EVERY SPOKEN WORD
150 min read · 30,261 words- 0:00 – 15:00
Johann Hari. I got…
- JRJoe Rogan
Johann Hari. I got it right.
- JHJohann Hari
You said it right. You are literally the first person-
- JRJoe Rogan
(laughs)
- JHJohann Hari
... to ever say my... I was saying to Jophet that I once waited for six hours with a broken arm in an emergency room 'cause they were calling for Joanna Hairy to come forward. So anyone who gets my name better than that is fine by me.
- JRJoe Rogan
Didn't they just assume that was you when you hear- you heard "Joanna Hairy"-
- JHJohann Hari
No. To be fair-
- JRJoe Rogan
... you were like, "Hmm."
- JHJohann Hari
... I had a broken arm and I was lying there-
- JRJoe Rogan
Oh, right.
- JHJohann Hari
... like a weeping and being like, "Fuck, someone help me."
- JRJoe Rogan
What happened to your arm?
- JHJohann Hari
So, I think in my normal mind, I would have done.
- JRJoe Rogan
What went down with your arm?
- JHJohann Hari
Oh, I just... I fell.
- JRJoe Rogan
Oh.
- JHJohann Hari
And, uh, it tragically... Nothing, no glamorous story to it. I fell down-
- JRJoe Rogan
Damn.
- JHJohann Hari
... a staircase. I wasn't even drunk. I wasn't even fucked on anything.
- JRJoe Rogan
(laughs)
- JHJohann Hari
I just fell down the stairs, right?
- JRJoe Rogan
Damn.
- JHJohann Hari
I wasn't even a victim of domestic violence. You know, like no-
- JRJoe Rogan
Right.
- JHJohann Hari
... no, uh, surrounding narrative that would make that an interesting story, sadly.
- JRJoe Rogan
So, give me your... if you had, like, a- a one paragraph take on depression.
- JHJohann Hari
Sure.
- JRJoe Rogan
What is your take on depression?
- JHJohann Hari
So, this is why I wrote this book, Lost Connections-
- JRJoe Rogan
Yeah.
- JHJohann Hari
... Uncovering the Real Causes of Depression and Anxiety and the Real Solutions. So, I wanted to understand, why does depression and anxiety... why do depression and anxiety seem to be rising so much?
- 15:00 – 30:00
Mm-hmm. …
- JHJohann Hari
kinds of motives that human beings have, right? You've got them. I've got them. Jamie's got them. Everyone's got them, right? Um, the- the- the first set of motives, imagine- imagine if you play the piano, right? I'm totally unmusical. But imagine if you play the piano. If you play the piano in the morning 'cause you love it and it gives you joy, that's called an intrinsic motive to play the piano, right? You're not doing it to get anything out of it. You're just doing it 'cause you love it, right? The experience is the point. Now imagine you play the piano in a dive bar, you know, to- to pay the rent, and you don't like it, right? Or you play the piano 'cause your parents really want you to be a piano maestro, or I don't know, there's a woman who's really into pianists, so you learn the piano to impress her. That would be an extrinsic reason to play the piano, right? You're not doing it for the thing itself. You- you're not, you're not- you're doing it to get something out of it, right? And what Professor Kasser discovered loads of really important things about this, but there's a few. We're all a mixture of these things, but we move throughout our lives. And what he discovered is the more you are driven by extrinsic values, the more your life is guided by how you look to the outside, by, you know, what you're trying to get out of life rather than enjoying it, the more you will become depressed and anxious by quite a large margin. There's loads of studies that show this. Um, and also he found that we have become much more obsessed with- much more driven by these values over the last 30 years for all sorts of reasons, partly 'cause we- from the minute we're born, we're immersed in a machine that tells us life is about consumption, right? About externally consuming things. More 18-month-old children know what the McDonald's M means than know their own last name, right? So there's this machine constantly geared towards getting us to think extrinsic. Imagine- imagine an advert that said to you, "You know, Joe, you look great today. You- you smell great. You're doing fine," right? "You don't need to buy anything today." That would, from the perspective of the advertising industry, be the worst- worst advert ever, right? Wouldn't make you want to buy anything. So this movement towards these kind of junk values, and he- and he shows lots of reasons why these junk values make us feel like shit. One is it just corrodes the quality of your relationships, right? If your wife- if you think your wife loves you not because you're you, but because you're rich, because you look good, or for some other reason, then think about the insecurity that enters into that relationship. You know, oh, right, if you suddenly got fat or if you suddenly lost all your money, it's over. It creates that- that- a sand of insecurity enters all your relationships. The more you're extrinsically motivated, the more insecure your relationships will be and the worse you'll feel. Or another example would be-
- JRJoe Rogan
Mm-hmm.
