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