Introduction: A Mystery
addictions to legal and illegal drugs are now so widespread that the life expectancy of white men is declining for the first time in the entire peacetime history of the United States
I was told by my doctor that I was suffering from both depression and acute anxiety. I had believed that those were separate problems, and that is how they were discussed for the thirteen years I received medical care for them. But I noticed something odd as I did my research. Everything that causes an increase in depression also causes an increase in anxiety, and the other way around. They rise and fall together
Unhappiness and depression are totally different things. There is nothing more infuriating to a depressed person than to be told to cheer up, or to be offered jolly little solutions as if they were merely having a bad week. It feels like being told to cheer yourself up by going out dancing after you've broken both your legs
As you read this book, please look up and read the scientific studies I'm referencing in the endnotes as I go, and try to look at them with the same skepticism that I brought to them. Kick the evidence. See if it breaks. The stakes are too high for us to get this wrong
The Wand
The third group, Irving says, is really important—although almost all studies leave it out. "Imagine," he explains, "that you are investigating a new remedy for colds." You give people either a placebo or a drug. Over time, everyone gets better. The success rate seems amazing. But then you remember: lots of people with a cold recover within a few days anyway. If you don't factor that in, you'll get a really misleading impression about how well a cold remedy works—it would look like the drug was curing people who were just recovering naturally. You need the third group to test the rate that people will simply get better on their own, without any help
The Grief Exception
Far from being irrational, Joanne says, the pain of grief is necessary. "I don't even want to recover from her death," she says about her daughter Chayenne. "Staying connected to the pain of her death helps me to do my work with such a full, compassionate heart," and to live as fully as she can. [...] It made her fully understand the pain of others in a way she couldn't before. It "makes me stronger," she says, "even in my vulnerable places"
I told her that in thirteen years of being handed over higher doses of antidepressants, no doctor ever asked me if there was any reason why I might be feeling so distressed. She told me I'm not unusual—and it's a disaster. The message my doctors gave me—that our pain is simply a result of a malfunctioning brain—makes us, she told me, "disconnected from ourselves, which leads to disconnection from others"
In most cases, Joanne says, we would have to stop talking about "mental health"—which conjure pictures of brain scans and defective synapses—and start talking about "emotional health." "Why do we call it mental health?" she asked me. "Because we want to scientize it. We want to make it sound scientific. But it's our emotions"
Sometimes, all you can do for a person is hold them. The mother whose daughter was burned alive came to see Jo one day howling and screaming with pain. Jo sat on the floor, and held her, and let the pain come out, and after it did, the mother felt some relief, for a time, because she knew she was not alone. Sometimes, that is the most we can do. It's a lot
I was beginning to think there was something significant about the fact that grief and depression have identical symptoms. Then one day, after interviewing several depressed people, I asked myself: What if depression is, in fact, a form of grief—for our own lives not being as they should? What if it is a form of grief for the connections we have lost, yet still need?
The First Flag on the Moon
"What I recall was how moving the interviews could be," George told me when I went to see him. "These women on the whole weren't used to talking about themselves. Here was someone who showed interest in them, and someone who had allowed them to talk." He could see "it meant something to the women"
Cause One: Disconnection from Meaningful Work
The attitude of his employers, he told me, was: "You're going to do it this way. And you're going to show up at this time. And as long as you do that, you're fine." But he found himself thinking, as he put it to me, as he put it to me, "Where's the ability to change? Where's the ability to grow? Where's the ability to really make an impact on this company that I'm working for? Because anyone can just show up on time, do what they tell you to do."
Joe felt like his human thoughts and insights and feelings were almost a defect. But whenever he told me about how his work made him feel, as we ate dinner in a Chinese restaurant, Joe would chastise himself soon afterward. "There's people out there who would die for this job, and I understand that. I'm grateful for that." It was reasonably paid; he could live with his girlfriend in an okay place; he knew plenty of people who didn't have any of that. He felt guilty for feeling this way. But then the feelings kept coming back
He began to wonder—you "go through this forty- to fifty-hour workweek, and if you don't really like it, you're just setting yourself up for depression, and anxiety. And questioning—why am I doing this? There's got to be something better than this." He started to feel, he said, that there was "no hope. What's the point?"
"You have to be challenged in a healthy way," he told me, shrugging a little; I think he felt embarrassed to say it. "You have to know that your voice counts. You have to know that if you have a good idea, you can speak up, and change something." He had never had a job like that, and he feared he never would.
If you spend so many of your waking hours deadening yourself to get through the day, it's hard—he explained—to turn that off and be engaged with the people you love when you get home. Joe would have five hours to himself before he had to sleep and then shake paint again. He wanted to just collapse in front of the television, or to be alone. On weekends, all he wanted to do was drink a lot and watch a game
Between 2011 and 2012, the polling company Gallup conducted the most detailed study ever carried out of how people across the world feel about their work. They studied millions of workers across 142 countries. They found that 13 percent of us say we are "engaged" in our jobs—which means they are "enthusiastic about, and committed to their work and contribute to their organization in a positive manner."
Against them, 63 percent say they are "not engaged," which is defined as "sleepwalking through their workday, putting time—but not energy or passion—into their work."
And a further 24 percent are "actively disengaged." They, Gallup explained, "aren't just unhappy at work; they're busy acting out their unhappiness. Every day, these workers undermine what their engaged co-workers accomplish ... Actively disengaged employees are more or less out to damage their company"
One professor who has studied this in detail writes: "A recent survey has confirmed that nine to five is indeed a relic of the past. Today the average worker checks their work e-mail at 7.42 am, gets to the office at 8.18 am and leave as 7.19 pm ... The recent survey found that one in three British workers check their e-mails before 6.30 am, while 80% of British employers consider it acceptable to phone employees out of hours." The concept of "work hours" is vanishing for most people—so this thing that 87 percent of us don't enjoy is spreading over more and more of our lives
A common symptom of depression is something called "derealization"—which is where you feel like nothing you are doing is authentic or real
Who's more likely to have a heart attack? Who's more likely to be overwhelmed? Who's more likely to become depressed? Almost everyone believed the answer was clear: It was the boss. He has a more stressful job. He has to take really tough decisions, with big consequences. The guy doing his filing has a lot less responsibility; it will weigh on him less; his life will be easier [...]