- JHJohann Hari
... something that really makes human beings feel good are what are called flow states, right? They're moments when you're doing something you love. For me, it's writing. For you, I'm sure it's partly broadcasting, partly working out. As you can see, it's not working out for me. Uh, the- the- where you just get into the zone and time seems to collapse and you're in that moment, right? But what ex- thinking extrinsically, what being dominated by these junk values does is it jolts you out of the intrinsic value. So imagine, go back to the piano example.... if you're playing the piano just 'cause you love it, and then suddenly you think, "Am I the best piano player in Los Angeles today?" Right? "How are these people in this room thinking about my piano playing? Uh, how much am I gonna be paid for this piano playing?" You can see how that would jolt you out of the flow state, right?
- JRJoe Rogan
Mm-hmm.
- JHJohann Hari
People who... The more we're driven by extrinsic values, the less we get into flow states and the worse we feel. And there's lots of other reasons as well to talk about, but...
- JRJoe Rogan
Well, that completely makes sense, that relying constantly on other people's approval and recognition and love i- in order for you to be satisfied and happy, uh, is n- is not a good recipe for getting by in this life smoothly. Um, when you were young and you were experiencing depression, w- as you called it, what was the root cause of it?
- JHJohann Hari
So, in my case, it was... Uh, I mean, there were a few things going on. And this is quite difficult for me to talk about, but, um, one of the people I got to know for Lost Connections is this, uh, amazing guy called Dr. Vincent Felitti in San Diego. And if you don't mind, I'll tell you his story first, and I'll tell you-
- JRJoe Rogan
Sure.
- JHJohann Hari
... why I, why... sure, why, what it made me realize about myself, and actually why I was very resistant to this. So this is gonna sound-
- JRJoe Rogan
You were very resistant to this...
- JHJohann Hari
Very resistant to this insight that he had.
- JRJoe Rogan
Okay.
- JHJohann Hari
And really did not wanna absorb it. Um, so he actually, uh, made this discovery, and this is gonna sound like I'm talking about a whole other subject, but trust me, I... it gets to depression, it led to an incredible breakthrough in depression. So in the mid-1980s, Dr. Felitti is doing all this research into obesity. Basically, Kaiser Permanente, a not-for-profit medical provider down in San Diego, um, just had a massive fucking problem with obesity, right? They... it was just ex- hugely growing problem with obesity. And, uh, they were trying everything and nothing was work. Like, giving people nutritional advice, that stage, it wasn't working, right? So, they basically said to him... They gave him quite a big budget, and they're like, "Just figure out what the hell is going on here." So, he went away and he started, he started to work with, I think it was about 350 extremely obese people, right? People who weighed more than 400 pounds. And, um, he starts doing all sorts of different research with them. And one day, he just had this, this kind of almost stupidly simple thought. He thought, "What if they just literally stopped eating and we gave them the nutrients they need? Would they just lose loads of weight and then come down to a healthy weight?" So, they... obviously with, like, massive medical supervision, they did this, right? People, they just monitor them and they stop eating and they give them loads of vitamins and everything. And it worked, right? They did, in fact, lose loads of weight. But then something happened that no one expected. So, there's a woman I'm gonna call Susan to protect her medical confidentiality. She'd been over 400 pounds. She got down to 138 pounds, and one... and everyone's celebrating. They think Vincent's like a miracle worker. And then one day, she freaks the fuck out, starts massively, obsessively eating, and very quickly, she's back to not quite where she was, but close, right? And Vincent sits with Susan and he's like, "What happened?" And she's like, "I don't know." And he said, "Well, tell me about the day you cracked," right? Turned out something had happened to her that hadn't happened to her in, I, I think ever or certainly in a very long time. A man hit on her, right? When she'd been hu- you know, hugely overweight and no man had hit on her. A man hit on her, and that was the trigger, right? And he's like, "Okay." So, they talk a lot more. He's like, "When was it you started to put on weight?" For her, it was when she was 11. Um, and so he's like, "Well, what, what happened when you were 11 that didn't happen when you were 10, that didn't happen when you were 12 or 15?" And she said, "Oh, well, that's when my grandfather started raping me." And he... this really stuck with him, and so he starts talking to the group, and he discovered 55% of the extremely overweight people in the group, oh, 50% of people in the group had s- had put on their weight after being sexually abused. Right? Which was extraordinary, far more than the wider population. He's like, "Wait, what's going on here? This is really..." Susan said to him, "Overweight is overlooked, and that's what I wanted to be." Right?
