Joe Rogan Experience #1077 - Johann Hari

1. 0:06 – 0:44

   Name jokes, broken arm story, and teeing up a big question: what is depression?

   1. JRJoe Rogan0:06

      Johann Hari. I got it right.

   2. JHJohann Hari0:08

      You said it right. You are literally the first person-

   3. JRJoe Rogan0:10

      (laughs)

   4. JHJohann Hari0:10

      ... 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.

   5. JRJoe Rogan0:18

      Didn't they just assume that was you when you hear- you heard "Joanna Hairy"-

   6. JHJohann Hari0:21

      No. To be fair-

   7. JRJoe Rogan0:22

      ... you were like, "Hmm."

   8. JHJohann Hari0:22

      ... I had a broken arm and I was lying there-

   9. JRJoe Rogan0:23

      Oh, right.

   10. JHJohann Hari0:23

       ... like a weeping and being like, "Fuck, someone help me."

   11. JRJoe Rogan0:26

       What happened to your arm?

   12. JHJohann Hari0:26

       So, I think in my normal mind, I would have done.

   13. JRJoe Rogan0:28

       What went down with your arm?

   14. JHJohann Hari0:30

       Oh, I just... I fell.

   15. JRJoe Rogan0:31

       Oh.

   16. JHJohann Hari0:31

       And, uh, it tragically... Nothing, no glamorous story to it. I fell down-

   17. JRJoe Rogan0:34

       Damn.

   18. JHJohann Hari0:34

       ... a staircase. I wasn't even drunk. I wasn't even fucked on anything.

   19. JRJoe Rogan0:36

       (laughs)

   20. JHJohann Hari0:36

       I just fell down the stairs, right?

   21. JRJoe Rogan0:38

       Damn.

   22. JHJohann Hari0:38

       I wasn't even a victim of domestic violence. You know, like no-

   23. JRJoe Rogan0:40

       Right.

   24. JHJohann Hari0:41

       ... no, uh, surrounding narrative that would make that an interesting story, sadly.

2. 0:44 – 2:24

   Lost Connections thesis: depression/anxiety rising because our lives are misaligned

   1. JRJoe Rogan0:44

      So, give me your... if you had, like, a- a one paragraph take on depression.

   2. JHJohann Hari0:52

      Sure.

   3. JRJoe Rogan0:52

      What is your take on depression?

   4. JHJohann Hari0:54

      So, this is why I wrote this book, Lost Connections-

   5. JRJoe Rogan0:56

      Yeah.

   6. JHJohann Hari0:56

      ... 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?

   7. JRJoe Rogan1:06

      Right.

   8. JHJohann Hari1:06

      It's very personal to me. When I was a teenager, I'd gone to my doctor, I'd explained that I was in this deep sense of pain, and all my doctor did was tell me a biological story, just said, "Basically, your brain's broken," and all he did was give me drugs, right? And drugs play a role in treating people, but I was still depressed all that time I was taking these drugs, right? Most of the time. And after 13 years of it, I thought, "Right, I need to understand what's really going on here." So I ended up going on this big, long journey, over 40,000 miles, interviewing the leading experts in the world on what causes depression and anxiety and what solves them. And what I discovered is the... we- we've told a ridiculously simplistic story to people about what depression is and how to solve it, that, you know, until I was a teenager, um, and I went to my doctor, I thought depression was all in my head, meaning, you know, you're just being weak, you're being a pussy, basically. And then the next 13 years, I thought it was all in my head, meaning, you know, it's a chemical imbalance in your brain. What I discovered is, uh, the overwhelming evidence from the World Health Organization, leading medical body in the world, and loads of other places is, uh, there are real biological factors that can make you more sensitive to this stuff, but the causes of depression and anxiety are overwhelmingly in the way we're living. There are these nine causes of depression and anxiety for which I could find scientific evidence, seven of which are in the way we're living, and some of which are rising, which explains this kind of epidemic, and that opens up a whole different way of finding solutions.

3. 2:24 – 3:38

   Depression as “despair spreading”: psychological needs, meaning, autonomy, belonging

   1. JRJoe Rogan2:24

      Now, when you were young and you were experiencing depression, how would you categorize it? Like, what... How would you describe it if you had to describe it to someone who didn't understand depression?

   2. JHJohann Hari2:34

      Yeah.

   3. JRJoe Rogan2:35

      I'm trying to keep this about a fist away from your face.

   4. JHJohann Hari2:36

      Oh, sure. I think I'll move a bit closer to it, yeah. I think depression, um, depression is despair spreading... Everyone has moments of hopelessness in their lives, right?

   5. JRJoe Rogan2:45

      Right.

   6. JHJohann Hari2:45

      It's that spreading further. But I think one of the things I learned is a- a deeper way of thinking about this, which is everyone listening to this, everyone watching this knows that they have natural physical needs, right? You need food. You need water. You need clean air. You need warmth. If I took those things away from you, you would be in real trouble real fast, right?