After years of intensive interviewing, Michael and the team added up the results. It turned out the people at the top of the civil service were four times less likely to have a heart attack than the people of the bottom of the Whitehall ladder
Michael noticed right away a difference between the different rungs on this social ladder. When he talked with the top-level civil servants, they would lean back and take charge of the conversation, demanding to know what Michael wanted. When he talked to the lower-grade civil servants, they would lean forward and wait for him to tell them what to do
The higher up you went in the civil service, he found, the more friends and social activity you had after work. The lower you went, the more that tapered off—the people with boring, low-status jobs just wanted to collapse in front of the television where they got home. Why would that be? "When work is enriching, life is fuller, and that spills over into the things you do outside work," he said to me. But "when it's deadening," you feel "shattered at the end of the day, just shattered"
If these tax inspectors worked really hard and gave it their best, nobody noticed. And if they did a lousy job, nobody noticed, either. Despair often happen, he had learned, when there is a "lack of balance between efforts and rewards." It was the same for Joe in his paint shop. Nobody ever noticed how much effort he put in. The signal you get from the world, in that situation, is—you're irrelevant. Nobody cares what you do
Back in Philly, I started to tell Joe about the Whitehall studies and the other scientific evidence I had learned about. He was interested at first, but after a while, he said, a little impatiently: "You get real in-depth and intellectual with all that stuff, but when it comes down to it—doing anything, and not having a purpose behind it, and then feeling like you don't have any other option except to continue: it's terrible. At least for me, it turns into—well, what's the point?"
There was one last thing about Joe that puzzled me. He hated working in paint, but unlike a lot of people, Joe wasn't trapped: he didn't have kids or any responsibilities; he was still young, and he had an alternative. "I love to fish," he told me. "My goal is to fish all fifty state before I die. I have [done] twenty-seven of them, at [the age of] thirty-two." He's looked into being a fishing guide in Florida. It pays a lot less than he earns now, but he would love it. He would look forward to work every day. He thought out loud what that would be like. He asked: "Do you sacrifice monetary stability to do something you thoroughly enjoy, but, at the same time—the cost of living..."
Joe had been thinking about quitting and going to Florida for years. "I can only speak for myself," he said, "that when I leave work every day, I have this overwhelming feeling—there's no way this is all that's on the horizon for me. There's time when I say to myself—dude, quit your job ... Move to Florida, and be a fishing guide on a boat, and you'll be happy."
So I asked—why don't you do it, Joe? Why don't you leave? "Right," he said. And he looked hopeful. And then he looked afraid. Later in our conversation, I came back to it. "You could do it tomorrow," I said. "What's stopping your?" There's a part of all of us, he says, that thinks "if I keep buying more stuff, and I get the Mercedes, and I buy the house with the four garages, people on the outside [will] think I'm doing good, and then I can will myself into being happy." He wanted to go. Yet he was being blocked by something neither he nor I fully understood. Ever since then, I've been trying to understand why Joe probably won't go. Something keeps many of us trapped in those situations that's more than just needing to pay the bills. I was going to investigate it soon.
As I said goodbye to Joe, and he began to walk away, I called after him: "Go to Florida!" The moment I said it, I felt foolish. He didn't look back
Cause Two: Disconnection from Other People
In Edgware, people weren't hostile. We know our neighbors to smile at. But that was it; any attempt at engagement beyond brief chitchat was shut down
Feeling lonely, it turned out, caused your cortisol levels to absolutely soar—as much as some of the most disturbing things that can ever happen to you. Becoming acutely lonely, the experiment found, was as stressful as experiencing a physical attack
What he wanted to know was—would the isolated people get sicker than the connected people? It turned out that they were three times more likely to catch the cold than people who had lots of close connections to other people
Another scientist, Lisa Berkman, had followed both isolated and highly connected people over nine years, to see whether one group was more likely to die than the other. She discovered that isolated people were two to three times more likely to die during that period. Almost everything became more fatal when you were alone: cancer, heart disease, respiratory problems.
Loneliness itself, John was slowly discovering as he pieced together the evidence, seemed to be deadly. When they added up the figures, John and other scientists found that being disconnected from the people around you had the same effect on your health as being obese—which was, until then, considered the biggest health crises the developed world faced
It turned out that—for the initial five years of data that have been studied so far—in most cases, loneliness preceded depressive symptoms. You became lonely, and that was followed by feelings of despair and profound sadness and depression
This would help us to understand why loneliness so often comes alongside anxiety. "Evolution fashioned us not only to feel good when connected, but to feel secure," John writes. "The vitally important corollary is that evolution shaped us not only to feel bad in isolation, but to feel insecure
Anywhere in the world where people describe being lonely, they will also—throughout their sleep—experience more of something called "micro-awakenings." These are small moments you won't recall when you wake up, but in which you rise a little from your slumber. All other social animals do the same thing when they're isolated too. The best theory is that you don't feel safe going to sleep when you're lonely, because early humans literally weren't safe if they were sleeping apart from the tribe. You know nobody's got your back—so your brain won't let you go into full sleep mode. Measuring these "micro-awakenings" is a good way of measuring loneliness. So John's team wired up the Hutterites, to see how many of them they experienced each night.
