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← This could be why you're depressed or anxious

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Showing Revision 8 created 10/02/2019 by Brian Greene.

  1. For a really long time,

  2. I had two mysteries
    that were hanging over me.
  3. I didn't understand them
  4. and, to be honest, I was quite afraid
    to look into them.
  5. The first mystery was, I'm 40 years old,
  6. and all throughout my lifetime,
    year after year,
  7. serious depression and anxiety have risen,
  8. in the United States, in Britain,
  9. and across the Western world.
  10. And I wanted to understand why.
  11. Why is this happening to us?
  12. Why is it that with each year that passes,
  13. more and more of us are finding it harder
    to get through the day?
  14. And I wanted to understand this
    because of a more personal mystery.
  15. When I was a teenager,

  16. I remember going to my doctor
  17. and explaining that I had this feeling,
    like pain was leaking out of me.
  18. I couldn't control it,
  19. I didn't understand why it was happening,
  20. I felt quite ashamed of it.
  21. And my doctor told me a story
  22. that I now realize was well-intentioned,
  23. but quite oversimplified.
  24. Not totally wrong.
  25. My doctor said, "We know
    why people get like this.
  26. Some people just naturally get
    a chemical imbalance in their heads --
  27. you're clearly one of them.
  28. All we need to do is give you some drugs,
  29. it will get your chemical
    balance back to normal."
  30. So I started taking a drug
    called Paxil or Seroxat,

  31. it's the same thing with different names
    in different countries.
  32. And I felt much better,
    I got a real boost.
  33. But not very long afterwards,
  34. this feeling of pain started to come back.
  35. So I was given higher and higher doses
  36. until, for 13 years, I was taking
    the maximum possible dose
  37. that you're legally allowed to take.
  38. And for a lot of those 13 years,
    and pretty much all the time by the end,
  39. I was still in a lot of pain.
  40. And I started asking myself,
    "What's going on here?
  41. Because you're doing everything
  42. you're told to do by the story
    that's dominating the culture --
  43. why do you still feel like this?"
  44. So to get to the bottom
    of these two mysteries,

  45. for a book that I've written
  46. I ended up going on a big journey
    all over the world,
  47. I traveled over 40,000 miles.
  48. I wanted to sit with the leading
    experts in the world
  49. about what causes depression and anxiety
  50. and crucially, what solves them,
  51. and people who have come through
    depression and anxiety
  52. and out the other side
    in all sorts of ways.
  53. And I learned a huge amount
  54. from the amazing people
    I got to know along the way.
  55. But I think at the heart
    of what I learned is,

  56. so far, we have scientific evidence
  57. for nine different causes
    of depression and anxiety.
  58. Two of them are indeed in our biology.
  59. Your genes can make you
    more sensitive to these problems,
  60. though they don't write your destiny.
  61. And there are real brain changes
    that can happen when you become depressed
  62. that can make it harder to get out.
  63. But most of the factors
    that have been proven
  64. to cause depression and anxiety
  65. are not in our biology.
  66. They are factors in the way we live.
  67. And once you understand them,
  68. it opens up a very different
    set of solutions
  69. that should be offered to people
  70. alongside the option
    of chemical antidepressants.
  71. For example,

  72. if you're lonely, you're more likely
    to become depressed.
  73. If, when you go to work,
    you don't have any control over your job,
  74. you've just got to do what you're told,
  75. you're more likely to become depressed.
  76. If you very rarely get out
    into the natural world,
  77. you're more likely to become depressed.
  78. And one thing unites a lot of the causes
    of depression and anxiety

  79. that I learned about.
  80. Not all of them, but a lot of them.
  81. Everyone here knows
  82. you've all got natural
    physical needs, right?
  83. Obviously.
  84. You need food, you need water,
  85. you need shelter, you need clean air.
  86. If I took those things away from you,
  87. you'd all be in real trouble, real fast.
  88. But at the same time,
  89. every human being
    has natural psychological needs.
  90. You need to feel you belong.
  91. You need to feel your life
    has meaning and purpose.
  92. You need to feel that people
    see you and value you.
  93. You need to feel you've got
    a future that makes sense.
  94. And this culture we built
    is good at lots of things.
  95. And many things are better
    than in the past --
  96. I'm glad to be alive today.
  97. But we've been getting less and less good
  98. at meeting these deep,
    underlying psychological needs.
  99. And it's not the only thing
    that's going on,
  100. but I think it's the key reason
    why this crisis keeps rising and rising.
  101. And I found this really hard to absorb.
  102. I really wrestled with the idea
  103. of shifting from thinking of my depression
    as just a problem in my brain,
  104. to one with many causes,
  105. including many in the way we're living.
  106. And it only really began
    to fall into place for me