   7. JRJoe Rogan3:03

      Right.

   8. JHJohann Hari3:03

      There's equally strong evidence that human beings have natural psychological needs, right? You've got to feel you belong. You've got to feel your life has meaning and purpose. You've got to feel that people see you and value you. You've got to feel that you've got autonomy. You've got to feel that you've got a future that makes sense. And our culture is good at lots of things. I'm glad to be alive today. But our culture has been getting less and less good at meeting these deep, underlying psychological needs for lots of people. And that is the key reason, it's not the only one, but that's the key reason why we have this rising depression and anxiety epidemic. That can sound a bit weird in the abstract. So I can give you some specific examples if you want.

   9. JRJoe Rogan3:37

      Okay, sure.

4. 3:38 – 10:18

   Work as a depression engine: Gallup numbers, control, and the cooperative alternative

   1. JHJohann Hari3:38

      So I'll give you one example. I noticed that lots of the people I know who are depressed and anxious, their depression and anxiety focuses around their work, right? I started to think, "What's going on here?" So I started to look for evidence about how people feel about their work. Best research on this was done by Gallup, the opinion poll company. Massive detailed study, took a couple of years. They found the figures for how people feel about work in the US and- and other comparable countries. What they found is 13% of us, one three percent, basically like our work most of the time. We get energy from it. 63% of us, um, are what they called sleep working. So don't like their work, don't hate their work. They're just kind of enduring it. And 24% of people fucking hate their work, right? Fear it and dread it. So I was quite struck by that when I looked at it. That means 87% of people don't like the thing they're doing most of the time, right?

   2. JRJoe Rogan4:27

      That's incredible.

   3. JHJohann Hari4:28

      It's striking. And bear in mind, this thing that we don't like has spread over even more of our lives, right? Average person answers their first email at 7:48 AM and leaves work at 7:15 PM. So this is most of our waking lives we're doing something we don't like. I started to think, could there be some connection between that and this epidemic of all sort of forms of despair, anxiety, depression, addiction? So I started to look for scientists who had studied this. I discovered an amazing Australian social scientist called Professor Michael Marmot, who I got to know, who discovered the key to what causes depression at work, right? There's several aspects to this. I can tell you the story of how he discovered it if- if you want, 'cause I think it's an amazing story. But the core of it is, if you go to work and you are controlled, so you feel you have low or no control, you are radically more likely to become depressed. You're even more likely to have a stress-related heart attack. And I think the reason is clear, although I'm going a bit further than Professor Marmot does. Um, human beings need to feel our lives have meaning, right? And if you're controlled all the time, you don't feel like your life has meaning. You don't feel like... it- it disrupts your ability to create meaning out of your work.

   4. JRJoe Rogan5:36

      Hmm.

   5. JHJohann Hari5:36

      And it makes you feel like shit, right?

   6. JRJoe Rogan5:38

      Mm. That makes sense.