It turned out they had barely any. "What we found was that the community showed the lowest level of loneliness that I'd seen anywhere in the world," John explained to me. "It really stunned me."
This showed that loneliness isn't just some inevitable human sadness, like death. It's a product of the way we live now
social scientists have been asking a cross-section of U.S. citizens a simple question for years: "How many confidants do you have?" They wanted to know how many people you could turn to in a crisis or when something really good happens to you. When they started doing the study several decades ago, the average number of close friends an American had was three. By 2004, the most common answer was none.
It's worth pausing on that: there are now more Americans who have no close friends than any other option
And it's not that we turned inward to our families. The research he gathered showed across the world we've stopped doing stuff with them, too. We eat together as families far less; we go on vacation together far less. "Virtually all forms of family togetherness," Putnam shows with a battery of graphs and studies, "became less common over the last quarter of the twentieth century." There are similar figures for Britain and the rest of the Western world
I noticed that in the room next to mine, the door was always open, the TV was always on, and a middle-aged man was perched on the bed, rocking a little, in a strange and awkward position.
The fifth time I walked past, I stopped to ask him what was wrong. He told me in a voice that was hard to understand that he had gotten in a fight with his stepson a few days before—he wouldn't say why—and his stepson had beaten him up and beaten his jaw. He'd been to the hospital a few days ago, he said, and they were going to operate on him in forty-eight hours, but in the meantime they'd given him a prescription for pain meds and sent him on his way. The only problem was that he didn't have any money to fill the prescription, so he was sitting there, weeping, alone.
I wanted to say: Don't you have any friends? Isn't there anyone who can help you? But it was clear he had nobody. So he was sitting there, crying softly into his broken jaw
For example, Professor Martha McClintock separated our lab rats. Some were raised in a cage, alone. Others were raised in groups. The isolated rats developed eighty-four times the number of breast cancer tumors as the rats who had a community
When he put lonely people into brain-scanning machines, he noticed something. They would spot potential threats within 150 milliseconds, while it took socially connected people twice as long, 300 milliseconds, to notice the same threat. What was happening?
Protracted loneliness causes you to shut down socially, and to be more suspicious of any social contact, he found. You become hypervigilant. You start to be more likely to take offense where none was intended, and to be afraid of strangers. You start to be afraid of the very thing you need most. John calls this a "snowball" effect, as disconnection spirals into more disconnection.
Lonely people are scanning for threats because they unconsciously know that nobody is looking out for them, so no one will help them if they are hurt. The snowball effect, he learned, can be reversed—but to help a depressed or severely anxious person out of it, they need more love, and more reassurance, than they would have needed in the first place.
The tragedy, John realized, is that many depressed and anxious people receive less love, as they become harder to be around. Indeed, they receive judgment and criticism, and this accelerates their retreat from the world. They snowball into an every colder place
Surprisingly, the sensation of loneliness didn't have much to do with how many people you spoke to every day, or every week. Some of the people in his study who felt most lonely actually talked to lots of people every day. "There's a relatively low correlation between the objective connections and perceived connections," he says.
I puzzled when John first told me this. But when he told me to picture being alone in a big city, where you hardly know anyone. Go to a major public square—the equivalent of Times Square, or the Vegas Strip, or the Place de la République. You won't be alone anymore: the place will be crammed with people. But you'll feel lonely—probably acutely lonely.
Loneliness isn't the physical absence of the other people, he said—it's the sense that you're not sharing anything that matters with anyone else. If you have lots of people around you—perhaps even a husband or wife, or a family, or a busy workplace—but you don't share anything that matters with them, then you'll still be lonely. To end loneliness, you need to have a sense of "mutual aid and protection," John figured out, with at least one other person, and ideally many more
The Internet was born into a world where many people had already lost their sense of connection to each other. The collapse had already been taking place for decades by then. The web arrived offering them a kind of parody of what they were losing—Facebook friends in place of neighbors, video games in place of meaningful work, status updates in place of status in the world. The comedian Marc Maron once wrote that "every status update is a just of variation on a single request: 'Would someone please acknowledge me?'"
Cause Three: Loss of Meaningful Values
The first are called intrinsic motives—they are the things you do purely because you value them in and of themselves, not because of anything you get out of them. When a kid plays, she's acting totally on intrinsic motives—she's doing it because it gives her joy. The other day, I asked my friend's five-year-old son why he was playing. "Because I love it," he said. Then he scrunched up his face and said, "You're silly!" and ran off, pretending to be Batman. These intrinsic motivations persist all through our lives, long after childhood.
At the same time, there's a rival set of values, which are called extrinsic motives. They're the things you do not because you actually want to do them, but because you'll get something in return—whether it's money, or admiration, or sex, or superior status. Joe, who you met two chapters ago, went to work every day in the paint shop for purely extrinsic reasons—he hated the job, but he needed to be able to pay the rent, buy the Oxy that would numb his way through the day, and have the car and clothes that he thought made people respect him. We all have some motives like that
thinking extrinsically poisons your relationships with other people. He teamed up again with another professor, Richard Ryan—who had been an ally from the start—to study two hundred people in depth, and they found that the more materialistic you become, the shorter your relationships will be, and the worse their quality will be. If you value people for how they look, or how they impress other people, it's easy to see that you'll be happy to dump them if someone hotter or more impressive comes along. And at the same time, if all you're interested in is the surface of another person, it's easy to see why you'll be less rewarding to be around, and they'll be more likely to dump you, too. You will have fewer friends and connections, and they won't last as long
Every day, Tim spends at least half an hour playing the piano and singing, often with his kids. He does it for no reason except that he love it—it makes him, on a good day, feel satisfied, and joyful. He feels his ego dissolve, and he is purely present in the moment. There's strong scientific evidence that we all get most pleasure from what are "flow states" like this—moments when we simply lose ourselves doing something we love and are carried along in the moment. They're proof we can maintain the pure intrinsic motivation that a child feels when she is playing.
