Post-Prozac Nation: Did our Drugs Work?

Vanessa Krasinski, MSN, RN
16
984

In 1995, days after having received my first psychiatric drug prescription, I purchased and speed-read Elizabeth Wurtzel’s best-selling memoir, Prozac Nation. Often compared to Sylvia Plath’s The Bell Jar in subject and cultural impact, this book put bio-psychiatry’s chemical imbalance theory of distress on the young person’s literary map. In the final two pages of her memoir, Wurtzel, a young and depressed Harvard University student writes, “One morning I woke up…it was as if the miasma of depression had lifted off of me, in the same way that the fog in San Francisco rises as the day wears on. Was it the Prozac? No Doubt.”

This tagline praise for Prozac made her the pharma-friendly ally to a growing number of young people who were, like I, told their fear, fury or heart’s desire were identifiable disease and expressions of faulty genetics. Thousands of young people in my generation were quietly ushered into the mental health system because we were energetic and disinterested in classroom lessons, or because we tried hard and alone to metabolize difficult life experience. We stumbled upon doctors, pills, psychiatric labels, and this best-selling book in the absence of someone we could talk to. Its plug for Prozac, alongside shaky scientific theory, helped to create our teenaged view that the drugs we had been told we needed were harmless and effective.

Elizabeth Wurtzel was well cast for the role of unofficial Eli Lilly spokesperson. She was young, beautiful and Harvard-educated. And while she accepted her mental health diagnosis and daily dose of medication, Wurtzel lived out a stereotypically counterculture life publicly packed with sex and rock music. With the distribution of this book, Wurtzel, an already established rock music critic, garnered fans of her own. They created fan clubs and joined her on book tour. During one Portland, Oregon stop, a young man offered Wurtzel his SSRI prescription slip, which, she signed in solidarity. Wurtzel’s book and rise to stardom happened to coincide with Lilly’s marketing efforts which sky-rocketed their stock value over 300% from 1994-1996.

Rightfully, this young fan felt a prescription slip would be the archetypal place for her to autograph.

Eighteen years later, her book is still touted as a Prozac success story. In the April 19, 2012 New York Times Magazine article, “Post-Prozac Nation: The Science and History of Treating Depression”, Dr. Siddhartha Mukherjee refers to her experience on Prozac as “transcendental”. He uses her story to question what he sees as America’s careless tendency to throw the proverbial baby out with the bath water as critics, patients and activists call attention to a conspicuous absence of reliable science and improved outcomes with use of these drugs, while exposing their potential dangers. Mukherjee cites Wurtzel’s words that before Prozac she was living in, “a computer program of totally negativity…an absence of affect, absence of feeling, absence of response, absence of interest.” Dr. Mukherjee asserts that, “just a few weeks after starting Prozac, her life was transformed.”

Last spring, I rested in bed under the covers and cradled my laptop computer to read this article. Mired in month four of a painful and still-protracted period of withdrawal from psychiatric drugs, I had called out sick from work, again. I read this article as my body, covered in welts, shook and ached. I slept for hours at a time during the day or else I sat and stared at the wall, nearly catatonic. But that was only the beginning. One month later I experienced episodes of paranoia and hallucinations. I saw cartoon-like rats running around my bedroom floor. Exposed wall pipes in a church basement turned into cameras. At the May 6th event in Philadelphia, “Imagining a Different Future in Mental Health”, I imagined a man in the pew across from me was concealing a gun and planned to kill me. I sat, breathing slowly and deeply to ground myself while following the sound of speaker Robert Whitaker’s voice, amplified by the microphone he gently held to question the ethics of a mental health system that isn’t clear about its own self-deception: “Delusion is just not a good foundation for good medicine”.

In more private moments, I cried. I considered suicide.

But there was also a part of me, deep and unshakable, that knew this mess wasn’t me. These visions and symptoms were my body’s final push to heal itself, to grow new receptors and recalibrate a chemical messaging system that had been perturbed by 17 years of 12 psychiatric drugs, up to five at a time, for supposed clinical depression turned bipolar, neither of which actually existed in the first place. I woke up to the fact that over the years, each time I had tried unsuccessfully to come off of these drugs, I was not experiencing a reemergence of mental illness, as I was told. I was going through psychiatric drug withdrawal and a phase of repair, which I now understood could take months, if not years to get through. This awakening, combined with Dr. Mukherjee’s NYT magazine article prompted me to reread Prozac Nation with a more critical eye. I asked the question: Did her drugs really work?