   7. JHJohann Hari5:39

      And o-one of the things... So, one of the things that was really important to me i- in everything I was learning, f- for... in the research for Lost Connections was, there was this... It required this kind of shift in my mind, 'cause what I was basically told by my doctor is, "Your pain is a malfunction." Right? He said, you know, "We know what causes depression. It's just some people naturally have low levels of serotonin in their brains. Um, you know, uh, you're clearly one of them. Uh, that, that's what's going on here." And one of the things that was really striking, speaking to the leading experts in the world, is that story's just not true. There are real biological factors. There are real things that happen in your brain, obviously. But actually, a Professor Andrew Scull at Princeton University says it's deeply misleading and unscientific to say depression is just caused by low serotonin, right? It's, it's just not true. Um, but, but one of the things that was so important to me, looking at these nine real causes of depression and anxiety, was realizing, actually, our pain makes sense, right? If you're depressed, if you're anxious, you've been told, basically, that you're a bit crazy. There's something not working. But actually, you're not a machine with broken parts, right? You're a human being with unmet needs, and that requires a very different set of responses. So you think about... I started to think, well, let's think about that problem with work, right? Most people feel they've got no control at work, or low control, and it's making them feel terrible. They're not wrong to feel that, right? They've got a need as human beings and it's not being met. How can we deal with this? And I, I learned there's a really interesting strategy to deal with this. Now, this is something some people will be able to do as individuals, but it's something we can actually change as a society so far more people could do it. I went to Baltimore and I interviewed a woman called Meredith Keogh, a young woman. Meredith used to go to bed every Sunday night just fucking sick with anxiety, right? She would, she would... She had an office job. It wasn't the worst office job in the world, right? She wasn't being bullied, she wasn't being harassed. But she just, she just felt like... she just couldn't bear the thought the next 40 years of her life were gonna be this, right? And one day with her husband, Josh, she does a quite bold thing. Josh was a working-class guy from Baltimore. Since he was a teenager, he'd, he'd, um, worked in bike stores. And, you know, working in a bike store, your viewers will know, it's insecure work. It's, um, controlled. You do what your boss tells you. You don't even get vacations unless the boss, you know, is nice to you. And, and Josh and his colleagues in the store, they didn't hate their boss. He wasn't a particularly bad boss as far as bosses go. They quite liked him as a person. But one day they just asked, "What does our boss actually do," right? "We fix all the bikes, and he seems to make all the money. What's, what's going on here?" They decided to do an experiment. They, they, they, they set up a, a different bike store, a rival bike store. It's called Baltimore Bicycle Works, and it works on a different principle. So most people who are listening to this all work in corporations, right? Top-down, you do what the boss says. It's modeled like an army. That is a very recent human invention, right? It only comes along in the late 19th century. What they did was try a different model. They're called democratic cooperatives. So, at Baltimore Bicycle Works, they, uh, take all the big decisions together about their work. They vote. Uh, they share out the good tasks and the shitty tasks so no one just gets stuck with all the shitty tasks. They share the profits, obviously. So they control their environment together. They're like a little tribe that control their environment instead of an army with one guy at the top controlling it. And one of the things that was so fascinating spending time with them, which is totally in finding with Professor Michael Marmot's research about what causes depression at work, is how many of them talked about having been really depressed and anxious when they were, when they were working in this controlled way. And their depression and anxiety had largely gone. They still had bad days, of course, but their... that kind of nagging depression and anxiety had gone away in this different environment. And as Josh said to me, "There's no reason why any business should work in this top-down, controlled way that makes people depressed." It's not even more efficient. A study at Cornell University found that democratic businesses grow four times faster than, um, than, uh, you know, top-down businesses. And I think what this opens up is a different way of thinking about depression. So what we've done up to now is we've said to depressed and anxious people, "The job of fixing this is basically on you, buddy," right? Maybe, if you're lucky, your family. Maybe, if you're lucky, your doctor. But actually, once you begin to realize that the reasons why people are depressed and anxious make sense... This is just one of many reasons why people are depressed and anxious, and also one of the things that's fueling the addiction crisis, which we can talk about if you want. Um, once you realize it makes sense, you suddenly realize what you've got to do is deal with the problem in the world, as well as the problem just in the individual's skull. Do you see what I mean?

   8. JRJoe Rogan10:00

      Yeah, so you're focusing on work environments, right? Um, and there's, there's many reasons, as you were saying, for, for people being depressed. Uh, have you... When you talk about work environments, have you researched people who are independent, people who work for themselves, people who, you know, make things or make furniture or what have you?

5. 10:18 – 18:39

   Meaningless labor and “junk values”: intrinsic vs extrinsic motivation

   1. JHJohann Hari10:18

      Yeah, and that was one of the things as well at Baltimore Bicycle. It's just most people are so removed from the product... from their work, right, from the, the outcome of their work. So I'll give you an example of a guy I interviewed a lot, um, a guy called Joe. He, he works in Philly and he worked, when I met him, in a, uh, paint st... a paint store, right? And Joe's job was to turn up at whatever it was, 8:30 in the morning, stay there all day until 7:00 PM, and just take your order for paint. And then when you ask for a specific shade, his job was to put it in a machine that shook it, right? And then just give you the paint. That's it. That was his whole life, week after week, year after year. And Joe was acutely depressed. And Joe was... really felt really guilty about telling me how depressed he was, right? He kept saying, "Look, I know how lucky I am. I know how lucky I am." Um, but he felt like, felt like shit. And, and he said... I remember him saying to me, "Look, I know people need paint," right? "It's not... I know that I have some function here in the economy." I don't think he put it quite like that. "But this is not giving me any sense of meaning." But one of the real mysteries to me about Joe, and for that I had to learn about one of the other causes of depression and anxiety and solutions to that, was... So Joe... A lot of people, some of my relatives who do work like that, they're basically... The margin for them to change their lives is really narrow, right? Like one of my closest relatives is a struggling single mom. Um, you know, she's... she works every hour she can. She gets home at the end of the day, collapses, right? The idea of saying to her, "Your job now is to democratize your workplace," is ridiculous, right? She can't do that. That's why most of Lost Connections is about how we can change the culture to free people up to make the changes they need to make, although there are things individuals can do that I go through in the book. But the, but, but the, the...A lot of people, um, how would I put it? They- they h- we live in such an individualistic culture that people think what you're saying is, "You need to do it yourself." But Joe was in an unusual position, in that Joe, uh, loved fishing, right? He'd fished in, I think, 20 of the 50 states. And he'd recently been to Florida, and he said, "You know, when I was in Florida, I, um, I realized I could just quit this job. I could go live as a fisherman in Florida. I'd make less money, but I'd be much happier," right? And there was- somehow I knew as I was talking to Joe, and I followed up with him over the years that followed, I knew he wasn't gonna go to Florida, right? And I made it along-

   2. JRJoe Rogan12:34

      How did you know?

