Book SummaryLost Connections, by Johann Hari

1-Page Summary1-Page Book Summary of Lost Connections

Many people think depression is just a “chemical imbalance” in the brain: specifically, that it’s caused by low serotonin levels. However, that’s not the whole story: There’s more to depression than just biology.

Today, most experts use the biopsychosocial model to talk about depression, which recognizes three root causes of depression: biology, psychological history, and social factors. In Lost Connections, journalist Johann Hari investigates the psychological and social factors that contribute to depression (which he calls “disconnections”), as well as innovative social and environmental treatments for depression (or “reconnections”).

In this summary, we’ll explore seven types of disconnections that contribute to depression (including the real role of biology). We’ll also discuss the reason antidepressants don’t work for most people. Finally, we’ll explore seven reconnections that may help us to collectively heal depression.

Disconnections From Others

Even if biology isn’t the primary cause of depression for most people, depression is a very real physical illness that can be triggered by external factors (just like how dust or dairy can trigger an allergic reaction). This section explores the social factors that contribute to depression.

Disconnection From Meaningful Relationships

One factor that can cause depression is disconnection from meaningful relationships with other people. The reason why this causes depression is rooted deep in human evolutionary history: Millions of years ago, the only way for early humans to avoid becoming a tasty snack for a predator was to band together into tribes. People who felt miserably depressed when they wandered off on their own were more motivated to stick with the tribe, so they were more likely than loners to survive long enough to pass on their genes.

Now, humans are more socially isolated than ever before. Studies show that most American adults have zero close confidants. Living with other people or in a big city doesn’t change that because solving loneliness isn’t just about gaining physical proximity to others: It’s about developing a mutually meaningful connection with someone else.

Disconnection From Positive Social Status

Some scientists think that human depression is a stress response from our evolutionary history, linked to a feeling of low social status. Researchers discovered this effect by studying the social hierarchies of baboons. For male baboons in particular, competition for the top spots is brutal. To avoid being ripped apart, low-status baboons make themselves as non-threatening as possible by lowering themselves physically as a way to say, “You win. Please don’t hurt me.” Their posture and behavior mimic those of severely depressed people.

Common life hardships like financial insecurity, lack of control over your daily life, and fractured relationships can inflict as much pain on a person as an alpha baboon inflicts on weaker male, and make us feel that we’re “worse” or lower-status than other people. So, we react with the same submission response.

Threatened Social Status Triggers Depression, Too

It’s not just those with low social status who suffer from depression. People with high social status are also prone to depression because they’re constantly worried about threats to their position. Research shows that highly unequal societies (with a large gap between those at the bottom and those at the top) have higher rates of depression for everyone, regardless of their status, than countries with a smaller gap between the top and bottom rungs of the social ladder.

Disconnections From Your Past and Future

In addition to disconnections from other people, being disconnected from your own trauma history and from a sense of a hopeful future can both cause depression, too.

Disconnection From Past Trauma

Childhood trauma is one of the most reliable predictors of adult depression according to the Adverse Childhood Experiences (ACE) Study. The study’s results show that people who had experienced ACEs were more likely to suffer health problems, including depression, and the more ACEs you have, the more likely you are to experience depression.

Disconnection From Hope for the Future

Losing the ability to imagine and plan for the future due to financial instability can contribute to depression. The rise of the “gig economy” means that stable, guaranteed employment is no longer the norm. More people than ever are working for hourly wages with no contract and no guarantee that they’ll still have a job next week, let alone next year. Without that security, it becomes impossible to picture the future—and easy to get depressed.

Disconnections From Meaning and Purpose

When everyday life feels meaningless, it’s easy to slip into a deep depression. For people living in cities, struggling to find stable work and surrounded by shallow advertisements, fighting back against that sense of meaninglessness is even more difficult.

Disconnection From a Rewarding Work Life

In 2011 and 2012, a Gallup poll showed that only 13% of adults are “enthusiastic about and committed to” their work. The three main reasons for this are a lack of control over the job, low professional status, and a disconnect between effort and reward (for example, if working harder doesn’t translate to more money or status). At the same time, work hours are expanding—the “nine to five” is now more of a “seven to seven”—which means that many people spend the majority of their time working a job they don’t like.

Disconnection From Intrinsic Motivation

Many people persevere in a depressing job because it pays well. That’s an example of extrinsic motivation—doing something just as a means to an end. On the other hand, intrinsic motivation is what drives you to do things purely for the joy of them. Studies show that **achieving intrinsic goals increases happiness,...