- JRJoe Rogan
Wow.
- JHJohann Hari
So, this thing that had looked like a pathology, right? And it is a pathology in one sense. Being extremely overweight will kill you. Suddenly didn't look like a sign of madness. It was actually performing a function that we couldn't see, right? It was, it was, uh, it, it was protecting them from sexual attention. But, you know, this is a small group, it's a small study, so Vincent wanted to get a lot more research on this, and this is where it led to the breakthrough in depression. So, he set it up with funding from the CDC, the Center for Disease Control, kind of gold-plated, uh, organization in this, uh, in the S for this kind of research. Everyone who came to Kaiser Permanente in the next, uh, I think it was a year, uh, for anything, whether you broke your leg, you had ha- migraines, you had schizophrenia, anything, you were given a questionnaire. And it asked about... It had two parts. Firstly, it said, "Did any of these 10 bad things happen to you when you were a kid?" Right? Could be sexual abuse, neglect, that kind of thing. And then it says, "Have you had any of these problems as an adult?" Obesity, uh, injecting drug use, and at the last minute, they added depression, right? By luck. So, when they got the results back, the CDC were just like, "What the fuck is this?" For every category of childhood trauma you went through, you were radically more likely to become depressed. If you had six of those categories, you were 3100% more likely to have attempted suicide as an adult. If you were, um... if you'd had six of them, you were 4600% more likely to have become an adult injecting drug user, right? And there's a debate about why this is, and I'm going beyond what Vincent says now, b- but on what the science says, and this comes... it brings it back to, to my experience. So I had... when I was a kid, I had experienced some very extreme acts of violence from an adult in my family. You know, my mother had been very ill, and when I was a kid, my dad had... was mostly in another country, and I'd experienced these really, really extreme, um, and frightening acts of violence. And I... This sounds stupid, but until I went to see Vincent, if you had asked me, "Do you think that played a role in your depression?" I would have said no. Right? And it makes me realize, one of the reasons why I clung to this very simplistic chemical imbalance theory of depression for so long, because I did not want to give the individual who behaved so appallingly towards me that sense of power over me. I didn't wanna... I didn't wanna think about that stuff, I wanted to cauterize it, I wanted to cut it out of my life and say, "Well, okay, that's a bad thing that happens to you." But, you know, but the... but-... the reason why I stayed with this and the reason why I kept, uh, you know, s- spent this time with Vincent in San Diego, and the reason why I kept going with all these different causes of depression and anxiety, is 'cause once you understand what's happened, you can find solutions you otherwise didn't find. So there was a second stage of Vincent... Dr. Felitti's research that to me was so powerful, it's one of the reasons why I make myself talk about this now. So if you'd indicated on the form that you'd experienced one of these forms of childhood trauma, the next time you went back to your doctor, you weren't called back, but the next time you went to your doctor, your doctor was told to say something to you like, "Hi Jo. I see on the form you indicated that you were violently abused when you were a child. I'm really sorry that happened to you. That should never have happened. Would you like to talk about it?" And quite a lot of people said, "Thank you, but no, I don't wanna talk about that." But a lot of people did want to talk about it. On average, the conversations lasted five minutes, and then the doctor said, "I can refer you to a therapist to talk more about this if you want." And they were monitored to see what happened. The results were kinda incredible. There was a th- enormous fall in depression and anxiety just from the five-minute meeting, right? And from the... Obviously, people who were referred to therapy saw an even bigger fall. And it seems to be... Again, this is going beyond... This bit is going beyond what Vincent said, said. He- he said... I asked him about it, he said, "No." I think partly what happens is it's related to shame, right? If you are a kid and you experience some kind of abuse, you- you can basically do one of two things, right? You can either say, "Look, I'm fucked here." Right? "I've- I'm like a pinball being smacked around a pinball machine 'cause I can't stop this happening, and I've just got to accept it, and I'm really vulnerable." Or you can say, "This must be my fault at some level." Right? Um, which is what I did. And of course, it's what you're being told anyway by who- whoever's treating you badly in almost every case. And a weird thing is if you tell yourself it's your fault, actually, you gain a sort of weird internal power, right? You're not the pinball being smacked around the machine. You're the person controlling the pinball machine, you can change your behavior, right? You can't, you can't change the other person's behavior. So you- you kind of develop this kind of shame. And one of the things we know is, and there's plenty of evidence from this, people like Professor Jim Pennebaker have shown it, shame is a catastrophe for human psychology, right? We know, for example, openly gay men died two years later than closeted gay men in the AIDS crisis, even when they got medical care at the same time, right? Shame destroys you. It makes you sick. And what Vincent found was this model of releasing your shame, which led to this significant for-... I remember one of the letters he got was from an old woman, think she was in her 80s, who just said... She had been sexually abused when she was a kid, and she said, "Thank you for asking. I thought I'd die and no one would ever know." And you can see how that release of shame would have a transformative effect on people.