But when Tim studied highly materialistic people, he discovered they experience significantly fewer flow states than the rest of us. Why would that be?
He seems to have found an explanation. Imagine if, when Tim was playing the piano every day, he kept thinking: Am I the best piano player in Illinois? Are people going to applaud this performance? Am I going to get paid for this? How much? Suddenly his joy would shrivel up like a salted snail. Instead of his ego dissolving, his ego would be aggravated and jabbed and poked.
That is what your heads starts to look like when you become materialistic. If you are doing something not for itself but to achieve an effect, you can't relax into the pleasure of a moment. You are constantly monitoring yourself. Your ego will shriek like an alarm you can't shut off
Even if you're the richest person in the world, how long will that last? Materialism leaves you constantly vulnerable to a world beyond your control
"I can't do both. It's one or the other. If my materialistic values are bigger, I'm going to stay and work. If my family values are bigger, I'm going to go home and play with my kids." It's not that materialistic people don't care about their kids—but "as the materialistic values get bigger, other values are necessarily going to be crowded out," he says, even if you tell yourself they won't
There's an experiment, by a different group of social scientists, that gives us one early clue. In 1978, two Canadian social scientists got a bunch of four- and five-year-old kids and divided them into two groups. The first group was shown no commercials. The second group was shown two commercials for a particular toy. Then they offered these four- or five-year-old kids a choice. They told them: You have to choose, now, to play with one of these two boys here. You can play with this little boy who has the toy from the commercials—but we have to warn you, he's not a nice boy. He's mean. Or you can play with a boy who doesn't have the toy, but who is really nice.
If they had seen the commercial for the toy, the kids mostly chose to play with the mean boy with the toy. If they hadn't seen the commercial, they mostly chose to play with the nice boy who had no toys.
In other words, the advertisements led them to choose an inferior human connection over a superior human connection—because they'd been primed to think that a lump of plastic is what really matters
Imagine if I watched an ad and it told me—Johann, you're fine how you are. You look good. You smell good. You're likable. People want to be around you. You've got enough stuff now. You don't need any more. Enjoy life.
That would—from the perspective of the advertising industry—be the worst ad in human history, because I wouldn't want to go out shopping, or lunge at my laptop to spend, or do any of the other things that feed my junk values. It would make me want to pursue my intrinsic values—which involve a whole lot less spending, and a whole lost more happiness.
When they talk among themselves, advertising people have been admitting since the 1920s that their job is to make people feel inadequate—and then offer their product as the solution to the sense of inadequacy they have created
Most people know all this in their hearts, he believes. "At some level I really believe that most people know that intrinsic values are what's going to give them a good life," he told me. When you do surveys and ask people what's most important in life, they almost always name personal growth and relationships as the top two. "But I think part of why people are depressed is that our society is not set up in order to help people live lifestyles, have jobs, participate in the economy, [or] participate in their neighborhoods" in ways that support their intrinsic values. The change Tim saw happening in Florida as a kid—when the beachfronts were transformed into shopping malls and people shifted their attention there—has happened to the whole culture
Cause Four: Disconnection Because of Trauma
It turned out that for every category of traumatic experience you went through as a kid, you were radically more likely to become depressed as an adult. If you had six categories of traumatic events in your childhood, you were five times more likely to become depressed as an adult than somebody who didn't have any. If you had seven categories of traumatic event as a child, you were 3,100 percent more likely to attempt to commit suicide as an adult
Curiously, it turned out emotional abuse was more likely to cause depression than any other kind of trauma—even sexual molestation. Being treated cruelly by your parents was the biggest driver of depression, out of all these categories
Why do so many people who experience violence in childhood feel the same way? Why does it lead many of them to self-destructive behavior, like obesity, or hardcore addiction, or suicide? I have spent a lot of time thinking about this. When you're a child, you have very little power to change your environment. You can't move away, or force somebody to stop hurting you. So you have two choices. You can admit to yourself that you are powerless—that at any moment, you could be badly hurt, and there's simply nothing you can do about it. Or you can tell yourself it's your fault. If you do that, you actually gain some power—at least in your own mind. If it's your fault, then there's something you can do that might make it different. You aren't a pinball being smacked around a pinball machine. You're the person controlling the machine. You have your hands on the dangerous levers. In this way, just like obesity protected those women from the men they feared would rape them, blaming yourself for your childhood traumas protects you from seeing how vulnerable you were and are. You can become the powerful one. If it's your fault, it's under your control.
But that comes at a cost. If you were responsible for being hurt, then at some level, you have to think you deserved it. A person who thinks they deserved to be injured as a child isn't going to think they deserve much as an adult, either
Dr. Anda—one of the pioneers of this research—told me it had forced him to turn his thinking about depression and other problems inside out.
"When people have these kind of problems, it's time to stop asking what's wrong with them," he said, "and time to start asking what happened to them"
Cause Five: Disconnection from Status and Respect
To avoid getting savaged, the baboons with the lowest status would have to compulsively show that they knew they were defeated. They would do this by making what are called subordinance gestures—they lowered their heads, crawled on their bellies. It was how they signaled: Stop attacking me. I'm beaten. I'm no threat to you. I give up.
