Monday, August 08, 2005

Prozac for the Masses

I've been reading Peter Kramer's _Against Depression_ and debating whether or not he's right - that we've allowed depression and melancholia a too-central part of our sense of what constitutes culture. The problem is, even if he is right, I'm not entirely sure what we'd replace it with. He offers a distinction between melancholy and alienation - but is it even possible to be alienated without being depressed by what you are looking at?

My father, back when he was dating, used to claim that he never met a woman of his generation who wasn't on some psychopharmaceutical. I'd say that might simply be a comment on the kind of women who were interested in my Dad, except that it seems to be true. I look around at the copious number of parents (Eric and I have 8 between us), aunts, uncles, etc... of the boomer generation, and I know for a fact that more than half are on some kind of anti-depressant. I suspect the numbers are higher than that, since I doubt they'd all tell me.

While the numbers among my peers haven't quite hit the baby boomer ones yet, I certainly know of more than a few who take an antidepressent, or at least a tranquilizer now and then. My own husband has been on prozac for 7 years, as a treatment for panic attacks, and it works for him (although whether biochemically or as a placebo, we don't know). I certainly wouldn't trade back to the days when he had regular panic attacks. Don't get me wrong - while I'm not the depressive type (more like borderline personality), I recognize real and serious depression as a reality I am grateful for prozac - it has brought us a level of comfort and peace. But I admit, I have my doubts about it.

Some of them are the purely statistical ones - the fact that it hasn't been proved to have the physiological effects we claim. But more troubling to me is the question that keeps coming up - are all these people on medication really depressed? Were we as a people really walking around in such an agony of personal misery before their invention (or the invention of Freud)? Can it be that we're mistaking what Freud called "ordinary human misery" for depression? If we were that miserable, shouldn't we have been? And if we weren't, isn't it possible that knowing there's a "cure" creates the misery in the first place?

I know that when my first child was born, my obstetrician offered me anti-depressants. I was exhausted, and miserable. My baby nursed constantly and screamed when he didn't nurse or sleep (the latter rarely). Eli had terrible, terrible colic. No one could tend to him but me, because only I could nurse him, and that was the only thing that comforted him. He never slept more than 2 hours at a stretch. And frankly, he screamed most of the time that I held him, sang to him, comforted him. By the time I saw my OB, I was hysterical, had convinced myself my baby disliked me, and was beyond exhaustion. The doctor's immediate reaction was to offer me a script for zoloft - something I found strange then and now. What *was* the appropriate response to such an experience, other than misery, tears and hysteria? Of course I was depresssed - my life was hell. I declined the medications. And miraculously, when Eli's colic abated, so did my "depression." I've seen the same over and over again - Eric's grandmother was offered drugs just a month and a half after the death of her husband of 63 years. But shouldn't she be depressed?

On the other hand, everyone I know who takes anti-depressants feels better. Who cares if they don't really work, or whether the person was truly depressed. I admit, there's a real attraction there. Without anti-depressants, I'm neurotic, quick tempered, edgy, prone to self-destruction, irritable, bitchy, snide. With them, I like to fantasize, I could be calmer, gentler with my children, a better mother, less frantic, less foolish. I am absolutely sure I could convince a doctor to prescribe them - so why not? Part of the reason thus far is the habit of pregnancy and nursing - although they are acceptable while nursing, the thought of adding an unnecessary drug to my body seems inappropriate. But as my breeding years come to an end, the temptation will arise again - would I be a better person without prozac.

Kramer argues that depression has received the wrong treatment culturally - that it doesn't move us (or rather people like Van Gogh) to greater heights. Again, he returns to the distinction between depression and alienation - but I ask again, how does one look at our culture from the outside without at least ennui and perhaps despair? I will say, looking at my husband, I think there is a small down-side to prozac - he is calmer, less anxious, less easily stressed, but also has less of that sexy Heathcliffy (ok, one of the most loathsome books on earth, and I mention the boring bastard here only as an ironic reference to my own taste in men) vulnerability and crankiness that I admit (embarassedly) to finding attractive. Right now, this day, I don't need angst from my husband - I need a high-functioning working partner who can juggle his and his children's demands. But I will queasily admit to sometimes missing the husband whose amibivalence and angst made him so fascinating, and so much fun to compare internal states with.

I'm just not sure that introspection and depression are wholly seperate. Looking at one's self *is* fundamentally depressing, or, in the words of an old Prof of mine, disappointing, unless, of course, you are Condoleeza Rice and lack both interiority at self-doubt. And I'm not sure that normal human misery, or even normal human depression, aren't a logical consequence of self-examination (so is boredom, frankly - introspection is really dull, when it isn't depressing). I'm not sure that rooting out ordinary (as opposed to disabling) depression is really all that good for us. After all, if we cease to be depressed by what we see inside and outside of us, what kind of appropriate response is left?

8 comments:

Gina said...

Hi--that last sentence is really something to consider. I really think depression in equivalent to pain response. I, too, have a spouse on antidepressents and wouldn't want to go back to pre-A.D. days, but I have often wondered to what degree are we being over-medicated in this area.

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