‘Lost Connections’ by Johann Hari, Part 2

In my last blog, I described Johann Hari’s enthralling and inspirational book Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions. This has to be one of the most important books I have read in the mental health field since I first started working in this arena over 40 years ago.

Johann asks himself, given all his new knowledge garnered during his research for the book, what he would say to his teenage self just before he popped his first antidepressant drug—he took the drugs for 13 years—if he could go back in time.

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‘Lost Connections’ by Johann Hari

One of the most interesting books I have read on mental health is Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions by Johann Hari. Johann points out that depression is NOT caused by a chemical imbalance in the brain, as is argued by drug companies and many biologically-oriented psychiatrists and  doctors.

Moreover, there is little, if any, scientific evidence that ‘antidepressants’ alleviate depression. [Some credible scientists suggest they give a temporary relief to a minority of users.] Johann talks about social factors that cause depression and considers new socially-related ways of alleviating the problem.

Johann describes seven forms of disconnection that cause depression:

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The Drug Experience and Beyond: Amphetamine

The experience of taking amphetamine, including the subjective pleasurable experiences of initial use, amphetamine-induced anxiety and psychosis, and withdrawal symptoms following long-term use. Also includes a brief consideration of the various factors that can influence the amphetamine experience. (964 words)


The ‘drug experience’ produced by a particular psychoactive substance depends on both drug and non-drug factors. Drug factors are the chemical properties or type of drug used, the dose, route of administration, and presence or absence of another drug. Non-drug factors include personal characteristics of the user (e.g. biological make-up, personality, previous experience), and the context or setting in which the drug is taken.

A person will first try a drug because of social or intrapersonal factors, such as curiosity about the effects of a drug, or the fact that their friends are taking it. They will probably have certain expectancies about the effects of the drug from conversations with experienced users and/or because of media exposure.

Once a person has taken a drug, the drug experience creates cognitive expectancies which become another factor that influences subsequent drug-taking. A person may continue to take the drug to increase his psychological comfort or change his level of consciousness.

Low doses of amphetamine produce a number of subjective effects: feelings of euphoria; heightened alertness; increased energy and excitement; increased feelings of well-being, confidence and power; increased ability to concentrate and stay awake; increased sociability and friendliness; a feeling of being less bored or tired; hyperactivity, talkativeness, and a rapid flow of ideas; a suppression of sexual inhibitions; lack of desire for food; nervousness and anxiety.

With higher drug doses, there are other effects. These are much more likely to occur when the drug has been taken repeatedly rather than on a single occasion. The user may experience repetitive (stereotyped) thought patterns and show repetitive behaviours, e.g. continually take apart and re-assemble some object, or pick continually at their skin. They may show restlessness, irritability, and various types of anxiety condition, including panic states.

The person may develop suspiciousness, paranoia (delusions of persecution), and experience visual and auditory hallucinations. This is known as amphetamine psychosis, which resembles paranoid schizophrenia.

Amphetamine psychosis is usually seen with chronic use of drug, but can be seen after an acute administration. The incidence of amphetamine psychosis increases greatly when the user switches to intravenous drug administration.The psychosis is transitory and usually terminates after drug use is terminated. Long-term amphetamine use can sometimes lead to sudden and intense acts of aggression and violence.

The subjective effects of amphetamine and similar-acting substances are not fixed. The amphetamine-like stimulant methylphenidate (Ritalin) is, paradoxically, used to treat hyperactivity in children. Some adults report the drug exerting a calming effect, allowing them to cope better.

In well-controlled laboratory conditions, under conditions where neither subject nor experimenter knew whether drug or placebo was administered, a fixed dose of amphetamine produced either euphoria or anxiety in different subjects.

Once a person has tried amphetamine, they may use the drug on a recreational basis, even over an extended period of time. They may keep a strict adherence to a particular pattern of drug use so that the drug is only used on certain occasions (e.g. weekends). The user retains control over drug use and there may be no medical or social complications—however, there is the possibility of legal sanction. Of course, a person may try amphetamine once and never do so again.

However, the pattern of drug-taking may intensify and a number of changes may occur. For example, a person may switch from oral or intranasal use to intravenous use. Drug effects will intensify when such a change occurs.

