This past February, the multimedia organization Big Think posted a video containing an interview with the Swiss-born British journalist Johann Hari. This year, Hari published a book titled Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, in which he attempts to show how the mainstream view of depression is overly-simplistic and even misleading.
In the interview, he summarizes some of his findings. One psychiatrist he spoke with, the South African psychiatrist Derek Summerfield, recounted to him a story that he had been told while traveling to Cambodia. A local rice farmer had accidentally stepped on a landmine, and had to have his leg amputated. After returning to work, he found it difficult to do his job, since it is difficult to move around in wet conditions with a prosthetic leg. He thus could no longer work, and eventually fell into a deep depression. After speaking with doctors, they gave him a cow. He then started to work as a dairy farmer, and eventually, within a matter of weeks, his depression subsided. In Hari’s words, “[T]hat cow was an anti-depressant.” That is to say, his life had been disturbed on a fundamental level, through no fault of his own. The job he had dedicated his entire life to, he could now no longer do. THIS was the cause of his depression. His depression subsided when he was able to restore some sense of normalcy in his life.
This corresponded to many of the other findings Hari had discovered. The World Health Organization reported that depression is a “social indicator, it requires social as well as individual solution [sic].” Depression and anxiety are the result of something gone wrong on a fundamental level. Several doctors and scientists told him that the notion that depression is primarily or solely the result of certain chemical imbalances was never a well-established scientific fact. Chemical imbalances in the brain do play a role in depression, but the causes of depression cannot be reduced merely to that. This was something that he had also learned through his own experiences. As a teenager, he struggled with depression. He was told by his doctor that the cause was the fact there was a chemical called serotonin, which is involved in the sensation of happiness. People who suffer from chronic depression either lack or are not producing enough of this chemical. After receiving depression medication, which was meant to increase his serotonin levels, he began to feel a recovery from his depression, but a few months later, he fell back into his depression, and so they increased the levels of anti-depression medication. Yet, he continued to struggle with depression even as he increased the amount of anti-depressants he was taking. 
The main point is that whenever something bad happens, our ability to cope with the chaos and pain, and pick up the pieces afterwards, plays a big role in whether or not we avoid or overcome depression. This aspect – that is, how we live our life – is an aspect of depression and anxiety that is often not emphasized enough by psychologists.
The state of our life in general and our mental state in specific are highly correlated. In a June 2017 article from Psychology Today, we are told of a study by an Australian mental health organization which found that 66% of those with mental illness reported feeling a sense of social isolation, as opposed to only 10% among the general population. In some cases, mental illness itself may be the cause of social isolation; but, social isolation has been shown to cause or make worse a variety of mental and physical disorders. The article also cites a 2005 study from SANE – a British-based charity dedicated to mental health – which stated that many people who suffered from mental health issues said that social relationships were important in “helping them manage their symptoms and improve their quality of life.” 
Further, a 2002 study in the journal titled Quality of Life Research studied a group of 157 adults under the age of 80 who suffered from COPD. The study was conducted in the period between January of 1991 and October of 1999, with follow-ups as late as May of 2000. The studies showed that “poor emotional functioning” was “associated with higher mortality.” This was something that was particularly true with women. Over the course of the study, there were 102 deaths. The median rate of survival was roughly three years – 31.3 months for females and 36 months for males. Yet, among women, those with “high emotional function” had a median survival rate of 50.8 months, as opposed to 29.5 months for those with “low emotional functionality.” Female patients with lower levels of fatigue survived almost 13 months longer than women with higher levels of fatigue (42.8 months as opposed to 29.5 months). There were similar trends among men, but the differences were not as large, and sometimes men even lived shorter lives in spite of a better emotional state. For example, men with less fatigue tended to live 6.3 months shorter than men with higher levels of fatigue, and men with “high emotional functionality” lived 4 months shorter than men with “low emotional functionality.” There were also other physical dynamics. For example, men who lived with their wives tended to live longer than men who were single, but men who were single lived an overall unhealthier lifestyle. For example, men who died alone smoked for an average of 68.3 years as opposed to men still living with their spouse, who smoked only an average of 50 years. The physiological and emotional states of the women living with their spouse was not much different than those living alone; thus, the social effects were much greater for women than for men. Nonetheless, among both men and women, those who were still with their spouse lived longer than those living alone, in some cases as much as almost a year. For example, men who were married survived 33.6 months, as opposed to 21.9 months for single men. Women who lived with their spouse survived 42.8 months, as opposed to 31.1 months among single women. 