Lost Connections Summary Part 1 | Chapter 1: Depression Is More Than a “Chemical Imbalance”

(Shortform note: We’ve reordered the book’s material in this summary to add clarity.)

When Lost Connections author Johann Hari first started taking antidepressants, his doctor explained depression the way the medical community sees it: Depression is a brain disease caused by low levels of a chemical called serotonin in the brain, and antidepressants treat depression by increasing the level of serotonin in the brain. Millions of people have heard this same explanation from doctors when they sought medical treatment for depression—in 2014, one out of every five adults in the United States was taking some form of psychiatric medication.

But the sheer number of people taking medications for mental health hints at a deeper issue: If depression is a purely biological illness caused by a random malfunction in the brain, how is it that so many people’s brains are going biologically haywire at the same time? As it turns out, depression is not just about your biology. Brain chemicals (called neurotransmitters) and genetics do play a role, but even if you’re genetically predisposed to depression, your genes alone won’t make you depressed—something in the environment outside the...

Shortform Exercise: Explore the Facts and Myths of Depression

There’s a lot of misinformation about depression out there. Use this exercise as a chance to reflect on your exposure to those myths.

Think back: When was the first time you remember hearing about depression explicitly? What was the context? (For example, in a school health class, on television, or talking to a parent about their own experience with depression.)

Lost Connections Summary Chapter 2: The Arguments Against Antidepressants

Now that we’ve explored the history of the medical and biopsychosocial models, let’s examine the arguments against antidepressants: the golden standard of treatment in the medical model.

Before you dive into this chapter, remember that Hari’s goal is not to talk anyone into or out of taking antidepressants—it’s to make us question the way we think about depression and the societal conditions that contribute to it. Chemical antidepressants do work for a small minority of people, and Hari stresses that the information in Lost Connections is not medical advice. Going off these medications can cause severe physical withdrawal symptoms, so if you do decide to stop taking antidepressants, talk to your doctor first. They can help you create a plan to reduce your dosage gradually and minimize withdrawal symptoms.

In this section, we’ll discuss the lack of evidence for the “chemical imbalance” that forms the foundation of the medical model of depression and see how psychiatry itself undermined that idea with the former “grief exception” in the DSM. Then, we’ll discuss why pharmaceutical antidepressants continue to be so popular (and can still be legally sold at all) despite the...

Lost Connections Summary Part 2 | Chapter 3: Disconnections From Others

We’ve seen that biology isn’t the primary cause of depression for most people. In this part, we’ll cover what does cause depression: 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.

In this chapter, we’ll begin by exploring forms of disconnections to others: namely disconnection from meaningful relationships and from positive social status.

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...

Shortform Exercise: Compare Online and In-Person Interactions

Between advances in technology and the rise of social media, many forms of communication that once took place face-to-face have moved online. Reflect on the differences between in-person and online interactions.

Interacting online and interacting face-to-face are very different experiences. Aside from not being in the same physical space, what differences do you notice in how you see these experiences? (For example, maybe you feel more anxious when communicating in person, or maybe you get distracted easier when communicating online.)

Lost Connections Summary Chapter 4: Disconnections From Your Past and Future

In addition to disconnections from other people, being disconnected from your own trauma history and from a sense of a hopeful future can both cause depression, too.

Disconnection From Past Trauma

It may seem counterintuitive that being disconnected from past trauma could cause depression: 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...

Shortform Exercise: Compare Work Experiences

The way we think about work has changed radically over the years. Think about how these changes might impact your own mental health.

If you have experience with both stable, contracted work and unstable, gig-based or freelance work: How did each of them impact your mental health? Which did you prefer and why?

Lost Connections Summary Chapter 5: Disconnections From Meaning and Purpose

The final group of disconnections we’ll look at are disconnections from meaning and purpose. For many people, the loss of hope for the future hinges on an unsatisfying and seemingly meaningless work life. Being low on your organization’s totem pole and having little control over the day-to-day responsibilities of your work can lead to depression. That feeling of being an unimportant cog in the machine can also spill over into your personal life and prevent you from doing the things you truly enjoy doing for their own sake.

Furthermore, for people living in cities, those work and life struggles are coupled with a disconnection from the natural world. This makes it much harder to see how small many problems really are in the grand scheme of things.

We’ll look at each of these factors below.

Disconnection From a Rewarding Work Life

For many people, an unfulfilling and unhappy work life leads to depression. Most people sleepwalk through their work day or actively dread going to work, often because they feel they have little control over their responsibilities and thus disengage from their work. In 2011 and 2012, a Gallup poll surveyed millions of people all over the...

