This article is an excerpt from the Shortform book guide to "Lost Connections" by Johann Hari. Shortform has the world's best summaries and analyses of books you should be reading.
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What are the most common causes of depression and anxiety? Why isn’t biology the main cause of depression?
The main causes of depression and anxiety are acute loneliness, childhood trauma, loss of purpose in life, and a severe disconnection with nature. There are biological factors that can make an individual vulnerable to depression, but these factors are usually latent. It is social, psychological, and environmental factors that can trigger a genetic tendency to have depression and anxiety.
Read on to learn more about the major causes of depression and anxiety.
What Are the Causes of Depression and Anxiety?
We’ve seen that biology isn’t the primary cause of depression for most people. In this part, we’ll cover the major causes of depression and anxiety: the social, psychological, and environmental factors in our daily lives.
Hari calls these factors “disconnections” because they represent a fundamental disconnect between the realities of modern life and the healthy practices we need in order to stave off depression. Disconnections fall into three broad categories: disconnections from others, disconnections from your past and future, and disconnections from a meaningful life.
We’ll start our examination of the causes of depression and anxiety by first exploring forms of disconnections to others: namely disconnection from meaningful relationships and from positive social status.
1. Disconnection From Meaningful Relationships
The first factor that can cause depression is disconnection from meaningful relationships with other people. Social isolation can create loneliness, which impacts us on more than just an emotional level: It creates real, measurable change in the body. In one study, researchers found that acute loneliness raises your levels of the stress hormone cortisol as much as being physically attacked.
(Loneliness also lowers your immune response. One study found that lonely people are three times more likely to catch the common cold than socially connected people; another study found that when people get sick with cancer or heart disease, lonely people are two to three times more likely to die from that illness than connected people are. These health effects will become an even bigger concern as technology starts to replace all types of in-person connections.)
The link between loneliness and depression is deceiving because it could reasonably go both ways: Loneliness could trigger the onset of depression, or being depressed could lead to social withdrawal and ultimately trigger loneliness. Researchers tested the direction of this effect using the power of hypnosis. They administered a battery of personality tests (including a test of depression symptoms) to participants and divided them into two groups. A psychiatrist who specializes in the clinical use of hypnosis then prompted one group to remember experiences of profound loneliness and the other group to remember feeling profoundly socially connected.
After coming out of hypnosis, the participants completed the personality tests a second time. The results were conclusive: People who remembered feeling lonely were significantly more depressed than they had been before undergoing hypnosis, and people who remembered feeling connected were significantly less depressed. In other words, this study showed that loneliness is a cause of depression, not just a result, because making people feel more lonely also made them feel more depressed.
2. Disconnection From Positive Social Status
Not all forms of in-person connections are helpful—if your social status is low or threatened, interaction with others can actually make depression worse. Surprisingly, the first researchers to study this effect weren’t psychologists or sociologists—they were primatologists studying the social hierarchies of baboons in Kenya. Monkeys and apes are humankind’s closest evolutionary cousins, and like us, they live in social communities. Studying those groups gives researchers a chance to watch social relationships play out in a much more concentrated way than they can when studying human communities.
3. Disconnection From Past Trauma
It may seem counterintuitive to deem disconnection from past trauma as one of the causes of depression and anxiety: If you’re not thinking about the terrible things that happened to you, shouldn’t you be happy? However, trauma affects us in powerful ways, many of which operate subconsciously—in other words, just because you’re not thinking or talking about the trauma doesn’t mean it’s not still impacting your life and contributing to depression, even decades later. Childhood trauma is one of the most reliable predictors of adult depression, and fully processing that trauma by facing it head-on is a powerful way to begin healing depression.
Scientists still don’t know exactly how childhood trauma causes adult depression, but Hari has his own theory based on the fact that people who experienced trauma as a child often irrationally blame themselves for what happened. He argues that this impulse starts out as a coping mechanism—when kids experience trauma, blaming themselves is a way of taking back control. In the short term, that sense of control is a relief—especially when the alternative is feeling totally powerless in a big, scary world—but in the long run, the false idea that the trauma was their fault and that they deserved what happened creates a deep emotional wound.
4. Disconnection From Hope for the Future
While disconnection from childhood trauma is a form of disconnection from the past, this section focuses on disconnection from the future: specifically, being unable to picture a hopeful future for yourself—or even any future at all.
You might assume that a lost sense of the future is just another symptom of depression—people get depressed, so they stop planning ahead because there doesn’t seem to be a point—but a lost sense of the future can also cause depression. Researchers confirmed this by studying indigenous First Nations groups in Canada. For generations, indigenous Canadians have suffered the same state-sanctioned abuses as Native Americans in the United States, including being forced off their ancestral land and into reservations. As a result, suicide rates were higher among First Nations people than any other group in Canada—but those suicides were clustered in only half of the 196 indigenous nations. The other half had zero suicides.
The reason for that stark difference had to do with control. Until recently, the Canadian government took over control of nearly every aspect of life in indigenous communities, including schools, elected officials, and even the local language. In the last few decades, some indigenous nations have successfully reclaimed control of some of their rights; others are still completely at the mercy of the federal government. That split in nations’ degree of control maps perfectly onto the suicide data: Nations with the most control of their own lives had the lowest suicide rates, while nations with the least control had the highest suicide rates.
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- The psychological and social factors that contribute to mental illness
- The history of antidepressants and the science behind them
- Why Amish people hardly ever get depressed
