South African psychiatrist Derek Summerfield was in Cambodia when he heard a curious story.
He was explaining to the local doctors about antidepressants. His Cambodian counterparts told him they did not need chemical antidepressants.
They told Summerfield about a rice farmer whose leg was blown off by a land mine. He got an artificial limb and returned to work in the rice fields. He was in a lot of pain and highly anxious. He sank into a deep depression.
His doctors talked to him about his problems and then came up with a creative solution to lift his mood. They bought him a cow and suggested he become a dairy farmer. It worked wonders. His depression lifted. The Cambodian doctors told Summerfield the cow was his antidepressant.
The story changed the way Summerfield viewed depression.
The tale of the rice farmer also had a profound effect on journalist Johann Hari. As a teenager, Hari was suffering from serious depression.
A doctor explained to Johann that his depression was caused by a chemical imbalance in his brain and gave him antidepressants.
It helped at first, but after a few months, the pain returned. The doctor increased Johann’s dose and a familiar pattern formed. The pain would return and Johann would take stronger and stronger pills. After 13 years of this, Johann was at the end of his tether.
He began to question why, despite medication, he was still so down in the dumps. This question led him to research and write a book on the real causes of depression.
In the U.K., antidepressant use has doubled in a decade. In the U.S., one in five adults now take psychiatric drugs. Johann believes that a small minority of depression cases do have biological causes. But for most people, chemical medication is not the answer.
According to psychology professor Steve Ilardi, “Only about 50 percent of depressed individuals experience an initial positive response to antidepressants.” And while 50% is nothing to sneeze at, only 30% report long term success with medication.
Johann believes that depression is mainly a social problem. For most people, it boils down to disconnection. He says there are many forms of disconnection: “from other people, from meaningful work, from meaningful values, from the natural world, from a safe and secure childhood, from status, and from a future that makes sense to you.”
Summerfield has also changed his beliefs on depression after hearing of the Cambodian farmer and his cow. He now believes that depression is best treated by focusing on patients’ social situation, not on “what’s between their ears.”