 |
Bargaining with Prozac
A memoir of a decade on antidepressants raises haunting questions about the price of being normal
By Scott Stossel
SEPTEMBER 21, 1998:
PROZAC DIARY, by Lauren Slater. Random House, 203 pages, $21.95.
Why is Boston so overrepresented in the Memoir of Madness genre? Is there
something about New England's repressed Puritan culture that induces
melancholia and anxiety? Something about the outsize egos around Harvard that
leads not only to nervous breakdowns but also to the need to brag about them?
Or does it have something to do with the toxic sludge polluting the Charles
River?
Whatever the reason, the Boston-Cambridge area has been the setting for a
disproportionate number of those books that might be described as
"autopathographies": think of Susanna Kaysen's Girl, Interrupted,
Caroline Knapp's Drinking: A Love Story, and Elizabeth Wurtzel's
Prozac Nation. The seminal book in the genre, Sylvia Plath's
fictionalized memoir The Bell Jar (1963), is set here, too. Given the
similarities not only in setting but in the writers' backgrounds, one would
expect that a certain sameness would be inevitable. Yet these books range
widely in their style and quality. Lauren Slater's Prozac Diary ranks
among the best.
The most obvious point of comparison is with Wurtzel's Prozac Nation;
and in that context, Slater, who first revealed her mental health problems in
1996's Welcome to My Country, almost can't help but fare well. Prozac
Nation was a bad book: it was readable only because it was impossible to
stop watching such self-indulgence, such an overbearing ego on voluntary public
display. While I have no doubt that Wurtzel sincerely meant to convey the depth
of her pain, what came across was only the arrogant preening of a world-class
bitch.
Slater, on the other hand, manages to describe her pre-Prozac suffering
without seeming to wallow in it. And as she recounts how the Prozac began to
work, we begin to understand depression and mental illness as she does -- by
understanding its absence. When the drug kicked in, Slater says, she felt "as
though I'd been visited by a . . . piano tuner who had crept into my
apartment at night, who had tweaked the ivory bones of my body, the taut
strings in my skull, and now, when I pressed on myself, the same notes but with
a mellower, fuller sound sprang out."
For Slater, Prozac has an almost magical effect. Her depression and anxiety
and compulsive behavior recede and, for the first time in her life, she can
travel and work and have relationships and eat and do all the things that most
people do without even thinking about them. Yet for all that, Slater has a
profoundly ambivalent relationship with the drug. She worries not just about
its long-term side effects but about what she's lost by taking it. Having been
on Prozac since 1988, Slater is one of the cohort that serves as the collective
canary in the Prozac coal mine. True, 12 million Americans take the pill
without significant problems. But what about over the long haul? Will these
people have to be medicated forever? What happens after you've taken the drug
for 10 or 20 years? Slater notices she has trouble remembering things that she
used to recall easily. Is loss of memory a long-term symptom? What's more, for
the entire time she's been on the drug she has been unable to have an orgasm;
indeed, her sex drive and sexual sensitivity overall have declined, common side
effects of the drug.
Her most resonant fears are not sexual or medical but existential. What gets
lost when you elide suffering? What happens when yearning gets muted by
pharmacological dampers? She's happier, yes; she can function, yes. But is it
necessarily a good thing that staring into the abyss has been replaced by the
quotidian, by the errands and small pleasures of everyday life?
Slater, appropriately, doesn't give clear answers to these questions. Her
overall view of Prozac is implicit in her continuing to take it. She needs it
to survive and thrive (she's a psychologist and a teacher of writing). But her
uncertainty comes across in the ambiguous portrait of the unnamed Prozac
Doctor. One might expect she would regard him as her savior; yet from the way
she describes his blasé reduction of all suffering to the neurochemical
(when she worries about side effects, he considers this a symptom of her
illness and raises her dose), it is clear she feels the pharmaceutical bargain
he has offered her is a Faustian one.
Prozac Diary is a rich and provocative little book; its evocation of
the trajectory of mental illness under chemical assault is as good as Kay
Redfield Jamison's in An Unquiet Mind and William Styron's in
Darkness Visible. The haunting thing about these books is that all --
including The Bell Jar -- end on a note of cautious optimism; yet we all
know what happened to Plath, which raises questions about whether this optimism
is merited. Will Slater, Styron, and the rest end up better off than Plath
because they live in the age of pharmacological therapy? What if Plath had
taken Prozac? Would she have been as brilliant and creative? If she had found
herself wrestling with diapers, say, or a bank job (instead of the abyss),
would it have made her poetry worse? Most important, would she have lived?
Slater doesn't pose these questions about Plath, but it's clear she knows she
is not home free just because she has hitched herself to a chemical capsule.
Scott Stossel, the executive editor of the American Prospect, has
written political and cultural criticism for the Atlantic Monthly, the New Republic, and the New Yorker.

|



|