And here's the striking thing. When a baboon is behaving this way—when nobody around him shows him any respect, and he's been pushed to the bottom of the pile—he looks an awful lot like a depressed human being. He keeps his head down and his body low; he doesn't want to move; he loses his appetite; he loses all his energy; when somebody near comes him, he backs away
The more unequal your society, the more prevalent all forms of mental illness are. Other social scientists then broke this down to look at depression specifically—and found the higher the inequality, the higher the depression. This is true if you compare different countries, and if you compare different states within the United States. It strongly suggested that something about inequality seems to be driving up depression and anxiety
Cause Six: Disconnection from the Natural World
I coughed and explained to Isabel as politely as possible that I don't do nature. I like nice concrete walls, covered with bookshelves. I like skyscrapers. I like subway stations opening out onto taco trucks. I regard Central Park as excessively rural, and walk up Tenth Avenue to avoid it. I go out into the natural world only when I'm forced to because I'm chasing a story.
So Isabel explained—no mountain trek, no interview. "Come on," she said. "Let's see where we can avoid dying and take a danger selfie!" And so, reluctantly—for journalistic reasons only—I began to trudge. As we started to walk, it occurred to me that of all the people I know, Isabel is the one most likely to survive an apocalypse
In the State Prison of Southern Michigan in the 1970s, there was—quite by accident—an experiment exploring one of these ideas. Because of the way the prison was built, half the prisoners' cells looked out over rolling farmland and trees, and half looked out onto bare brick walls. An architect named Ernest Moore studied the medical records for these different groups of prisoners (who didn't suffer in any other way), and he found that if you were in the group who could see the natural world, you were 24 percent less likely to get physically or mentally sick
Cause Seven: Disconnection from a Hopeful or Secure Future
"Almost unique to the suicidal group was a kind of across-the-board failure to be able to understand how a person coudl go on being the same individual," Michael told me. The very depressed kids could answer all sorts of other questions normally—but when it came to these questions about what they or anyone else would be in the future, they would look puzzled. They knew they should be able to give an answer. But then they would say, sadly: "I don't have the foggiest idea."
And here's the interesting thing. Just as they couldn't see who Jean Valjean would be in the future, it turned out they couldn't see who they, as individuals, would be in the future, either. For them, the future had disappeared. Asked to describe themselves five or ten or twenty years from now, they were at a loss. It was like a muscle they couldn't work.
At some professional level, Michael had discovered, extremely depressed people have become disconnected from a sense of the future, in a way that other really distressed people have not
After we graduated, Angela explained, she earned a master's degree, and when she started to apply for jobs, she kept getting a consistent piece of feedback: they said she was overqualified and that if they offered her a place, she would only leave. This dragged on for months. And then a year had passed, and she was still hearing the same thing. Angela was a hard worker, and being out of work was weird for her. In the end, she couldn't pay her bills, so she applied for shifts at a call center at £8 (around $10) an hour, a little above Britain's minimum wage at the time
She was auditioning for her job every hour, every call, she said. It made her feel "frightened of going in to work," she says, "because of how horrible the day would be, and the fear that this would be the day I really fucked up and got fired, and then we would be in trouble."
She realized one day that she could never shake off "that sense of having no future." She couldn't plan even a few days ahead
For the past thirty years, across almost all of the Western world, this kind of insecurity has been characterizing work for more and more people. Around 20 percent of people in the United States and Germany have no job contract, but instead have to work from shift to shift. They Italian philosopher Paolo Virno says we have moved from having a "proletariat"—a solid block of manual workers with jobs—to a "precariat," a shifting mass of chronically insecure people who don't know whether they will have any work next week and may never have a stable job.
When Angela had a sense of a positive future, back when we were students, she had been a whirl of positivity. Now, sitting opposite me, talking about being choked off from a sense of a hopeful future, she was drained, almost affectless.
There was a window when people on the middle-class and working-class incomes had some sense of security and could plan for the future. That window has been closing, as a direct result of political decisions to free businesses from regulation and to make it very hard for workers to organize to protect their rights, and what we are losing is a predictable sense of the future. Angela didn't know what was waiting for her. Working this way meant she couldn't create a picture of her in a few months, never mind in a few years, or a few decades.
First, this sense of precariousness started with people in the lowest-paying jobs. But ever since, it has been rising further and further up the chain. By now, many middle-class people are working from task to task, without any contract or security. We give it a fancy name: we call it being "self-employed," or the "gig economy"—as if we're all Kanye playing Madison Square Garden. For most of us, a stable sense of the future is dissolving, and we are told to see it as a form of liberation
Causes Eight and Nine: The Real Role of Genes and Brain Changes
Your brain, he said, is like that: it changes according to how you use it. "Neuroplasticity is the tendency for the brain to continue to restructure itself based on experience," he said [...] For as long as you live, this neuroplasticity never stops, and the brain "is always changing," Marc explained to me. This is why, he says, what I was told as a teenager about my brain was badly wrong: he told me that a doctor saying to a depressed person "'now you've got a fucked-up brain, because it's different from a normal brain,' makes no sense in the current context—because we know that brains are changing their wiring all the time. Physiology is always paralleling psychology. It just does." A brain scan is "a snapshot of a moving picture," he says. "You can take a snapshot of any moment in a football game—it doesn't tell you what's going to happen, or where the brain is going." The brain changes as you become depressed and anxious, and it changes again when you stop being depressed and anxious. It's always changing in response to signals from the world.
When Marc was addicted, his brain would have looked very different from the way it does today. That just tells you that he is using it differently
So all those years I was taking antidepressants, insofar as I had thought about depression as related to anything other than a brain malfunction, I had assumed I inherited it in my genes. I sometimes thought of depression as a lost twin, born in the womb alongside me
So genes increase your sensitivity, sometimes significantly. But they aren't—in themselves—the cause
This means that if other genes sometimes work like 5-HTT—and it looks as if they do—then nobody is condemned to be depressed or anxious by their genes. Your genes can certainly make you more vulnerable, but they don't write your destiny. We all know how this works when it comes to weight
Picture a 1950s housewife living before modern feminism. She goes to her doctor to say there is something terribly wrong with her. She says something like: "I have everything a woman could possibly want. I have a good husband who provides for me. I have a nice house with a picket fence. I have two healthy children. I have a car. I have nothing to be unhappy about. But look at me—I feel terrible. I must be broken inside. Please—can I have some Valium"
The feminist classics talk a lot about women like this. There were millions of women saying things just like it. And the women meant what they said. They were sincere. Yet now, if we could go back in a time machine and talk to these women, what we'd say is: You had everything a woman could possibly want by the standards of the culture. You had nothing to be unhappy about by the stands of the culture. But now we know that the standards of the culture were wrong. Women need more than a house and a car and a husband and kids. They need equality, and meaningful work, and autonomy.
