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This could be why you're depressed or anxious

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    For a really long time,
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    I had two mysteries
    that were hanging over me.
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    I didn't understand them
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    and, to be honest, I was quite afraid
    to look into them.
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    The first mystery was, I'm 40 years old,
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    and all throughout my lifetime,
    year after year,
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    serious depression and anxiety have risen,
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    in the United States, in Britain,
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    and across the Western world.
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    And I wanted to understand why.
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    Why is this happening to us?
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    Why is it that with each year that passes,
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    more and more of us are finding it harder
    to get through the day?
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    And I wanted to understand this
    because of a more personal mystery.
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    When I was a teenager,
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    I remember going to my doctor
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    and explaining that I had this feeling,
    like pain was leaking out of me.
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    I couldn't control it,
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    I didn't understand why it was happening,
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    I felt quite ashamed of it.
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    And my doctor told me a story
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    that I now realize was well-intentioned,
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    but quite oversimplified.
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    Not totally wrong.
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    My doctor said, "We know
    why people get like this.
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    Some people just naturally get
    a chemical imbalance in their heads --
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    you're clearly one of them.
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    All we need to do is give you some drugs,
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    it will get your chemical
    balance back to normal."
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    So I started taking a drug
    called Paxil or Seroxat,
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    it's the same thing with different names
    in different countries.
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    And I felt much better,
    I got a real boost.
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    But not very long afterwards,
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    this feeling of pain started to come back.
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    So I was given higher and higher doses
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    until, for 13 years, I was taking
    the maximum possible dose
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    that you're legally allowed to take.
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    And for a lot of those 13 years,
    and pretty much all the time by the end,
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    I was still in a lot of pain.
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    And I started asking myself,
    "What's going on here?
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    Because you're doing everything
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    you're told to do by the story
    that's dominating the culture --
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    why do you still feel like this?"
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    So to get to the bottom
    of these two mysteries,
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    for a book that I've written
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    I ended up going on a big journey
    all over the world,
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    I traveled over 40,000 miles.
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    I wanted to sit with the leading
    experts in the world
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    about what causes depression and anxiety
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    and crucially, what solves them,
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    and people who have come through
    depression and anxiety
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    and out the other side
    in all sorts of ways.
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    And I learned a huge amount
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    from the amazing people
    I got to know along the way.
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    But I think at the heart
    of what I learned is,
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    so far, we have scientific evidence
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    for nine different causes
    of depression and anxiety.
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    Two of them are indeed in our biology.
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    Your genes can make you
    more sensitive to these problems,
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    though they don't write your destiny.
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    And there are real brain changes
    that can happen when you become depressed
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    that can make it harder to get out.
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    But most of the factors
    that have been proven
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    to cause depression and anxiety
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    are not in our biology.
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    They are factors in the way we live.
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    And once you understand them,
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    it opens up a very different
    set of solutions
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    that should be offered to people
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    alongside the option
    of chemical antidepressants.
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    For example,
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    if you're lonely, you're more likely
    to become depressed.
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    If, when you go to work,
    you don't have any control over your job,
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    you've just got to do what you're told,
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    you're more likely to become depressed.
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    If you very rarely get out
    into the natural world,
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    you're more likely to become depressed.
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    And one thing unites a lot of the causes
    of depression and anxiety
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    that I learned about.
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    Not all of them, but a lot of them.
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    Everyone here knows
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    you've all got natural
    physical needs, right?
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    Obviously.
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    You need food, you need water,
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    you need shelter, you need clean air.
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    If I took those things away from you,
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    you'd all be in real trouble, real fast.
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    But at the same time,
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    every human being
    has natural psychological needs.
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    You need to feel you belong.
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    You need to feel your life
    has meaning and purpose.
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    You need to feel that people
    see you and value you.
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    You need to feel you've got
    a future that makes sense.
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    And this culture we built
    is good at lots of things.
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    And many things are better
    than in the past --
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    I'm glad to be alive today.
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    But we've been getting less and less good
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    at meeting these deep,
    underlying psychological needs.
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    And it's not the only thing
    that's going on,
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    but I think it's the key reason
    why this crisis keeps rising and rising.
