Lost Connections: Uncovering the Real Causes of Depression - and the Unexpected Solutions

Lost Connections challenges the idea that depression and anxiety are mainly caused by an imbalance in brain chemistry. The idea that depression is brought about by physical problems is deeply rooted in Western thought. Medical treatments for what we today call depression are not new. In the West, beginning in ancient Greece, depression was considered a common symptom of an illness called melancholy. It was thought melancholy was caused by a physical imbalance in the body, and it was often treated with herbal remedies, changes in diet, and other physical prescriptions. By the 19th century, drugs like lithium and opioids began to be prescribed instead of traditional herbal remedies and treatments like bleeding. These drugs were used to treat a variety of conditions, not just depression. They tended to be highly addictive or have harsh side effects. This meant that they weren’t widely commercially available, especially once the drug market became more strictly regulated in the early 20th century.

The first “true” antidepressants, or drugs meant to treat only depression and closely related disorders like anxiety, were developed in 1951. As Hari points out, doctors in New York City developing treatments for tuberculosis discovered the drugs they developed, iproniazid and isoniazid, drastically improved patients’ moods by affecting chemical processes involving the brain (33-34). This opened the path for further prescription antidepressants. In the same era, there were technological developments in the mass development and production of medical drugs, as well as the rise of international pharmaceutical companies that made millions in profits from specific drugs. Deregulation of the drug industries in the 1980s and 1990s allowed pharmaceutical companies to advertise specific drugs they developed to the general public. These trends resulted in the mass marketing and popularity of Prozac, an SSRI invented in 1987. Whatever their actual medical benefits, SSRIs like Prozac became hugely profitable and heavily promoted through advertising.