A Female Melancholic Philosopher Takes Prozac
When I was in my mid-twenties, I discovered I was what Prozac frontman Peter Kramer called a “good responder.” I had just the right temperamental mix to get the “feminist” boost much extolled by Kramer from the then-newly released miracle drug. I was the 1990s face of female troubles—a woman in the male-dominated environment of academia working twice as hard to earn the respect of the least talented male philosophers around me.
The 1970s feminist movement successfully opened the door for me to pursue a Ph.D. in philosophy. And while the ceiling circumscribing women’s upward mobility hadn’t shattered, a hatch had been opened just wide enough to allow some women into an otherwise exclusive men’s club. While I was in, I was never free from challenges to my right to be there: “they just let you in because you are a woman.” Trying to identify the acceptable way to present myself to the male philosophical world was full of traps and pitfalls.
In his 1993 Listening to Prozac, Kramer, an astute observer of the stress and strain on women battling to earn respect as they entered professions organized around masculine ideals in greater numbers, made the case directly to these women to try a newly synthesized antidepressant molecule to help. Prozac was an updated feminist version of soccer-mom’s little helper.
His message essentially boiled down to this: wouldn’t it be so much easier to thrive in a masculine workplace environment if we could give you a quick and simple cosmetic psychopharmacology makeover, i.e., personality enhancement, one capsule in the morning engendered the perfect mix of utter insensitivity to others in the morning, a boost of energy to get the kids to soccer practice in the afternoon, and a bit of bubbly feminine coyness for the bedroom.
A Prozac feminist would enjoy a re-tuning of her sensitivity receptors so that she would be dimly, if at all, aware of the hostilities to her presence. A Prozac feminist would experience, almost instantly, her personality re-sculpted into the more socially rewarded traits of resilience, assertiveness, competitiveness, and confidence. The molecule gave good responders, like me, a leg up in an environment designed to make women feel out of place.
This was Kramer’s vision of feminism—a drug that inured women to widespread, systematic efforts to sabotage her rather than question the status quo of the workplace. The obvious shortcoming of his vision: Prozac would not restructure those environments to make them more supportive and hospitable to persons who didn’t typify the aggressive, macho, unencumbered male.
I remember vividly the first day I felt my Selective Serotonin Reuptake Inhibitor (SSRI) was working. I passed one of my many male tormenters on campus, casually waved, my gait steady, my forehead placid, and registered no spiraling of my sympathetic nervous system. His usual instinct to pounce as he detected my fear, insecurity, and defensiveness was, when I later reflected upon this encounter, simply not stimulated. Instead, he asked me to join the other graduate students at the pub. My first real invitation that didn’t feel predatory!
A week after this surprising encounter, I was pretty sure I wouldn’t drop out of graduate school, which was the reason that landed me in the health center in the first place. Mind you; I hadn’t scheduled an appointment because I thought I had depression; I wanted to deal with a chronic cold that made it hard to get my work done, sleep, and stick to my running schedule. My nurse suggested my problem wasn’t a cold but rather a low-level chronic depression upon seeing me reduced to a puddle of tears after she asked: “so, what brings you in today?”
Before that moment, I had never once considered I suffered from depression. Sure, I was extremely stressed out, overworked, and a bit paranoid about how to prove myself. I didn’t know anyone who would admit out loud that my low mood and self-doubts might be as serious as depression. I didn’t know anyone who took medication for depression that wasn’t locked up in a ward.
Almost overnight, my experience with this nurse became commonplace as the entire landscape of ‘depression’ as a kind of experience or thing in the world got radically reduced to a simple matter of diseased neuroanatomy easily resolved with the right pill. Not only did depression become a mere disease, but this kind of radical reductionism of a long-standing, mysterious cultural experience was not lost on me as a philosophy graduate student.
Depression, or melancholy, was often heralded as the philosopher’s disease in texts stretching from Aristotle’s Problemata, Marsilio Ficino’s The Book of Life, Robert Burton’s The Anatomy of Melancholy, John Stuart Mill’s Autobiography, to Jean-Paul Sartre’s Nausea. Depression, in this (masculine) tradition, was the unfortunate side-effect of dedicating one’s life to the pursuit of truth.