- JRJoe Rogan
Wow. So for you, you had this traumatic experience of violence when you were young. You were depressed. You were trying to figure out what the source of this was, whether it was some sort of a chemical imbalance in your brain. Now, when- when they say, "Chemical imbalance is in the brain," have... Are they capable of measuring the level of serotonin in your brain?
- JHJohann Hari
Yes. So there's a huge debate about this. You can, for example, do autopsies. Um, there's a big debate about...
- JRJoe Rogan
But that's when someone's dead?
- JHJohann Hari
Yeah. But there's a big debate about... So there seems to be... Most scientists agree lo-... Not all of them, and there are some people who dissent from this, but most scientists agree low serotonin correlates with depression, right? But it's not the same thing. In the same way stretch marks correlate with obesity, but they're not the-
- JRJoe Rogan
Right. I understand.
- JHJohann Hari
... cause of obesity. They're the product of it.
- JRJoe Rogan
Yeah.
- JHJohann Hari
So there are real brain changes that happen, which I write about in Lost Connections. And important to say that, um, that I don't think they should be described as chemical imbalances, but one of the things that was really shocking to me was, uh, one of the British experts on this, Dr. David Healy, said to me, um, "You can't even say the sero- the idea that depression causes serotonin, you can't even say that that theory is discredited, 'cause it was never credited." There was never a time when half of the scientists in the field believed that, right? The reason that story got sold to me, and most people listening to this in the '90s, is 'cause it worked really well for the drug companies, right? Because what it makes it sound like if you've just got a chemical imbalance, the solution is just to give you chemicals. Now, it's important to say chemical antidepressants do play a role. We can measure that. And there's a slightly nuanced point to make about this, which is... So depression is measured by something called the Hamilton Scale, right? I've always felt sorry for whoever Hamilton was, that the only way we remember him is by how fucking miserable we are.
- JRJoe Rogan
(laughs)
- JHJohann Hari
But anyway, so Hamilton Scale goes from one, where you are, you know, dancing around in ecstasy or on ecstasy, to 51, when you would be acutely suicidal, right? And to give you a sense of what movement on the Hamilton Scale looks like, if you move six points on the Hamilton Scale... Oh, sorry. If your sleep patterns get better, you'll gain six points on the Hamilton Scale. And if your sleep patterns deteriorate, say you have a baby who's crying all the time, you'll generally lose six points on the Hamilton Scale, right? So Professor Irving Kirsch at Harvard Medical School did the best research on this, and what he found is on average, chemical antidepressants move people 1.8 points on the Hamilton Scale, right? About a third of what improving your sleep patterns does. It's important to say that's an average, so some people do get more than that, some people get less. And you can see 1.8 points is not nothing, right? If you're acutely suicidal, 1.8 points can take the edge off. There's real value in giving people that relief. But it's not solving the problem for most people. I thought I was, you know, weird for being on antidepressants for so long and remaining depressed. Turns out I was totally typical. According to Dr. Steve Ilardi, who's a professor of psychology, he's done a lot of work on this, between 65 and 80% of people taking chemical antidepressants become depressed again, right? So you can see, that's not 100%. There is some value-
- JRJoe Rogan
Well, isn't that, that's what Abilify is for, right? Is Abilify is the idea that your antidepressant is not enough, so you take Abilify on top of your antidepressant, which is supposed to help even further. And it's one of the most prescribed medications in the country, and it's an antipsychotic.
- JHJohann Hari
Yeah. Well, the-
- JRJoe Rogan
Which is terrifying.
- JHJohann Hari
The doling
- 30:00 – 45:00
There's some value to…
- JHJohann Hari
out... I mean, one in five Americans will take a psychiatric drug in their lifetime, right? It's a sign of a...... a, a, a cultural madness that we are doing this, right? Where the- now, this is not to say, that I wanna stress again, there is a real value in these drugs. There is some value to them. But-
- JRJoe Rogan
There's some value to them-
- JHJohann Hari
Yeah.
- JRJoe Rogan
... but they're most certainly over-prescribed-
- JHJohann Hari
Oh-
- JRJoe Rogan
... and there's most certainly actual methods that you could use to improve your life without any cour- sort of chemical intervention that are readily available to everybody, like exercise and diet.
