Listening to Prozac: The Book That Just Won’t Go Away
As if we didn’t have enough tiresome ’90s throwbacks, Peter Kramer is back in the news—with yet another defense of antidepressants. Scott Stossel—the author of the excellent book, My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind, and who generally knows what he’s talking about—notes that Kramer’s instinct in the Great Antidepressant War to side in favor of the drugs may be the right one. Still, I can’t shake the idea that Kramer, the author of Listening to Prozac, has had, in several regards, a less-than-positive impact on patients’ lives in the long run.
I read Listening to Prozac about a year ago, largely to make sense of my childhood. At 16, I realized—after an almost year-long low-grade depressive episode—that my mental health was on a downward trajectory. Like most teens, there wasn’t much I could do about it myself. I told my parents, who took me to my pediatrician, who, despite feeling somewhat uncomfortable with the idea of meddling with my brain chemistry, prescribed me Prozac. Life on Prozac was a series of “mehs” (when the first dose—and later dose changes—kicked in after three to four weeks) and extreme, agonizing lows (when, all of a sudden, the drug just stopped working). I was just one of thousands of patients who presented a cog in Kramer’s neat little thesis that antidepressants were, on the whole, good—and in some cases, miraculous.
Kramer’s numerous tales of personal transformations on Prozac paints a picture of adults who, having lived in agony for much (or part) of their lives, are finally freed from the yolk of their own mental anguish and are free to live their lives. People become more sociable. Their love lives go from non-existent to glorious. Their professional lives become case studies in success. They feel whole again—a feeling that, frankly, shouldn’t be more than fleeting if you’re actually aware of your own mortality and tiny place in the world. Of Kramer’s more preposterous claims is the idea that an extraordinary number of patients will experience such a radical change. If that assessment was, in fact, correct, Prozac’s introduction into the world of medicine would be game-changing. But, as Sherwin B. Nuland noted in a devastating review of the bestseller in 1994, “The highest estimate I have been able to find [of this transformation] is 10 percent, and most of my sources say that this is far too generous a figure.”
But what’s curious about Kramer’s legacy from a patient’s perspective isn’t whether or not his (likely misplaced) trust in the healing powers of antidepressants is backed by actual science; rather, it’s just how much Listening to Prozac shaped how we thinking antidepressants should work. Medication is marketed as transformative—they give our lives “back.” Ads rely heavily stark “before” and “after” imagery. Before [insert brand name of drug here] I did nothing but glower in front of a window as rain poured off my eerily reflective window and into my well-trimmed lawn. After [insert brand name of drug here] the sun came out, the rain went away, and I threw open the window to twirl happily about the yard with my young children! Thank you, [insert brand name of drug here], my life is finally complete. Glory to the god of psychopharmacology!
As Lindy West wrote in Jezebel a few years ago, “To apply cynical marketing techniques to something as complex, stigmatized, and gravely serious as mental illness is deeply troubling.” Troubling, certainly, but if we’re inclined to think of medication as possibly transformative on an intensely personal level, it’s almost natural that this how drug companies would sell it.
(Side note: While we’re on the subject, isn’t it insanely creepy that drug companies want you, an idiot consumer, to tell your doctor what they should give you? This isn’t a new insight; it’s just one that’s so deeply irksome that it should be brought up frequently and with vigor.)
Not everyone is as enamored with antidepressants as the proliferation of advertisements begging us to ask our doctors about them would suggest. There’s was enough fearmongering regarding antidepressants’ ability to somehow cause suicide to cause a sea of takes in a pre-web 2.0 world. The resulting FDA warnings concerning use of antidepressants (SSRIs, specifically) in teens is another notable effect. The hype, while probably overblown, is still with us.
That’s not to underestimate the negative effects of antidepressants, of course; it’s just to say that if there was a not-so-positive personal transformation, it took a slightly different form for most of us. I wonder how much of Kramer’s emphasis on the positive transformations that were born out of SSRI revolution has caused us to overlook this point. For my teenage self, and a hell of a lot of other youngsters, Prozac was the harbinger of extended bouts of absolute misery. Whatever personality “transformation” took place wasn’t a worthwhile one—it was one of even more intense agony, pocked by an occasional high that came when the dosage was raised. Or, to put it another way, Prozac was the rough equivilant of being dragged out of the darkness and into a bright room for a brief, fleeting glance at a life filled with hope—only to be punted back within seconds of feeling finally at home. It’s exhausting, dehumanizing, and tremendously frustrating.
Maybe one day we’ll be released from hearing from Prozac Man on the reg. Until then, it’s worth releasing our SSRI-related grievances on him from time to time.