   3. JHJohann Hari12:35

      He- it was just the way he said it. It was a wistful longing, not a-

   4. JRJoe Rogan12:38

      A whimsical idea, not something based on a- a real possibility.

   5. JHJohann Hari12:42

      That's a really good way of putting it. But I remember the last time I saw him, and he walked off, I- and I felt like a complete dick for doing this, but I shouted after him 'cause I felt it so strongly, "Joe, go to Florida!" Right?

   6. JRJoe Rogan12:52

      Right.

   7. JHJohann Hari12:52

      And one of the things that really troubled me was why are so- so a lot of people are trapped in the way our culture works, which is why we've gotta change the culture. And I talk about specific concrete things that have been tried in other countries that have freed people up and have reduced depressions. I'm sure we'll get to that. But if you think about an individual like Joe, what's going on there? And one of the things I learned, uh, from this amazing professor, Tim Kasser in Illinois, at Knox College in Illinois, is I think one of the things... This was one of the hardest causes of depression to learn about, 'cause I realized how much it played out in my own life as well. So just like we all know junk food has taken over our diets and made us physically sick, right? Something similar has happened with our minds. A kind of junk values have taken over our minds. When I kept- started learning about this, I- I kept remembering. So I ate nothing but junk food for like 10 years from my 20s, basically. And I remember one day, it makes it ev- this story even sadder that it was Christmas Eve in 2009. At lunchtime, I went to my local KFC, and I ordered, said my order, which I won't even repeat to you 'cause it was so disgusting. And the guy behind the counter said, "Oh, Johann, we're so glad you're here." I was like, "Okay." And he said, "Wait a minute, wait a minute." And he went back, and he came out, and the whole staff had bought a fucking massive Christmas card for me, and they'd written in it, "To our best customer." And my heart was like- sang 'cause I was looking at this, and I suddenly realized, this wasn't even the fried chicken shop I went to the most, right? So that- so I was at an extreme end of the junk food spectrum, right? I'm not anymore, though I've relapsed a bit lately. But, um, but- but- so we all know how that works, right? Junk food appeals to the part of us that evolved to want nutrients, but it tricks that. It's not actually a part of you that wants nutrients. It actually makes you sick, right? And what Professor Kasser found is that there's- similar things happen in our minds. So, um, weirdly, so for thousands of years, philosophers have said if you think life is about, you know, money and status and showing off, you're gonna feel like shit, right? But it's not an exact quote from Confucius, but that's the gist of what he said, right? But weirdly, no one had actually scientifically investigated this until, uh, until Professor Kasser 25 years ago. So he knew that basically, to put it crudely, there's two 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-

   8. JRJoe Rogan17:29

      Mm-hmm.

   9. JHJohann Hari17:30

      ... 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?

   10. JRJoe Rogan18:11

       Mm-hmm.

   11. JHJohann Hari18:12

       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...

   12. JRJoe Rogan18:18

       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?

6. 18:39 – 24:08

   Childhood trauma, obesity, and the ACEs breakthrough: pain that makes sense

   1. JHJohann Hari18:39

      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-

   2. JRJoe Rogan18:53

      Sure.

   3. JHJohann Hari18:54

      ... 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-

   4. JRJoe Rogan18:59

      You were very resistant to this...

   5. JHJohann Hari19:00

      Very resistant to this insight that he had.

   6. JRJoe Rogan19:02

      Okay.

   7. JHJohann Hari19:02

      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?

   8. JRJoe Rogan21:37

      Wow.

   9. JHJohann Hari21:37

      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,

7. 24:08 – 26:51

   Shame relief as treatment: the surprising power of being asked and heard

   1. JHJohann Hari24:08

      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.

8. 26:51 – 30:52

   Debunking the ‘chemical imbalance’ story and measuring antidepressant impact

   1. JRJoe Rogan26:51

      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?

   2. JHJohann Hari27:12

      Yes. So there's a huge debate about this. You can, for example, do autopsies. Um, there's a big debate about...

   3. JRJoe Rogan27:18

      But that's when someone's dead?

   4. JHJohann Hari27:19

      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-

   5. JRJoe Rogan27:33

      Right. I understand.

   6. JHJohann Hari27:33

      ... cause of obesity. They're the product of it.

   7. JRJoe Rogan27:35

      Yeah.

   8. JHJohann Hari27:35

      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.

   9. JRJoe Rogan28:26

      (laughs)

   10. JHJohann Hari28:26

       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-

   11. JRJoe Rogan29:41

       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.