- JHJohann Hari
Yeah. Well, I'll give you a really-
- JRJoe Rogan
And those... But those things aren't stressed when you, when you go to a doctor. The first thing the doctor doesn't say is, "Listen, what we need to do is get you to start running and get you to start eating really healthy, and then let's talk about antidepressants."
- JHJohann Hari
(laughs) You're totally right. There's a $10 billion industry in that doctor giving you drugs.
- JRJoe Rogan
That's a crazy number you just said.
- JHJohann Hari
Yeah. And, and I think-
- JRJoe Rogan
$10 billion.
- JHJohann Hari
Exactly. So this is why, although there is a real value for those drugs-
- JRJoe Rogan
Wow.
- JHJohann Hari
... with the, the, the... Why this is the first primary and, for most people, only option that's ever offered. And one of the things that really helped me change, think about this differently, and it fits exactly what you're saying, Joe, is I went to interview this South African psychiatrist called Derek Summerfield. And Derek happened to be in Cambodia when chemical antidepressants were first introduced, right?
- JRJoe Rogan
That's where they were introduced?
- JHJohann Hari
No, no. He was just there-
- JRJoe Rogan
To when?
- JHJohann Hari
... when they were first introduced-
- JRJoe Rogan
Okay.
- JHJohann Hari
... in Cambodia. They, they, I thought that would've been one of the last countries in the world they made their way to. And the Cambodian doctors didn't know what they were, right? So, they're like, "What is this?" And he explained. And they said, "Uh, we don't need them. We've already got antidepressants." And he said, "What do you mean?" He thought they were gonna talk about some kinda like herbal remedy or something. Instead, they told him a story. There was a farmer in their community who one day... He worked in the rice fields... who one day had stood on a landmine and got his leg blown off. So, they gave him an artificial limb and he went back to work in the rice fields. But apparently, it's super painful to work in water when your leg's been, you know, when you've got an artificial limb and your leg's been blown off. And I'm guessing it's pretty traumatic 'cause he's in the fields where he's been blown up. He starts to cry all day, doesn't wanna get out of bed. Classic depression, right? They said to Derek, "We gave him an antidepressant." He said, "What was it?" They said, they explained, they went and sat with him. They listened to him. They realized that his pain made sense. They realized that it actually made perfect sense that he felt so bad. They figured if they bought him a cow, he could become a dairy farmer. He wouldn't be in these fields where he was being fucked up. So, they bought him a cow. Within a couple of weeks, he stopped crying. They said to Derek, "So you see, Doctor, that cow was an antidepressant. That's what you mean, right?" Now, if you've been raised to think about depression the way we have, we've been propagandized to, that sounds like a bad joke, right? "I went to my doctor for an antidepressant, he gave me a cow." If you understand what all these experts who I met have been... and interviewed extensively have been ex- trying to tell us, if you understand what the World Health Organization has been trying to tell us, those Cambodian doctors knew intuitively what they knew through the science, which is our pain makes sense, right? You're not crazy to feel like shit. You've got unmet needs, and what you need is help to get your needs met. Now, some of the things you're talking about are really good examples. Exercise, diet. Some of them are these bigger interventions, so one of the heroes of Lost Connections is this doctor I got to know called Sam Everington, who, who, um, is based in, in East London, actually where I... near where I lived for a long time, a very poor part of East London. And sadly, he was never my doctor. But Sam was really uncomfortable, 'cause he's a general practitioner, he's a general doctor. Loads of people were coming to him with depression and anxiety, right? And he'd been told in his medical training, even though he knew the science was much more complicated than this, to just say to people, you know, "You've just got a chemical imbalance in your brain," and just drug them, right? And Sam thought... Right, like me, he's not opposed to the drugs. He does give them out to some people, but he just thought, "This is... This is not right. This isn't dealing with the reason they feel so shit," right? So, he tried a different approach. He noticed that one of the factors that was making them depressed and anxious was how profoundly lonely they were. There's a study that asks... Obviously, this is in Britain, but the figures are similar for Britain, but I'll give you an American example. There was a study that asked Americans, "How many close friends do you have who you could call on in a crisis?" When they started doing the study years ago, the most common answer was five. Today, the most common answer is none. Right? It's not the average, but more people say none than any other option. So, you think about that. Many people-
- JRJoe Rogan
More people in America?
- JHJohann Hari
Yeah.