Lost Connections Summary Chapter 6: The Real Role of Biology

Now that we’ve explored the many social and environmental factors that contribute to depression, it’s time to explore the real role of biology in this illness. The fact that biology isn’t the sole cause of (or sole treatment for) depression doesn’t mean there aren’t very real biological factors at play in the disease. The two most important biological factors that influence depression are neuroplasticity and genetics.

Neuroplasticity

Your brain is made up of different parts that control every aspect of your life, from the most basic functions (like remembering to breathe) to the most advanced (like doing calculus or building Swedish flatpack furniture). Neuroplasticity is your brain’s ability to change that structure in response to the environment. It does this by adding and subtracting synapses, which are connections between brain cells. When you learn new information or practice a skill, new synapses form; if you don’t use that skill for decades afterward, the brain prunes those synapses to save energy to power the skills you do use.

The way your brain adds and subtracts synapses depends on how you use it. **Essentially, each part of the...

Lost Connections Summary Part 3 | Chapter 7: Reconnecting to Others

As we’ve seen, there is strong scientific evidence for social and environmental causes of depression, like Adverse Childhood Events, separation from nature, and a lack of control over your working life. All of this evidence points to one thing: If biology isn’t the only problem causing depression, then medication shouldn’t be the only solution to it.

Part 3 of this summary uses examples from all over the world to illustrate non-pharmaceutical forms of antidepressants. Hari calls these ideas “reconnections” because they can help us bridge the disconnections that contribute to depression. Many of these ideas seem radically new, but for the most part, they are actually a return to the way people lived their lives for most of human history.

As you read these sections, keep in mind that many of these strategies aren’t designed to be implemented individually. There are some remedies you can try on your own (like getting to know your neighbors or practicing loving-kindness meditation), but many more involve widespread social changes that require banding together with others and demanding policy changes that will improve everyone’s mental health on a societal level....

Shortform Exercise: Help Yourself by Helping Others

Depression can make us hyperfocus on ourselves and our own pain. Refocusing on people around us can help break that habit.

When you feel particularly depressed, what things do you usually do for yourself to lift your spirits?

Lost Connections Summary Chapter 8: Reconnecting to Your Past, Your Future, and a Meaningful Life

In addition to connecting with others, recovering from depression requires acknowledging past trauma, reclaiming a hopeful future. Likewise, it requires reconnecting to a sense of meaning and purpose in everyday life. Collectively changing the way we think about work is a major part of this: For most people, work takes up more waking hours than any other activity, so if work feels meaningless, it’s easy for everything to feel meaningless. On top of that, we need to reconnect to deeper, meaningful values, rather than being sucked into the materialistic worldview we discussed in Chapter 5.

Note that these are all examples of the type of collective action to fight depression that we mentioned at the beginning of Chapter 7. They aren’t just individual solutions—they involve steps we can all take to help everyone reconnect to their full self.

Work Through Childhood Trauma

To heal depression, we need to reconnect to our childhood trauma by talking about it. Talking openly about childhood trauma is painful, and it’s understandable to want to avoid that pain. However, research shows that it’s not just trauma itself that causes depression—it’s the experience of keeping that...

Shortform Exercise: Reflect on the Idea of Universal Basic Income

Universal basic income is an extremely divisive idea—some people think it could cure a whole host of societal ills, while others think it would be a moral and economic failure. Take a moment to reflect on where you stand.

Had you heard of Universal Basic Income before reading this chapter? When you first encountered the idea (here or elsewhere), what were your first reactions?

Shortform Exercise: Identify Values and Intrinsic Motivations

Making financial decisions based on your core values (things that you consider most important for living a good life) and intrinsic motivations (things you love to do just for the joy of it) can help alleviate depression. Use this exercise as a chance to take inventory of those values and how they affect your decisions.

Other than necessities like food and rent, what things do you typically spend money on? (For example, a daily coffee shop visit, vacations, gadgets, and so on.)

Lost Connections Summary Conclusion: The Need for Collective Change

As we’ve seen, depression is more than just an individual issue, and we can’t expect to conquer it individually. Even if it were possible to cure depression on your own, if you’re working endless hours at a dead-end job just to make rent, you’re unlikely to have the time or energy! Instead, as previously noted, to truly tackle depression, we need large-scale societal changes, including a fundamental restructuring of personal, cultural, and economic priorities. The way depression has become nearly universal should be a wake-up call: The old ways of doing things are not working.

This may seem like a daunting task. Fundamentally changing the systems that cause depression is undeniably a massive undertaking. However, so were...