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    And I found this really hard to absorb.
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    I really wrestled with the idea
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    of shifting from thinking of my depression
    as just a problem in my brain,
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    to one with many causes,
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    including many in the way we're living.
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    And it only really began
    to fall into place for me
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    when one day, I went to interview
    a South African psychiatrist
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    named Dr. Derek Summerfield.
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    He's a great guy.
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    And Dr. Summerfield
    happened to be in Cambodia in 2001,
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    when they first introduced
    chemical antidepressants
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    for people in that country.
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    And the local doctors, the Cambodians,
    had never heard of these drugs,
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    so they were like, what are they?
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    And he explained.
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    And they said to him,
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    "We don't need them,
    we've already got antidepressants."
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    And he was like, "What do you mean?"
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    He thought they were going to talk about
    some kind of herbal remedy,
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    like St. John's Wort, ginkgo biloba,
    something like that.
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    Instead, they told him a story.
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    There was a farmer in their community
    who worked in the rice fields.
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    And one day, he stood on a land mine
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    left over from the war
    with the United States,
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    and he got his leg blown off.
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    So they him an artificial leg,
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    and after a while, he went back
    to work in the rice fields.
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    But apparently, it's super painful
    to work under water
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    when you've got an artificial limb,
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    and I'm guessing it was pretty traumatic
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    to go back and work in the field
    where he got blown up.
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    The guy started to cry all day,
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    he refused to get out of bed,
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    he developed all the symptoms
    of classic depression.
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    The Cambodian doctor said,
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    "This is when we gave him
    an antidepressant."
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    And Dr. Summerfield said,
    "What was it?"
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    They explained that they went
    and sat with him.
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    They listened to him.
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    They realized that his pain made sense --
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    it was hard for him to see it
    in the throes of his depression,
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    but actually, it had perfectly
    understandable causes in his life.
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    One of the doctors, talking to the people
    in the community, figured,
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    "You know, if we bought this guy a cow,
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    he could become a dairy farmer,
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    he wouldn't be in this position
    that was screwing him up so much,
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    he wouldn't have to go
    and work in the rice fields."
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    So they bought him a cow.
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    Within a couple of weeks,
    his crying stopped,
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    within a month, his depression was gone.
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    They said to doctor Summerfield,
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    "So you see, doctor, that cow,
    that was an antidepressant,
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    that's what you mean, right?"
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    (Laughter)
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    (Applause)
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    If you'd been raised to think
    about depression the way I was,
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    and most of the people here were,
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    that sounds like a bad joke, right?
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    "I went to my doctor
    for an antidepressant,
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    she gave me a cow."
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    But what those Cambodian
    doctors knew intuitively,
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    based on this individual,
    unscientific anecdote,
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    is what the leading
    medical body in the world,
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    the World Health Organization,
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    has been trying to tell us for years,
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    based on the best scientific evidence.
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    If you're depressed,
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    if you're anxious,
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    you're not weak, you're not crazy,
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    you're not, in the main,
    a machine with broken parts.
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    You're a human being with unmet needs.
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    And it's just as important to think here
    about what those Cambodian doctors
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    and the World Health Organization
    are not saying.
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    They did not say to this farmer,
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    "Hey, buddy, you need
    to pull yourself together.
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    It's your job to figure out
    and fix this problem on your own."
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    On the contrary, what they said is,
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    "We're here as a group
    to pull together with you,
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    so together, we can figure out
    and fix this problem."
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    This is what every depressed person needs,
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    and it's what every
    depressed person deserves.
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    This is why one of the leading
    doctors at the United Nations,
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    in their official statement
    for World Health Day,
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    couple of years back in 2017,
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    said we need to talk less
    about chemical imbalances
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    and more about the imbalances
    in the way we live.
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    Drugs give real relief to some people --
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    they gave relief to me for a while --
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    but precisely because this problem
    goes deeper than their biology,
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    the solutions need to go much deeper, too.
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    But when I first learned that,
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    I remember thinking,
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    "OK, I could see
    all the scientific evidence,
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    I read a huge number of studies,
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    I interviewed a huge number of the experts
    who were explaining this,"
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    but I kept thinking, "How can we
    possibly do that?"