- JRJoe Rogan
Or more-
- JHJohann Hari
More people in the United States have nobody to turn to when there's a crisis than any other option, right? So, you think about what life must be like when you're alone. That is not the species we are. The reason why you and I are sitting here, Joe, in LA, the reason why we're alive, is 'cause our ancestors in Africa, wha- on the savannas of Africa, were unbelievably good at one thing, right? They weren't bigger than the animals they took down, but they were much better at cooperating than the animals they took down. We exist because our ancestors formed into tribes. Every instinct we have is to live in a tribe, right? Bees need a hive, humans need a tribe. We are the first humans ever to try to disband our tribes, right? No one's ever done that before in human history. And it's quite rightly-
- JRJoe Rogan
Well, what do you... Let me stop you there-
- JHJohann Hari
Sure.
- JRJoe Rogan
... because we're getting deep in the weeds here. What do you say to someone who is happy with what they do, lives a, a fulfilled life, exercises, and is still depressed?
- JHJohann Hari
Yes, so I've thought a lot about this, but remind me to come back to the thing about East London.
- JRJoe Rogan
Because I know this is, this is an issue with a lot of people. I-
- 45:00 – 1:00:00
Do doctors still say…
- JHJohann Hari
imbalance in your brain," right? That's the, w-
- JRJoe Rogan
Do doctors still say that?
- JHJohann Hari
Uh, all the time. My, my nephew's best friend, um, just literally couple of weeks ago went to the doctor and was told, "Yeah, you've got a dopamine imbalance," the doctor said. It's migrated in the 20 years since I went there for a surgery-
- JRJoe Rogan
Was this in England or in the United States?
- JHJohann Hari
This was in England, but I mean, I get contacted constantly by people who are being told they've got chemical i- they're told they've got chemical imbalances in their brains.
- JRJoe Rogan
Now, are they just as likely to prescribe antidepressants in England a- as they are American? Um, Americans who-
- JHJohann Hari
It's slightly lower, but it's still exceptionally high.
- JRJoe Rogan
Yeah, still is. Yeah, yeah. There's, uh, that narrative that an antidepressant must be in some sort of a pill form and that even, even the expression antidepressant, an antidepressant, it's just a very confusing thing that we've sort of adopted very quickly in this country. And it's, uh, relatively recent, you know, over the last 60, 70 years. And the people that have antidepressants, uh, in their body, that take them all the time and swear by them, boy, if you try to tell them, in, in any way, that there's a better option, they get extremely defensive. Um, I have a friend. She's very smart and she's, she's one of the, um, one of the people that will, you know, very aggressively debate this idea that it's anything but a chemical depression, chemical, uh, imbalance, you know, but she doesn't take care of her body. She's not... She doesn't exercise all the time, you know. She's slightly overweight. She doesn't eat the best foods. You know, it's, it's, it's a weird thing.
- JHJohann Hari
Well, and she's living in a society and culture that has all these forces that are rising that make people feel terrible, right?
- JRJoe Rogan
Yes. Yeah.
- JHJohann Hari
And so a, a big thing for me is, when I'm talking to this, because I've had some of that reaction as well, not too much, but I've had some of that reaction as well. First thing for me to s- I always say is, "I wanna expand the menu of options. I don't wanna take anything off the table," right? It's not about-
- JRJoe Rogan
W- well, you say that, and I, and I think you're probably being pretty honest, but you really do want to. You wanna eliminate m- I mean, you w- but just by the standard of improvement, you do probably wanna take most people off of antidepressants, don't you? Wouldn't you rather they have a-
- JHJohann Hari
I would draw an analogy.
- JRJoe Rogan
... have a better choice?
- JHJohann Hari
Yeah, I would draw an analogy. Obesity has massively risen in the Western world. It hasn't risen 'cause people suddenly became greedy and lazy. It's risen because our food system is terrible, the way food supply system is terrible, and we built cities that people can't walk and bicycle around, right? And they're really stressed all the time and they get home from work exhausted so they don't have time to exercise, a lot of them. In that context, some people will do, was it a stomach stapling, liposuction, that kind of thing, right?
- JRJoe Rogan
Yeah.
- JHJohann Hari
Now, I'm not against that, but if we change the society in the way that I would want to with obesity, so that people could walk and cycle and, you know, they had access to healthy food, far fewer people would need stomach stapling or liposuction, right? So I would draw... it's not a perfect analogy, but I'd say is if the social changes that I want to happen, happen, if we follow the places that have succeeded in reducing depression and anxiety, over time, you would see fewer people feeling they needed an- chemical antidepressants. It's not about saying that-
- JRJoe Rogan
I would stop you right-
- JHJohann Hari
Yeah.
- JRJoe Rogan
... with a couple of things.
- JHJohann Hari
Sure.
