Saturday, October 15, 2005

Notes from the Prozac Nation, Vol. 1, No. 7

  • Effexor Rox!: One of my all time favorite bloggers, Bitch Ph.D., offered up the following good news Effexor update. She also mentions Andrew Solomon’s book, The Noonday Demon: An Atlas of Depression. I agree with Dr. B that this book is exceptionally well written and chock full of thoughtful and subtle analyses of the relationship between depression, poverty, culture and trauma. I first read Solomon’s work in the New Yorker, where he published a shorter piece called the “Anatomy of Melancholy,” meant to allude to Robert Burton's 17th Century tome, Anatomy of Melancholy. Solomon’s essay became one of the pieces of inspiration for my dissertation on melancholia and gender. While I love Solomon’s work and writing, I continue to be bemused by the grandiosity of the titles of memoirs that men write about depression versus the women's titles. Men also tend to make part of their memoirs into Natural history, perhaps following in the tradition of Burton or Marsilio Ficino. Solomon calls his book An Atlas on Depression; biologist Lewis Wolpert calls his book Malignant Sadness: The Anatomy of Depression; and, therapist Jeffrey Smith titles his memoir Where the Roots Reach for Water: A Personal and Natural History of Melancholia. The famous female memoirs however have more prosaic, or shall we say, Prozac titles: Lauren Slater’s Prozac Diary, or Elizabeth Wurtzel’s Prozac Nation: Young and Depressed in America. The title differences mark more than superficial differences. If you pay close attention to the differences in content and authorial voice of the memoirs, the gender differences are striking. The men situate themselves in the pantheon of great men befallen by the noonday demon. The women write more about banal, domestic details, believing themselves to be irritating and draining to their loved ones.

  • Cosmetic Psychopharmacology: I have been attending a board meeting for an academic organization this weekend. The board is comprised of both philosophers and psychiatrists. One of my favorite parts of this fall meeting is the day dedicated to sharing our research with each other. I discussed my interest in the "cosmetic psychopharmacology" debate, which considers the ethical permissibility of prescribing SSRIs, such as Prozac, as enhancement drugs. My basic position on the debate is that the two sides: the psychopharmacological hedonists and the psychopharmacological calvinists talk about this enhancement/treatment question in far too abstract terms. They overlook the fact that the majority of SSRI scripts are written for women. Moreover, the majority of TV commercials are aimed at the stressed out, overworked professional mom. I was enthusiastic about how much discussion my research project generated. I was also fascinated by the response of the psychiatrists, all of whom I greatly respect. Three of them stated that they absolutely did not see any prescribing of SSRIs as enhancement. I was pressed to consider switching the focus of my argument to Ritalin or Provigil, a drug which, apparently many psychiatrists take. I am not yet persuaded to drop my interest in cosmetic psychopharmacology and ensuing ethical questions. I do think that many women seek out SSRIs as an often rational solution to coping with ridiculous demands on their time. I also think the criteria for depression are more likely to pick out pathological femininity rather than depression. Big Pharma capitalizes a lot on this latter feature of depression diagnoses, hence why I think the commercials are aimed at women. And, of course, another unfortunate result of the gendered nature of depression criteria is that men are underdiagnosed. For more on my position, read this, this, this, this, this, and this. (That should keep you busy for awhile!)