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  • 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 have 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 most 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 into the natural world,

  • you're more likely to become depressed.

  • And 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,

  • every 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 wrestled 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 Dr. 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 throes 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, in the main, 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 São Paulo.

  • I kept meeting people who were understanding

  • the deeper causes of depression and anxiety

  • and, as groups, fixing them.

  • Obviously, I can't tell you about all the amazing people

  • 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 --

  • you can complain about that to them.

  • 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.