Prozac Nation: Depression and Medication in Contemporary Psychological Treatment

In Elizabeth Wurtzel’s Prozac Nation, the author describes her own battle with severe depression and the ways in which her use of various medications directly impacted her life. From a troubled childhood all the way to a difficult adult life, Wurtzel experiences the emotional ups and downs of her depression, and the ways in which the drug culture of the United States mental healthcare system may have contributed to her deep troubles. The book is written in such a fashion that the reader is encouraged to immerse themselves in the story—highly personalized, the book tells a very human story of the ways in which a mental health diagnosis can drastically impact the life of a troubled individual. Moreover, the text allows the reader a way to conceptualize the author’s underlying issues by creating an empathetic approach that enables full immersion into the patient’s problems and the solutions adopted by Wurtzel that she thinks will help her case.  

The book begins by telling the story of Wurtzel’s childhood, beginning with her experiences in the United States as a young girl. Raised by her Jewish mother, Wurtzel quickly begins to experience a sense of a “strange and insecure household” where she does not feel out of place or strange (p. 33). Indeed, when the young girl visits the homes of her friends, she is cognizant of the fact that their homes seem far duller and more uninteresting than hers. Up until this point in her life, Wurtzel’s childhood is one that she describes herself as being a “golden girl”, even though her parents experienced some marital discord and did not get along terribly well. Even so, the young girl excelled in her classes, even earning extra credit in Hebrew class as a sign of her, as she terms, future that was “full of promise” (p. 36). However, things would soon take a turn for the worse when Wurtzel began to cut herself. The cutting began “when [she] started to spend [her] lunch period hiding in the girls’ locker room, scared to death of everybody around me” (p. 38). She had, by this stage in her life, transformed her identity into that of a completely different person. Unable to identify with her previous identity as a good student, reliable daughter, and unwilling to talk to people. She experienced panic attacks, mood swings, and had become, in her words, a “nihilistic, unhappy girl” (p. 40). By the time Wurtzel reaches eighth grade, her parents’ relationship is in a terminal state of decline.

It is in the relationship between Wurtzel and her parents, specifically her father that we can begin to see the impetus of her massive depression. An absentee father throughout much of her childhood is not an uncommon story to be sure, and the ways in which Wurtzel expresses her anger at her father throughout the text are palpable. Painful memories can be a great source of depression. At one point she is having a massive argument with her father in which she informs him that “for once you’re going to go get it right in your face and know how horrible you were! Just for once you’re going to quit blaming everybody else” (p. 123). Wurtzel continues the narrative of her life that culminates in her attempted suicide, which is an expected occurrence from the start of the text. Indeed, it seems that Wurtzel wrote the book specifically to hint around the edges of her attempted suicide and paint a picture of how close suicide always seemed to be—the cutting of her own skin as a young girl, her drug abuse, the significance of Rafe leaving her all work in tandem to try to persuade the reader that suicide is just around the corner (p. 219). Drugs like Mellaril, Xanax, Valium, and Thorazine (the latter of the two only after her unexpected miscarriage) did nothing to stabilize her mood swings and ensure a positive, depression-free outlook on life (p. 166). 

The culmination of Wurtzel’s story is the suicide attempt in Dr. Sterling’s office. Though the paints the picture of the suicide as something she was set on performing, she is forced to at least try an attempt on her life given that Sterling is likely going to take her to a hospital to be placed on suicide watch. Without her original plan to slit her wrists in a bathtub, Wurtzel decides to run to Sterling’s bathroom and swallow as many Mellaril pills as possible (p. 283). Wurtzel’s suicide attempt definitively fails when she opens the bathroom door in a daze to let Sterling in and she is rushed to the hospital where her life is saved. Once the Prozac finally kicks in, she is able to “become all right, safe in my own skin” (p. 292). Wurtzel’s long struggle with depression was finally won with the aid of the new drug, and the epilogue of the text continues on with a long exposition on the development of the American drug culture and the mainstreaming of mental illnesses like depression.

The psychological concept of the text can be defined as the ways in which society interacts with serious depressives, and the methods by which depressives can seek alleviation from their affliction. The author is quick to note, however, that in the contemporary world, the mainstreaming of mental disorders has placed an almost humorous tone on serious problems like depression, and that few people are capable of acknowledging the severity of the situation. My experience reading this text was quite telling, as reading this text revealed serious structural difficulties present in American society with regards to the effective diagnosis and treatment of mental illness. It was quite frightening to think that serious mental disorders exist and that the subjective nature present in the initial diagnoses can be so prevalent. Wurtzel, for example, did not get actually diagnoses for depression until quite late in her life. In reading this book, my views of society have been substantially negatively impacted in that the simple idea that society at large is apparently so incapable of addressing these serious issues that suicide becomes the only effective way to actually achieve results in the system is a terrifying thought.  My experience relates to the author’s experiences in that we can both understand the significance that disorders like depression have on afflicted individuals. As Wurtzel discusses in the epilogue, society has largely mainstreamed mental disorders and does not acknowledge the actual severity of the conditions. Instead, Prozac is readily administered to millions of Americans for anxiety disorders and depression, many of whom likely are not actually serious depressives. The other solution to the proliferation of Prozac is that the lives of individuals are so terrible that medication is the only way of making it bearable. 

The author’s diagnosis and issues can be conceptualized to be a case study for an example of severe depression, significant enough to lead to a suicide attempt. While the suicide attempt was not successful and, realistically speaking, stood a fairly low chance of actually working, it is clear that the author’s issues are rooted in her depression. The fundamental causes of her depression are certainly up for debate, however. Her parental situation, while not the best, is hardly the worst one imaginable, and millions of Americans suffer through the same rough childhood as she. In the end, the root causes of her diagnosis are unknowable—Wurtzel herself cannot possibly, in any rational sense, explain the origins of her disorder in any sociocultural terms. Instead, the medical and genetic nature of her depression is central to understanding the ways in which she viewed her own condition—without Prozac, she was a suicidal depressive. With Prozac, her life seems to brim with possibilities. 

I have mixed feelings regarding the book. On the surface, I enjoyed it. It is an interesting tale of a woman who experienced a difficult life and, in the end, emerged intact from her trials. At the same time, Wurtzel seems dishonest in her style of writing. Her father issues, while somewhat substantial, are hardly anything unique, and she experiences nothing from her father on the level of serious psychological trauma or abuse. The writing itself is bloated and grandiose and, while honest in its attempts to convey meaning, comes off as tiringly boorish. It seems to worship her own sense of self-pity and screams at the reader in a way to attract sympathy. Lastly, Wurtzel gives me the impression that she, and only she, has any idea of what it means to have depression and its effects. In addition, the author seems incredibly self-entitled—a Harvard education, therapy, Cambridge, and yet she continually seems incapable of accepting responsibility for her own actions. I enjoyed the book immensely and Wurtzel does well to convey the brutal nature of depression, but she does it while wallowing in self-pity, and that detracts from the powerful themes of the text.

Reference

Wurtzel, E. (1995). Prozac Nation. New York, NY: Riverhead Trade.