I was shocked to find what Wurtzel’s story reveals. Dr. Mukherjee and the majority of readers gloss over a critical detail of her experience on Prozac, and an entire second book in which she changes her tune about the drug’s effectiveness. In Prozac Nation, she reflects on the attempt she made to take her own life after taking Prozac, “The suicide attempt startled even me. It seemed to happen so out of context…it should have never have happened within a few days of returning to Cambridge, at a point when, even I had to admit, the fluoxetine (Prozac) was starting to kick in.” But in interest of preserving a particular narrative and, coincidentally, satisfying Eli Lilly’s need to spin a bit of bad press they endured in 1994 with their first product liability case which went to trial (Wesbecker vs. Eli Lilly), Wurtzel explains that swallowing a full bottle of Mellaril, a drug classified as an anti-psychotic, was par for a worthy course of treatment.

This sudden, trance-like drive to suicide Wurtzel describes is strikingly similar to my own experience. Within weeks of taking Prozac, I developed an insatiable appetite. I could not sleep. I began to behave in unusual ways, expressing uncharacteristic levels of anxiety, recklessness and aggression. Several incidents of self-harm landed me in a northern New Jersey psychiatric ward where I was held and told my behavior was an indication of even greater disease. I could be bipolar. Like Wurtzel, hospital doctors gave me two additional pills: one sedative and one mood stabilizer. Eleven years later Eli Lilly is forced by the FDA to include a black-box warning with its product which states that SSRIs can cause an increase in aggression, suicide (which they call suicidal behavior) and suicidal thinking in teenagers and young adults. I was 16 years old. I was not bipolar or anxious. I was having a reaction to Prozac. It would be years of struggle, strange symptoms and research before I’d come to understand the connection.

I also read Wurtzel’s 2002 follow-up book, More, Now and Again: A Memoir of Addiction to find out if what happened to my life over time on these drugs, happened to hers. In this memoir, readers find Wurtzel doubting the value of the drugs she was prescribed. She writes that her old, “reliable antidepressants were not working so well, the whole regimen needed a boost.” Here Wurtzel uses the word ‘regimen’ to describe what had, over time, become a cocktail of drugs. The “boost” she and her psychiatrist summon comes in the form of Ritalin, a stimulant prescribed to treat her curious emergence of extreme fatigue and an inability to concentrate, two common effects of a serotonergic system which has been damaged by the long term use of psychotropic drugs. Though in her case and mine, this was not known or admitted by the prescriber.

I was told the onset of fatigue and memory loss were manifestations of continued depression. Or else I had an entirely separate condition called Chronic Fatigue Syndrome, which itself was unexplainable. My provider encouraged me to stay on prescription medication, offering to up doses or add more pills. Like Wurtzel, I was offered a stimulant to help me stay awake and alert to treat what I would discover were effects of the drugs I was told I needed. However, given my experience with benzodiazepines, another highly addictive class of drugs, I declined.

Ultimately, Wurtzel’s life on psychiatric drugs inspires her to write, “I start to think that this is a cabal of the pharmaceutical industry to make us into addicts.” This book walks readers through the years she spent in drug rehabilitation centers, step-down facilities and therapist’s offices.  Essentially, we see the same thing happen in Wurtzel’s life that happens in so many peoples’ lives, including my own. One diagnosis and one drug in a young person quickly become new symptoms, which become multiple diagnoses, and multiple drugs, which pave a life-path of unwitting addiction, even to those drugs like antidepressants which we’re told are not habit forming.

Dr. Mukherjee left this critical perspective on the devastating, long-term effects of these drugs out of his New York Times Magazine article.

While some people feel helped by psychiatric drugs, so many of us, particularly those who were denied informed consent, who were not offered alternatives, or who were forced to take these drugs, feel violated to discover they were also causing us harm, perturbing multiple chemical messaging systems in our bodies. These drugs created the symptoms doctors could not explain—everything from acne to cognitive dysfunction, amenorrhea to dissociation, and a worsening of the symptoms which the drug was meant to treat.

Four months ago, when I endeavored to reread Prozac Nation, I didn’t have to check it out at the local library. I have held onto it over the last 17 years of my life as a patient in our mental health system. No matter how many times I took off for a new state, coast, crash pad or credential, ditching bell bottoms and other appliances along the way, Wurtzel’s book and my psychiatric drugs stayed with me—as did my distress. Now, in some kind of strange synchronicity, it sits on my bookshelf in the same quiet Cambridge, Massachusetts neighborhood in which Elizabeth Wurtzel lived while writing this book. Though it’s ideology and apparently incomplete picture of her life (and mine) on psychiatric drugs make it difficult to read, I don’t toss it just yet.