- JRJoe Rogan
First of all, I don't think it's access to healthy food. I think most people have access to healthy food. They choose not to eat it. They choose to eat refined carbohydrates, high sugar foods, fast food. Those are the things that are getting people fat. And I don't, I don't think that salad is so outside of the reach of the normal person. I just don't agree with that.
- JHJohann Hari
And, you know-
- JRJoe Rogan
I just think they make unhealthy choices. That's much more li- And they get addicted to refined carbohydrates.
- JHJohann Hari
But people make choices. I think... I, I understand what you're saying, and I d- I think there's some truth in it, but I think people make choices in a context, right? So for example, um, you know-... one of my relatives who's very overweight, you know, she's constantly fucking stressed because she's trying to hold together so much. And one of the few reliefs and pleasures she has is to eat too much, right? And to eat pretty shitty food, right? I'm not critical of her for that. Uh, uh, what I want is to help her change her life and change the society in which we live so she's not got that constant stress. Do you know what I mean?
- JRJoe Rogan
Mm-hmm.
- JHJohann Hari
I mean, I think of this in relation to addiction. And you tweeted once about a TED Talk I gave, everything you think you know about, um, addiction is wrong. Uh, which I- for which I'm grateful. Thank you. And- and which is based on my previous- partly taken from my previous book, Chasing the Scream, which is about addiction. And I think about what you're saying in relation to that context. So, we had a lot of addiction in my family. And, um, you know, one of the things that really changed my mind about this, and I think it really relates to what you're saying about food, is most people think, you know, addiction, i- i- say drug addiction, let's say heroin addiction, right-
- JRJoe Rogan
Mm-hmm.
- JHJohann Hari
... which is very close to me. Most people think heroin addiction, if you said, "What causes heroin addiction?" They'd say, "Duh, heroin causes heroin addiction," right? We've been told this story for a really long time that, um, you know, if you took- if we kidnapped someone off the street, we injected them all- we injected them with heroin every day for 20 days, at the end of that, they'd have this desperate physical hunger for the chemical hooks in heroin. Their body would desperately need it, and that's- that's why they would be addicted, right? The first thing that alerted me to the fact there's something not right about that is when it was explained to me, in Britain, if you get hit by a truck and, you know, you break your hip and you're taken to hospital, you'll be given loads of a drug called diamorphine, right, for the pain. Diamorphine is heroin. It's much better than street heroin because it's medically pure, right? If anyone listening to this has a British grandmother who had a hip replacement operation, your grandmother's taken a lot of heroin, right? If what we've been told about the chemical hooks is right, what should be happening to all these people in hospital? Loads of them should be becoming addicted. It doesn't happen in Britain with- with people who are given diamorphine. So it's like, "Well, wait, what's going on?" And I only began to understand it when I went to Vancouver and interviewed this incredible professor there called Bruce Alexander, who did this experiment that's changed how we think about addiction, and I think it's very relevant to what you're saying about food. So, this theory, the chemical hooks theory of addiction... The chemical hooks are real, they're just a small part of it. The chemical hooks theory of addiction comes from a series of experiments that were done years ago. They're really simple. You take a rat, you put it in a cage, and you give it two water bottles. One is just water, the other is water laced with either heroin or cocaine. If you do that, the rat will almost always prefer the drugged water and almost always die quite quickly, right? Within, I think it's a week. So there you go. You might remember there's a famous advertisement for-
- JRJoe Rogan
Yes.
