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?”
If you’d been raised to think about depression the way I was, and most of the people here were, that sounds like a bad joke, right?
“I went to my doctor for an antidepressant, she gave me a cow.”
But what those Cambodian doctors knew intuitively, based on this individual, unscientific anecdote, is what the leading medical body in the world, the World Health Organization, has been trying to tell us for years, based on the best scientific evidence.
If you’re depressed, if you’re anxious, you’re not weak, you’re not crazy, you’re not, in the main, a machine with broken parts. You’re a human being with unmet needs.
And it’s just as important to think here about what those Cambodian doctors and the World Health Organization are not saying. They did not say to this farmer, “Hey, buddy, you need to pull yourself together. It’s your job to figure out and fix this problem on your own.”
On the contrary, what they said is, “We’re here as a group to pull together with you, so together, we can figure out and fix this problem.”
This is what every depressed person needs, and it’s what every depressed person deserves. This is why one of the leading doctors at the United Nations, in their official statement for World Health Day, couple of years back in 2017, said we need to talk less about chemical imbalances and more about the imbalances in the way we live.
Drugs give real relief to some people — they gave relief to me for a while — but precisely because this problem goes deeper than their biology, the solutions need to go much deeper, too.
But when I first learned that, I remember thinking, “OK, I could see all the scientific evidence, I read a huge number of studies, I interviewed a huge number of the experts who were explaining this,” but I kept thinking, “How can we possibly do that?”
The things that are making us depressed are in most cases more complex than what was going on with this Cambodian farmer.
Where do we even begin with that insight? But then, in the long journey for my book, all over the world, I kept meeting people who were doing exactly that, from Sydney, to San Francisco, to São Paulo.
I kept meeting people who were understanding the deeper causes of depression and anxiety and, as groups, fixing them. Obviously, I can’t tell you about all the amazing people I got to know and wrote about, or all of the nine causes of depression and anxiety that I learned about, because they won’t let me give a 10-hour TED Talk — you can complain about that to them.
But I want to focus on two of the causes and two of the solutions that emerge from them, if that’s all right.
Here’s the first. We are the loneliest society in human history. There was a recent study that asked Americans, “Do you feel like you’re no longer close to anyone?” And 39% of people said that described them. “No longer close to anyone.”
In the international measurements of loneliness, Britain and the rest of Europe are just behind the US, in case anyone here is feeling smug. I spent a lot of time discussing this with the leading expert in the world on loneliness, an incredible man named professor John Cacioppo, who was at Chicago, and I thought a lot about one question his work poses to us.