  107. when one day, I went to interview
    a South African psychiatrist
  108. named Dr. Derek Summerfield.
  109. He's a great guy.
  110. And Dr. Summerfield
    happened to be in Cambodia in 2001,
  111. when they first introduced
    chemical antidepressants
  112. for people in that country.
  113. And the local doctors, the Cambodians,
    had never heard of these drugs,
  114. so they were like, what are they?
  115. And he explained.
  116. And they said to him,
  117. "We don't need them,
    we've already got antidepressants."
  118. And he was like, "What do you mean?"
  119. He thought they were going to talk about
    some kind of herbal remedy,
  120. like St. John's Wort, ginkgo biloba,
    something like that.
  121. Instead, they told him a story.
  122. There was a farmer in their community
    who worked in the rice fields.

  123. And one day, he stood on a land mine
  124. left over from the war
    with the United States,
  125. and he got his leg blown off.
  126. So they him an artificial leg,
  127. and after a while, he went back
    to work in the rice fields.
  128. But apparently, it's super painful
    to work under water
  129. when you've got an artificial limb,
  130. and I'm guessing it was pretty traumatic
  131. to go back and work in the field
    where he got blown up.
  132. The guy started to cry all day,
  133. he refused to get out of bed,
  134. he developed all the symptoms
    of classic depression.
  135. The Cambodian doctor said,
  136. "This is when we gave him
    an antidepressant."
  137. And Dr. Summerfield said,
    "What was it?"
  138. They explained that they went
    and sat with him.
  139. They listened to him.
  140. They realized that his pain made sense --
  141. it was hard for him to see it
    in the throes of his depression,
  142. but actually, it had perfectly
    understandable causes in his life.
  143. One of the doctors, talking to the people
    in the community, figured,
  144. "You know, if we bought this guy a cow,
  145. he could become a dairy farmer,
  146. he wouldn't be in this position
    that was screwing him up so much,
  147. he wouldn't have to go
    and work in the rice fields."
  148. So they bought him a cow.
  149. Within a couple of weeks,
    his crying stopped,
  150. within a month, his depression was gone.
  151. They said to doctor Summerfield,
  152. "So you see, doctor, that cow,
    that was an antidepressant,
  153. that's what you mean, right?"
  154. (Laughter)

  155. (Applause)

  156. If you'd been raised to think
    about depression the way I was,

  157. and most of the people here were,
  158. that sounds like a bad joke, right?
  159. "I went to my doctor
    for an antidepressant,
  160. she gave me a cow."
  161. But what those Cambodian
    doctors knew intuitively,
  162. based on this individual,
    unscientific anecdote,
  163. is what the leading
    medical body in the world,
  164. the World Health Organization,
  165. has been trying to tell us for years,
  166. based on the best scientific evidence.
  167. If you're depressed,

  168. if you're anxious,
  169. you're not weak, you're not crazy,
  170. you're not, in the main,
    a machine with broken parts.
  171. You're a human being with unmet needs.
  172. And it's just as important to think here
    about what those Cambodian doctors
  173. and the World Health Organization
    are not saying.
  174. They did not say to this farmer,
  175. "Hey, buddy, you need
    to pull yourself together.
  176. It's your job to figure out
    and fix this problem on your own."
  177. On the contrary, what they said is,
  178. "We're here as a group
    to pull together with you,
  179. so together, we can figure out
    and fix this problem."
  180. This is what every depressed person needs,
  181. and it's what every
    depressed person deserves.
  182. This is why one of the leading
    doctors at the United Nations,

  183. in their official statement
    for World Health Day,
  184. couple of years back in 2017,
  185. said we need to talk less
    about chemical imbalances
  186. and more about the imbalances
    in the way we live.
  187. Drugs give real relief to some people --
  188. they gave relief to me for a while --
  189. but precisely because this problem
    goes deeper than their biology,
  190. the solutions need to go much deeper, too.
  191. But when I first learned that,