I thought again about my elderly friend who was suddenly plunged into despair. He said he felt that nobody needed him, or had any interest in an old man. He said his life from now on was going to be all about being ignored, and it was humiliating, and he couldn't bear it. I wanted to see it as a brain malfunction, I realized now—because I didn't want to see what our culture was doing to him. I was like a doctor telling a 1950s housewife that the only reason a woman could be unhappy—without work, without creativity, and without control over her own life—was a defect in her brain or nerves
So I was worried that if I told people the evidence that depression is not primarily caused by a problem in the brain or the body, I'd be reopening the door to this jeering. See! Even you admit it's not a disease like cancer. So pull yourself together!
We have come to believe that the only route out of stigma is to explain to people that this is a biological disease with purely biological causes. So—based on this positive motive—we have scrambled to find the biological effects, and held them up as evidence to rebut the sneerers
It turns out that you were more likely to hurt somebody if you believed their mental illness was a result of their biochemistry than if you believed it was the result of what had happened to them in life. Believing depression was a disease didn't reduce hostility. In fact, it increased it.
This experiment—like so much of what I had learned—hints at something. For a long time, we have been told there are only two ways of thinking about depression. Either it's a moral failing—a sign of weakness—or it's a brain disease. Neither has worked well in ending depression, or in ending its stigma. But everything I had learned suggests that there's a third options—to regard depression as largely a reaction to the way we are living.
This way is better. Marc said, because if it's an innate biological disease, the most you can hope for from other people is sympathy—a sense that you, with your difference, deserve their big-hearted kindness. But if it's a response to how we live, you can get something richer: empathy—because it could happen to any of us. It's not some alien thing. It's a universal human source of vulnerability.
The evidence suggests Marc is right—looking at it this way makes people less cruel, to themselves and to other people
"it pitches us against parts of ourselves. It says there is a war taking place in your head. On one side there are your feeling of distress, caused by the malfunctions in your brain and genes. On the other side there's the sane part of you. You can only hope to drug the enemy within into submission—forever.
But it does something even more profound than that. It tells you that your distress has no meaning—it's just defective tissue. But "I think we're distressed for good reasons," Rufus said
We Built This City
She had never told anyone before, but she confided to Taina that her husband didn't die in Turkey because he had heart trouble, as she had always said. He died of tuberculosis. "I was always ashamed to say it," she said. "It's a disease of poverty. He didn't have enough food, he didn't have medical care. That's one reason I came here—I thought he would get medical treatment, and maybe I could bring him. But it was too late"
Reconnection One: To Other People
They wanted to know: Does trying consciously to make yourself happier actually work? If you decided—today, now—to dedicate more of your life to deliberately seeking out happiness, would you actually be happier a week from now, or a year from now? The team studied this question in four countries: the United States, Russia (at two different locations), Japan, and Taiwan. They tracked thousands of people, some of whom had decided to deliberately pursue happiness and some of whom hadn't.
When they compared the results, they found something they had no expected. If you deliberately try to become happy, you will not become happier—if you live in the United States. but if you live in Russia, Japan, or Taiwan, you will become happier. Why, they next wanted to know, would that be?
Social scientists have known for a long time that—to put it crudely—there is a significant difference between how we think of ourselves in Western societies and how people in most of Asia conceive of themselves
For example—take a group of Western friends, and show them a picture of a man addressing a crowd. Ask them to describe what they see. Then approach the next group of Chinese tourists you see, show them the same picture, and ask them to describe it. The Westerners will almost always describe the individual at the front of the crowd first, in a lot of detail—then they describe the crowd. For Asians, it's the other way around: they'll usually describe the crowd, and then, afterward, almost as an afterthought, they'll describe the guy at the front.
Or take a picture of a little girl who is smiling broadly, in the middle of a group of other little girls who look sad. Show it to some kids and ask them—does this girl in the middle seem happy or sad to you? Western kids think she is happy. Asian kids think she is sad. Why? Because the Western kids have no problem isolating an individual from a group, whereas Asian kids take it for granted that if a kid is surrounded by distress, he'll be distressed, too
If you decide to pursue happiness in the United States or Britain, you pursue it for yourself—because you think that's how it works. You do what I did most of the time: you get stuff for yourself, you rack up achievement for yourself, you build up your own ego. But if you consciously pursue happiness in Russia or Japan or China, you do something quite different. You try to make things better for you group—for the people around you. That's what you think happiness means, so it seems obvious to you. That's what you think happiness means, so it seems obvious to you. These are fundamentally conflicting visions of what it means to become happier. And it turns out—for all the reasons I described earlier—that our Western version of happiness doesn't actually work—whereas the collectivist vision of happiness does
Yet if I'm honest, that's the kind of solution I craved. Something individual; something you can do alone, without any effort; something that takes twenty seconds to swallow every morning, so you get on with life as it was before. If it couldn't be chemical, I wanted some other trick, some switch I could flip to make it all fine.
