The idea of a non-pharmaceutical anti-depressant might be the single most important thing in Johann Hari’s amazing and fairly recent book: Lost Connections: Why You’re Depressed and How to Find Hope. (More about that book here.) The creation of this concept is, according Deleuze and Guattari’s very modern understanding of philosophy as the creation of concepts, properly philosophical. It is also, I believe, even more important than all of the factual information regarding causes of depression and the prevention and healing of depression. It radically reframes the entire dominant way of thinking about the treatment and prevention of depression, and does this by radically expanding, in a hopeful, realistic, and evidence-based manner, the way we’ve come to assume depression will be treated: the prescription of anti-depressants.
But what is an anti-depressant? Presumably (I have not researched this as yet), the term ‘anti-depressant’ came about as a shortening of “anti-depressant drug,” or of some phrase to that effect. But with the shortened term having become the norm, there arrive new possibilities of meaning. ‘Anti-depressant drug’ means a type of drug. But ‘anti-depressant’, on its own, simply means something which works against depression. And this might be anything, drug or otherwise, so long as it works against depression.
I love the way Hari draws our attention to this: He relates a specific example of a case where, in the most literal possible sense, a cow was a most effective anti-depressant. Yes that’s right, a cow. In the chapter called “The Cow” (Chapter 14), Hari relates the story of a Cambodian rice farmer who had lost one leg to a landmine. Even with a prosthetic leg, he became profoundly depressed. No one thought to prescribe this man anti-depressant drugs, which were not available or widely known in Cambodia at that time. The man’s doctors and local community investigated, by talking at length with him, what might be causing these feelings. They found that since his injury, rice farming, which was the man’s livelihood, was too painful and difficult to sustain, not only physically but psychologically. He was thus in a state of despair.
Their solution was to pool some resources and purchase the man a cow, in order that he could take up dairy farming, which was a livelihood his body could handle. This worked, and the man’s depression lifted. That cow, for this man, was, in the most literal sense, an anti-depressant.
There are two conceptual creations involved here. One is an expansion of the concept of anti-depressant, expanding its notion from “a drug which mitigates or relieves depression” to “something which mitigates or relieves depression.” This expanded notion does not exclude pharmaceutical anti-depressants; it simply does not restrict anti-depressants to pharmaceuticals. It thus allows the possibility of non-pharmaceutical anti-depressants, which are the second conceptual creation: something other than a drug, which mitigates or relieves depression.
These creations open up vast and hardly explored fields of possibilities for treatment and prevention, whether prescribed by oneself or by others. Many starting points can be found through investigating depression’s various causes, which one can then seek to reverse, remove, or heal. Loneliness, for example, can be a significant cause of depression. Prescribing and supporting things to reduce or remove loneliness could therefore be important parts of a treatment plan. That knowledge points us toward exploring what things can reduce or remove loneliness.
In Lost Connections Hari does, by the way, collect a good deal of existing knowledge concerning loneliness and other causes of depression, and begins to explore ways these might begin to be addressed. Loneliness, or a lack of connection with other people, is one such cause. I aim to write more about this and other causes, plus corresponding directions for solutions, in future posts.
He also creates visual art and designs under his Leaf Town brand at society6.com/leaftown.
Images by (and property of) SeekerFive unless otherwise indicated.