Therefore, emotional stability and social isolation were major factors in survival among those with COPD, particularly for women. And this is true with all people. For example, a 2017 article published by NPR found that increased use of social media is connected with feelings of social isolation. For example, in a study of over 1,700 people between the ages of 19 and 32, people who used social media for large periods of time – two hours or more per day – tended to have twice the odds of suffering from social isolation when compared to those who had very little use of social media (an half an hour a day or less).  In a 2017 study of 1,500 young people between the ages of 11 and 25, the use of social media increased the chances of feelings of inadequacy and social isolation (though some social media sites, such as YouTube, actually had a positive influence on the behavior of young people).  Feelings of social isolation are literally deadly. A December 2016 article from the New York Times showed that those who live alone have a 29% chance of heart disease and a 32% chance of getting a stroke. An analysis of 70 different studies showed that people who are socially isolated have 30% higher risk of dying within the next seven years. Social isolation can also accelerate the rate of cognitive decline among older adults. Nonetheless, one-third of adults over the age of 65 and half of those over the age of 85 now live alone. 
Another study showed that since the year 2000 there was a 16% increase in mental health visits among college students, and between 2009 and 2014, there was an increase in crisis response. Recent studies showed that 44% of college students displayed signs of depression, and suicide is the leading cause of death among college students. For young adults in their 20’s and 30’s, many of them not only have difficulty with emotional issues – such as anxiety and depression – but also had a difficult time dealing with hardship and had time-management issues. Some have attributed this to the phenomenon of “helicopter parents” – parents who are overly-involved with their children’s’ lives. Helicopter parents are more concerned with protecting their children than with forming them into well-adjusted adults who can deal with hardship and responsibility.  So, people with very little basis to deal with the realities of life have increased levels of social and emotional issues.
What is the string connecting all of this? Our emotional and psychological state is influenced just as much by social issues – i.e., our relationships, the choices we make, etc. – as by biological or physical factors. Further, not only can physiological or biological issues have an effect on our state of mind, but our sate of mind can also have an effect on our physical well-being. This should point towards two insights which classical philosophy and theology has known for centuries: 1)the close connection between the body and the soul; and 2)the choices we make have a MAJOR impact on our life turns out.
Concerning the first point, I think the best example of this truth is in the Aristotelian-Thomistic school of thought. The Stanford Encyclopedia of Philosophy noted how it is difficult to place Aquinas’s view on the mind-body connection within the spectrum of the categories of modern philosophy. Aquinas believed that the soul was incorruptible, and thus could survive even after the death of the body. This would seem to imply that the soul is its own substance which interacts within another substance, namely a physical substance (the body). Yet, Aquinas does not see the soul as a complete nature or substance in and of itself. It was a particular subsistent reality – that is, it could exist on its own without being united to anything else – but this does not mean that it was complete on its own. A particular thing or a part of a thing may be able to exist on its own, but it does not represent the fullness of an essence. The fullness of what it means to be human rests in the unity of the body and the soul/mind, the physical and the non-physical. 
The reason for this is because Thomas was a proponent of hylemorphism. Hylemorphism states that everything that exists consists in some combination of matter and form. Matter is what a thing is made out of, the building blocks of existence; form is what a thing is, that which differentiates one type of being from another type of being. Form gives intelligibility to matter and makes it to exist as a specific type of thing. Matter, on the other hand, allows a particular form to express itself in a specific, concrete manner. An analogy used by Aristotle – also a proponent of hylemorphism – is found in Book II of his work On the Soul, in which he compares the relationship between matter and form to the relationship between wax and a seal: the wax provides the matter which allows the form to exist in a concrete manner, while the seal gives a particular shape, allows the wax to exist in a particular manner.  The rational soul is, for Aristotle and Aquinas, the form of the human person. The term “soul” referred to that which made a living thing alive, and the rational soul referred to that which laid the basis for all the qualities of a living being with rationality. Not only did a rational soul vivify the body, but also endowed it with sense perception, and, most importantly, the ability to think rationally. It is for this reason that Fr. Bernard J. Wuellner, S.J. – a Catholic priest and professor of philosophy who taught at Loyola University, the University of Detroit, John Carroll University, and Xavier University – wrote in his commentary on Scholastic theology that the rational soul includes every grade of perfection: those associated with rational creatures, those associated with living things in general, and those involved with existent things in general. Thus, the soul is “the noblest of forms.” It derives its nobility from its ability to bring about perfection on all levels. 
