Prozac Americans: Depression, Identity, and Selfhood - Critical Essay

Twentieth Century Literature, Fall, 2000 by Abigail Cheever

At the end of The Thanatos Syndrome, after Feliciana returns to its preconspiracy malaise, Mickey returns to Tom's couch and asks, "'Do you remember that dream I had . . . I had it again"' (371). The return of the dream invokes for Mickey, as it did for Styron, the reawakening of the self to its own internality. Yet what indicates for Styron the recovery of the self from depression, for Percy constitutes only the beginning of the self's journey to authenticity. Tom's encouraging "'Well?"' is then repeated three times: the novel ends with the words "Well well well" to emphasize the wrongness of understanding depression as an illness, the rightness of a world where depression is possible. The Thanatos Syndrome thus provides a veritable lament for a world without depression, for the loss of the self--or the loss of the search--around which Percy's career has been in many respects defined.

Percy's fear of a medication, widely available, that might eradicate depression itself seems remarkably prescient. Written two years before Prozac became available by prescription, The Thanatos Syndrome foreshadows many of the professional debates about Prozac in the psychiatric community and their lay interpretation in the mainstream media. As Dr. Peter Kramer remembers in his best-selling Listening to Prozac, his introduction of the expression "cosmetic psychopharmacology" (246) brought him instant notoriety as a psychiatrist unafraid to discuss "how [Prozac] went beyond treating illness to changing personality, how it entered into our struggle to understand the self" (xviii). Six years before Kramer considered the questions brought on by Prozac's success and popularity, Percy divined the issues Prozac raised, illustrating what later appeared as a widespread interest in the ethical consequences of medication that goes beyond happiness to alter selfhood. [9] In Kramer's cosmetic psychopharmacological nightma re, a woman who wished to be less shy would take Prozac "to cure her" of this aspect of her self. "Prozac does not just brighten mood," Kramer claims, "it allows a woman with the traits we now consider 'overly feminine,' in the sense of passivity and a tendency to histrionics, to opt, if she is a good responder, for a spunkier persona" (270-71). On the one hand, Kramer easily sympathizes with the person trapped and limited by shyness, unable to make friends or have relationships: no one would want to deny this individual what we consider a healthy social life. On the other hand, Kramer's discomfort stems from the fear that the shy woman is asked "to be someone she's not" (270) and is encouraged to take Prozac as a means to submit to social standards.

For Percy, the alternative to depression is identity--an ontology of persons that defines the individual as a fixed composite of certain biological and sociological contingencies. In Kramer, it is conformity: he fears that "a mood elevator for [individuals with persistent, low-grade depression], at least one that works through altering temperament, will necessarily be a drug that induces 'conformity'" (269). [10] The discrepancy between them is crucial to understanding contemporary notions of the self: what Kramer questions are the philosophical standards for self identity; he wants to know how much an individual can change--to be liked, to fit in--and still remain the same. It is the Jekyll and Hyde question: is Jekyll/Hyde two people or one person with a particularly severe mental illness? [11] Kramer questions at what point an individual becomes a different person and which one-- pre- or post-Prozac--is considered "real." The original, which is to say, the depressed person? The person the patient likes mor e? The person society likes more? But for Percy the criterion of self-identity does not apply. His model of selfhood is inherently dynamic; it takes as given the self's continual change and (he would maintain) growth. For Percy, the individual on medication does not have two selves--a Jekyll and a Hyde, a pre- and a post-Prozac--between which we need differentiate. Rather, he has no self at all. The fault lies not in the change but in the loss of the capacity to change, the insistence that there is a permanent answer to questions regarding the nature of the self. But both authors take at their core the idea that depression is more than an illness, that it involves a complicated negotiation between the individual and the community in which he or she operates. And while Kramer has been criticized for the extremity of his examples--few individuals have the dramatic results with Prozac that he describes--his fears encapsulate what Percy imagined five years earlier: depression is traditionally understood as someth ing importantly more than a biological condition, a sign of or means to the self rather than a hindrance to daily life.