That hypothesis was originally developed to try to explain why drugs that blocked serotonin reuptake had an antidepressant effect, and at the time they didn’t have the scientific techniques available to test whether this was really accurate.

Hari presented the inaccurate serotonin deficiency hypothesis for depression as a reason to believe the illness doesn’t have a biological basis. This sounds all well and good, except that it gives you zero new information about what the drug does, making it rather irrelevant. Kirsch argued that to truly understand the effect of a drug, there should be 3 arms to these kinds of studies: drug, placebo, and no-intervention, with the third arm capturing the number of people who get better with no treatment or placebo at all. Kirsch criticized the typical design of drug trials, i.e. Part of Hari’s information-gathering in preparing this book was speaking to researcher Irving Kirsch. If whatever is going on with you is fixed by sex, let me suggest that it’s probably not depression. “It was only when I stopped taking the and I started having more pleasurable sex again that I remembered regular sex is one of the best natural antidepressants in the world.” After that, he changed his mind and decided to stop meds. Years later, his therapist pointed out to him that he still seemed depressed the author insisted that he couldn’t possibly be, because paroxetine was keeping his serotonin levels up. He even spread the word to others that depression was all about serotonin and antidepressants were the best thing since sliced bread. Initially, he believed that paroxetine made him feel even better than simply not being depressed. From information in the media, he knew that antidepressants were just the thing to quickly fix everything. The author wrote that, at age 18, he had an epiphany-he had this medical condition called depression. This book set off red flags for me early on. Now that we’ve got that out of the way, let’s jump headfirst into the book. Meds aren’t a miracle cure, but then again, nothing is. Sometimes that’s meds, sometimes that’s psychotherapy, and more often than not, it’s a combination of multiple different strategies. Every individual’s illness stems from a unique combination of factors, and for a treatment plan to work best it needs to effectively target whatever contributing factors can be identified. I support a biopsychosocial model that recognizes mental illness as complex and multifactorial. To start off, let me tell you the perspective I’m coming from.

I expected going in that I would disagree with what Hari had to say, but it surpassed my expectations. In Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, Johann Hari takes a stand against the idea of biological causation of depression and anxiety.

Lostconnections