Elizabeth Wurtzel, both the author and protagonist in the autobiographical novel, “Prozac Nation” suffers from a case of major depression and possibly bipolar II disorder. Wurtzel’s novel describes years of depression as well as self-destructive activities while “up,” including risky sex and drug use. These impulsive behaviors are consistent with hypomania (DSM-IV Criteria for Hypomanic Episode).
Wurtzel’s symptoms are almost textbook-classic and reflect the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) criteria for depression. She expresses her debilitating depression and hopelessness in poetic language for example: “But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. The fog is like a cage without a key.” This description incorporates symptoms of major depression, including feelings of worthlessness, diminished pleasure, and loss of energy (DSM-IV Criteria for Major Depressive Episode).
But in between these heavy spells of depression, the risk-taking behavior with sex and drugs suggests that Wurtzel could be diagnosed with bipolar II disorder (DSM-IV Criteria Bipolar II Disorder) rather than her formal diagnosis of atypical depression. She provides evidence for a diagnosis of bipolar disorder during the “Drinking in Dallas” chapter in which she notes that she writes much more than usual. This could be a combination of creativity and a hypomanic mood swing.
At times, Wurtzel can be rather tiresome, and it is likely a result of her illness’ natural self-pitying behavior coupled with a sense of almost invincibility. I wondered if her character is completely authentic and if her story has been enhanced by an unknown book editor in order to sell more prescriptions of Prozac to other white women of privilege. However, there are many moments where she seems authentic and aware of her condition, for example, when she compared depression to cancer. Both diseases can be treated with modern medical science, and both typically do not suddenly show up one day. They both grow within the body, and then they manifest symptoms that are diagnosable.
Wurtzel explained in her poetic voice that depression has nothing to do with life at all, which seems true to me. Depression, like cancer or any other illness, works to destroy and even kill. As the afflicted suffers, so do the people around him or her. Relationships are strained and even broken, and not every patient makes it out alive. The victory of “Prozac Nation” is that Wurtzel does make it out alive. The fact that she survives makes the self-pitying behavior in the book forgivable and renders the work of great value to the general public.
“Prozac Nation” also offers validation that depression is a serious, but treatable mental illness that renders some of its sufferers like the walking dead. People such as Wurtzel can just exist when in their depressive shell, rather than really living. No matter how successful she was, no matter how popular she was, and no matter how loved she was, Wurtzel did not just have a bad case of the “blues” that could be easily shaken off without treatment. This book could serve as an educational piece to those misguided few who still believe depression and other mental illnesses are entirely an issue of not having enough in life and something that can easily be “forgotten” without proper medical intervention.
Prozac is still controversial even 15 years after the book’s initial publication, and Wurtzel took a long time to actually get into psychiatric drugs as a form of treatment. While the debate over whether Prozac makes people “better off” or “better” may continue on, Wurtzel’s life shows that at least some segment of the population benefits from the fairly safe psychiatric drug. This can be a valid argument against scientologists and other naysayers who try to condemn such pharmaceutical products. Prozac may well have saved Wurtzel’s life, and at the very least, it saved her and her loved ones unneeded heartache. Fortunately, Prozac itself is affordable and available to even the poorest of populations – yet getting the actual prescription itself can still be a difficult and expensive process to those who are not fortunate enough to have the financial resources, and access to treatment.
No matter what Wurtzel’s actual condition is or whether or not she continues to take Prozac to treat it, “Prozac Nation” offers as in-depth look at modern mental illness. She goes beyond such as Sylvia Plath’s “The Bell Jar” or Susanna Kaysen’s “Girl, Interrupted,” which have some sense of being dated because they talk of mid-20th century mental asylums and electroshock therapy. The experiences of any mental illness remain the same, but the treatments and awareness do change over time. Wurtzel is like the protagonist of these similar autobiographical novels: privileged, intelligent, Caucasian, and female. Yet, her stark honesty is more common today than when other major works about depression were written and it rings ageless (even if some of it could be for the benefit of public attention as some critics have claimed). There is no doubt that Wurtzel has profited from publicizing her illness, yet it seems likely that she would have rather not gone through any of her mental problems at all than to get a serious case of depression just to make money.
Books such as “Prozac Nation” show mental illness as truly devastating, non-discriminating, and fully treatable with patience and the right medication and therapy. Unfortunately, “Prozac Nation” and books like it seem to bring the most hope for a reprieve to white females of privilege and intelligence, and one is left to wonder how much this may or may not change in the future of mental health care. At the very least, the drug Prozac has become more of a household word with books such as “Prozac Nation,” and that in itself may help.
DSM-IV Criteria Bipolar II Disorder. (2008). Retrieved March 26, 2009, from Biological Unhappiness: http://www.biologicalunhappiness.com/Bipolar2.htm
DSM-IV Criteria for Hypomanic Episode. (2008). Retrieved March 26, 2009, from Biological Unhappiness: http://www.biologicalunhappiness.com/Hypomani.htm
DSM-IV Criteria for Major Depressive Episode. (2008). Retrieved March 26, 2009, from Biological Unhappiness: http://www.biologicalunhappiness.com/dsmdpres.htm