What this evidence was telling me was that this search for quick individual solutions is a trap. In fact, this search for individual solutions is part of what got us into this problem in the first place. We have become imprisoned inside our own egos, walled off where true connection cannot reach us
But what I was being taught is—if you want to stop being depressed, don't be you. Don't be yourself. Don't fixate on how you're worth it. It's thinking about you, you, you that's helped to make you feel so lousy. Don't be you. Be us. Be we. Be part of a group. Make the group work it. The real path to happiness, they were telling me, comes from dismantling our ego walls—from letting yourself flow into other people's stories and letting their stories flow into yours; from pooling your identity, from realizing that you were never you—alone, heroic, sad—all along.
No, don't be you. Be connected with everyone around you. Be part of the whole. Don't strive to be the guy addressing the crowd. Strive to be part of the crowd
Freeman Lee loved a lot of things about the outside world, he told me—he still misses watching baseball games on TV, and listening to the latest pop songs. But one of the reason he came back is because he believed an Amish community was a better place to have children, and to be a child. Out in the world, he felt like "you're always just hustling. You have no time for family. You have no time for kids." He couldn't understand what happens to kids in a culture like that. How do they grow up? What kind of life is it? I asked him how his relationship with his kids would change if (say) he got a TV. "We could watch it together," he says, shrugging. "We could enjoy TV time together. It still doesn't do justice [compared] with going out in the backyard. Even if just going to clean the buggy together. It doesn't do justice"
We sat in his front room, surrounded by books (he loved William Faulkner the most), and he explained to me that you can only understand the difference between the Amish world and the outside world if you understand that the Amish have consciously chosen to slow down—and they don't see that as a deprivation
Amish - If we had cars, then our church district is going to be scattered across twenty miles. We couldn't live right beside each other. The neighbors wouldn't come over for supper so often ... There's a physical closeness, and as a result of that a spiritual or mental closeness, too. The automobiles and airplanes are ever convenient, and we see the convenience to that speed, but as a group I suppose we decided to resist it, [so we can instead have] a close-knit community"
We keep each other warm, he stays, by staying together. "I would have loved to be an over-the-road trucker and see the country and get paid and not have to sweat," he says. "I would have loved to watch the NBA playoffs every night. I like watching That '70s Show—I think they're hilarious. but they're not hard to give up"
As a younger man, I would have dismissed all this as just backwardness. But a major scientific study carried out on Amish mental health in the 1970s found that they have significantly lower levels of depression than other Americans. Several smaller studies since have backed up this finding.
It was in Elkhart-LaGrange that I felt I could see most clearly what we have lost in the modern world—and, at the same time, what we have gained. The Amish had a profound sense of belonging and meaning. But I could also see that it would be absurd to see the way they lived as a panacea. Jim and I spent an afternoon with an Amish woman who begged the community to help her when her husband was violently abusing her and their sons. The church elders told her it was the job of an Amish woman to submit to her husband, no matter what. She continued to be violently abused for years, before she finally left—scandalizing many in the community
"I understand how you guys would look at it," he said. "But our thought is—you can have a little bit of heaven here on earth, if you just interact with other people. Because that's how we imagine it to be, you know—when life comes to an end, if you get to heaven, it's interacting with people That's how we look at it." If your picture of a perfect afterlife is being with the people you love all the time, he asked me, why wouldn't you choose today—while you're still alive—to be truly present with the people you love? Why would you rather be lost in a haze of distractions?
Reconnection Two: Social Prescribing
Normally, depressed or anxious people—when they are offered treatment beyond drugs—are put in a position where they have to talk about how they feel, but often that's the last thing they want to do. Their feelings are unbearable. Here they had a place where there was something slow and steady to do, and there was no pressure to talk about anything but that. But as the began to trust one another, they would talk about how they felt—at a pace they were comfortable with
Most people come to their doctors because they are distressed. Even when you have a physical pain—like a bad knee—that will feel far worse if you have nothing else in your life, and no connections
He says he has learned, especially with depression and anxiety, to shift from asking "What's the matter with you?" to "What matters to you?" If you want to find a solution, you need to listen to what's missing in the depressed or anxious person's life—and help them to find a way to resolving this, the underlying problem
Reconnection Three: To Meaningful Work
Meredith knew that in the abstract her work was probably doing some good, but she never felt any connection to it. It felt like a karaoke life—her job was to sing along to a song sheet written by somebody else. It wasn't a life where she would ever get to write her ow song. At the age of twenty-four, she would see this stretching out before her for the next forty years.
Around this time, Meredith started to feel a pervasive sense of anxiety she couldn't quite understand. On Sunday nights, she'd feel her heart pounding in her chest, and a sense of dread about the week to come. Before long, she found she couldn't sleep during the week, either. She kept waking up feeling cripplingly nervous, but she didn't know why
Everyone at the Baltimore Bicycle Works said they were dramatically happier, less anxious, and less depressed than they had been working in the kind of top-down organizations that dominate our society.