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    The things that are making us depressed
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    are in most cases more complex
    than what was going on
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    with this Cambodian farmer.
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    Where do we even begin with that insight?
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    But then, in the long journey for my book,
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    all over the world,
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    I kept meeting people
    who were doing exactly that,
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    from Sydney, to San Francisco,
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    to São Paulo.
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    I kept meeting people
    who were understanding
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    the deeper causes
    of depression and anxiety
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    and, as groups, fixing them.
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    Obviously, I can't tell you
    about all the amazing people
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    I got to know and wrote about,
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    or all of the nine causes of depression
    and anxiety that I learned about,
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    because they won't let me give
    a 10-hour TED Talk --
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    you can complain about that to them.
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    But I want to focus on two of the causes
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    and two of the solutions
    that emerge from them, if that's alright.
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    Here's the first.
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    We are the loneliest society
    in human history.
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    There was a recent study
    that asked Americans,
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    "Do you feel like you're no longer
    close to anyone?"
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    And 39 percent of people
    said that described them.
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    "No longer close to anyone."
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    In the international
    measurements of loneliness,
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    Britain and the rest of Europe
    are just behind the US,
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    in case anyone here is feeling smug.
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    (Laughter)
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    I spent a lot of time discussing this
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    with the leading expert
    in the world on loneliness,
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    an incredible man
    named professor John Cacioppo,
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    who was at Chicago,
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    and I thought a lot about one question
    his work poses to us.
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    Professor Cacioppo asked,
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    "Why do we exist?
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    Why are we here, why are we alive?"
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    One key reason
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    is that our ancestors
    on the savannas of Africa
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    were really good at one thing.
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    They weren't bigger than the animals
    they took down a lot of the time,
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    they weren't faster than the animals
    they took down a lot of the time,
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    but they were much better
    at banding together into groups
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    and cooperating.
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    This was our superpower as a species --
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    we band together,
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    just like bees evolved to live in a hive,
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    humans evolved to live in a tribe.
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    And we are the first humans ever
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    to disband our tribes.
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    And it is making us feel awful.
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    But it doesn't have to be this way.
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    One of the heroes in my book,
    and in fact, in my life,
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    is a doctor named Sam Everington.
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    He's a general practitioner
    in a poor part of East London,
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    where I lived for many years.
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    And Sam was really uncomfortable,
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    because he had loads of patients
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    coming to him with terrible
    depression and anxiety.
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    And like me, he's not opposed
    to chemical antidepressants,
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    he thinks they give
    some relief to some people.
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    But he could see two things.
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    Firstly, his patients were depressed
    and anxious a lot of the time
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    for totally understandable
    reasons, like loneliness.
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    And secondly, although the drugs
    were giving some relief to some people,
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    for many people,
    they didn't solve the problem.
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    The underlying problem.
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    One day, Sam decided
    to pioneer a different approach.
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    A woman came to his center,
    his medical center,
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    called Lisa Cunningham.
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    I got to know Lisa later.
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    And Lisa had been shut away in her home
    with crippling depression and anxiety
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    for seven years.
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    And when she came to Sam's center,
    she was told, "Don't worry,
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    we'll carry on giving you these drugs,
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    but we're also going to prescribe
    something else.
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    We're going to prescribe for you
    to come here to this center twice a week
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    to meet with a group of other
    depressed and anxious people,
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    not to talk about how miserable you are,
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    but to figure out something
    meaningful you can all do together
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    so you won't be lonely and you won't feel
    like life is pointless."
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    The first time this group met,
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    Lisa literally started
    vomiting with anxiety,
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    it was so overwhelming for her.
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    But people rubbed her back,
    the group started talking,
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    they were like, "What could we do?"
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    These are inner-city,
    East London people like me,
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    they didn't know anything about gardening.
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    They were like, "Why don't we
    learn gardening?"
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    There was an area
    behind the doctors' offices
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    that was just scrubland.
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    "Why don't we make this into a garden?"
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    They started to take books
    out of the library,
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    started to watch YouTube clips.
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    They started to get
    their fingers in the soil.
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    They started to learn
    the rhythms of the seasons.