Depression, in this tradition, may warrant medical treatments, but its ultimate value lay in the moral insight gained by the sufferer in his pursuit of truth. An unvarnished look at reality may be a path to a kind of madness, for it looked squarely at the evil humans can do to each other. Before psychiatry, in other words, the experience of depression was something like a spiritual insight, burdening its sufferer to either make peace with the world as it is (stoicism) or, in cases such as John Stuart Mill, meliorate the conditions of the world that harm.
Hence, receiving a diagnosis that I was depressed, as a female graduate student, was jarring from two different sources. First, who was I to enter the hallowed halls of melancholic philosophers? But, more disturbing, if I was depressed, why was a tiny capsule capable of so dramatically changing my relationship with the cruelties of reality such that I was fairly indifferent to them now? In his 2005 book, Against Depression, Kramer suggested we see antidepressants as a kind of inoculation against caring too much. Was that really the significance of depression—a maladaptive brain that tends to care for others? Was this what it meant to listen to Prozac?
Nothing But Neurochemical Selves
My brush with Kramer’s Prozac feminism occurred during the beginning of the “decade of the brain.” A new era in psychiatry, an opportunity for psychiatrists to save their tattered reputations from Freudian hogwash or, what Professor of Psychology and Neuroscience Eliot Valenstein called “great and desperate cures” (insulin comas, lobotomies, primitive electro-shock therapy), was manically (and with some real merit) being seized upon.
However, to those of us trained to think through the logical consequences of treating ‘depression’ as a neurochemical imbalance rather than the essential existential situation of many human beings, a set of important questions about the nature of consciousness, free will, and a life worth living needed to be addressed.
The Prozac era presented us with a 21st-century brand of the “simple-minded system” of “medical materialism” William James set out to discredit in his 1901 fin-de-siècle, Varieties of Religious Experience. James was trained in physiology, a founder of empirical psychology, and a proponent of the experimental scientific method. From this point of view, he took the podium to deliver a series of lectures at the University of Edinburgh dedicated to exploring “religious feelings” and “religious impulses”—well aware of the suspicions some audience members harbored toward his empirical approach to the subject matter.
To allay his audiences’ concerns and thereby try to win them over to his approach, James carefully distinguishes between ‘existential judgments’ and ‘religious judgments.’ The former sorts out the origin, nature, course, or history of phenomena, i.e., what is the molecular structure of sugar? The latter makes claims about the value, the meaning, the significance of phenomena, i.e., is the ebullient and effortless joy one feels knowing they are connected to a benevolent God the point of life, or is the hard-nosed, white-knuckled stoicism that accepts evil the point of life?
James wanted his audience to be very clear that these were not only very different orders of judgments but also that it is illogical to derive the value of an experience from its material nature. (Even if depression has a neurochemical nature, it is nonetheless still a manifestation of an existential crisis in the face of certain truths about the world). Moreover, even if one could give a physiological account of the origin of religious experience—melancholy or depression being variations thereof—such a materialist account in no way discredited the value of those experiences “as revelations of the living truth.”
Those who made that mistake were guilty of the nothing but mistake: “we are surely all familiar in a general way with this method of discrediting states of mind for which we have an antipathy . . . by calling them ‘nothing but’ expressions of organic disposition.” A Medical materialist, James continued, finishes up Saint Paul by calling his vision on the road to Damascus a discharging lesion of the occipital cortex, he being an epileptic. It snuffs out Saint Teresa as an hysteric and Saint Francis of Assisi as an hereditary degenerate.
But, if we are going to discredit religious experiences this way, then to be logically consistent, we must also discredit atheism, which also can be traced to organic explanations:
Scientific theories are organically conditioned just as much as religious emotions are, and if we only knew the facts intimately enough, we should doubtless see ‘the liver’ determining the dicta of the sturdy atheist as decisively as it does those of the Methodist under conviction anxious about his soul. When it alters in one way the blood that percolates it, we get the Methodist, when in another way, we get the atheist form of mind.
Armed with James’ helpful distinction, it seems important to point out how some of the most vociferous promoters of a nothing-but-neuroscientific approach to diagnosing, treating, and assessing the human (and perhaps spiritual) significance of depression make this same simple-minded mistake.
Describing depression in neurochemical terms does not exhaust the phenomena, nor ought it dismiss the value of one’s insights about the world while depressed. Part of my own reckoning with my depression diagnosis was to avoid the simple-minded trap laid by the nothing but neuroscientists who wished to dismiss the veracity or value of my insights as depressed.