Prozac Nation stands as a reminder of the failed promise and language of bio-psychiatry. It also highlights what the first and real problem was for me at age 16. Still underlined are the words that drew me in, made her an ally, and which could have inspired great dialogue had they not been sidelined by psychiatric drugs. She writes, “I feel like a defective model, like I came off the assembly line flat-out fucked and my parents should have taken me back for repairs before the warranty ran out.”

At 16, I stood alone, enflamed with a fear of questioning the politics of family, my own identity and life’s purpose. The elusive feeling of brokenness which Wurtzel describes, a common imprint of traumatic experience, was something I could relate to. No one said, “Let’s imagine you aren’t broken”, or “How did you come to entertain this idea about yourself?” or “Let’s talk about this brokenness…what does it look like?” bio-psychiatry did exactly the opposite. This ghostly fear or cast spell, smoke-screened by weight loss and a withdrawal from all that I loved, was actualized, codified and amplified by our bio-psychiatric model of mental health care. I only started to heal eight months ago when I shed my labels, swore to endure whatever psychiatric drug withdrawal would bring, and swiftly exited the system.

Previous articleRichard Lewis – Short Bio
Next articleAll Quiet on the DSM Front
Vanessa Krasinski, MSN, RN
Vanessa has worked for over a decade in various social system settings: a group home for pregnant and parenting foster youth, a Federal Bureau of Prisons pre-release facility in California, and a Housing First Initiative in Boston, Massachusetts. Inspired by this work and her own journey through the mental health system, Vanessa takes a trauma informed and harm reduction approach to clinical practice. She lives with her trusted beagle companion Henry in Providence, Rhode Island. Vanessa can be contacted at [email protected]

16 COMMENTS

  1. Thanks for sharing your story Vanessa!

    “…perturbed by 17 years of 12 psychiatric drugs, up to five at a time…”

    Wow! I like your insight that given this lengthy period of drug use, it may well take your body some time to re-adjust. My hope for you is that you have a support network in place that can help you through the difficult times and celebrate along the way. I hope this website and the connections you make can be useful as well.

    Best,
    David

  2. Dear Vanessa,

    I feel for you. I was there just a year ago. When I told my psychiatrist I was going to get off my drugs, her advice was: “Some people find they can’t do it.” Professionals can be so helpful! It turns out I didn’t need her help or any other mental health professional: I just needed faith in myself and in time. It worked out better than I could have ever imagined. Where you are going is worth the trouble it takes to get there!

    I’m proud of you, and I know that you will be an inspiration to others.

    I took an undergrad online History survey class this summer where our primary text was a Norton Anthology of American Biography. Interestingly, as part of our last unit we were assigned Wurtzl’s “Prozac Nation”. The excerpt we read actually said by her own admission that drugs didn’t help her depression, her friendships did. In the subsequent discussion my fellow students who posted on that topic agreed on how Wurtzl’s parents’ divorce was her primary problem and not some health condition. I was impressed. I’ve seen the movie but I haven’t read the book.

    Wishing you strength,
    Emily

  3. Wow, what a powerful testimony to the promise and betrayal of these drugs, both for you personally and for our society as a whole! I did not know the coda to Wurtzel’s story, which of course, received no press while her original thesis was broadcast around the world. This should serve to remind us all that these are aggressive, vested interests in operation and being “nice” and “understanding” and sharing data aren’t going to change the dynamic we’re seeing. Your personal struggle is so touching, and so reflective of the many others I’ve seen, especially the drug-induced move from depressed to “bipolar” without any attention to the real issues at hand, such as historical trauma, identity, and purpose in life.

    I hope your painful experience has helped you to find a new direction. I am sure that your writing will do that for some who really need it. Maybe it’s time for you to do a book!

    Thanks for sharing your story.

    —- Steve

  4. Thanks for sharing your story. It seems similar in many ways to the pattern followed by several members of my family (except they are still buying the drug model hook, line and sinker in spite of having their health, mood and functioning becoming worse on them). The only reason I did not follow that same drugged path was due to a very lucky combination of circumstances.

    Also, thanks for the excellent work on following-up on the “Elizabeth Wurtzel” story.

  5. Vanessa,

    I choose to avoid the low flying psychiatrists who post here, but I wanted to reach out and congratulate you again on your efforts and encourage you to hang in there during the difficult days. You were kind to me when I communicated here about my own tapering process and it meant a lot to me.