In another pattern of use, the person initiates repeated ‘runs’, taking amphetamine for hours and sometimes days. They may snort new lines of drug whenever they feel the drug effects wearing off. This pattern of drug-taking is more evident with cocaine, which is a much shorter–acting drug.

In yet another pattern of use, they may chronically abuse amphetamine in combination with depressant drugs. They may drink large amounts of alcohol whilst under the influence of amphetamine.

Users may use depressant drugs (benzodiazepines, alcohol, opiates) to take ‘the edge off’ the stimulant, and help them feel less anxious. Research suggests that users who abuse stimulants and depressants experience more psychological and physical problems than those who only abuse stimulants.

Tolerance develops to many of the psychological and physical effects of amphetamine, e.g. euphoria, anorexia, hyperthermia and hypertension. This tolerance may develop within hours to days. However, there appears to be little tolerance to the anxiogenic effects of the drug. In fact, repeated use of amphetamine may sensitise individuals to amphetamine psychosis.

The effects of a single dose of amphetamine lasts 2 – 4 hours and generally leaves the user feeling tired after the drug’s primary effects are over. It may take as long as a couple of days to feel normal again. With chronic drug use, feelings of tiredness, lethargy and irritability become stronger and may have a more dramatic onset following the wearing off of drug effects.

The user may want to keep taking drug to avoid these feelings. Tolerance develops with regular use and higher doses will be required. Eventually, ‘what goes up must come down’. The ‘withdrawal’ effects are even stronger when a user has completed repeated ‘runs’ over a period of days. Amphetamine produces a withdrawal syndrome, which not only includes tiredness, but also anhedonia (an inability to feel pleasure), depression, anxiety, dysphoria, sleep disturbances, and a strong craving for drug.

The person may experience terrible mood swings as he oscillates between periods of drug-taking and withdrawal. He may experience periods of paranoia and anxiety when taking the drug, and periods of deep depression when not taking the drug. The impact of this on psychological well-being can be considerable.

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‘A bright light in a dark world’ by Maddie

One of the highlights of my career has been the development of Wired In To Recovery. Our online recovery community attracted over 4,000 members, who were from around the world and had a diverse range of backgrounds. A significant number (over 1,000) of community members blogged, generating over 7,500 blogs and 35,000 comments!

I loved reading the blog posts and had many favourites. Here is just one of the moving posts I was lucky enough to read.

“I’m almost nine months into my recovery journey, during which time I have not had a drop of alcohol. I’ve been reflecting back to my past, the time that I was drinking very heavily. Today, I can’t imagine drinking every day as I did, waking up with a hangover every morning. My mind just can’t seem to go back there.

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‘Neutralising Suffering: How the Medicalisation of Distress Obliterates Meaning and Creates Profit’ by Joanna Moncrieff

jmoncrieffThere is so much great content on Mad in America. Here’s an excellent article from British psychiatrist Joanna Moncrieff, one I wholeheartedly endorse. On the one hand, society discourages people from taking psychoactive drugs, and even prosecutes them for doing so, whilst on the other hand it encourages people to take psychoactive (prescription) drugs. Sometimes, they are the same drugs or very similar-acting.

‘People have used psychoactive substances to dull and deaden pain, misery and suffering since time immemorial, but only recently, in the last few decades, have people been persuaded that what they are doing in this situation is rightly thought of as taking a remedy for an underlying disease.

The spread of the use of prescription drugs has gone hand in hand with the increasing medicalization of everyday life, and a corresponding loss of the previous relationship that people had with psychoactive substances.

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This could be why you’re depressed or anxious | Johann Hari

In a moving 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. TED. [20’31”]

Johann Hari on uncovering the real causes of depression, from his new book

Benjamin Ramm talks to Johann Hari about depression and its unexpected solutions. openDemocracy. [24’34”]

Andy Puddicombe: All it Takes is 10 Mindful Minutes

When is the last time you did absolutely nothing for 10 whole minutes? Not texting, talking or even thinking?

