How Prozac Became a Symbol of Biomedical Control and Storytelling Became an Act of Resistance

A new study published in Medical Humanities examines how memoir and metaphor reshape ideas of recovery in psychiatry. Researchers Swikriti Sanyal and Hemechandran Karah of the Indian Institute of Technology Madras analyze Prozac Diary, Lauren Slater’s 1998 memoir, to explore how figurative language challenges the psychiatric discourse on mental illness, medication, and normalcy.

By framing her experience with Prozac through metaphor, Slater resists the idea that recovery is simply a biomedical process. Instead, her memoir presents recovery as an active, rhetorical process—one that allows individuals to reclaim their experiences from psychiatric definitions of illness and health.

Prozac Diary introduces complexity and nuance to Slater’s relationship with Prozac, challenging the popular 90s narrative that the antidepressant “cures the chemical imbalances” of the brain in those with mental illness.

“By unraveling the intrapersonal, socio-cultural, and discursive ramifications of recovery, as opposed to psychiatry’s perfunctory understanding of biological cure as a restoration of a socially desirable state of ‘normalcy,’ she is able to reclaim the lived experience of recovery,” the authors write.

“We argue that in Prozac Diary, recovery does not merely imply a passive internalization of psychiatry’s biological determinism and its psychopharmaceutical approaches. Instead, it is a rhetorical process that enables the medicalized individuals to actively engage with the mental health system and interrogate the possibility of critically responding to its normative frameworks as agentic subjects.”

At the heart of the study is a critical interrogation of what it means to “recover”—and who gets to define it. Psychiatry has historically positioned recovery as a return to a pre-determined, functional state, often framed within a neoliberal logic of productivity and social conformity. In contrast, disability rights activists and service-user movements have long emphasized recovery as a process of self-determination, one that does not necessarily align with mainstream ideas of normalcy. Slater’s memoir, as Sanyal and Karah argue, resists the psychiatric model’s passive, compliance-driven version of recovery by engaging in an active, rhetorical redefinition of selfhood.

The idea of “recovery” as a guiding principle in mental health care was originally a radical political demand from service-user movements in the 1980s. Drawing from disability rights frameworks, these activists sought to challenge conventional ideas of normalcy, advocating for a reimagining of mental distress that allowed individuals to shape their own paths toward well-being.

That vision changed in the 1990s, as psychiatry embraced a biological model of mental illness and positioned drugs like Prozac as solutions to distress. The rise of SSRIs reframed recovery as a return to a chemically balanced, socially acceptable self. This shift placed the responsibility on individuals to seek treatment, adhere to medication, and function productively within society.

Prozac became more than a drug—it became a cultural symbol of self-improvement, personal transformation, and the idea that mental suffering could be solved by science. In this context, psychiatric medications shaped not only how mental distress was understood but also how people saw themselves. Those who took medication often found that their identities were defined by it, while those who resisted treatment risked being seen as irrational or non-compliant.

Slater’s memoir offers a counter-narrative to this dominant psychiatric framing. Unlike the mainstream discourse, which presents Prozac in clinical and neurochemical terms, Prozac Diary uses personal storytelling and metaphor to explore a more complicated relationship with the drug. Slater neither fully embraces nor outright rejects Prozac. Instead, she examines the shifting ways it shapes her sense of self.

Rhetorical Care of the Body-Mind

In Prozac Diary, Slater questions dominant constructs of mental health and mental illness by portraying the complexities of illness and health-based identities, which the author argues “enacts a rhetorical care of the body-mind.” The authors demonstrate how her techniques can be a tool for individual and collective recovery.

They use a disability studies definition of “bodymind,” which views the self/brain as a collection of social and personal experiences shaped by power, violence, and individual experiences, distinct from a medical view that views the brain in a narrow and disconnected way.

