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Book Commentary: Prozac Nation

Riki's picture

Depression has been on the rise in the United States, with as many as 10% of people suffering at any given time. One in ten people will suffer a depressive episode at least once in their lifetime. It is becoming increasingly common in adolescents, and physicians are more eager than ever to prescribe antidepressants to anyone who shows even mild signs of depression. Prozac Nation chronicles a decade’s worth of suffering of Elizabeth Wurtzel, a young woman in the throes of an atypical depression.

Wurtzel’s depression began when she was a pre-teen. No doubt genetics played some role, but it is quite clear that her environment played a huge role. Her parents were divorced and constantly fighting, which is not uncommon these days, but their dysfunction left her with the responsibility of trying to put her family back together again. She went back and forth, telling each what they wanted to hear, just to try to feel some modicum of love. Eventually, her father just disappeared, leaving no hint of his motives or whereabouts. He had never been much support to her anyway; she felt like a stranger in his house, and he only seemed to take interest in her when it was clear that she had psychological issues. Her mother was emotionally unstable, almost relying on her daughter to take care of her instead of playing the role of the mother herself. She didn’t understand what was happening to her daughter and couldn’t see the warning signs of a serious disorder. It is sad and unfortunate that many parents who are divorced are too selfish and concerned with hurting the other parent that they fail to recognize the effects their actions and words have on their children. Often, one parent will try to turn the child against the other, involving the child in something they shouldn’t be in the middle of. Another serious issue is that parents don’t know the symptoms of depression and may just chalk it up to being an adolescent when in fact their child may be seriously depressed. This misunderstanding can lead to further depression if the parents aren’t supportive or involved in their child’s emotional well-being.

Of course Wurtzel’s depression only worsened with time and lack of compassion from anyone. She was seeing a therapist, but only saw his visits as a temporary solution to an unsolvable problem. It doesn’t seem as though his treatment was up to par anyway, as she would express interest in dying and he didn’t do anything about it. At camp, she talked extensively of suicide, even detailing how she would do it, and still, no one cared enough to get her serious help. This seems to be a common theme throughout the book. Wurtzel expresses genuine interest in killing herself but receives no response. I see desperation in her speech and thoughts, as if she’s begging, pleading to be saved. No one would make it so explicit her wish to die for so long without actually following through if she didn’t secretly want to live. It’s amazing that even in times of utter despair, when there is seemingly no hope, Wurtzel still manages to keep herself alive. Understandably, when one is as depressed as she was, one simply does not have the energy to commit the act; however, I think there was also a small part of her that was willing to give life a chance, and however small, however seemingly trivial that reason was, it was always enough. This is something I find very interesting – the small reasons people find for staying alive. It’s astounding how one small act, say returning a dropped twenty dollar bill to someone, can renew their faith in humanity and tip the scales toward living.

Wurtzel endured a series of relationships and ensuing break ups, leaving her completely devastated. At this point she was a full-time student at Harvard University, succeeding in her classes and winning awards for her writing. However, these academic accomplishments couldn’t fill the growing “black hole” inside her, so she tried to fill it with drugs. She was admitted to the hospital several times, but still doctors failed to recognize her series of self-destructive acts as a sign of mental illness. She was constantly escaping to various locations, hoping to break away from her inner demons, but never finding relief. She lost a baby she never knew she was carrying and lost more of herself in failed relationships.

Finally she found a doctor who actually cared about her and was persistent in her treatment. Her doctor took her seriously enough to admit her to full-time care. She prescribed her medications to help her feel better and to help her sleep. She talked to Wurtzel on the phone at all hours of the night and even when she herself was on vacation with her family. Eventually Wurtzel was put on fluoxetine, or Prozac, which actually seemed to make her feel better. Unfortunately, this was the jolt of energy she needed to carry out her suicidal ideations. She made a half-assed attempt at killing herself, so she was able to be saved without even getting her stomach pumped. From what I understand, her suicide attempt was what she needed to gain some perspective on her life. She needed to know what it felt like to be there, on the verge of death, to understand that what she really wanted was not to die, but to live. She continued with her pharmacological and talk therapy and managed to recover from her serious depression.

In the afterword, Wurtzel points out that the United States might be over-medicated on anti-depressants. If anything, I think this is an indicator that yes, there might be a problem with our culture, but also that depression is a common mood disorder that should be taken seriously. Her memoir tells how painful the experience is, and I think if more people read her story, they might understand some of the suffering depressives must endure.

Wurtzel eloquently and accurately describes what it feels like to be at the lowest of lows. I think it’s very important for there to be stories out there like hers. People need to know that they are not alone, that their feelings are legitimate, that they are allowed to suffer. More importantly, though, people should read this to know that there is hope. While Wurtzel’s story seems like a somewhat extreme case of drug abuse and self-destruction, there are people who think the same things and feel the same feelings, and who need to know that there is help available, that if this one girl can make it out alive, so can they.


Paul Grobstein's picture

Prozac Nation: finding hope individually and collectively?

I too am very much intrigued by the "small part of her that was willing to give life a chance," by the importance of actions that give "some perspective on ... life," by how small acts "can renew ... faith in humanity and tip the scales toward living," and by how hard it can sometimes be to find in our culture enough of those small acts. Maybe this is not only a story of hope through an individual life, but also one with implications for thinking about what kinds of research might make hopefulness a bigger part of everyone's life?
bpyenson's picture


What is the redemption from the deepest throes of depression? Is it bliss? Epiphany? Catharsis? Pain?  Is it truly happiness, or only moments of self-gratification?

Perhaps research concerning depression should seek out the small moments, in whatever form they take, heeding the advice of William Blake, who in Milton, Book the Second says :

"There is a Moment in each Day that Satan cannot find/ Nor can his Watch Fiends find it, but the Industrious find/ This Moment and it multiply. and when it once is found/ It renovates every Moment of the Day if rightly placed."

Paul Grobstein's picture

Humean depression

Perhaps "industry" is a good prescription in some cases, less so in others ...

"my coldness proceeded from a laziness of temper, which must be overcome by redoubling my application" ... David Hume

Hume's account suggests it didn't work for him.