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    There's a lot of evidence
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    that exposure to the natural world
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    is a really powerful antidepressant.
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    But they started to do something
    even more important.
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    They started to form a tribe.
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    They started to form a group.
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    They started to care about each other.
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    If one of them didn't show up,
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    the others would go
    looking for them -- "Are you OK?"
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    Help them figure out
    what was troubling them that day.
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    The way Lisa put it to me,
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    "As the garden began to bloom,
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    we began to bloom."
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    This approach is called
    social prescribing,
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    it's spreading all over Europe.
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    And there's a small,
    but growing body of evidence
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    suggesting it can produce real
    and meaningful falls
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    in depression and anxiety.
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    And one day, I remember
    standing in the garden
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    that Lisa and her once-depressed
    friends had built --
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    it's a really beautiful garden --
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    and having this thought,
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    it's very much inspired by a guy
    called professor Hugh Mackay in Australia.
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    I was thinking, so often
    when people feel down in this culture,
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    what we say to them -- I'm sure
    everyone here said it, I have --
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    we say, "You just need
    to be you, be yourself."
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    And I've realized, actually,
    what we should say to people is,
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    "Don't be you.
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    Don't be yourself.
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    Be us, be we.
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    Be part of a group."
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    (Applause)
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    The solution to these problems
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    does not lie in drawing
    more and more on your resources
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    as an isolated individual --
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    that's partly what got us in this crisis.
  • 13:31 - 13:34
    It lies on reconnecting
    with something bigger than you.
  • 13:34 - 13:36
    And that really connects
    to one of the other causes
  • 13:36 - 13:39
    of depression and anxiety
    that I wanted to talk to you about.
  • 13:39 - 13:41
    So everyone knows
  • 13:41 - 13:45
    junk food has taken over our diets
    and made us physically sick.
  • 13:45 - 13:47
    I don't say that
    with any sense of superiority,
  • 13:47 - 13:49
    I literally came to give
    this talk from McDonald's.
  • 13:49 - 13:53
    I saw all of you eating that
    healthy TED breakfast, I was like no way.
  • 13:53 - 13:58
    But just like junk food has taken over
    our diets and made us physically sick,
  • 13:58 - 14:02
    a kind of junk values
    have taken over our minds
  • 14:02 - 14:04
    and made us mentally sick.
  • 14:04 - 14:07
    For thousands of years,
    philosophers have said,
  • 14:07 - 14:12
    if you think life is about money,
    and status and showing off,
  • 14:12 - 14:13
    you're going to feel like crap.
  • 14:13 - 14:16
    That's not an exact quote
    from Schopenhauer,
  • 14:16 - 14:17
    but that is the gist of what he said.
  • 14:17 - 14:20
    But weirdly, hardy anyone
    had scientifically investigated this,
  • 14:20 - 14:24
    until a truly extraordinary person
    I got to know, named professor Tim Kasser,
  • 14:24 - 14:26
    who's at Knox College in Illinois,
  • 14:26 - 14:29
    and he's been researching this
    for about 30 years now.
  • 14:29 - 14:32
    And his research suggests
    several really important things.
  • 14:32 - 14:35
    Firstly, the more you believe
  • 14:35 - 14:40
    you can buy and display
    your way out of sadness,
  • 14:40 - 14:42
    and into a good life,
  • 14:42 - 14:45
    the more likely you are to become
    depressed and anxious.
  • 14:45 - 14:46
    And secondly,
  • 14:46 - 14:51
    as a society, we have become
    much more driven by these beliefs.
  • 14:51 - 14:52
    All throughout my lifetime,
  • 14:52 - 14:56
    under the weight of advertising
    and Instagram and everything like them.
  • 14:57 - 14:58
    And as I thought about this,
  • 14:58 - 15:04
    I realized it's like we've all been fed
    since birth, a kind of KFC for the soul.
  • 15:04 - 15:08
    We've been trained to look for happiness
    in all the wrong places,
  • 15:08 - 15:11
    and just like junk food
    doesn't meet your nutritional needs
  • 15:11 - 15:13
    and actually makes you feel terrible,
  • 15:13 - 15:16
    junk values don't meet
    your psychological needs,
  • 15:16 - 15:19
    and they take you away from a good life.