The following are some examples of Slater’s figurative language that adds depth and complexity to her experience and relationship with Prozac:

• Prozac as Metonym: The authors show how Slater uses ‘Prozac’ as a metonym for biomedical discourse – excessive pathologization and medicalization of (ab)normal psychological states – which shows the pervasiveness of the Prozac discourse in the 90s in America and all its underlying assumptions alongside the complexities of the lived experiences of cure and the Prozac selfhood.

• Prozac as Metaphor: Slater describes her experience with Prozac as trading one version of herself for another, with the drug becoming an inseparable part of her life. Over time, Prozac shifted from being a vital “lover” to a “close friend” that helps but doesn’t fix everything. The metaphors she used marks a shift in her recovery, where she moves from being a passive patient to an a

• The Prozac ‘I’ as an Existential Self: Slater presents the Prozac ‘I’ as a drug-dependent, high-functioning identity that lacks true autonomy, challenging traditional ideas of health and the purpose of Prozac as a “cure.” This Prozac ‘I’ is not a passive subject but an active, critical self that questions and analyzes the discourses shaping it, and cannot be reduced to just a chemical-based identity.

The authors highlight how Slater’s reframing of Prozac through metaphor challenges the idea that health is a natural, stable state. Instead, she presents a vision of selfhood that is fluid, contextual, and intertwined with pharmaceutical and social forces.

“Finally, we add that this reclamation of the ‘mind’ and ‘body’ from their narrow, disconnected and reductive definitions within the medico-pharmaceutical discourses opens up new ways of perceiving ‘healthy’ bodyminds and redefining recovery, rather than unequivocally accepting the biomedical approaches that focus on curing the chemical imbalances of the brain,” they write.

Rhetorical Care About the Body-Mind

The authors explain that by normalizing the experience of illness and presenting a drug-dependent health identity, Slater portrays the Prozac ‘I’ as a dismodernist subject and engages in rhetorical care about the bodymind. This concept, borrowed from Davis’s essay “Dismodernist Discourse of the Body,” focuses on human rights, social justice, and disability rights in society and culture.

In Prozac Diary, Slater uses metaphors to challenge the common belief that health is the natural or standard state, advocating for the inclusion of disabled bodyminds in the normalcy paradigm.

“Contrary to popular understanding, ‘health’ is neither the natural nor the standard state of existence, thereby making a case for disabled bodyminds to be included within the paradigm of normalcy. Simultaneously, she also suggests that in a consumer society, contemporary body-minds are incomplete without the biochemical technologies and the psychopharmaceutical interventions that make them productive, desirable, and ‘normal,’” the authors argue.

By positioning herself as an active, critical subject rather than a passive recipient of medical expertise, Slater subverts the conventional psychiatric portrayal of a “healthy” individual. She neither entirely rejects Prozac nor wholly embraces it, offering instead a more nuanced understanding of recovery—one that resists psychiatry’s demand for compliance and control.

Ultimately, Sanyal and Karah show how Prozac Diary complicates dominant psychiatric narratives by refusing to frame recovery as a simple return to health. Slater’s use of metaphor, storytelling, and rhetorical framing allows her to reclaim agency, challenging the idea that healing means becoming neurochemically “normal.”

While the memoir does not entirely denounce psychiatric medications, it reveals both their benefits and their limitations. In doing so, it offers an alternative vision of recovery—one that is neither dictated by psychiatry nor reducible to a simple biochemical equation.

This work highlights the strength of the psychological humanities, the power of narrative storytelling, and the role language and metaphors play in expressing, challenging, and reframing personal and collective ideas surrounding recovery, illness, and normalcy. Metaphors structure our thoughts, perceptions, and experiences. This work shows how a rhetorical exploration of illness narratives offers a unique perspective and understanding of how mental distress is perceived and experienced by individuals and societies in given contexts.

 

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Sanyal, S., & Karah, H. (2025). Prozac as medicine, metaphor and identity: Reimagining recovery as a rhetorical process in Lauren Slater’s Prozac Diary. Medical Humanities, medhum-2024-012973. https://doi.org/10.1136/medhum-2024-012973