Lauren Slater's Prozac Diary
Kisner, Kathleen
IN THE RICH but little-known literature of mental illness, Prozac Diary shines. This slim, elegant memoir, a pastiche of journal entries and meditations, describes the transformative powers of...
...Without the Federal Drug Administration's approval of Prozac in 1988, it is unlikely that we would have heard Slater's story at all...
...The winner of the 1993 New Letters Literary Award in creative nonfiction and of the 1994 Missouri Review Award, she is a clinical psychologist who also teaches creative nonfiction writing at Goucher College...
...When her doctor prescribed Prozac to relieve the burgeoning symptoms of obsessive-compulsive disorder she had developed in addition to depression, her identity was defined by chronic mental illness...
...The truth is, we have not heard Slater's story before...
...But that doesn't make it any less miraculous...
...What happens if "regular life" to such a person has always meant cutting one's arms, or gagging...
...Her book chronicles not the descent into depression, but the difficult journey into a world of "normalcy" by someone who had never experienced it...
...She claims she has never been able to recover her former facility for writing poems and stories, despite Prozac's overall positive effect on her life (and, indeed, she includes in this book a pre-Prozac poem that is stunning...
...Although Jamison experienced her first mood swings as an undergraduate in the sixties, and as a clinician and scientist understood the consequences of not taking lithium, she resisted taking medication for many years after her initial diagnosis: 116 DISSENT / Summer 1999 Some of my reluctance, no doubt, stemmed from a fundamental denial that what I had was a real disease...
...It was a Saturday, and stripes of sun were on my walls...
...The failure of these pills to act positively and quickly—a defect which is now the general case—is somewhat analogous to the failure of nearly all drugs to stem massive bacterial infections in the years before antibiotics became a specific remedy...
...For many years she had written poetry and stories, inspired by the voices of eight people she saw as living inside of her, the most memorable of whom was Blue Baby, an infant she envisioned as sometimes dying, sometimes dead...
...I was five and the roses were red claws...
...When she finally decided to risk taking the new drug Prozac, the results were stunning...
...In the stigmatized world of chronic mental illness, the memoir is one of the repositories of history...
...After her doctor ups the dosage of the drug, her dignity is restored, but the drug never works as well as it did initially...
...On a research trip to Kentucky—one of her first trips outside the state of Massachusetts —she finds herself counting, checking, tapping surfaces, and walking backward again...
...Although no studies have linked Prozac to lessened creativity, one is inclined to trust the accuracy of Slater's reporting on her personal experience...
...One of the first people in the United States to take Prozac, Slater is a woman whose chronic mental illness prevented her from leading a normal life for her first twenty-six years...
...She believes the effects of Prozac are in direct proportion to the subjective distress of the consumer...
...The something can be "bad...
...I sat up...
...I was twelve and grew so thin the bones turned to blades in my neck...
...Slater writes honestly about the drug's negative side effects...
...Slater compares Prozac to a piano tuner that adjusts her biochemical rhythms: This is what was different—tempo, tone...
...The prevailing pattern for mental-illness memoirs in the 1990s has covered different ground, the descents into madness and triumphs over mental illness by prominent men and women who tell their stories to educate the public about the disease...
...It is for those reasons, all literary merit aside, that Prozac Diary is one of the most important books of the decade...
...Slater and many real-world people I have interviewed in depression-support groups take the drug because they need it, and deal with the unwanted side effects because of the severity and, in many cases, life-threatening nature of the illness...
...Slater's experience was completely different...
...She had been hospitalized five times for depression by the age of twenty-six...
...Slater's memoir is an important document in the history of the treatment of mental illness...
...This slim, elegant memoir, a pastiche of journal entries and meditations, describes the transformative powers of Prozac on Lauren Slater's life over a ten-year period...
...She experiences the world as "the new, strange planet, pressing in...
...If this is the case, then the "normal state" that Prozac ushers in is an experience in the surreal, Dali's dripping clock, a disorientation so deep and sweet you spin...
...She learns to form relationships with people, learns to clean her apartment, lands a job in a literacy center, and eventually returns to school, where she earns a Ph.D...
...Fortunately for lovers of literature, Slater also can write...
...She is the author of the critically acclaimed Welcome to My Country, a collection of essays about her work with schizophrenic men, in the last chapter of which she revealed that she had been hospitalized for major depression...
...She tells her story simply and beautifully, with so few embellishments that its dramatic essence may be lost on some readers...
...Slater appears to fit this profile of successful professional who goes public about her illness...
...in two years...
...Not smell, for everything smelled the same...
...Moods are such an essential part of the substance of life, of one's notion of oneself, that even psychotic extremes in mood and behavior somehow can be seen as temporary, even understandable, reactions to what life has dealt...
...The concept of a "high" from a psychiatric drug would have seemed inconceivable to Kay Redfield Jamison, who documents in her 1995 memoir her struggles to accept her illness as a physical condition that, like diabetes, required medication...
...She writes: In the field of drug studies there is considerable debate over terms like addiction and dependence and the delicate distinction between the two...
...Styron published his eloquent essay about pre-Prozac-era depression in 1990, concentrating on the intermingled factors of abnormal chemistry, behavior, and genetics that resulted in the severe depressive illness that struck him at age sixty...
...She is among the 40 percent to 50 percent of patients on Prozac (and other SSRI antidepressants, such as Zoloft and Paxil) who report sexual dysfunction...
...In 1988 she began to develop symptoms of obsessive compulsive disorder—tapping surfaces, compulsively checking the burners on the stove...
...I knew nothing of pleasure...
...And then one morning, about five days after I'd first started the drug, I opened my eyes at eight a.m...