- 1:00:00 – 1:05:40
What about all the…
- JHJohann Hari
in Lost Connections and then the kind of seven solutions to this problem that I offer. So again, that's about if you're ... So let's say, uh, Joe, right? Joe in the paint store who I was talking about who's, you know, he, who, who has this job he can't bear, has very little meaning in his life, feels his life is just slipping through his fingers. He took Oxy for quite a long time. He actually contacted me because of my, my book, um, and bec- uh, and, and my TED Talk and he thought he was telling me a story about addiction, right? But the truth is when he took Oxy, he was numbed. It made him as numb as the work itself. And then when he stopped, he was acutely depressed and felt like shit. So I think the challenge is, if you are coming off of this drug into a society of profoundly lonely and isolated people who are financially insecure-... who've been told that life is about money and status, who- who- you know, who- who think life is about screaming at each other through screens, a lot of those people are gonna feel like shit. And it's not because they're individually weak, right? It's bec- now there may be individual weaknesses, of course, we all have flaws, every human being has flaws. But- but I think it's much more- because the fact that it's risen so much tells you that it's a response to social changes, right? Just like the fact obesity has risen so much tells us. Now there are, of course, individual agency. I don't wanna infantilize anyone. There are things individuals can do, obviously, and I talk about them a lot in Lost Connections. But I think the fact that it's a social transformation, um, does tell you something. There's a g- a good illustration of this, a kind of weird thing that was discovered about depression in the '70s that was so inconvenient that psychiatrists kind- tried to brush it under the carpet. So in the '70s, the American Psychiatric Association for the first time wanted to standardize how depression is diagnosed across the US, because up to then doctors were just using their own judgment about what it even was, right? So they drew up a list of 10 symptoms, kind of obvious things like feeling worthless, crying a lot, you know, you could guess what they were. And they sent this out to doctors all over the US and, uh, they use it. But a coup- within a couple of months, doctors start to come back and go, "Look, we've got a real, we've got a real problem here because if we just use this checklist, we should be diagnosing every grieving person as mentally ill because these are the symptoms of grief." Right? Everyone, when you lose someone f- wants to cry a lot, f- you know, has persistent feelings of sadness, that kind of thing. So like what do we do? So the psychiatrists regrouped and they were like, "Okay, we'll create something." It was called the grief exception, which basically said, "Use this checklist to diagnose depression, unless the person has lost someone they love in the last year, in which case none of this counts." So they start using that. But over the next few years that followed, there's this really awkward debate because they're like, "Wait a minute, we're being told to tell our patients that depression is just a brain disease that you can just identify from a checklist, unless there's one situation in life where it's perfectly legitimate to react this way." But if that begs the question, what about the oth-
- JRJoe Rogan
What about all the other different things in your life?
- JHJohann Hari
Exactly. Why not if you're made homeless? Why not if you've stuck in a shitty job you hate? Why not if you're really lonely? The minute you admit all that, you have to admit context. And that was so inconvenient, they just got rid of the grief exception. It doesn't exist.
- JRJoe Rogan
That's a fascinating fact and that seems to be a- a huge issue. That seems to be one of the primary reasons why people today, I mean if you- if you stop and ask the average person today who's not feeling well, uh, I guarantee you they're gonna be able to come up with at least one or two of those things on the list that- that are- that are factors.
- JHJohann Hari
You're totally right. Whether-
- JRJoe Rogan
Whether it's a job, a financial stress, relationship stress, loneliness, friendship issues, or death in the family, or losing someone they love. But the fact that losing someone they love, like, we'll count that.
- JHJohann Hari
Yeah. (laughs) That- that's-
- JRJoe Rogan
That's the one thing we'll count, right?
- JHJohann Hari
Yeah. That- that seems very preposterous. And the w- woman who did the most research on this, and one of the best people I got to know for Lost Connections, a woman called Dr. Joanne Cacciatore, is an amazing person. She lost her baby, um, in childbirth, her baby was called Cheyenne, and she became an expert on this. And she said, you know, she talks about the craziness of this. It just shows we don't understand pain in this society.
- JRJoe Rogan
Right.
- JHJohann Hari
Grie- she said, she put it to me, "We don't... Grief isn't a pathology, right?" We don't... She- she's done this research that shows, I think the figure is 32% of grieving parents are diagnosed and drugged in the first 48 hours after their child dies. And she said this is a sickness, right? The- the- the- grief is not a pathology. We grieve because we've loved someone, right? It's not a malfunction, it's not a sign of madness, it's a sign that you loved the person. And in a way, I'm going beyond what she says now, but you know, I think one of the thing- the fact that depression and grief have the same symptoms is really significant, 'cause I think depression is grief for your own life not going how it should, right? It's grief for your own needs not being met. Now, when someone we love dies, all we can do is hold the survivors and love them, right? But with, um, but with, um, with your own needs not being met... I mean, a really interesting example, this is something you've covered brilliantly on the show, Joe, about psychedelics, some of the research around psychedelics, which taught me a lot about how we might think about this differently. So as you know, uh, you know better than anyone, th- until the mid '60s, loads of research was done giving LSD to people with depression, alcoholism, various problems. They weren't done to the standards we wanna do scientific experiments now, but they found really promising results and then Nixon shuts the whole thing down, right? In the last six years, there's been a huge reawakening of this. I went and interviewed for Lost Connections the teams that worked on this in, um, uh, here in LA at UCLA, at NYU, at Johns Hopkins in Baltimore, in London at UCL, uh, in Sao Paolo and in Norway. And loads of fascinating things can be found about this, but there's one that I think really relates to our conversation powerfully, um, w- uh, well loads of things, but we'll talk about one.
Episode duration: 2:32:24
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