We need to change the nature of work, community and wealth distribution.

What causes depression and anxiety? I have been a practicing psychologist and psychoanalyst for almost 40 years and have seen hundreds of patients suffering from both. In my experience, some factors are obvious. People who suffer from depression and anxiety have experienced stresses and traumas in their development that predispose them to mood disorders. Garden-variety psychodynamic theory teaches us that issues involving loss, neglect, guilt, and rejection usually figure prominently in the backgrounds of people who present with significant symptoms of depression and anxiety.

In addition, over 50 years of research into the neurobiology of mood disorders strongly suggests that genetic and biological factors usually accompany, if not underlie these painful affective states. As a result of these assumptions, the treatment of depression today usually relies heavily on pharmacology, and drug companies have spent billions making sure this explanation is widely accepted. Some one in five US adults is taking at least one drug for a psychiatric problem; nearly one in four middle-aged women in the United States is taking antidepressants at any given time; and around one in 10 boys at American high schools are being given powerful stimulants to make them focus.

Since it’s well known that psychological events produce biological changes, it remains debatable whether or not disorders of our biochemistry are causes or effects. What we do know is that untold amounts of money have been spent by the pharmaceutical industry to finance research and public relations designed to enshrine biochemistry and pharmacology as primary in the diagnosis and treatment of depression and anxiety.

However, what of the social, cultural and even political contexts that contribute to emotional suffering? We owe writer and journalist Johann Hari a great debt for illuminating these broader contextual factors in his new book, Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions.