³Yeah, I'm on Prozac,² I hear quite often, said as if the speaker had just received a new Porsche. I often do catch myself responding with, ³I'm on Zoloft‹isn't modern medicine great?² In a way, this exchange is a way of bonding. In another, more twisted way, it is a way of receiving a stamp of approval from my peers, for antidepressants have become extremely widespread and widely accepted. ³Prozac...has entered pop culture...becoming the stuff of cartoons and stand-up comedy routines² ‹and, of course, really bad jokes by people who do not take the drug. (Chisholm and Nichols 36).
These days, being prescribed an antidepressant carries less stigma than in the past. ³Prozac has attained the familiarity of Kleenex and the social status of spring water² (Cowley 41). Gone are the days when the label ³loony² is slapped upon a person taking these drugs. Antidepressants have become almost as commonplace as Tylenol. Prozac is being prescribed for much more than clinical depression. Some of the other illnesses that are treatable by Prozac include bulimia, obsessive-compulsive disorder, and dysthymia, which is chronic low-grade depression. In some cases, it is even prescribed for anxiety or low self-esteem (Chisholm and Nichols 38).
Part of the popularity of Prozac stems from declining health care. ³As medical plans cut back on coverage for psychotherapy, says [Dr. Robert] Birnbaum of Boston's Beth Israel, psychiatrists feel pressure simply to Œmedicate and then monitor side effects¹² (Cowley 42). General practitioners, however, write the majority of Prozac prescriptions. Both of these scenarios raise concerns, as some psychiatrists state that it can be dangerous for antidepressants to be used without concurrent psychotherapy sessions (Chisholm and Nichols 38). When I discontinued my therapy sessions after two years, yet still continued to take my antidepressants, I felt as if something was missing from my life. Therapy has been a very important part of my treatment, and I would not have recovered as well if I had not attended regular psychotherapy sessions.
With the common use of Prozac and other antidepressants, another consideration arises: are these drugs becoming a substitute for really coping with problems? Prozac and the related antidepressants, such as Paxil and Zoloft, are known as selective serotonin re-uptake inhibitors (SSRIs). They prevent brain cells from re-absorbing used serotonin, which can elevate the moods and thoughts of people suffering from depression (37). But ³no disease can be blamed solely on a serotonin imbalance² (Watson 86). External factors and genetics often affect depression. As a two-year recipient of Zoloft, I discovered that, during the course of my treatment, my interludes of depression would return at stressful times, despite the medication. Mental illness also runs in my family. On my father¹s side of the family, my great-grandmother suffered from dementia, and on the maternal branch of the family tree, my mother shows signs of dysthymia.
This, of course, does not mean that clinical depression is not caused by a serotonin imbalance. The truth is, researchers are still looking for the causes of emotional illnesses in order to design more specific solutions (86).
In the meantime, many people are receiving Prozac and related medications for trivial personality disorders, and a stigma remains firmly attached to people with genuine mental illness. ³Mental illness is still often thought of as something you or your parents did wrong,² which is another reason why many patients are simply taking the medication instead of also seeing a therapist (Marrou). I will readily admit that I am on Zoloft, but I usually keep my ³shrink² appointments a secret from all but my closest friends.
Of course, the pop culture references only serve to heighten the overall contempt toward younger people on antidepressants, and the glamour of taking them. In the recent Kids in the Hall movie, ³we [were] offered a wacky dystopian vision of a world Prozaced out of its wits² (Ansen). This refers to the wide usage of antidepressants to treat trivial disorders. ³Happy pills for every occasion² ‹doctors are still looking for the perfect way to treat minor personality disorders (Chisholm and Nichols 40). It seems that taking Prozac is ³cool,² especially among young people, who can prove that they, too, are angst-ridden and rich enough to take these seemingly designer drugs.
Yet, where would Sylvia Plath be if she had taken an antidepressant? True, she would be alive, but her work would not have been so introspective or moving. She would also have been easily forgettable. Prozac is said to reduce insight and emotions (Cowley 42). As a recipient of Zoloft, I can attest to that statement. My moods have been dulled. I once possessed a great deal of emotions, and now only feel two: ³bummed out² (slightly depressed and highly irritable) and hyperactive. I have also noticed that my poetry is not as moving as it was when I was medication-free.
Lately, I have thought of discontinuing my medication. The social stigma does irritate me; after the first five Prozac jokes, I stopped laughing. That is not my reason for desiring an end to the medication, however. I want to quit because I do not feel like, well, me. I do not cry or laugh normally; it all seems as if I am watching someone else cry or laugh for me.
Technically, I am not even clinically depressed. I have been diagnosed with dysthymia, a mild yet chronic form of depression, which I know was caused by extreme stress several years ago. I continue to experience a great deal of stress in my life, but I would like to learn how to cope with it instead of merely popping a little yellow pill. What happens if I lose my health insurance? I would not be able to afford medication, and would have to learn anyway. As it is, my most recent therapist decided that I no longer need psychotherapy, so why am I still taking this medication? It has become a crutch for me. I agree with Kurt Cobain when he sings, ³I¹m so happy/ Œcause today I¹ve found my friends/ in my head.² My own emotions are always better than drug-induced feelings.
Even the lyrics by Cobain prove just how mainstream antidepressants have become, even though Cobain sings about Lithium, which is used to treat manic-depressive patients. An entire computer bulletin board is devoted to Prozac alone, and endless resources exist on the World Wide Web (Cowley 41). As we joke about Prozac and recommend it to our friends, though, it is becoming too widespread to be ignored.
In ten years, we might all be taking some form of medication to stabilize our moods and ³fine-tune the behavior of a given person. We may be able to almost modulate personality² (Chisholm and Nichols 40). There is something truly creepy about an entire nation walking around with what my friend Joy calls ³perma-smiles,² the alleged happiness found in antidepressants. Is it even ethical to create a society where nobody feels their own emotions? ³The ultimate question, assuming that the new antidepressants can safely banish unpleasant feelings, is whether we really want to be rid of them² (Cowley 42). And do we all want to be happy all the time? If you cease to feel pain, then your happiness seems dulled.
More alarming is the amount of people I know that have been on some antidepressant or another by the age of eighteen. It seems that normal teenage mood swings are being diagnosed as depression, and medication is readily prescribed. While some experts say that ³treatable psychiatric problems are far more common than most people realize,² why has medication become so popular as a treatment? (42). Another friend of mine likes to cling to the ³conspiracy² theory: the medication is being used to lull us into complacency. I sometimes wonder about this myself. Annually, Prozac¹s worldwide sales reach nearly $1.2 billion (41). Millions of people take some form of an antidepressant (Marrou). It is sick, in a way.
Still, doctors and patients alike have nothing but praise for these drugs that make treating a debilitating illness so much easier (Chisholm and Nichols 36). The side effects are fewer than the older antidepressants, and they do not last that long. I experienced only three days of nausea, gastrointestinal problems, and a dry mouth when I first started taking Zoloft. Now I experience no side effects. The absence of these side effects seems to contribute to the popularity of the drugs. After all, who would want to take a pill that makes them sick, especially if the person is only experiencing anxiety or slight depression?
This all contributes to the entire culture behind Prozac and other antidepressants. The culture that I have observed extends from successful students to clove-smoking, sour-faced poets sitting in offbeat coffeehouses. Antidepressants have become drugs for everyone, the ³feel-good² drugs of the nineties, it seems.
Yet the liberal usage of Prozac raises another, more important concern. Prozac may have many unforeseen consequences, and is being compared to Valium, which was on the market for ten years before doctors discovered just how addictive it was in the mid-1970s. Some say that Prozac has become the Valium of the nineties (38). Since its release in 1988 by Eli Lilly and Co. of Indianapolis, it has been prescribed to numerous patients. But what side effects and dangers will we discover in the future? Ostensibly, individuals taking Prozac are guinea pigs.
The glamour of antidepressants fades when factors such as possible side or after-effects, dulled emotions, and the necessity of therapy is taken into consideration. However, the use of Prozac will continue just as strongly as ever. Doctors will continue to medicate patients for as long as health plans cut back psychotherapy benefits. The pop culture references will remain firmly in place as more people begin to take Prozac, including the unfunny jokes. And where will we be in ten years? Hopefully, we will not be diagnosed with cancer or some other antidepressant-induced illness. For some reason, I doubt we will be joking about that as liberally as we do our antidepressants.
Ansen, David. ³Kids in the Hall Send Up Our Prozac Culture.² Newsweek: America Online (keyword: newsweek) 22 April 1996.
Chisholm, Patricia and Nichols, Mark. ³Questioning Prozac.² Maclean¹s 23 May 1994: 36-40.
Cobain, Kurt. ³Lithium.² Nevermind. Nirvana. Virgin Songs, Inc. and The David Geffen Company, Track 5, 1991.
Cowley, Geoffrey. ³The Culture of Prozac.² Newsweek: America Online (keyword: newsweek) 7 February 1994: 41-42.
Marrou, Chris. ³I hope that one day mental illness will be as openly accepted as any physical disability.² Newsweek Online 24 June 1996.
Watson, Traci. ³Ode to a mellifluous brain molecule.² U.S. News & World Report 25 November 1996: 86.
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