health

Johann Hari says there are nine causes of depression. They're not what you think.

Johann Hari was a teenager when he went to see his doctor about pain he was feeling. 

"I had this feeling like pain was leaking out of me. And I couldn't control it," the British author and journalist told Mia Freedman on the No Filter podcast.

"I didn't understand it. I was ashamed of it."

Listen to Mia Freedman's full interview with Johann Hari on No Filter below. Post continues after. 


What his doctor told him next is something he now realises was "totally well-intentioned, but grossly oversimplified". 

"My doctor said, 'We know why people get like this. Some people just naturally have a chemical imbalance in their brains, you're clearly one of them. All we need to do is give you some drugs, you're going to be fine'."

Following the doctor's advice, Hari began taking anti-depressants and felt "significantly better".

Until he didn't. 

"Months down the line, this feeling of pain came back," he explained. 

Returning to the doctor, he was given a higher dose of medication, which again made him feel "significantly better". 

But again, the pain came back. 

It wasn't until Hari was older and began speaking to experts for his book Lost Connections, that he came to understand what really causes depression.

Here's what he wants you to know. 

Contrary to what his doctor told him all those years ago, Hari says depression is not caused by a chemical imbalance. 

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"I'm conscious people hearing that will feel really destabilised... because I felt really destabilised when I heard that," he told Mia Freedman. 

Referencing a major study by British Professor Joanna Moncrieff, Hari said "an overview of all the science showed there's never been any evidence that depression is caused by chemical imbalance". 

"That doesn't mean there aren't some biological contributions, there are, [and] it doesn't mean chemical antidepressants don't give some people some relief, they do. But depression is not caused by chemical imbalance."

It's why he wants people experiencing depression to remember that your pain is simply not a "malfunction" or "glitch" in your system. 

Instead, it's a "signal" your psychological needs aren't being met. 

"If you're depressed, if you're anxious, you're not weak, you're not crazy, you're not broken, you're not a machine with broken parts. You're a human being with unmet psychological needs. And what you need is practical help and support to get those deeper needs met." 

Of course, Hari also doesn't rule out the use of antidepressants and absolutely does not encourage anyone to come off them without supervision from their doctor. 

"For something as complex as depression, which is just a form of deep human distress, you need to have a big broad menu of options... Chemical antidepressants should always be one of the things on the menu, but they should never be the only thing on the menu. We need to tailor the approach."

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The nine causes of depression.

According to Hari, there's evidence to suggest there are nine causes of depression, many of which are related to our psychological needs. 

"Everyone knows they have natural physical needs. You need food, you need water, you need shelter, you need clean air. If I took those things away from you, you'd be in real trouble real fast," he explained. 

"But there's equally strong evidence that everyone 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."

Hari says the nine causes include: 

1. Disconnection from meaningful work.

When it comes to our work, Hari says "control is essential". 

The more control we have over our work, the less likely we are to become depressed and anxious.

2. Disconnect from others. 

Loneliness is another big factor that can lead to depression. And it traces back to human evolution. 

Referencing a conversation with loneliness expert Professor John Cacioppo, Hari said, "Just like bees evolved to live in a hive, humans evolved to live in a tribe."

"Loneliness evolved as a signal to tell you to get back to the tribe. You're meant to feel anxious when you're separated from the tribe because you're vulnerable."

3. Disconnect from meaningful values.

Hari says people often spend time doing things that are extrinsically motivated, meaning we don't do them because we enjoy them but because we know we'll be getting something in return. 

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The more time we spend doing things that are only extrinsically motivated, the more likely we are to experience depression.

4. Childhood trauma.

Experiencing trauma in your formative years greatly increases your chances of developing depression as you get older. 

Dr Robert Anda, who Hari spoke to for his book, said "when you're confronted with someone who's addicted or obese or depressed, we need to stop asking what's wrong with you, and start asking what happened to you." 

5. Disconnect from status. 

In his book, Hari writes, "the more unequal your society, the more prevalent all forms of mental illness are". 

6. Disconnect from nature. 

Studies show spending time outdoors can lift your mood and outlook on life, with those living in greener neighbourhoods feeling less stressed. 

7. Disconnect from a secure and hopeful future. 

As part of our physiological needs, Hari says we need to feel like we have a "future that makes sense". 

8. Genes. 

While Hair says genes "don't write your destiny", they can make you more sensitive to problems. 

9. Changes in the brain.

Hari says "there are real brain changes that happen when you become anxious or depressed that can make it harder to get out". 

If you think you may be experiencing depression or another mental health problem, please contact your general practitioner. If you're based in Australia, 24-hour support is available through Lifeline on 13 11 14 or beyondblue on 1300 22 4636.

Feature Image: Getty.

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