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A gifted writer examines her experience with Prozac
on 7 February 1999
Ten years into her relationship with Eli Lilly's breakthrough antidepressant Prozac, Lauren Slater contemplates the cost her dependence holds. She notices tremors in her hands. Her memory, once a point of pride, fails her in subtle ways. Is she just getting older or is her cure exacting a physical toll? Then, there is the loss of her sex drive.
There is a tradeoff here, however. For while these symptoms are troubling, and open profound questions about a drug that has no long term track history, there is the patient herself to consider. Hospitalized five times in her teens to early twenties, she was unable to hold steady employment. Ms. Slater becomes one of the early Prozac users in 1988 as the onset of obsessive-compulsive disorder (OCD) begins to haunt her. She has carried the burden of unrelenting depression as well as a diagnosis of borderline personality disorder.
Contrast this with the Dr. Lauren Slater who appeared on National Public Radio's Talk of the Nation in early 1997. She has earned a master's degree in psychology from Harvard, and completed her doctorate in just two years. Her first book, Welcome to My Country, published in 1996 was critically acclaimed. Her essays have merited national recognition. Listening to her talk eloquently on the struggles of mental illness one can't help but be awed by her achievements. Clearly, the cream and green capsules Slater writes so effectively about in Prozac Diary have had a stunning impact on her own life.
The 204-page book offers depth and color to arguments that have often been hardened in black and white. From press coverage earlier in this decade that once surrounded Prozac in negative controversy to recent literature that painted it as a miracle compound, rarely have we visited the subject from the middle. Slater's account is of the give and take, a wondrous return to normal life followed by the disappointment of the drug suddenly losing effectiveness. It never again has the same impact, yet she realizes she is bound to it for each time she tries to stop using it symptoms recur. At the same time one realizes in reading her moving account, that maybe the true turning point in her life is when she realizes that even without Prozac she can exert some control over her condition.
The questions she digs at from so deep a personal level are fundamentally unsettling. As research into brain chemistry yields ever more effective pharmacological compounds, several issues creep into the picture. What is gained and what is lost from tampering with chemicals so closely linked to a person's sense of self? Do we lose in creativity what we gain in function? Ms. Slater finds herself concerned over an inability to write easily and by her own indifference to that fact early in her experience with Prozac. She is on the other hand amazed by her ability to perform at a level she has rarely touched beforehand. She wonders if when the drug is it yields unfair advantages. Where does a personality begin and chemistry end? Are the traits that make us who we are easily changed by advanced pharmaceutical design? Can we separate ourselves from the science?
While there are no easy answers here, Prozac Diary offers a funny and touching memoir about life changed forever by chemical interaction. Its strength is in Lauren Slater's ability to write so poetically about a struggle to emerge from the darkness of a life lived on the edges of mental illness. That she has the insight to ponder the price and meaning of her experience make this a provocatively engaging read.