[Towards the end of my teaching career at Roanoke College, I was increasingly distressed by the mental state of students. It seemed to me as if we suffered an epidemic of depression. Half the students were on medication. I kept asking about the etiology but got the same old answers about chemical imbalances in the brain. Well, I dug deeper: what’s causing these chemical imbalances? No one seemed to have answers, just the bromides about how great it was to have Big Pharma coming to the rescue with pills, coupled with the scolding that challenging its narrative about brain malfunction would be cruel, compounding the trauma of the sufferers. With some resources at my disposal, I invited faculty and staff colleagues to a reading group to discuss Johann Hari’s Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions. I had stumbled upon this book in my own search for answers and found it to be an illuminating alternative to the Big Pharma narrative. Interweaved with his own personal journey through depression to mental health, he made the striking case that depression was most often misdiagnosed grief at loss – lost connections, as he titled his book.

Frankly, I was not aware at the time of the hit job that had been coordinated against Hari to discredit him as an amateur interloper into medical science who had been guilty early in his journalistic career of plagiarism. Hate the message? Discredit the messenger with personal attacks! When I read the book, however, I was quite impressed by his empirical and inductive method of research, the extensive documentation of his claims in the scientific literature and the nuanced claims he was actually making.

My faculty reading group included psychologists, brain scientists, sociologists, counselors and the campus chaplain among others. None of the scientists disputed the scientific claims made in the book. In fact, they expressed disappointment that the book broke no new ground i.e. that they already knew that antidepressant medications largely worked by the placebo effect and provided only temporary relief. The general conclusion we reached was that in the epidemic of depression in young lives we are confronted with the massive social problem which Hari identifies.

I thought after the reading group finished that I should put together my own reflections on the book and our conversation. Naturally, that would be a theological reading – interesting, not least of all because Hari-self identifies as an atheist. I shopped the following to First Things, which declined to publish on the grounds of its length. I was very busy with other things at the time, and let the project to drop. I will serialize my essay, posting installments weekly beginning now.]

A Wrenching Disillusionment

The iconoclastic philosopher Friedrich Nietzsche once observed that human beings would rather have nothing for a meaning than no meaning at all. The acerbic barb was aimed at 19th-century German Protestantism which Nietzsche (son of a Protestant pastor) pilloried as “Platonism for the people.” The pun mocked the liberal Protestant deity, parasitic upon the idealism of German philosophy’s transcendental turn a century before, as a “no-thing” i.e., something we know not what -- but assuredly Beyond this world. But for Nietzsche this idealist posit of empty transcendence as supreme object, moreover, of salutary devotion de facto slandered life on the earth. Nevertheless weak souls embrace this “nothing” as “God” in fear of the perceived alternative: that without it the life of this world, recently unveiled red in tooth and claw by Darwin, would have no meaning at all.

Johann Hari has written a popular but well-documented science book about depression. The richly detailed report on academic human science research is vividly animated by the interspersing of his personal memoir about a journey through depression to mental health. The punchline, however, comes as a punch in the gut for millions upon millions of innocent sufferers who have bought the narrative promoted by Big Pharma and dispensed by countless mental health therapists. It turns out that Nietzsche’s caustic poke at the bad faith of modern Protestantism’s “stillborn God” (Mark Lilla) applies quite directly to the story told in the recent generation about depression as a chemical imbalance of the brain, in other words, as a physical disease, whose repair consisted in brain-altering medications.

Hari tells how as a teenager this narrative provided at last an explanation for his mystifying distress and as such gave him hope that pharmacological intervention would restore a sense of well-being. And so, it seemed to have worked at first and then again at times. But inevitably (in a cycle familiar to 65-80% under such treatment, so the research shows), the soul-sorrow would return. Dosage would be adjusted and or alternative medications explored until again a relief that will prove only temporary would return… and then slip away again. Hari at wit’s end after years of this cycle posed to his experience the probing question of genuine science, the question more broadly of all critical thinking: what really is going on here?

And Hari uncovered a truth that had been but little known outside of academic circles of scientific psychological research: the medications work, so far as they actually do, primarily by the placebo effect! It seems, then, that because prescription from experts in mental health provides a meaningful and authoritative narrative of psychic distress in full sync with the truisms of our secular age –a diagnosis that locates the problem in malfunctioning brain machinery with a prognosis of chemical intervention to restore functionality – the narrative turns out to be the “nothing” desperately preferred to “no meaning at all.”

Hari’s uncovering of this truth by study of the “unvarnished” scientific research was at first so distressing to him that he angrily rejected it. It implied “no meaning at all,” neither to his suffering nor to his quest for well-being. It undermined his false faith in the “nothing” which had more or less kept him above water for years. Yet insidiously, it also kept him from digging deeper into his soul-sorrow, diverting attention “from figuring out what was making us so unhappy in our lives to trying to block the neurotransmitters in the brain that allow us to feel it” (53).

Truth be told, however, the prevailing pharmacological narrative had traction because it fitted perfectly the standards of current culture which Hari himself had internalized: “I wanted quick solutions to my depression and anxiety – ones that I could pursue on my own, fast. I wanted something that I could do now, for myself, to make me feel better… I wanted something as brisk as a pill” (181). Only in hindsight did Hari come to the realization that his “desire [was] for a solution that was private and personal… A symptom of the mindset that had caused [his] depression in the first place” (183). What precisely had this mindset obscured, the true source of his chronic sadness?

To be continued…