A different take on depression

A really fascinating read that aligns with a lot of my thinking about depression after the years working in various public hospital pain clinics. The author is not without controversy, and has also given a highly watched TED talk.

Lessons learnt:

  1. It’s in the pharmaceutical industry’s interest to frame depression as a neurochemical imbalance.
  2. The author quotes Professor Joanna Moncrieff who questions the chemical imbalance hypothesis.
  3. It is speculated that much of the benefit of antidepressants may be due to placebo effect (something we are also familiar with in the pain medicine context).
  4. The author cites the anecdotes of Henry Beecher and Haygarth from 1799 as examples of placebo.
  5. George Brown was a sociologist who studied depression. His body of work showed an association between depression and the psychosocial circumstances of the patient. He has been liken to the fairy godmother of social psychiatry.
  6. Prof Gisjbers told me that addiction is a disease of relationships. Looks like Hari comes to the same conclusion.
  7. The first disconnection is from meaningful work.
  8. The second disconnection is social.
  9. The third disconnection is with values. There are intrinsic and extrinsic values. If you seek extrinsic value, you are more likely to be depressed. (I think this ties with with Victor Frankl and his search for meaning.)
  10. 4th – disconnection from childhood trauma. Dr Vincent Felitti is cited. (He is one of the principle investigators of the Adverse Childhood Experiences study, and interestingly his research started out in obesity! – quite a bit of overlap there with me!!)
  11. 5th – status and respect; 6th – nature; 7th – hope and future; 8th – genes; 9th – neuroplastic changes.
  12. The solution – social prescription. Dr Sam Everington is cited – looks like he’s a bit of a stirrer.
  13. Psychodelics may play a role in the cure in the future.

Lost connections – Johann Hari (Blinkist summary)

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