  192. I remember thinking,
  193. "OK, I could see
    all the scientific evidence,
  194. I read a huge number of studies,
  195. I interviewed a huge number of the experts
    who were explaining this,"
  196. but I kept thinking, "How can we
    possibly do that?"
  197. The things that are making us depressed
  198. are in most cases more complex
    than what was going on
  199. with this Cambodian farmer.
  200. Where do we even begin with that insight?
  201. But then, in the long journey for my book,

  202. all over the world,
  203. I kept meeting people
    who were doing exactly that,
  204. from Sydney, to San Francisco,
  205. to São Paulo.
  206. I kept meeting people
    who were understanding
  207. the deeper causes
    of depression and anxiety
  208. and, as groups, fixing them.
  209. Obviously, I can't tell you
    about all the amazing people
  210. I got to know and wrote about,
  211. or all of the nine causes of depression
    and anxiety that I learned about,
  212. because they won't let me give
    a 10-hour TED Talk --
  213. you can complain about that to them.
  214. But I want to focus on two of the causes

  215. and two of the solutions
    that emerge from them, if that's alright.
  216. Here's the first.
  217. We are the loneliest society
    in human history.
  218. There was a recent study
    that asked Americans,
  219. "Do you feel like you're no longer
    close to anyone?"
  220. And 39 percent of people
    said that described them.
  221. "No longer close to anyone."
  222. In the international
    measurements of loneliness,
  223. Britain and the rest of Europe
    are just behind the US,
  224. in case anyone here is feeling smug.
  225. (Laughter)

  226. I spent a lot of time discussing this

  227. with the leading expert
    in the world on loneliness,
  228. an incredible man
    named professor John Cacioppo,
  229. who was at Chicago,
  230. and I thought a lot about one question
    his work poses to us.
  231. Professor Cacioppo asked,
  232. "Why do we exist?
  233. Why are we here, why are we alive?"
  234. One key reason
  235. is that our ancestors
    on the savannas of Africa
  236. were really good at one thing.
  237. They weren't bigger than the animals
    they took down a lot of the time,
  238. they weren't faster than the animals
    they took down a lot of the time,
  239. but they were much better
    at banding together into groups
  240. and cooperating.
  241. This was our superpower as a species --
  242. we band together,
  243. just like bees evolved to live in a hive,
  244. humans evolved to live in a tribe.
  245. And we are the first humans ever
  246. to disband our tribes.
  247. And it is making us feel awful.
  248. But it doesn't have to be this way.
  249. One of the heroes in my book,
    and in fact, in my life,

  250. is a doctor named Sam Everington.
  251. He's a general practitioner
    in a poor part of East London,
  252. where I lived for many years.
  253. And Sam was really uncomfortable,
  254. because he had loads of patients
  255. coming to him with terrible
    depression and anxiety.
  256. And like me, he's not opposed
    to chemical antidepressants,
  257. he thinks they give
    some relief to some people.
  258. But he could see two things.
  259. Firstly, his patients were depressed
    and anxious a lot of the time
  260. for totally understandable
    reasons, like loneliness.
  261. And secondly, although the drugs
    were giving some relief to some people,
  262. for many people,
    they didn't solve the problem.
  263. The underlying problem.
  264. One day, Sam decided
    to pioneer a different approach.
  265. A woman came to his center,
    his medical center,
  266. called Lisa Cunningham.
  267. I got to know Lisa later.
  268. And Lisa had been shut away in her home
    with crippling depression and anxiety
  269. for seven years.
  270. And when she came to Sam's center,
    she was told, "Don't worry,
  271. we'll carry on giving you these drugs,
  272. but we're also going to prescribe
    something else.
  273. We're going to prescribe for you
    to come here to this center twice a week
  274. to meet with a group of other
    depressed and anxious people,
  275. not to talk about how miserable you are,
  276. but to figure out something
    meaningful you can all do together
  277. so you won't be lonely and you won't feel
    like life is pointless."
  278. The first time this group met,