But here's the thing that most fascinated me—and showed me a way beyond the obstacle I thought was insurmountable. The actual day-to-day work, for most of the people here, hasn't changed radically. The guys who fixed bikes before fix bikes now. The guys who did publicity before do publicity now. But changing the structure radically change how they felt about the work itself
When you have no say over your work, it becomes dead and meaningless. But when you control it, you can begin to infuse it with meaning. It becomes yours. And if there's something about the work that depresses you, you can argue for it to be broken up, or alternated with something more meaningful—and you have a good chance of being listened to
Of course, they all told me, they still have bad days. They have days when they have to prod each other to do something; they have days when they don't feel like being at work; there are aspects of the job that feel like a chore. One of the original partners explained that it felt like too much responsibility—to be partly in charge of the whole business—and went back to a more conventional office job. This isn't a magical solution. But "when I started working here, I didn't have trouble sleeping anymore," Meredith says, and she's echoed by several of her colleagues
From this experience, she has learned that "people want to work. Everybody wants to work. Everybody wants to feel useful, and have purpose." The humiliation and control of so many workplaces can suppress that, or drive it out of people, b tit's always there, and it reemerges in the right environment. People "want to feel like they've had an impact on other humans—that they've improved the world in some way"
A major study by scientists at Cornell University investigated 320 small businesses. Half had top-down control, and half let the workers set their own agency in a model that was closer to the democratic system at Baltimore Bicycle Works. The businesses closer to the democratic model grew, on average, four times more than the others. Why? Alex Ticu, who was still performing surgery on a bike, told me that here, for the first time, "I feel proud of the work I do." Another one of the bike mechanics, Scott Myers, told me: "It definitely feels very rewarding when you show up and see the building and don't think of it as the place where you come in to put your hours, but as the things you've contributed to making"
Nathan started the conversation by handing everyone worksheets with a list of open-ended questions. He explained there was no right answer: he just wanted them to start to think about these questions. One of them said: "For me, money is..." and you had to fill in the blank.
At first, people were confused. They'd never been asked a question like this before. Lots of the participants wrote that money is scarce. Or a source of stress. Or something they try not to think about
Just asking these two questions—"What do you spend your money on?" and "What do you really value?"—made most people see a gap between the answers that they began to discuss. They were accumulating and spending money on things that were not—in the end—the things that they believed in their heart mattered. Why would that be?
Reconnection Five: Sympathetic Joy, and Overcoming Addiction to the Self
We bonded over several things—and one of them was bitching. She had lived in Switzerland for two long years; my dad is from Switzerland and I used to be banished there for the summers as a kid; so we bitched about the Swiss. We bitched about some of the other people in the class. We bitched about our teacher. We laughed a lot. But it was often—though not always—bitter laughter, the kind that doesn't leave you feeling good. There was a lot of joy in our friendship—her love of British comedy bonded us for life—but there was a lot of rage when we met
Rachel had come to realize that she was angry and envious a lot of the time. She was embarrassed to say it, because she knew it mad her sound bad—but, to give one example, she had a relative who had been driving her crazy for years. She was nice, and Rachel had no reason to dislike her. But her every success—in work, in her family—felt like a put-down to Rachel, and it made her dislike the relative, and that in turn made her dislike herself. This envy had spread through her life, tugging her mood down every day. It felt like a major cause of her depression and anxiety
She's conscious that to many people, this would sound like a philosophy for losers—you can't make it, so you have to get a thrill when somebody else does. You'll lose your edge. You'll fall behind in the constant race for success. But Rachel thinks this is a false dichotomy. Why can't you be happy for other people and for yourself?
She felt she was slowly realizing that the things she had been trained by the culture to envy were in fact the least valuable things we have: "Who's envious of someone else's good character? Who's envious of somebody else's wonderful treatment of their spouse? You're no envious of that. You admire that. You're not envious of it. You're envious of other shit: you're envious of what people have materially, or status-wise"
I had been wary about medication. There were, I realized, two reasons. The first is that I was afraid of being still and alone with my thoughts—I associated that with depression and anxiety
calling these drugs "hallucinogens" is a bit of a mistake. A true hallucination involves seeing something that isn't there and thinking it's as real as this book you're reading—a physical object in the world. That's actually very rare. It's more accurate, they said, to call them "psychedelics"—which in Greek means, literally, mind-manifesting. What these drugs do is draw things out of your subconscious and bring them into your conscious mind. So you don't hallucinate—rather, you will see things the same way you see them in a dream, except you are conscious
I had built up my ego—my sense of importance in the world—to protect me, sometimes in dangerous circumstances. When you see a person under the influence of psychedelics, you see why we need an ego. Their ego is switched off—and they are literally defenseless; you wouldn't leave them alone to walk down the street. Our egos protect us. They guard us. They are necessary. But when they grow too big, they cut us off from the possibility of connection. Taking them down, then, isn't something to be done casually. To people who feel safe only behind walls, dismantling their walls won't feel like a jail break; it will feel like an invasion
What this suggests is it's not just the childhood trauma in itself that causes these problems, including depression and anxiety—it's hiding away the childhood trauma. It' snot telling anyone because you're ashamed. When you lock it away in your mind, it festers, and the sense of shame grows
Reconnection Seven: Restoring the Future
If you're going to try to reconnect in the ways I've been describing—if you're going to (say) develop a community, democratize your workplace, or set up groups to explore your intrinsic values—you will need time, and you need confidence.
But we are being constantly drained of both. Most people are working all the time, and they are insecure about the future. They are exhausted, and they feel as if the pressure is being ratcheted up every year. It's hard to join a big struggle when it feels like a struggle to make it to the end of the day. Asking people to take on more—when they're already run down—seems almost like a taunt
If you know you have enough money to live on securely, no matter what happens, you can turn down a job that treats you badly, or that you find humiliating. "It makes you less of a hostage to the job you have, and some of the jobs that people work just in order to survive are terrible, demeaning jobs," she says. It gives you "that little bit of power to say—I don't need to stay here." That meant that employers had to make work more appealing. And over time, it was poised to reduce inequality in the town—which we would expect to reduce the depression caused by extreme status differences
Conclusion: Homecoming
your distress is not a malfunction. It is a signal—a necessary signal.
I know this is going to be hard to hear, I'd tell him, because I know how deep your suffering cuts. But this pain isn't your enemy, however much it hurts (and Jesus, I know how much it hurts). It's your ally—leading you away from a wasted life and pointing the way toward a more fulfilling one
Deep grief and depression, she explained to me, have identical symptoms for a reason. Depression, I realized, is itself a form of grief—for all the connections we need, but don't have
LOST CONNECTIONS: https://thelostconnections.com/
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