The depression I fell into was a sort of attunement to hostile forces trying to either eject me from a certain masculine environment or mold me into something other than who I was. Neuroscience is only one lens on this experience. James taught me to be a pluralist, that is, to recognize that “the universe [is] a more many-sided affair than any sect, even the scientific sect.”
Listening to People, Not to Prozac
My life-long struggle with depression as a female, feminist, and philosopher has certainly been a many-sided affair. There are seasons when chalking up the impressions I form of the world while depressed taunt me so much that I feel an enormous relief in calling it a mere chemical imbalance. But to take this as the only attitude is to try to neaten up the messiness and complexity of conscious experience into one single story. And as any good storyteller knows, the only way to tell one single story is to leave a great deal unaccounted for or edited out.
Of course, part of why I have spent a good deal of my career railing against a psychiatric landscape that describes our experiences only in terms of chemical signaling or maladaptive brain circuitry is because Prozac and its SSRI cousins, for many, are not wonder drugs. Almost every Prozac memoir written has the arc of a conversion experience to medical materialism that implodes when depression rears its head again and there is no higher dose to take—just more pills to add on.
Moreover, my depressive bouts really have forced me to acknowledge the often-paralyzing forces of systemic sexism—the impossibility of being the just right combination of philosopher and female. Feminist philosopher Marilyn Frye famously described sexism as a “double-bind” that reduces the options for how to be female and valued to “very few” and exposes, in almost the occupying every one of those limited options, to “penalty, censure, or deprivation.” Frye continues, “it is often a requirement upon oppressed people that we smile and be cheerful. If we comply, we signal our complicity and acquiescence in our situation. On the other hand, anything but the sunniest countenance exposes us to being perceived as bitter, angry, or dangerous.”
Of course, sexism isn’t the only face of oppression. In fact, over the same period that psychiatry transformed itself from an eclectic pluralism, willing to experiment with a variety of theories and assessments of what depression means, into a single scientific account of brain failure, feminism continues to pluralize into a many-sided intersectional picture of oppression. Psychiatry certainly could learn a great deal from studying the arguments that have demanded more pluralist, nuanced accounts of the many-sided expression of oppression. After all, not only does depression feel like oppression, but oppression is one of the forces that depresses.
No one theory of oppression can sum up, reduce, or simplify our understanding of the forces working to marginalize and exclude vast segments of people all over the globe while elevating a select few. ‘Oppression’—if we want to consider it a wholly medical issue—is better understood as cunning as a virus, mutating to adapt to a dynamic environment. Just when we think we stamped it out, it rears its ugly head, sometimes far more lethally in the bodies that survived it to take out those already practically decimated.
Peter Kramer titled his book Listening to Prozac because he wanted to propose that trying to really attend to the complexity of life experiences in search for answers that might improve the suffering depression brings was wrong-headed and inefficient. A mature psychiatry should listen only to drug action on conscious experience so we might efficiently inoculate ourselves from tragedy, hate, and violence—just some psychopharmacological tweaking of our brains to be utterly insensitive to them.
Psychopharmacology might show us that economic reform or anti-racism efforts were as foolish as the Freudian couch. Such a simple-minded line of thinking the neuromania analyses take on depression and oppression asserts that the suffering isn’t owing to the evils humans render to each other, but rather a deficiency of our brains that makes some of us less resilient than others. Moral philosophy or political reform are now the old theologies that seem naïve to the modern neuroscientific eye.
But there are a variety of experiences of oppression, just as there are a variety of experiences of the mental anguish wrought by depression. Moreover, there are a variety of oppressed who are depressed. So, of course, there must be a variety of interventions for ameliorating the human condition. We cannot afford to stop listening to people, taking their perspectives, and walking in their skin. Only when we allow ourselves the possibility that we are, as James said in another work, blind to the significance and value of life experiences so remote from our own might we soften up just enough to be remade. To adopt multiple ways of finding value in organizing our lives, communities, institutions, and cultures, we must value and celebrate many human stories.
Not only has my depressive nature forced me to reassess what really matters to me, but it has also reminded me that what matters to me is not what should matter to all. I will never fit myself neatly into the (hopefully dying) stereotype of a philosopher (read: the woolly-bearded, unencumbered, white Anglo-Saxon male). But nor should philosophy require this of me. This is one of the most valuable insights—or living truth—drawn from the depressed moods my physiology may adopt to fend off further damages of oppressive forces: a living truth that the tiny capsule couldn’t successfully banish from the curriculum of my life.