Friday, February 6, 2009

In Defense of Prozac

A few days ago someone whose blog I respect and read almost daily Twittered a question: “Does anyone know how long it takes for SSRI’s to kick in?” SSRI, an acronym for Selective Seratonin Reuptake Inhibitors is a group of anti-depressants that includes Prozac.

A few years ago I had an experience that affected me profoundly, and I swore that if I ever had the opportunity to speak up for anti-depressants, I would. In my second summer here at Dancing Rabbit (2000) we had a spectacular group of interns. Ranging in age from 19 to about 26, they were enthusiastic, intelligent, and an inspiration. One of the brightest stars was Minna – with a dazzling smile, a zest for life and an infectious laugh, she was an absolute delight. When the summer ended the group of interns went their various ways; Minna went back to Stanford to complete her degree.

In July of 2001 Kurt and I were leading a hiking trip at the Sierra Club’s Clare Tappan Lodge in northern California. One afternoon we walked into the great room and there on table was the latest edition of the San Francisco Chronicle, with headlines screaming about a search for a missing Stanford coed. The accompanying photo showed an effervescent blond with a gorgeous smile – it was Minna. She was found three weeks later, hanging from a tree in a secluded wooded area. Like many of those who knew her, I felt like I had failed her. If I been more candid and honest about my own struggle with depression would she have been able to hear it? Would she have gotten the help that might have saved her life? I will never know, and carry the guilt and shame of that with me always.

My experience: In 1990 I found myself desperately searching for reasons to live. This sounds incredibly melodramatic; it felt incredibly awful. This feeling was particularly strong when driving. On the freeway (I was living in Berkeley and commuting to San Francisco and Hayward – I spent half of my time on one freeway or another) I would have to concentrate in order to not drive into the concrete abutments holding up the over passes; when taking the exit for highway 24, which rose high above the massive interchange and had a tight left curve, it was all I could do to turn the wheel instead of allowing myself and my white bug convertible to go sailing off the side. I could not think of reasons to get up in the morning, I couldn’t think of anyone who liked me. None of it made sense logically – messages from friends were piling up on my answering machine, I had a full social schedule and a job I enjoyed. It was very frightening, as my nature is naturally sunny and optimistic.

Depression wasn’t talked about much then. It was still discussed in whispers, with a kind of knowing look accompanied by eye-rolling; “too bad about XX’ and “why don’t they just snap out of it.”

About the same time my therapist put me on Prozac I found the book Darkness Visible, A Memoir of Madness by William Styron. The two of them saved my life.
"A meditation on Styron's ( Sophie's Choice ) serious depression at the age of 60, this essay evokes with detachment and dignity the months-long turmoil whose symptoms included the novelist's "dank joylessness," insomnia…and his persistent "fantasies of self-destruction" leading to psychiatric treatment and hospitalization. The book's virtues--considerable--are twofold. First, it is a pitiless and chastened record of a nearly fatal human trial far commoner than assumed--and then a literary discourse on the ways and means of our cultural discontents, observed in the figures of poet Randall Jarrell, activist Abbie Hoffman, writer Albert Camus and others. Written by one whose book-learning proves a match for his misery, the memoir travels fastidiously over perilous ground, receiving intimations of mortality and reckoning delicately with them. Always clarifying his demons, never succumbing to them in his prose, Styron's neat, tight narrative carries the bemusement of the worldly wise suddenly set off-course--and the hard-won wisdom therein. In abridged form, the essay first appeared in Vanity Fair." ~ The Publisher’s Weekly review on Amazon

One of the worst parts of depression, at least for me, is the sheer incomprehensibility of it for others. When I wasn’t actively wanting to die, I simply wanted to go away, to not exist. It was all too much work, and far too painful. Styron’s book helped me feel a bit more normal and less psychotic (although I hated the subtitle, A Memoir of Madness). It gave me reference points, a reality check, and let me know that things really would get better.

Therapy, a lot of work, kindness from friends and loved ones all contributed to my recovery. I have come to understand that life is a series of ups and downs, and I no longer fear the downs – I know that I will come through them just fine. And I continue to take Prozac.

I do not consider Prozac a crutch, a moral weakness or a sign of a lack of character. If my brain needs more seratonin then I am going to take it, much like I would take insulin if I were diabetic, or iron if I were deficient. I do not take Prozac to be “happy.” I take it so that I can be alive and function and so that I can work on what is causing me distress.

Also recommended: Unholy Ghost: Writers on Depression edited by Nell Casey. (Can you tell I'm a reader, and that I learn a lot about my world through the words of others?)

"A reader on melancholy," the editor calls this book: a collection of 22 modern essays about depression by writers (several well known) who know their subject intimately. Some face depression as a sudden interruption of a previously gratifying life; others have never known life without it. Their words wrestle to express their vision, their gloom, their attempts to cope, their interactions, their isolation, and, often, their reactions to medications. Some attempt to analyze their depression; others just want you to know what it's like. Besides the essays by writers who have experienced depression firsthand, editor Nell Casey (also a writer of one of the chapters) includes a few essays by their spouses and siblings about what it was like to live with a person suffering from depression. As a whole, the collection is a valuable contribution to the field of depression studies, and will lend some insight and cheer to those struggling with this little-understood condition." ~Review on Amazon

Friends, if you are depressed, go see a therapist, and inquire about anti-depressants. You are important, you matter, you have a whole life ahead of you in which to contribute, and we don’t want to do it without you. If I can help you in any way, please don’t hesitate to contact me.


sumari said...

Hi Alline,

Thanks for posting this. I've been on both ends of this--I've suffered from periodic depression and know how easy it is to hide that from friends; I also have had a good friend commit suicide and know how hard it is to deal with not having realized just how bad she felt. You are amazing Alline and I thank God(dess) for Prozac and William Styron. I'll have to check out that book.

Nathalie Brault said...

I've been dealing with depression for the past 20 years and so I,ve been dealing with the medications up and down but I need the meds. they try to take me off of it, but the system here in Quebec is shit, we have to wait for everything kind of service so it takes years to get help and when you do you get worse. But I think I'll need them meds all my life, My husband is still with me has been for the past 21 years but I don't know for how much longer my back is always getting worse so he's getting fed up with that, this is gonna be my 3rd back surgery in september, and man I can't take it cause my physical pain is too much for my mental state to get better get it?
sometimes I wish that it would all just end.