  279. Lisa literally started
    vomiting with anxiety,
  280. it was so overwhelming for her.
  281. But people rubbed her back,
    the group started talking,
  282. they were like, "What could we do?"
  283. These are inner-city,
    East London people like me,
  284. they didn't know anything about gardening.
  285. They were like, "Why don't we
    learn gardening?"
  286. There was an area
    behind the doctors' offices
  287. that was just scrubland.
  288. "Why don't we make this into a garden?"
  289. They started to take books
    out of the library,
  290. started to watch YouTube clips.
  291. They started to get
    their fingers in the soil.
  292. They started to learn
    the rhythms of the seasons.
  293. There's a lot of evidence
  294. that exposure to the natural world
  295. is a really powerful antidepressant.
  296. But they started to do something
    even more important.
  297. They started to form a tribe.
  298. They started to form a group.
  299. They started to care about each other.
  300. If one of them didn't show up,
  301. the others would go
    looking for them -- "Are you OK?"
  302. Help them figure out
    what was troubling them that day.
  303. The way Lisa put it to me,
  304. "As the garden began to bloom,
  305. we began to bloom."
  306. This approach is called
    social prescribing,

  307. it's spreading all over Europe.
  308. And there's a small,
    but growing body of evidence
  309. suggesting it can produce real
    and meaningful falls
  310. in depression and anxiety.
  311. And one day, I remember
    standing in the garden

  312. that Lisa and her once-depressed
    friends had built --
  313. it's a really beautiful garden --
  314. and having this thought,
  315. it's very much inspired by a guy
    called professor Hugh Mackay in Australia.
  316. I was thinking, so often
    when people feel down in this culture,
  317. what we say to them -- I'm sure
    everyone here said it, I have --
  318. we say, "You just need
    to be you, be yourself."
  319. And I've realized, actually,
    what we should say to people is,
  320. "Don't be you.
  321. Don't be yourself.
  322. Be us, be we.
  323. Be part of a group."
  324. (Applause)

  325. The solution to these problems

  326. does not lie in drawing
    more and more on your resources
  327. as an isolated individual --
  328. that's partly what got us in this crisis.
  329. It lies on reconnecting
    with something bigger than you.
  330. And that really connects
    to one of the other causes

  331. of depression and anxiety
    that I wanted to talk to you about.
  332. So everyone knows
  333. junk food has taken over our diets
    and made us physically sick.
  334. I don't say that
    with any sense of superiority,
  335. I literally came to give
    this talk from McDonald's.
  336. I saw all of you eating that
    healthy TED breakfast, I was like no way.
  337. But just like junk food has taken over
    our diets and made us physically sick,
  338. a kind of junk values
    have taken over our minds
  339. and made us mentally sick.
  340. For thousands of years,
    philosophers have said,
  341. if you think life is about money,
    and status and showing off,
  342. you're going to feel like crap.
  343. That's not an exact quote
    from Schopenhauer,
  344. but that is the gist of what he said.
  345. But weirdly, hardy anyone
    had scientifically investigated this,

  346. until a truly extraordinary person
    I got to know, named professor Tim Kasser,
  347. who's at Knox College in Illinois,
  348. and he's been researching this
    for about 30 years now.
  349. And his research suggests
    several really important things.
  350. Firstly, the more you believe
  351. you can buy and display
    your way out of sadness,
  352. and into a good life,
  353. the more likely you are to become
    depressed and anxious.
  354. And secondly,
  355. as a society, we have become
    much more driven by these beliefs.
  356. All throughout my lifetime,
  357. under the weight of advertising
    and Instagram and everything like them.
  358. And as I thought about this,

  359. I realized it's like we've all been fed
    since birth, a kind of KFC for the soul.
  360. We've been trained to look for happiness
    in all the wrong places,
  361. and just like junk food
    doesn't meet your nutritional needs
  362. and actually makes you feel terrible,
  363. junk values don't meet
    your psychological needs,
  364. and they take you away from a good life.
  365. But when I first spent time
    with professor Kasser
  366. and I was learning all this,
  367. I felt a really weird mixture of emotions.
  368. Because on the one hand,
    I found this really challenging.
  369. I could see how often
    in my own life, when I felt down,
  370. I tried to remedy it with some kind of
    show-offy, grand external solution.
  371. And I could see why that
    did not work well for me.
  372. I also thought,
    isn't this kind of obvious?
  373. Isn't this almost like banal, right?
  374. If I said to everyone here,
  375. none of you are going to lie
    on your deathbed
  376. and think about all the shoes you bought
    and all the retweets you got,
  377. you're going to think about moments
  378. of love, meaning
    and connection in your life.
  379. I think that seems almost like a cliché.
  380. But I kept talking
    to professor Kasser and saying,
  381. "Why am I feeling
    this strange doubleness?"
  382. And he said, "At some level,
    we all know these things.
  383. But in this culture,
    we don't live by them."
  384. We know them so well
    they've become clichés,
  385. but we don't live by them.
  386. I kept asking why, why would we know
    something so profound,
  387. but not live by it?
  388. And after a while,
    professor Kasser said to me,
  389. "Because we live in a machine
  390. that is designed to get us to neglect
    what is important about life."
  391. I had to really think about that.
  392. "Because we live in a machine
  393. that is designed to get us
    to neglect what is important about life."
  394. And professor Kasser wanted to figure out
    if we can disrupt that machine.

