If you are depressed and anxious, there is one thing I want to tell you, above anything else. Your pain makes sense. You feel this way for a range of reasons – ones that are totally understandable when you look at the scientific evidence. You are not crazy. You are not a machine with broken parts. You are not a computer with a glitch in its coding. You are a human being with unmet needs – and what you deserve is love and practical support to get these deeper needs met. 

The sinking lifeboat

I learned this only late in the day, and it was hard-won. I had intermittent severe depression from my teenage years into my thirties – and I was only told one story by the doctors who treated me, and by the wider culture. Whenever I looked for explanations for my depression, I was told stories that simply said there was something wrong with my biology: either I had defective genes, or I had a naturally defective brain with an imbalance of one particular chemical. I believed those stories. I clung to those stories. I saw them as my lifeboat – a way to carry me away from this pain. But the more I clung to this story, the more depressed I became. My lifeboat seemed to be sinking.

So I set off on a long 40,000-mile journey across the world to interview the leading experts in the world about what causes depression and anxiety, and what solves them, for my book Lost Connectionss: Uncovering the Real Causes of Depression – and the Unexpected Solutions What I learned is that the story I was told is not totally untrue – but it was hugely simplified. 

Depression and anxiety: The root causes

There is a very broad scientific agreement that there are three kinds of cause of depression and anxiety. There are biological causes, which can increase your sensitivity to depression – for example, just like some people find it easier to put on weight than others, your genes can make you more sensitive to depression, but they never write your destiny. 

There are two other kinds of cause of depression and anxiety – ones that can be even more powerful. There are psychological causes of depression. For example, if you had a severely traumatic childhood and you have never found a way to process and release the shame that creates, you are 3100 percent more likely to attempt suicide as an adult. 

Then, most crucially, there are social causes – ones that relate to the way we live together. To give a few examples of how they play out: If you are lonely, you are much more likely to become depressed. If you go to work tomorrow to a job where you are controlled – where you have low or no choices about what you do – you are much more likely to become depressed. If you never get to see the natural world, you are more likely to become depressed.

Our natural psychological needs

Something connects most of the causes of depression and anxiety that I present the evidence for in my book. Everyone reading this post knows that they have natural physical needs. You need food, and water, and clean air, and shelter – if I took them away from you, you’d be in real trouble, real fast. But there’s equally strong evidence that human beings have natural psychological needs. You need to feel you belong. You need to feel your life has meaning and purpose. You need to feel that you have a future that makes sense. Our culture is good at lots of things – but we have been getting less and less good at meeting our deeper underlying psychological needs. This isn’t the only thing that’s going on, but I think it’s the key reason why I am 39 years old and almost every year I have been alive, depression and anxiety have increased across the Western world.

Because we live in a culture that has told us such a heavily biological story for so long, this more complex and truthful picture of depression can sound strange at first. But this isn’t some wacky left-field theory. It’s the position of the leading medical body in the world, the World Health Organisation. They explain: “Mental health is produced socially. It is above all a social indicator and requires social as well as individual solutions.” 

Social Health from Sydney to San Francisco

I then followed this trail across the world – from Sydney to San Francisco to Sao Paulo – to see what solutions it offers us. I discovered that once you adjust your picture, you can start to see solutions that you couldn’t see at the start. To name one of many I reported on: if depressed and anxious people are “prescribed” to take part in a weekly gardening program, where they are helped to reconnect with other people and with the natural world, it is more than twice as effective as chemical anti-depressants in reducing their pain. There are many solutions waiting for us (alongside the option of chemical anti-depressants, which should never be taken off the menu), if only we are ready to listen to the best science.

But it all starts with this key insight – one we need to keep repeating, like a mantra, until we have truly absorbed it. Your pain makes sense.