A lot of the issues that modern philosophy deals with stem from the philosophically unsound presumptions of modern philosophy. Concerning the mind-body or soul-body connection, most modern presumptions come from the French philosopher Rene Descartes, whose view on the relationship between the mind and the body or the soul and the body has been compared to a ghost trapped in a machine.  This dualistic view can easily create too sharp of a contrast between the mind and the body, or between the body and the soul. The things of one have no bearing on the the other, according to this viewpoint. As modernity marched on, people began to create even sharper division between the soul/mind on the one hand, and the body on the other, to the point to where the existence of the soul was denied, and reductionist philosophy reduced the mind to nothing more than the organ of the brain. So, at best, modernity rejects the reality that there is a dynamic interplay between the physical and the spiritual. At worst, it denies that there is anything more to man than the physical, and reduces all things to biological phenomena. So, the notion that depression is anything more than a medical condition that can be resolved simply with more medicine is absolutely unintelligible to modern-man.
This leads to the other point: if the state of the human person is based on a dynamic interplay between the body and the soul/mind, than at least part of man’s health and well-being is due to how man lives his life. This is true especially with regard to man’s psychological and emotional state. A good place to start is in Book I, chapter 4 of Aristotle’s Nicomachean Ethics. He writes, “Since all knowledge and every pursuit aim at some good…what is the highest of all practical goods? Well, so far as the name goes, there is pretty general agreement. ‘It is happiness,’ say both ordinary and cultured people…” Everything has a particular purpose, an end towards which it is aimed. This is true of our actions. This is true even of particular beings or things. What is the highest thing a person could aim for? All people would agree that is happiness. Happiness is the one thing that all people desire, and which all people desire for its own sake. What is the highest happiness for man? Happiness for man has to be rooted in something unique to man. It can’t rest in merely living, or in the goods that come from sense perception, for these man has in common with non-human creatures. It can’t rest with wealth, honor, or pleasure, for the happiness that comes from this easily passes away, and the goods themselves could be easily lost or taken away, hence have a certain impermanence to them. Man’s happiness rests in what is unique to man, namely a life lived in accordance with reason and the life of virtue that follows. Other goods can bring about happiness, but only insofar as they are ordered towards man’s most final end. Thus, in chapter 10 of Book I, Aristotle thus concludes that the happy man is “one who is active in accordance with complete virtue, and who is adequately furnished with external goods, and that not for some unspecified period, but throughout a complete life.”  That is, the happy man is the man who lives a life of virtue, and has access to all he needs on a material level to execute a virtuous life. Aquinas, building on Aristotle, states that the goods of this world are passing away, and thus the only thing that can provide true happiness for humans is an uncreated good, namely God. Living a life of virtue is thus not an end unto itself, but a means to a further end, namely union with God.  St. Augustine also supports this view, claiming that to sin is to desire a lesser good above a greater good, with the greatest of all goods being God, Who is the source of all goodness. 
So, to live a good life, man must first have an accurate view of what the end of his life is. And he must act in a manner the aligns with this end. That is why the Classical view sees life as constant journey of growth in holiness and virtue. The decisions we make thus have a cumulative effect on human behavior, creating certain dispositions or trends in human behavior. It thus should not come as a surprise if long periods of joy and inner peace, or of depression and anxiety, are, possibly to a great extent, determined by our view of what the purpose of human life is, or whether we have a clear vision of man’s end or have even thought about this issue in the first place, and whether the actions we take are ordered towards this end. A warped view of the meaning of human life could never produce a happy life; actions that do not align with man’s proper end have the same result.