   12. JHJohann Hari29:57

       Yeah. Well, the-

   13. JRJoe Rogan29:58

       Which is terrifying.

   14. JHJohann Hari29:59

       The doling 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-

   15. JRJoe Rogan30:14

       There's some value to them-

   16. JHJohann Hari30:15

       Yeah.

   17. JRJoe Rogan30:15

       ... but they're most certainly over-prescribed-

   18. JHJohann Hari30:17

       Oh-

   19. JRJoe Rogan30:17

       ... 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.

   20. JHJohann Hari30:30

       Yeah. Well, I'll give you a really-

   21. JRJoe Rogan30:31

       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."

   22. JHJohann Hari30:42

       (laughs) You're totally right. There's a $10 billion industry in that doctor giving you drugs.

   23. JRJoe Rogan30:45

       That's a crazy number you just said.

   24. JHJohann Hari30:47

       Yeah. And, and I think-

   25. JRJoe Rogan30:48

       $10 billion.

   26. JHJohann Hari30:49

       Exactly. So this is why, although there is a real value for those drugs-

   27. JRJoe Rogan30:52

       Wow.

9. 30:52 – 34:47

   ‘A cow as an antidepressant’: context-driven solutions and social prescribing

   1. JHJohann Hari30:52

      ... 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?

   2. JRJoe Rogan31:11

      That's where they were introduced?

   3. JHJohann Hari31:12

      No, no. He was just there-

   4. JRJoe Rogan31:13

      To when?

   5. JHJohann Hari31:13

      ... when they were first introduced-

   6. JRJoe Rogan31:13

      Okay.

   7. JHJohann Hari31:14

      ... 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-

   8. JRJoe Rogan34:05

      More people in America?

   9. JHJohann Hari34:06

      Yeah.

   10. JRJoe Rogan34:06

       Or more-

   11. JHJohann Hari34:06

       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-

   12. JRJoe Rogan34:46

       Well, what do you... Let me stop you there-

   13. JHJohann Hari34:47

       Sure.

10. 34:47 – 42:37

    When ‘having everything’ still feels awful: cultural scripts, happiness, and values

    1. JRJoe Rogan34:47

       ... 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?

    2. JHJohann Hari34:58

       Yes, so I've thought a lot about this, but remind me to come back to the thing about East London.

    3. JRJoe Rogan35:01

       Because I know this is, this is an issue with a lot of people. I-

    4. JHJohann Hari35:03

       Yeah.

    5. JRJoe Rogan35:04

       I know people that worship at the altar of science and modern medicine that firmly believe that all depression is because of some sort of chemical imbalance in the brain, and anything that debates that or anything that disputes that notion is, is... it pisses them off.

    6. JHJohann Hari35:19

       Yeah, no, I understand that, and I would've been like that for many-

    7. JRJoe Rogan35:21

       Do you get that?

    8. JHJohann Hari35:22

       Yeah, of course. I was like that for many years.

    9. JRJoe Rogan35:23

       But do you get... Do you mean, do you get some people responding that way?