...You are an addict, in my mind, if you feel compelled to consistently consume something you wish you wouldn't, and if that something exists outside the basic requirements of your central nervous system...
...But until that day when a swiftly acting agent is developed, one's faith in a pharmacological cure for major depression must remain provisional...
...In 1998 she won the Ohio Advocates for Mental Health Media Award...
...Not sight, for everything looked the same...
...For a time she feels ecstatic—almost high, as she says...
...Some may be tempted to dismiss the book on the basis of the title, because Prozac has become a jokey radio drive-time synonym for cosmetic psychopharmacology...
...KATHLEEN KISNER is a freelance writer in Cleveland...
...She writes, "I had experienced my various psychiatric conditions as devastating...
...In and out of psychiatric hospitals since adolescence, she had almost reached the end of options when she began to take Prozac, the miracle drug with minimal side effects that gave her the ability for the first time to live in the world...
...Thus Prozac, make no mistake about it, blissed me out and freaked me out and later on, when the full force of health hit me, sometimes stunned me with grief...
...To describe the subtle but potent shift caused by Prozac is to tussle with failing words, sensations that seep beyond language...
...Her impressive credentials include a master's degree in psychology from Harvard University and a Ph.D...
...Yet the cure that brought her out of the underworld of mental illness proved as devastating to Slater as the disease had to Styron and Jamison...
...In my case, I had a horrible sense of loss for who I had been and where I had been...
...BUT IN Prozac Diary, Slater explains she was severely incapacitated by depression until her mid-twenties...
...A seven-week psychiatric hospitalization—which would not be covered by insurance in today's businessdriven medical environment—finally gave him the time and relief from pressure to recover...
...This problem, known as "Prozac poop-out," is common, though not dwelled upon in the articles in popular magazines...
...So debilitating was her condition DISSENT / Summer 1999 115 that she was unable to hold a job, had never attended a rock concert or traveled, and lived in a basement apartment she had not managed to furnish or even to clean during her two-year tenancy...
...There are astonishingly few resources about the emotional lives of those who are afflicted by mental illness, or about physiological reactions to the drugs used in treatment, all of which make the memoir a precious source of information to those of us who suffer from such disorders...
...What it measurably does in one's life is less important than one's persistent and uncomfortable sense of servitude or even slavery...
...The trauma of the months of illness also made him a committed spokesperson on mental-illness issues...
...rather, supposedly they return the patient to a normal state of functioning...
...These books are testaments of courage by people whose willingness to "come out" and risk the stigma of illness have given hope to millions...
...This latter effect has been so widely reported that the 17.6 million Americans per year who are treated for depression or obsessive-compulsive disorder will understand her attempts to go off the drug, only to come crawling back when she reverts to illness...
...Prozac and subsequent selective serotonin reuptake inhibitors (SSRI) drugs have revolutionized treatment of depression and obsessive compulsive disorder in the last decade...
...The drug has also had an adverse effect on her sex life...
...I was ten and terrified to go outside...
...I'd turned out my light at midnight, which meant I'd gotten, for the first time in many months, a seamless eight hours of sleep...
...Slater also raises the question of addiction, the secret fear harbored by most people who take such drugs on a long-term basis...
...But about a year after Prozac brings her back into the world, the drug stops working...
...Two classic memoirs, William Styron's Darkness Visible: A Memoir of Madness and Kay Redfield Jamison's An Unquiet Mind: A Memoir of Moods and Madness, concentrate on educating readers about the biochemical nature of such illnesses and the stigma that prevents many people from seeking treatment...
...The something can be "good...
...In secret, on our wide porch, I cut myself...
...In an age when some critics complain of a glut of tell-all memoirs, it is important to remember that memoirs are also a respected DISSENT / Summer 1999 117 genre that have traditionally given voice to marginalized populations—women, slaves, religious minorities, African Americans, homosexuals...
...Doctors assure the public that psychotropic drugs don't get a patient high...
...Others may confuse it with Elizabeth Wurtzel's 1994 story of depression, Prozac Nation...
...Jamison, a psychologist who teaches in the Johns Hopkins University psychiatry program, concentrates more on transcendence than on the disease, and makes a point of writing about the many productive writers, artists, and scientists who have done important work despite the disease...
...Not pitch, for the vibrations of the world were just as they'd always been...
...None of the antidepressants then available had any effect on his illness, since he belonged to a medication-resistant minority of the population...
...This is a common reaction that follows, rather counterintuitively, in the wake of early episodes of manic-depressive illness...
...And it can be just as dangerous...
...All the comforts of her old life and identity, defined by chronic mental illness, are gone...
...Slater expresses skepticism about the patients described in the case studies in psychiatrist Peter Kramer's popular book Listening to Prozac, which gave rise to the myth that this drug enhances personality and can be used as cosmetic psychopharmacology...
...He wrote in 1990: Psychiatry must be given due credit for its continuing struggle to treat depression pharmacologically...
...in psychology from Boston University...
...The something can "enlarge" or the something can "diminish...
...At fifteen, right when my life should have been growing, it warbled and shrank to the size of a hard, dark dot...
...No such "blissed-out" state was possible for William Styron, who experienced his episode of severe depressive illness in 1985 after he gave up alcohol...
...Slater's blends personal history with scientific and philosophical speculation about the pros and cons of psychotropic drugs—a refreshing change from the public relations brochures distributed by pharmaceutical companies and well-meaning mental health advocacy organizations...
...Although she understands the double standard that sanctions insulin for a diabetic but questions the use of Prozac for a depressive, she nevertheless has tried repeatedly and failed to go off the drug...
Vol. 46 • July 1999 • No. 3