Mindfulness expert Andy Puddicombe describes the transformative power of doing just that: Refreshing your mind for 10 minutes a day, simply by being mindful and experiencing the present moment. (No need for incense or sitting in uncomfortable positions)

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Classic Blg: ‘All it takes is 10 mindful minutes’ by Andy Puddicombe

When is the last time you did absolutely nothing for 10 whole minutes? Not texting, talking or even thinking?

Mindfulness expert Andy Puddicombe describes the transformative power of doing just that: Refreshing your mind for 10 minutes a day, simply by being mindful and experiencing the present moment. (No need for incense or sitting in uncomfortable positions)

‘“Do I Have to Feel so Badly About Myself?” – The Legacies of Guilt, Shame and Anxiety’ by Peter Breggin, MD

pbregginGuilt, shame and anxiety are intimately tied to addiction. Here is a blog on these emotions by one of my favourite people, Dr. Peter Breggin, which appeared in Mad in America.

‘Guilt, Shame and Anxiety defines these negative emotions, shows how they act as primitive enforcers of anger management, describes many alternative methods of identifying their presence in our lives, enables us to discover our personal negative emotional profile, and shows how to reject these emotions and to triumph over them.

And now we can answer the question asked in the title, “Do I have to feel so badly about myself?” The answer is a definitive “No!”  You do not have to live with your emotions out of control.  You do not have to feel stymied by painful feelings whenever you seek to be more peaceful or relaxed, more creative, braver, more loving, more independent, or simply happier.  You do not have to live this way.

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‘How to Beat Panic Attacks: 3 Simple Mindfulness Techniques’ by Krista Lester

PauseFound this interesting blog on the Tiny Buddha website.

‘“By living deeply in the present moment we can understand the past better and we can prepare for a better future.” Thich Nhat Hanh

When I was in high school, a hit-and-run car accident changed my world. My boyfriend at the time lost his nineteen-year-old brother to the accident. I had never met his brother, but it didn’t matter; a dark veil had been cast over my life.

In the days, weeks, months, and years following the accident, I sank into a deeper and deeper depression. I started to have panic attacks and I cut myself daily, trying to feel anything other than terror and despair. I sought treatment, met with therapists, tried dozens of medications, and routinely turned back to alcohol when nothing worked.

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‘Neutralising Suffering: How the Medicalisation of Distress Obliterates Meaning and Creates Profit’ by Joanna Moncrieff

jmoncrieffThere is so much great content on Mad in America. Here’s a piece from British psychiatrist Joanna Moncrieff, one I wholeheartedly endorse. In fact, this blog is essential reading. I first posted this blog on Recovery Stories in 2014. The original article on Mad in America has all the references.

‘People have used psychoactive substances to dull and deaden pain, misery and suffering since time immemorial, but only recently, in the last few decades, have people been persuaded that what they are doing in this situation is rightly thought of as taking a remedy for an underlying disease. The spread of the use of prescription drugs has gone hand in hand with the increasing medicalization of everyday life, and a corresponding loss of the previous relationship that people had with psychoactive substances.

Elizabeth Gaskell’s novel Mary Barton was originally to be named after Mary’s father John Barton, a working class factory hand addicted to opium. The novel depicts the unimaginable poverty and exploitation of industrial Manchester that made opium-induced oblivion an appealing escape.

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Andy Puddicombe: All it takes is 10 mindful minutes

When is the last time you did absolutely nothing for 10 whole minutes? Not texting, talking or even thinking?

Mindfulness expert Andy Puddicombe describes the transformative power of doing just that: Refreshing your mind for 10 minutes a day, simply by being mindful and experiencing the present moment. (No need for incense or sitting in uncomfortable positions)

A letter to Alcohol

IMG_4467Here is a letter that Beth Burgess, recovery coach from Smyls, wrote in her early recovery:

“Dear Alcohol,

Well it’s been a while now, and although you are a bad influence, I do miss you sometimes. I miss our secret relationship, the way that no-one else was part of it and could never get in on it. I miss the way you comfort me when I’m down. It sometimes creeps up on me unexpectedly how much I miss you. And other times I am glad you are gone.

Of course you have changed – and I know that. You’re not fun any more. But I seem to forget that when we’re not together. I don’t know why my memory is so short and why I always remember the good times with such intensity. It hasn’t been that way for a while.

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