Prozac Nation (3 page)

There was no way I could have explained my chronic moroseness to the head counselor, no way I could tell her how I had already alienated most of my bunkmates—who were themselves into Donna Summer and Sister Sledge and arguing over who got to be John Travolta and who got to be Olivia Newton-John in their lip-sync renditions of
Grease—
by playing the Velvet Underground on my crappy little tape recorder late into the night. How could they possibly understand why it made no sense to me to listen to disco music and dance around the cabin when I could lie on the concrete floor with just the single bulb of bathroom light while Lou Reed's voice would lure me into a life of nihilism?

There was no way the head counselor or anyone else would ever understand that I didn't like being this way. How jealous I was of all the other girls who were boy crazy and loud and fun. How much I wanted to flip my hair and flirt and be rowdy but somehow just
couldn't
—didn't dare—even try anymore. How awful it would be for me when it was time to celebrate my birthday in a couple of weeks with a frosted cake at dinnertime. How horrible it would be when everyone sang and I blew out the candles, all the while everyone knowing that this was an elaborate act of pity or propriety, that it had nothing to do with anyone really being my friend. There was no way I could ever get them or the head counselor or anyone here who didn't know me from before to believe that it wasn't always like this, that I had convinced all the girls in my first-grade class that I was their boss (it was a simple swindle a basic Ponzi scheme if they didn't agree to accept me as their boss none of the people I'd already taken in would be allowed to be their friends) that the teacher had to meet with the class as a group to explain that we were all free that there was no such thing as a boss and still my friends would not renounce me as their leader. How could I ever get her to see that I'd been the class bully, I'd been popular, I'd been in Pampers commercials at six months had done Hi-C and Starburst ads later, had written a series of pet care books at age six, had adapted “Murders in the Rue Morgue” into a play at age seven, had turned construction paper and Magic Markers and tempera paint into an illustrated chapbook called
Penny the Penguin
at age eight, that no one in her right mind would ever have believed I'd come to this: eleven and almost gone.

My mother had attributed the changes in me to menarche, as if menstrual blood made everyone crazy, as if this were just a phase and I could still go to summer camp like I was okay after all. If my mom couldn't see what was happening, there was no way I could confide in this antediluvian head counselor, who seemed to have reached the safe verdict that I had mistakenly taken more pills than I should have, that perhaps the incessant rain was giving me such bad hay fever I'd gone a little overboard. “You realize you're supposed to give any prescription drugs to the nurse,” she said as if it mattered anymore. “You were supposed to do that at the beginning of the summer. She would have been able to administer these correctly.”

I should have said,
Do I look like I give a shit about having my pills ad-fucking-ministered correctly? Do I?

My little chat with the head counselor never really amounted to much. I saw her speak in hushed tones to my immediate counselors about why I was sleeping so much, and the next day one of the more senior medical people came to see me, but life went on as usual.

My parents never came charging up to the Pocono Mountains to bring me back home. In fact, the way the head counselor looked at the Atarax bottle, you'd have thought that the pills were a danger to me and not, as was the case, that I was dangerous to myself. Once I got back home, my mother never mentioned the Atarax incident to me. My father, in one of our Saturday afternoon visits, which were dwindling to no more than one or two a month, did manage to express some concern. But I think everyone thought it was just a mistake, a little kid plays with matches and gets burned, a preteen has slightly more complex tools to mess with, takes too many pills, dozes (doses?) off for a little too long. It happens.

 

Monday morning, two days after the party, I am back at the Fifth Avenue Crack House, a.k.a. Dr. Ira's office. It's actually about three in the afternoon, but that's early for me.

Dr. Ira is berating me for going off lithium without discussing it with him first. I explain that I panicked, the Graves' disease and all. He explains that the blood tests I get every couple of months monitor me so closely that we would know if there were a problem long before it got out of hand, that we could take necessary steps in advance of such an emergency. He's making sense. I can't and don't argue. Besides, he tells me that the results on a second set of blood levels came out perfectly normal. He thinks the mistake was all about a misplaced decimal point, a computer error that turned 1.4 into 14. Right now, the TSH level is a perfectly average 1.38.

Of course, I don't know what any of these numbers mean, don't really want to ask. But I can't pull myself away from a nagging suspicion that it just can't be this simple. What I mean is this: Prozac has rather minimal side effects, the lithium has a few more, but basically the pair keep me functioning as a sane human being, at least most of the time. And I can't help feeling that anything that works so effectively, that's so transformative, has got to be hurting me at another end, maybe sometime further down the road.

I can just hear the words
inoperable brain cancer
being whispered to me by some physician twenty years from now.

I mean, the law of conservation says that no matter or energy is ever destroyed, it's only converted into something else, and I still can't say exactly how my depression has metamorphosed. My guess is it's still hanging out in my head, doing deadly things to my gray matter, or worse, that it's just waiting for the clock on this Prozac stuff to run out so that it can attack again, send me back into a state of catatonia, just like those characters in the movie
Awakenings
who fall back into their pre-L-dopa stupor after just a few months.

Every time I come in for an appointment, I run my misgivings by Dr. Ira. I say something like: Come on, level with me, anything that works this well has got to have some unknown downside.

Or, taking another tack: Look, let's face it, I was one of the first people to be put on Prozac after the FDA approved it. Who's to say that I won't be the test case that proves it causes, well, um, say—
inoperable brain cancer?

He says a bunch of reassuring things, explains over and over again how carefully he is monitoring me—all the while admitting that psychopharmacology is more art than science, that he and his colleagues are all basically shooting in the dark. And he acts as if a million doctors didn't say the same things to women about DES, about the IUD, about silicone breast implants, as if they didn't once claim that Valium was a nonaddictive tranquilizer and that Halcion was a miracle sleeping pill. As if class-action suits against pharmaceutical companies were not fairly routine by now.