    10. JHJohann Hari35:26

        Yes. Sure, of course, of course. I think the... So, the World Health Organization is the leading medical body in the world, right? They did a ser- study of all the best evidence and they explained very clearly that de- that mental health, um, is a social indicator, right? It has social causes and needs social solutions as well as individual solutions. The science on this is overwhelming. You won't get many scientists who say, uh... In fact, you'd be, you'd struggle to find any scientist who'll say depression is purely a biological phenomenon, right? Pretty much everyone agrees there's some social and psychological component. I think when we... There's a weird disconnect between what the scientists know and what the public is told, right? I don't know anyone who went to their doctor who, um, apart from this wonderful doctor in East London who we can talk about...... who went with depression and anxiety, was told anything other than a biological story. I mean, they maybe asked, you know ... some of them were asked about childhood, you know, "What was your childhood like?" And referred to a therapist. But no one was told about these wider social causes. No one was told, like, "Do you feel controlled at work?" Well, okay, it's a fact that could be making you, make you depressed. But in terms of the people who, who, um, who are depressed but don't, uh... 'Cause this was a real mystery to me, right? I knew people, I thought, "But this guy's got everything and he feels, he's still depressed. What's going on here?" I think there's two things to say about that. One is, I started to, uh, for various reasons, for research for something else, I was reading some, like, feminist texts from the early '60s, right? And a really common thing that happened in the early '60s is women would go to their doctor and they'd say, "Doctor, there's something really wrong with my nerves." People ta- talked about in terms of nerves then, we don't do that anymore. Uh, "Something really wrong with my nerves because I've got everything a woman could possibly want. I've got a husband who doesn't beat me, I've got a car, I've got a washing machine, I've got two kids, but I feel like shit," right? And the doctor would go, "You're right," and give her a Valium. Now, if we could travel back in time and speak to those women, what we'd say is, "Right, you've got everything you could possibly want by the standards of the culture, but the standards of the culture are just wrong," right? As a wo- as a woman, as a human being, you need more than just a washing machine and a car, right? You need a fulfilling life, you need to feel, have meaning and purpose. And a very similar thing I think is happening today. If you ... So for e- when I speak to people who say, "I've got everything I could want, but I feel like shit." You say, "Tell me, tell me about your life," very often they're working really hard in prestigious jobs that they don't like, they don't enjoy hour by hour, to buy things that don't give them pleasure. It comes back to this hijacking by junk values that we're talking about that Professor Tim Kasser discovered. So what you've got is, because we've been told a totally misleading story about what makes us satisfied and happy as human beings, I think this comes up again and again in the interviews you do, because we've been taught in different ways, because we've been told a misleading story about that, we live our lives according to the wrong script. We feel like shit, and rather than question the script, we think there must be something wrong with us biologically. Now, there are biological contributions, it's important to say that, but one of the things that really blew my mind on this was, um, I interviewed this woman ca- uh, amazing social scientist called Dr. Brett Ford in Berkeley. She did this research, it's kind of simple research, it just asked, um, "If you consciously decided you were gonna spend more hours a day trying to make yourself happier, would you actually become happier," right? And they did this research, she didn't do it alone obviously, with her colleagues in the United States, uh, Japan, Russia, and Taiwan. And what they found was, in the US if you try to make yourself happier consciously, you do not become happier. In the other countries, if you try to make yourself happier, you do become happier. And they were like, "What's going on?" So they did more research and what they discovered was, in the US and i- uh, obviously I spent a lot more time here, but in Britain as well, if you try to make yourself happier, you try to do something generally for yourself. You buy something for yourself, you big yourself up, you try to get a promotion. In the other countries, generally, if you try to make yourself happier, you do something for someone else, right? You try to help your friends, your family, your community.

    11. JRJoe Rogan39:18

        Wh- wait a minute. Where, what countries stress this?

    12. JHJohann Hari39:21

        So it's Japan, Russia, and China. It's most of the rest of the world.

    13. JRJoe Rogan39:23

        They stress this? That if you ... This is a part of their culture, that if you wanna be happy, you do something for someone else?

    14. JHJohann Hari39:28

        It's- it's- it's so implicit in the culture that they live collectively, that it's not even ... Just like we wouldn't even, if you said, "Do you think happiness is an individualistic thing?" We'd be like, "What are you even talking about?"

    15. JRJoe Rogan39:37

        Isn't that sort of an ex- extrinsic idea as well? The idea that you're going to be happy by trying to make other people happy?

    16. JHJohann Hari39:44

        Well, this is the thing. So intrinsic values are not about just internal to yourself.

    17. JRJoe Rogan39:47

        Right.

    18. JHJohann Hari39:47

        They're things that you value. So your intrinsic value-

    19. JRJoe Rogan39:49

        Yes.

    20. JHJohann Hari39:49

        ... could be spending time with your kids, right?

    21. JRJoe Rogan39:51

        Right.

    22. JHJohann Hari39:51

        That was probably most people's strongest intrinsic value with their parents, is being with their kids, bonding with their kids, loving their kids.

    23. JRJoe Rogan39:57

        But my point is, if your goal is to get happy and the way you've chosen to get happy is, "I'm gonna get happy by making other people happy," that s- that seems very strange.

    24. JHJohann Hari40:08

        I don't think so.

    25. JRJoe Rogan40:09

        No?

    26. JHJohann Hari40:09

        I think that's the ... If you think about where humans evolve-

    27. JRJoe Rogan40:10

        Why won't- shouldn't you just make other people happy because you love them?

    28. JHJohann Hari40:14

        But that is a way, loving people and being present with them is a way of-

    29. JRJoe Rogan40:17

        But not as, like, a specific, for ... with a specific goal of making yourself happy. That seems-

    30. JHJohann Hari40:24

        But that's not why they did it. It's not like-
11. 42:37 – 48:55

    Economic insecurity and policy as mental-health intervention: basic income example