  395. He's done loads of research into this;
  396. I'll tell you about one example,
  397. and I really urge everyone here
    to try this with their friends and family.
  398. With a guy called Nathan Dungan,
    he got a group of teenagers and adults
  399. to come together for a series of sessions
    over a period of time, to meet up.
  400. And part of the point of the group
  401. was to get people to think
    about a moment in their life
  402. they had actually found
    meaning and purpose.
  403. For different people,
    it was different things.
  404. For some people, it was playing music,
    writing, helping someone --
  405. I'm sure everyone here
    can picture something, right?
  406. And part of the point of the group
    was to get people to ask,
  407. "OK, how could you dedicate
    more of your life
  408. to pursuing these moments
    of meaning and purpose,
  409. and less to, I don't know,
    buying crap you don't need,
  410. putting it on social media
    and trying to get people to go,
  411. 'OMG, so jealous!'"
  412. And what they found was,

  413. just having these meetings,
  414. it was like a kind of Alcoholics Anonymous
    for consumerism, right?
  415. Getting people to have these meetings,
    articulate these values,
  416. determine to act on them
    and check in with each other,
  417. led to a marked shift in people's values.
  418. It took them away from this hurricane
    of depression-generating messages
  419. training us to seek happiness
    in the wrong places,
  420. and towards more meaningful
    and nourishing values
  421. that lift us out of depression.
  422. But with all the solutions that I saw
    and have written about,

  423. and many I can't talk about here,
  424. I kept thinking,
  425. you know: Why did it take me so long
    to see these insights?
  426. Because when you explain them to people --
  427. some of them are more
    complicated, but not all --
  428. when you explain this to people,
    it's not like rocket science, right?
  429. At some level, we already
    know these things.
  430. Why do we find it so hard to understand?
  431. I think there's many reasons.
  432. But I think one reason is
    that we have to change our understanding
  433. of what depression
    and anxiety actually are.
  434. There are very real
    biological contributions
  435. to depression and anxiety.
  436. But if we allow the biology
    to become the whole picture,
  437. as I did for so long,
  438. as I would argue our culture
    has done pretty much most of my life,
  439. what we're implicitly saying to people
    is, and this isn't anyone's intention,
  440. but what we're implicitly
    saying to people is,
  441. "Your pain doesn't mean anything.
  442. It's just a malfunction.
  443. It's like a glitch in a computer program,
  444. it's just a wiring problem in your head."
  445. But I was only able to start
    changing my life
  446. when I realized your depression
    is not a malfunction.
  447. It's a signal.
  448. Your depression is a signal.
  449. It's telling you something.
  450. (Applause)

  451. We feel this way for reasons,

  452. and they can be hard to see
    in the throes of depression --
  453. I understand that really well
    from personal experience.
  454. But with the right help,
    we can understand these problems
  455. and we can fix these problems together.
  456. But to do that,
  457. the very first step
  458. is we have to stop insulting these signals
  459. by saying they're a sign of weakness,
    or madness or purely biological,
  460. except for a tiny number of people.
  461. We need to start
    listening to these signals,
  462. because they're telling us
    something we really need to hear.
  463. It's only when we truly
    listen to these signals,
  464. and we honor these signals
    and respect these signals,
  465. that we're going to begin to see
  466. the liberating, nourishing,
    deeper solutions.
  467. The cows that are waiting all around us.
  468. Thank you.

  469. (Applause)