  • 15:19 - 15:22
    But when I first spent time
    with professor Kasser
  • 15:22 - 15:23
    and I was learning all this,
  • 15:23 - 15:26
    I felt a really weird mixture of emotions.
  • 15:26 - 15:28
    Because on the one hand,
    I found this really challenging.
  • 15:28 - 15:32
    I could see how often
    in my own life, when I felt down,
  • 15:32 - 15:37
    I tried to remedy it with some kind of
    show-offy, grand external solution.
  • 15:37 - 15:40
    And I could see why that
    did not work well for me.
  • 15:41 - 15:44
    I also thought,
    isn't this kind of obvious?
  • 15:44 - 15:46
    Isn't this almost like banal, right?
  • 15:46 - 15:47
    If I said to everyone here,
  • 15:47 - 15:49
    none of you are going to lie
    on your deathbed
  • 15:49 - 15:52
    and think about all the shoes you bought
    and all the retweets you got,
  • 15:52 - 15:54
    you're going to think about moments
  • 15:54 - 15:56
    of love, meaning
    and connection in your life.
  • 15:56 - 15:58
    I think that seems almost like a cliché.
  • 15:58 - 16:01
    But I kept talking
    to professor Kasser and saying,
  • 16:01 - 16:03
    "Why am I feeling
    this strange doubleness?"
  • 16:03 - 16:07
    And he said, "At some level,
    we all know these things.
  • 16:07 - 16:09
    But in this culture,
    we don't live by them."
  • 16:09 - 16:11
    We know them so well
    they've become clichés,
  • 16:11 - 16:13
    but we don't live by them.
  • 16:13 - 16:16
    I kept asking why, why would we know
    something so profound,
  • 16:16 - 16:17
    but not live by it?
  • 16:17 - 16:21
    And after a while,
    professor Kasser said to me,
  • 16:21 - 16:23
    "Because we live in a machine
  • 16:23 - 16:27
    that is designed to get us to neglect
    what is important about life."
  • 16:27 - 16:29
    I had to really think about that.
  • 16:29 - 16:30
    "Because we live in a machine
  • 16:30 - 16:34
    that is designed to get us
    to neglect what is important about life."
  • 16:34 - 16:38
    And professor Kasser wanted to figure out
    if we can disrupt that machine.
  • 16:38 - 16:40
    He's done loads of research into this;
  • 16:40 - 16:42
    I'll tell you about one example,
  • 16:42 - 16:45
    and I really urge everyone here
    to try this with their friends and family.
  • 16:45 - 16:48
    With a guy called Nathan Dungan,
    he got a group of teenagers and adults
  • 16:48 - 16:53
    to come together for a series of sessions
    over a period of time, to meet up.
  • 16:53 - 16:54
    And part of the point of the group
  • 16:54 - 16:58
    was to get people to think
    about a moment in their life
  • 16:58 - 17:01
    they had actually found
    meaning and purpose.
  • 17:01 - 17:03
    For different people,
    it was different things.
  • 17:03 - 17:06
    For some people, it was playing music,
    writing, helping someone --
  • 17:06 - 17:09
    I'm sure everyone here
    can picture something, right?
  • 17:09 - 17:12
    And part of the point of the group
    was to get people to ask,
  • 17:12 - 17:15
    "OK, how could you dedicate
    more of your life
  • 17:15 - 17:18
    to pursuing these moments
    of meaning and purpose,
  • 17:18 - 17:21
    and less to, I don't know,
    buying crap you don't need,
  • 17:21 - 17:23
    putting it on social media
    and trying to get people to go,
  • 17:23 - 17:25
    'OMG, so jealous!'"
  • 17:25 - 17:27
    And what they found was,
  • 17:27 - 17:28
    just having these meetings,
  • 17:28 - 17:31
    it was like a kind of Alcoholics Anonymous
    for consumerism, right?
  • 17:32 - 17:35
    Getting people to have these meetings,
    articulate these values,
  • 17:35 - 17:37
    determine to act on them
    and check in with each other,
  • 17:37 - 17:40
    led to a marked shift in people's values.