Thus, just as, prior to the advent of modern science, psychological instability was seen as merely the result of bad choices, weakness, or something worse (demonic possession, etc.), likewise in the modern-era we have reduced all psychological phenomena to physical or biological phenomena. And just as, in the past, something that could not be explained within the context of morals or theology was an elusive mystery, likewise, anything that cannot be explained by means of scientific observation or experimentation is a mystery. And just as the former was considered a dark age, where a certain set of incomplete values and ideas defined our worldview and our view of the human person, likewise, in the modern world, we have also flattened out the meaning of life and the nature of the human person, one inspired by the rhetoric of science and rooted in the mindset of secularism. An authentic view of the human person accepts the full reality of man, both mind, body and soul.
- Johann Hari, “Depression Is A Social ill, not an individual flaw.” Published by Big Think, February 11, 2018. Accessed at: https://www.facebook.com/BigThinkdotcom/videos/1457149817730471/
- Dr. Judith J. Wurtman, Ph.D., “Social Lonliness May Make the Depressed Even More So.” Published in Psychology Today, June 19, 2017. Accessed at: https://www.psychologytoday.com/us/blog/the-antidepressant-diet/201706/social-loneliness-may-make-the-depressed-even-more-so
- Alan J. Crockett, Josephine M. Cranston, John R. Moss, & John Alpers, “The Impact of Anxiety, Depression, and Living Alone in Chronic Obstructive Pulmonary Disease.” Published in Quality of Life Research, 11 (2002). Pg. 209-316.
- Katherine Hobson, “Feeling Lonely? Too Much Time On Social Media May Be Why?” Published on NPR, March 6, 2017. Accessed at: https://www.npr.org/sections/health-shots/2017/03/06/518362255/feeling-lonely-too-much-time-on-social-media-may-be-why
- Jane Wakefield, “Is Social Media Causing Childhood Depression?” Published on BBC, February 10, 2018. Accessed at: https://www.bbc.com/news/technology-42705881
- Dhruv Khullar, “How Social Media Is Killing Us.” Published in the New York Times, December 22, 2016. Accessed at: https://www.nytimes.com/2016/12/22/upshot/how-social-isolation-is-killing-us.html
- Brooke Donatone, “Why Are So Many Millenials Depressed? A Therapist Points The Finger At Mom And Dad.” Published in the Washington Post, January 6, 2014. Accessed at: https://www.washingtonpost.com/national/health-science/why-are-so-many-millennials-depressed-a-therapist-points-the-finger-at-mom-and-dad/2014/01/06/19f4f1c4-69a1-11e3-8b5b-a77187b716a3_story.html?utm_term=.929b0d6c6fab
- Ralph McInerny and John O’Callaghan, “Saint Thomas Aquinas. Published in Stanford Encyclopedia of Philosophy, July 12, 1999 (revised May 23, 2014). Accessed at https://plato.stanford.edu/entries/aquinas/#BodSou
- See the article by McInery and O’Callaghan; see also Fr. Bernard J. Wuerl, S.J., Summary of Scholastic Principles, pg. 60. (cited below)
- Fr. Bernard J. Wuerl, S.J., Summary of Scholastic Principles. Chicago: Loyola University Press, 1956. Pg. 59
- For more information, see Fr. Joseph Torchia, Exploring Personhood: An Introduction to the Philosophy of Human Nature, chapter 6. Lanham: Rowman and Littlefield Publishers, Inc. 2008.
- Aristotle, Nicomachean Ethics, edited by J.A.K. Thomson. London: Penguin Books, 1976. Pg. 6-7, 24.
- St. Thomas Aquinas, Summa Theologiæ, I-II, Q. 3, A. 1. Translated by the Fathers of the English Dominican Province, 1920. Accessed in, http://www.newadvent.org/summa/2003.htm#article1
- Augustine makes this point in several of his texts, but one of the earliest systematic explanations of this can be found in his work On Free Choice, translated by Dom Mark Pontifex. New York City: Newman Press. Pg. 67-73.