Just the same, I am leaving for Miami Beach the next day, am sufficiently sick of being miserable that I take two little green and white Prozac capsules when I leave his office, and dutifully resume taking a twice-daily dose of lithium, also downing twenty milligrams of Inderal each day—a beta-blocker normally used to lower blood pressure—because I need it to counteract the hand shaking and the other tremorous side effects of lithium. Taking drugs breeds taking more drugs.

And I can't believe, looking at myself in the mirror, seeing what to all eyes must appear to be a young and healthy twenty-five-year-old with flushed skin and visible biceps—I can't believe anyone in his right mind would deny that these are just too damn many pills.

1

And suddenly, as he noted the fine shades of manner by which she harmonized herself with her surroundings, it flashed on him that, to need such adroit handling, the situation must indeed be desperate.

 

EDITH WHARTON

The House of Mirth

 

Some catastrophic situations invite clarity, explode in split moments: You smash your hand through a windowpane and then there is blood and shattered glass stained with red all over the place; you fall out a window and break some bones and scrape some skin. Stitches and casts and bandages and antiseptic solve and salve the wounds. But depression is not a sudden disaster. It is more like a cancer: At first its tumorous mass is not even noticeable to the careful eye, and then one day—wham!—there is a huge, deadly seven-pound lump lodged in your brain or your stomach or your shoulder blade, and this thing that your own body has produced is actually trying to kill you. Depression is a lot like that: Slowly, over the years, the data will accumulate in your heart and mind, a computer program for total negativity will build into your system, making life feel more and more unbearable. But you won't even notice it coming on, thinking that it is somehow normal, something about getting older, about turning eight or turning twelve or turning fifteen, and then one day you realize that your entire life is just awful, not worth living, a horror and a black blot on the white terrain of human existence. One morning you wake up afraid you are going to live.

In my case, I was not frightened in the least bit at the thought that I might live because I was certain, quite certain, that I was already dead. The actual dying part, the withering away of my physical body, was a mere formality. My spirit, my emotional being, whatever you want to call all that inner turmoil that has nothing to do with physical existence, were long gone, dead and gone, and only a mass of the most fucking god-awful excruciating pain like a pair of boiling hot tongs clamped tight around my spine and pressing on all my nerves was left in its wake.

That's the thing I want to make clear about depression: It's got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is in an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature's part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.

And the scariest part is that if you ask anyone in the throes of depression how he got there, to pin down the turning point, he'll never know. There is a classic moment in
The Sun Also Rises
when someone asks Mike Campbell how he went bankrupt, and all he can say in response is, “Gradually and then suddenly.” When someone asks how I lost my mind, that is all I can say too.

 

It seems to me that I was about eleven when it happened. Maybe I was ten or maybe I was twelve, but it was somewhere in my preadolescence. In other words, since puberty hadn't kicked in yet, no one was expecting it.

I remember the exact date, December 5, 1978, when I was eleven, and noticed some dry brown spots that were obviously blood on my little white cotton briefs. I met my mother at Bloomingdale's that night—Bloomingdale's to look, Alexander's to buy was our rule—in search of a winter coat, and I told her about the stains in my panties, told her I thought maybe I had my period (I knew about menstruation from reading
Lifecycle
books with Lisanne in elementary school, which at the time I was still in), and all she could say was, Oh no. Maybe afterward she said something like, God help me, the trouble has just begun. But whatever she said gave me the strong and distinct impression that suddenly I was going to become difficult and morose, which already seemed to be happening.

When I try to understand where I made a bad turn, how I stupidly meandered down the wrong road in the fork of life, I can't shake the sense that being born smack in the middle of the Summer of Love (July 31, 1967), with the confluence of social revolutions from no-fault divorce to feminism to free love to Vietnam—and their eventual displacement by punk rock and Reaganomics—all had something to do with it. I hate to think that personal development, with its template of idiosyncrasies, can be reduced to explanations as simple as “it was the times,” but the sixties counterculture—along with its alter ego, eighties greed—has imprinted itself all over me.

Even so, I wasn't raised by some wasted, crazed hippie parents who smoked pot in Central Park while carrying me in a tie-dyed Snugli, took me to Woodstock at age two, and by virtue of their reckless postadolescent irresponsibility, managed to screw me up but good. Nothing could be further from the truth. My mom was a die-hard Republican who voted for Nixon three times, who wanted them to escalate the Vietnam War effort, and who went to see William F. Buckley speak while she was an undergraduate at Cornell in the early sixties. As she tells it, so few students at the liberal college she attended showed up at the lecture that she threw her coat across several seats to make it look as if more were coming. (My mom, by the way, is the only person I know at this point who thinks Oliver North is a hero.) My dad was apolitical, had absolutely no professional aspirations, and worked as a low-level employee at a large corporation. He had short hair and wore Buddy Holly nerd glasses, read Isaac Asimov, and listened to Tony Bennett. The closest thing we ever had to a political discussion was sometime when I was about eight and he told me it was crappy of President Ford to pardon Nixon because lying was really bad. Basically, my parents had no unconventional tendencies, though they occasionally bought bad Mary Travers albums.

My parents, like the progenitors of most people my age, were not those freewheeling, footloose and fancy-free baby boomers who made the sixties happen. They were just an itty bit too old for that, born in 1939 and 1940 instead of 1944 and 1945 (in an accelerated culture, five years makes a world of difference). For the most part, the parents of my contemporaries were done with college and had moved onto the workaday world by the early sixties, several years before the campus uprisings, the antiwar activities, and the emerging sex-drugs-rock-and-roll culture had become a pervasive force.