    I had read the Mukerjhee article and was puzzled as to why a hematologist (perhaps he should have addressed the effects of SSRI’s on blood platelets) and oncologist was commissioned to write an analysis of the state of psycho-pharmacology. Given that most data on the effects of these drugs is gathered after they go to market, I guess Dr. Mukerjhee feels that the damage incurred by unwitting “consumers” in the name of “research progress” is well worth it. It’s not his life after all.

    Perhaps the NYT’s goal was to simply slap up yet another psych med booster article for the masses written by a celeb M.D., a la Peter Kramer. Now it seems big pharma must enlist medical marketers outside of psychiatry. Gag-worthy indeed.

  6. Dear Vanessa,

    Thank you for writing your inspiring story. I first tried to get off psychiatric drugs in 2003, with no knowledge of withdrawal, and had a terrible crash, which my psychiatrist said was evidence that I needed medication forever. I got right back on, but started to investigate the notion of withdrawal, and tried again, this time weaning, but again too fast, broke down and went back on. But I was determined to immediately try again, and continued going through this process, making it a little longer each time, until, after 6 years of efforts, I made it. I am now three years drug free.

    The emotional pain I experienced in withdrawal was more intense and relentless than “natural” depression of the past, which makes sense in terms of down-regulation of serotonin receptors from SSRIs. I think by getting on and off over the 6 years, with additional meds always added, I probably damaged myself even more. Part of the pain, in doing this against the wishes of all who knew me, was the self-doubt. From my first day off, after a period of agitation, I would plummet into excruciating despair.

    Since I have assumed, like you, that my brain changed in response to the drugs and needs to recover equilibrium, I have tried to eat nutritious food–no sugar, white grains, omega oils; and to exercize. Meditation and yoga are helpful for getting through agitation and depression. One problem that was intense when I first got off drugs was severe muscle cramps (arms, wrists, legs, feet) which made it hard to walk at first. It has gradually improved alot, but is still a problem.

    I think the hardest thing is keeping the faith with yourself, when family, doctors and society at large give you the message that you’re making a huge mistake, denying your mental illness, causing problems by being “non-compliant”, and when you may feel bad for not being up-to-speed and highly-functional because you are dealing with agitation and depression from withdrawal. Your very determination to get off is framed as a symptom of mental illness. (I forget the term for that symptom of not realizing that you’re mentally ill.)

    That’s why I think it’s so important for keeping resolve through the withdrawal period to hear stories like yours–beautifully written–and to keep learning about the damaging effects of the drugs, read critical analysis of how efficacy research is spun, and about the politics of disease-mongering and the disinformation tactics of the pharmaceutical companies. The publication of Anatomy of an Epidemic gave me so much motivation and validation in my effort. In fact, when I read what it was about, I ordered it 6 months before it was available. This all helps to keep the mainstream propaganda at bay. You have to be like Ulysses and tie yourself to the mast and not listen to the siren songs of the magic bullet.
    Also to expect it to be a slow process.

    I really used information such as Mad In America website now has (it didn’t exist then) to hold onto my interpretation of my mental pain as withdrawal to be endured for the sake of eventual freedom from debilitating drugs, as well as a authentic engagement with underlying experiential causes of my lifelong emotional difficulties — to see it as a painful, but worthwhile passage to a life of full possibility. While I understand that the website aims to change institutions and society at large, it’s even more important to me in offering hope, support and information to isolated individual “patients” attempting to get off drugs in the face of intense pressure from medical professionals, family and friends.

    Another thing that motivated me was that fact that of all the people I know who have opted to remain on drugs long-term–and I’ve known many–none is doing really well. They are struggling. They often seem to be switching or adding drugs in hopes of getting better results. In fact, there’s a certain kind of resigned malaise, stuckness, melancholy or apathy that I now associate with people who have been on drugs long-term. Whenever I see them, it’s like, “so what are you on now and how’s it working?” and they are caught in this trial and error merry-go-round of trying to monitor their moods and figure out how to tweek their drug regime. (not to mention physical and health effects.)

    Conversely, I know a number of people who were condemned by doctors to drugs for life, rebelled and got off, and are full of energy and doing fine.

    So thank you so much for offering your story, and I’m very grateful for this website.

  7. Vanessa, Thank you for sharing your story in such an honest, clear, and eloquent way. You really help paint the picture of your struggle and the absence of the type of support you so desperately needed…and not for lack of trying.

    I’m so proud of you and your work. Keep telling your story, clearly it helps so many.
    Susan