Following is the full transcript of journalist Johann Hari’s talk titled “This Could Be Why You’re Depressed Or Anxious” at TED Talk conference. In this talk, he shares fresh insights on the causes of depression and anxiety from experts around the world.
Johann Hari – TED Talk TRANSCRIPT
For a really long time, I had two mysteries that were hanging over me. I didn’t understand them and, to be honest, I was quite afraid to look into them.
And I wanted to understand why. Why is this happening to us? Why is it that with each year that passes, more and more of us are finding it harder to get through the day?
And I wanted to understand this because of a more personal mystery. When I was a teenager, I remember going to my doctor and explaining that I had this feeling, like pain was leaking out of me. I couldn’t control it, I didn’t understand why it was happening, I felt quite ashamed of it.
And my doctor told me a story that I now realize was well-intentioned, but quite oversimplified. Not totally wrong. My doctor said, “We know why people get like this. Some people just naturally get a chemical imbalance in their heads — you’re clearly one of them. All we need to do is give you some drugs, it will get your chemical balance back to normal.”
So I started taking a drug called Paxil or Seroxat, it’s the same thing with different names in different countries. And I felt much better, I got a real boost.
But not very long afterwards, this feeling of pain started to come back. So I was given higher and higher doses until, for 13 years, I was taking the maximum possible dose that you’re legally allowed to take.
And for a lot of those 13 years, and pretty much all the time by the end, I was still in a lot of pain. And I started asking myself, “What’s going on here? Because you’re doing everything you’re told to do by the story that’s dominating the culture — why do you still feel like this?”
So to get to the bottom of these two mysteries, for a book that I’ve written I ended up going on a big journey all over the world, I traveled over 40,000 miles.
I wanted to sit with the leading experts in the world about what causes depression and anxiety and crucially, what solves them, and people who have come through depression and anxiety and out the other side in all sorts of ways.
And I learned a huge amount from the amazing people I got to know along the way. But I think at the heart of what I learned is, so far, we have scientific evidence for nine different causes of depression and anxiety. Two of them are indeed in our biology.
Your genes can make you more sensitive to these problems, though they don’t write your destiny. And there are real brain changes that can happen when you become depressed that can make it harder to get out.
But most of the factors that have been proven to cause depression and anxiety are not in our biology. They are factors in the way we live. And once you understand them, it opens up a very different set of solutions that should be offered to people alongside the option of chemical antidepressants.
For example, if you’re lonely, you’re more likely to become depressed. If, when you go to work, you don’t have any control over your job, you’ve just got to do what you’re told, you’re more likely to become depressed. If you very rarely get out into the natural world, you’re more likely to become depressed.
And one thing unites a lot of the causes of depression and anxiety that I learned about. Not all of them, but a lot of them.
Everyone here knows you’ve all got natural physical needs, right? Obviously. You need food, you need water, you need shelter, you need clean air. If I took those things away from you, you’d all be in real trouble, real fast.
But at the same time, every human being has natural psychological needs. You need to feel you belong. You need to feel your life has meaning and purpose. You need to feel that people see you and value you. You need to feel you’ve got a future that makes sense.
And this culture we built is good at lots of things. And many things are better than in the past — I’m glad to be alive today. But we’ve been getting less and less good at meeting these deep, underlying psychological needs.
And it’s not the only thing that’s going on, but I think it’s the key reason why this crisis keeps rising and rising. And I found this really hard to absorb. I really wrestled with the idea of shifting from thinking of my depression as just a problem in my brain, to one with many causes, including many in the way we’re living.
And it only really began to fall into place for me when one day, I went to interview a South African psychiatrist named Dr. Derek Summerfield. He’s a great guy.
And Dr. Summerfield happened to be in Cambodia in 2001, when they first introduced chemical antidepressants for people in that country. And the local doctors, the Cambodians, had never heard of these drugs, so they were like, what are they?
And he explained. And they said to him, “We don’t need them, we’ve already got antidepressants.”
And he was like, “What do you mean?”
He thought they were going to talk about some kind of herbal remedy, like St. John’s Wort, ginkgo biloba, something like that. Instead, they told him a story.
There was a farmer in their community who worked in the rice fields. And one day, he stood on a land mine left over from the war with the United States, and he got his leg blown off. So they gave him an artificial leg, and after a while, he went back to work in the rice fields.
But apparently, it’s super painful to work under water when you’ve got an artificial limb, and I’m guessing it was pretty traumatic to go back and work in the field where he got blown up. The guy started to cry all day, he refused to get out of bed, he developed all the symptoms of classic depression.
The Cambodian doctor said, “This is when we gave him an antidepressant.”
And Dr. Summerfield said, “What was it?”
They explained that they went and sat with him. They listened to him. They realized that his pain made sense — it was hard for him to see it in the throes of his depression, but actually, it had perfectly understandable causes in his life.
One of the doctors, talking to the people in the community, figured, “You know, if we bought this guy a cow, he could become a dairy farmer, he wouldn’t be in this position that was screwing him up so much, he wouldn’t have to go and work in the rice fields.”
So they bought him a cow. Within a couple of weeks, his crying stopped, within a month, his depression was gone. They said to doctor Summerfield, “So you see, doctor, that cow, that was an antidepressant, that’s what you mean, right?”