a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs – for deep connection, to the things that really matter in life.

My Conclusion

Johann Hari’s findings can be one of the element we can look as part of the solution, because external factors in our life can form part, if not be the main part of an eventual depression diagnosis. Depression can be classed as mild, moderate to severe or chronic “DSM-IV-TR” refers. We have to take into consideration that Depression is a very complex subject. Everyone experiences different events and develops depression in their brain’s own special way, and thus it’ll need to be tackled differently from person to person too. Antidepressants are a godsend to many people and might work (or actually might make things worse) for others.

Chantal HELENE


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Source: Extract from Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions – Johann Hari