  • 17:40 - 17:45
    It took them away from this hurricane
    of depression-generating messages
  • 17:45 - 17:47
    training us to seek happiness
    in the wrong places,
  • 17:47 - 17:51
    and towards more meaningful
    and nourishing values
  • 17:51 - 17:53
    that lift us out of depression.
  • 17:53 - 17:57
    But with all the solutions that I saw
    and have written about,
  • 17:57 - 17:59
    and many I can't talk about here,
  • 17:59 - 18:01
    I kept thinking,
  • 18:01 - 18:05
    you know: Why did it take me so long
    to see these insights?
  • 18:05 - 18:07
    Because when you explain them to people --
  • 18:07 - 18:09
    some of them are more
    complicated, but not all --
  • 18:09 - 18:12
    when you explain this to people,
    it's not like rocket science, right?
  • 18:12 - 18:14
    At some level, we already
    know these things.
  • 18:14 - 18:17
    Why do we find it so hard to understand?
  • 18:17 - 18:19
    I think there's many reasons.
  • 18:19 - 18:24
    But I think one reason is
    that we have to change our understanding
  • 18:24 - 18:27
    of what depression
    and anxiety actually are.
  • 18:28 - 18:30
    There are very real
    biological contributions
  • 18:30 - 18:32
    to depression and anxiety.
  • 18:32 - 18:36
    But if we allow the biology
    to become the whole picture,
  • 18:36 - 18:37
    as I did for so long,
  • 18:37 - 18:41
    as I would argue our culture
    has done pretty much most of my life,
  • 18:41 - 18:45
    what we're implicitly saying to people
    is, and this isn't anyone's intention,
  • 18:45 - 18:48
    but what we're implicitly
    saying to people is,
  • 18:48 - 18:50
    "Your pain doesn't mean anything.
  • 18:51 - 18:52
    It's just a malfunction.
  • 18:52 - 18:54
    It's like a glitch in a computer program,
  • 18:54 - 18:57
    it's just a wiring problem in your head."
  • 18:58 - 19:01
    But I was only able to start
    changing my life
  • 19:01 - 19:05
    when I realized your depression
    is not a malfunction.
  • 19:07 - 19:08
    It's a signal.
  • 19:09 - 19:11
    Your depression is a signal.
  • 19:11 - 19:13
    It's telling you something.
  • 19:13 - 19:18
    (Applause)
  • 19:18 - 19:20
    We feel this way for reasons,
  • 19:20 - 19:23
    and they can be hard to see
    in the throes of depression --
  • 19:23 - 19:25
    I understand that really well
    from personal experience.
  • 19:25 - 19:29
    But with the right help,
    we can understand these problems
  • 19:29 - 19:31
    and we can fix these problems together.
  • 19:31 - 19:33
    But to do that,
  • 19:33 - 19:34
    the very first step
  • 19:34 - 19:37
    is we have to stop insulting these signals
  • 19:37 - 19:41
    by saying they're a sign of weakness,
    or madness or purely biological,
  • 19:41 - 19:43
    except for a tiny number of people.
  • 19:43 - 19:47
    We need to start
    listening to these signals,
  • 19:47 - 19:50
    because they're telling us
    something we really need to hear.
  • 19:51 - 19:56
    It's only when we truly
    listen to these signals,
  • 19:56 - 20:00
    and we honor these signals
    and respect these signals,
  • 20:00 - 20:02
    that we're going to begin to see
  • 20:02 - 20:06
    the liberating, nourishing,
    deeper solutions.
  • 20:07 - 20:11
    The cows that are waiting all around us.
  • 20:12 - 20:13
    Thank you.
  • 20:13 - 20:16
    (Applause)
Títol:
This could be why you're depressed or anxious
Speaker:
Johann Hari
Descripció:

In a moving, actionable talk, journalist Johann Hari shares fresh insights on the causes of depression and anxiety from experts around the world -- as well as some exciting emerging solutions. "If you're depressed or anxious, you're not weak and you're not crazy -- you're a human being with unmet needs," Hari says.

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Video Language:
English
Team:
TED
Projecte:
TEDTalks
Duration:
20:31

English subtitles

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