    1. JHJohann Hari42:37

       ... th- there, there's a lot of evidence to write that the financial anxiety is a massive driver of depression and, uh, an, and, and anxiety obviously, that there's a interesting study that found people who have an income from property are ten times less likely to develop an anxiety disorder than people who don't. And there was a really interesting experiment in how we can respond to that. It's one that President Obama said late in his term he thinks would have to happen across the country in the next 20 years for various reasons. So in Canada in the '70s, the Canadian government, um, chose a town at random, seems to genuinely have been random. It's a town called Dauphin. It's, um, anyone who knows, uh, Canada, it's about four hours out of Winnipeg. And they said to a big group of people in this town, "We're gonna give you guys, for the ne- for the foreseeable future, we're gonna give all of you a guaranteed basic income. We're gonna give you the equivalent of, in today's money, 15,000 US dollars, right? There's nothing you can do that means we'll take it away from you, and there's nothing you have to do in return for it. We're just, you're citizens of our country. We want you to have a good life, right?" It was partly 'cause they had a kind of welfare system, but it was, a lot of people were falling through the cracks, and they wanted to do a little experiment to see would this work better. And this was studied very carefully by a woman I interviewed called Dr. Evelyn Forget, uh, to see what happened and loads of interesting things happened. Um, people spent more time with their kids. Uh, very few people quit work, but a lot of people turned down shitty jobs, so j- actual overall work standards improved 'cause employers had to attract people with, with better standards. Um, but for me, the most interesting thing is, there was a huge fall in depression and anxiety, right? Depression and anxiety that were so severe people had to be hospitalized fell by 9%, which is, uh, remarkable in just three years. And then the program ended. Dr. Forget said to me, I thought so much about that, that w- I'd learned about the cow, Dr. Forget said, um, "You know, that's an antidepressant, right?" It, it, it... We should expand our idea of an antidepressant to be anything that reduces depression. That should include pills, but also ... So you're totally right. I mean, look, I grew up. My dad's, my dad's a bus driver. My mom worked in a shelter. My grandmother cleaned toilets. Financial anxiety is a massive driver of, um, uh, of the despair. There's, I mean, more than half of all Americans have not, because of the incredible financial pressure they've been put under, got $500 set aside for if a crisis comes along, right? So you're talking about, that's a huge dr- And again, that's really important, 'cause explain to people, if that's making you depressed and anxious, don't let a doctor tell you, "You've just got a chemical imbalance in your brain," right? That's the, w-

    2. JRJoe Rogan45:02

       Do doctors still say that?

    3. JHJohann Hari45:04

       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-

    4. JRJoe Rogan45:13

       Was this in England or in the United States?

    5. JHJohann Hari45:15

       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.

    6. JRJoe Rogan45:20

       Now, are they just as likely to prescribe antidepressants in England a- as they are American? Um, Americans who-

    7. JHJohann Hari45:25

       It's slightly lower, but it's still exceptionally high.

    8. JRJoe Rogan45:27

       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.

    9. JHJohann Hari46:29

       Well, and she's living in a society and culture that has all these forces that are rising that make people feel terrible, right?

    10. JRJoe Rogan46:34

        Yes. Yeah.

    11. JHJohann Hari46:35

        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-

    12. JRJoe Rogan46:47

        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-

    13. JHJohann Hari47:03

        I would draw an analogy.

    14. JRJoe Rogan47:04

        ... have a better choice?

    15. JHJohann Hari47:05

        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?

    16. JRJoe Rogan47:26

        Yeah.

    17. JHJohann Hari47:27

        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-

    18. JRJoe Rogan47:56

        I would stop you right-

    19. JHJohann Hari47:56

        Yeah.

    20. JRJoe Rogan47:56

        ... with a couple of things.

    21. JHJohann Hari47:57

        Sure.

    22. JRJoe Rogan47:57

        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.

    23. JHJohann Hari48:17

        And, you know-

    24. JRJoe Rogan48:17

        I just think they make unhealthy choices. That's much more li- And they get addicted to refined carbohydrates.

    25. JHJohann Hari48:21

        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?

    26. JRJoe Rogan48:55

        Mm-hmm.

12. 48:55 – 1:04:31

    Addiction as disconnection: Rat Park, Vietnam heroin, and the opioid crisis debate

    1. JHJohann Hari48:55

       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-

    2. JRJoe Rogan49:23

       Mm-hmm.

    3. JHJohann Hari49:24

       ... 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-

    4. JRJoe Rogan51:00

       Yes.

    5. JHJohann Hari51:00

       ... yeah, from the 80s. So there you go, right? That's our story. But in the 70s, Professor Alexander came along and said, "Well, hang on a minute. You put the rat alone in an empty cage where it's got nothing to do except use these drugs, what would happen if we did this differently?" So he built a cage that he called Rat Park, which is basically like heaven for rats, right? They can... They've got loads of friends, they can fuck all the time. They've got a grain they like and colored balls. And they've got both the water bottles, the normal water and the drugged water. But the fascinating thing is, in Rat Park, they don't like the drugged water that much. None of them used it c- some of them, they do use it, but none of them used it compulsively, and none of them ever overdosed. So when they're deprived of the things that make life meaningful, they turn obsessively to the drug. When they've got the things that make life meaningful for rats, they don't. The opposite of addiction isn't sobriety, the opposite of addiction is connection. And I think you can see a similar principle playing out with food, right? Of course there's some margin to the individual. I don't want to say that we're- we're not entirely the product of our environment.

    6. JRJoe Rogan51:52

       But we're g- you're getting for-

    7. JHJohann Hari51:53

       (sighs) Sorry. (laughs)

    8. JRJoe Rogan51:54

       ... very far away from this woman-

    9. JHJohann Hari51:55

       Sure.

    10. JRJoe Rogan51:55

        ... th- these- these people that were on this diamorphine. So, why are you saying that they don't get addicted to it?

    11. JHJohann Hari52:01

        Because they go back to their lives that are meaningful. There's a human example that happened at the same time as Rat Park, right?

    12. JRJoe Rogan52:05

        But why- why are their lives particularly meaningful in relationship to like the lives we're talking about here?

    13. JHJohann Hari52:10

        So I think you can see in an example, um, a good example that was happening at the same time as Rat Park, an experiment, the Vietnam War, right? Huge numbers of American troops in Vietnam, about 40% used heroin, right?

    14. JRJoe Rogan52:21

        Mm-hmm.

    15. JHJohann Hari52:21

        Um, and if you look at the reports from the time, they were shitting themselves, 'cause they were like, "My God, when the war ends, we're gonna have all these heroin addicts on the streets of the United States. They're gonna come home and..." Because they believed the chemical hooks theory. There's a really good study in the Archives of General Psychiatry by Professor Lee Robbins that followed these guys home, a select group of them. And what it found was, uh, 95% of them just stopped, right? Didn't go into some catastrophic withdrawal. Some of them did experience some physical discomfort, but they didn't, you know, they didn't... Now, if you believe the old theory of addiction that you're taken over by the chemical hooks, that makes no sense, right? Well, but they've been exposed to all the same chemical hooks as any homeless street- street-addicted person living on the streets. Um, but if you understand this different way of thinking, it makes perfect sense. If you took you and me now and put us in a hellish, pestilential jungle where we don't want to be, we could die at any moment, we're being made to kill people, you would definitely survive longer than me, but we would both find heroin a lot more appealing than we do now, right? And then when we come back to our lives, when we have meaning and purpose, we would be- find heroin a lot less appealing. The core of addiction is not wanting to be present in your life 'cause your life is too painful a place to be. So when something, an intervention happens that reduces the amount of pain in your life, you're gonna- you're gonna be less addicted. There's a very challenging line. Marianne Faithfull, you know, the British rock sl- sl-

    16. JRJoe Rogan53:37

        I'm just gonna stop you right there-

    17. JHJohann Hari53:38

        Sure.

    18. JRJoe Rogan53:38

        ... because there is a giant issue though with people taking pain pills after operations that weren't on pain pills before, and then they get addicted to them.

    19. JHJohann Hari53:47

        So, look. You look at what's actually happened-

    20. JRJoe Rogan53:47

        So do you think that's because a lack of meaning in their life, or is it because there is an absolute real chemical hook? Like I have a good friend who had his nose broken and, uh, they fixed his nose, and he got on some, I think it was OxyContin afterwards they prescribed to him, and then four months later he's taking it every day all day.

    21. JHJohann Hari54:05

        So, there's a few things to say about that. Firstly, chemical hooks are real, but they're a small part of the picture. We know how much they are, so there's experiments that measure this. So we, um, lots of people will have taken... In fact some people listening to this will be taking part in this experiment now. When nicotine patches were invented in the late 80s and they became marketed in the early 90s, there's this huge wave of optimism, right? 'Cause the chemical hook in cigarettes is nicotine, right?

    22. JRJoe Rogan54:27

        Right.

    23. JHJohann Hari54:27

        Nicotine patches give you the chemical hook you're addicted to. Um, and so there was this huge wave where they're like, "Oh great, we're gonna give people the chem- because it's- addiction is caused by chemical hooks, we're gonna give them the chemical hook, they'll stop wanting these filthy smoke-"... smoking's gonna end, right? Um, in fact what happened is 17% of people, according to the US Surgeon General's report, when they take nicotine, use nicotine patches and they're motivated to stop smoking, right? Really important to say, 17% is not no one.

    24. JRJoe Rogan54:54

        It's a big number.

    25. JHJohann Hari54:54

        Big number that has saved hundreds of thousands of people's lives at a conservative estimate.

    26. JRJoe Rogan54:58

        But-

    27. JHJohann Hari54:58

        But it still leaves 83%-

    28. JRJoe Rogan55:00

        Right.

    29. JHJohann Hari55:00

        ... where something else is going on, right?

    30. JRJoe Rogan55:01

        But isn't that because of the delivery method? The del- delivery method of cigarettes is incredibly satisfying. You take a hit, you get it right into your system, and boom, you get that nicotine.
13. 1:04:31 – 1:13:14

    Psychedelics and ‘learning experiences’: psilocybin, spiritual intensity, ego dissolution

    1. JHJohann Hari1:04:31

       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