Prozac Nation Depression Quotes

That's the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it's impossible to ever see the end.

That is all I want in life: for this pain to seem purposeful.

I don't want any more of this try, try again stuff. I just want out. I’ve had it. I am so tired. I am twenty and I am already exhausted.

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.

If you are chronically down, it is a lifelong fight to keep from sinking

Some friends don't understand this. They don't understand how desperate I am to have someone say, I love you and I support you just the way you are because you're wonderful just the way you are. They don't understand that I can't remember anyone ever saying that to me. I am so demanding and difficult for my friends because I want to crumble and fall apart before them so that they will love me even though I am no fun, lying in bed, crying all the time, not moving. Depression is all about If you loved me you would.

I was so scared to give up depression, fearing that somehow the worst part of me was actually all of me.

Mental illness is so much more complicated than any pill that any mortal could invent

I'm the girl who is lost in space, the girl who is disappearing always, forever fading away and receding farther and farther into the background. Just like the Cheshire cat, someday I will suddenly leave, but the artificial warmth of my smile, that phony, clownish curve, the kind you see on miserably sad people and villains in Disney movies, will remain behind as an ironic remnant. I am the girl you see in the photograph from some party someplace or some picnic in the park, the one who is in fact soon to be gone. When you look at the picture again, I want to assure you, I will no longer be there. I will be erased from history, like a traitor in the Soviet Union. Because with every day that goes by, I feel myself becoming more and more invisible...

At heart, I have always been a coper, I've mostly been able to walk around with my wounds safely hidden, and I've always stored up my deep depressive episodes for the weeks off when there was time to have an abbreviated version of a complete breakdown. But in the end, I'd be able to get up and on with it, could always do what little must be done to scratch by.

In the meantime, I could withdraw to my room, could hide and sleep as if I were dead

I start to think there really is no cure for depression, that happiness is an ongoing battle, and I wonder if it isn't one I'll have to fight for as long as I live. I wonder if it's worth it.

Depression is about as close as you get to somewhere between dead and alive, and it's the worst.

Sometimes, I get so consumed by depression that it is hard to believe that the whole world doesn't stop and suffer with me.

Sometimes it feels like we're all living in a Prozac nation. The United States of Depression.

Everything's plastic, we're all going to die sooner or later, so what does it matter.

In my case, I was not frightened in the least bit at the thought that I might live because I was certain, quite certain, that I was already dead.

It is so hard to learn to put sadness in perspective so hard to understand that it is a feeling that comes in degrees, it can be a candle burning gently and harmlessly in your home, or it can be a full-fledged forest fire that destroy almost everything and is controlled by almost nothing. It can also be so much in-between

It's nonverbal: I need love. I need the thing that happens when your brain shuts off and your heart turns on. And I know it's around me somewhere, but I just can't feel it.

In a strange way, I had fallen in love with my depression. Dr. Sterling was right about that. I loved it because I thought it was all I had. I thought depression was the part of my character that made me worthwhile. I thought so little of myself, felt that I had such scant offerings to give to the world, that the one thing that justified my existence at all was my agony.

Woke up this morning afraid I was gonna live.

I start to get the feeling that something is really wrong.

Hemingway has his classic moment in "The Sun Also Rises" when someone asks Mike Campbell how he went bankrupt. All he can say is, "Gradually, then suddenly." That's how depression hits. You wake up one morning, afraid that you're gonna live.

One of the terrible fallacies of contemporary psychotherapy is that if people would just say how they felt, a lot of problems could be solved.

In a typical mental health catch-22, the alienating nature of depression tends to keep its sufferers from finding their way to the very support groups that might help them.

Madness is too glamorous a term to convey what happens to most people who are losing their minds. That word is too exciting, too literary, too interesting in its connotations, to convey the boredom, the slowness, the dreariness, the dampness of depression…depression is pure dullness, tedium straight up. Depression is, especially these days, an overused term to be sure, but never one associated with anything wild, anything about dancing all night with a lampshade on your head and then going home and killing yourself…The word madness allows its users to celebrate the pain of its sufferers, to forget that underneath all the acting-out and quests for fabulousness and fine poetry, there is a person in huge amounts of dull, ugly agony...Remember that when you’re at the point at which you’re doing something as desperate and violent as sticking your head in an oven, it is only because the life that preceded this act felt even worse. Think about living in depression from moment to moment, and know it is not worth any of the great art that comes as its by-product.

I have studiously tried to avoid ever using the word 'madness' to describe my condition. Now and again, the word slips out, but I hate it. 'Madness' is too glamorous a term to convey what happens to most people who are losing their minds. That word is too exciting, too literary, too interesting in its connotations, to convey the boredom, the slowness, the dreariness, the dampness of depression.

And I know, knew for sure, with an absolute certainty, that this is rock bottom, this what the worst possible thing feels like. It is not some grand, wretched emotional breakdown. It is, in fact, so very mundane:…Rock Bottom is an inability to cope with the commonplace that is so extreme it makes even the grandest and loveliest things unbearable…Rock bottom is feeling that the only thing that matters in all of life is the one bad moment…Rock bottom is everything out of focus. It’s a failure of vision, a failure to see the world how it is, to see the good in what it is, and only to wonder why the hell things look the way they do and not—and not some other way.

Depression is a lot like that: slowly, over the years, the data will accumulate in your heart and mind, a computer program for total negativity will build into your system, making life feel more and more unbearale. But you won't even notice it coming on, thinking that it is somehow normal, something about getter older, about turning eight or about turning twelve or turning fifteeen, and then one day you realize that your entire life is just awful, not worth living, a horror and a black blot on the white terrain of human existence. One morning you wake up afraid you are going to live.

My God, I could raise a family of six children and hold down a full-time job with all the energy I expend on depression!

In those pamphlets that they give at mental health centers where they list the ten or so symptoms that would indicate a clinical depression, 'suicide threats' or even simple 'talk of suicide' is considered cause for concern. I guess the point is that what's just talk one day may become a real activity the next. So perhaps after years of walking around with these germinal feelings, these raw thoughts, these scattered moments of saying I wish I were dead, eventually I too, sooner or later, would succumb to the death urge. In the meantime, I could withdraw to my room, could hide and sleep as if I were dead.

The brief relief of seeing other people when I leave my room turns into a desperate need to be alone, and then being alone turns into a terrible fear that I will have no friends, I will be alone in this world and in my life. I will eventually be so crazy from this black wave, which seems to be taking over my head with increasing frequency, that one day I will just kill myself, not for any great, thoughtful existential reasons, but because I need immediate relief.

Some catastrophic moments invite clarity, explode in split moments: You smash your hand through a windowpane and then there is blood and shattered glass stained with red all over the place; you fall out a window and break some bones and scrape some skin. Stitches and casts and bandages and antiseptic solve and salve the wounds. But depression is not a sudden disaster. It is more like a cancer: At first its tumorous mass is not even noticeable to the careful eye, and then one day -- wham! -- there is a huge, deadly seven-pound lump lodged in your brain or your stomach or your shoulder blade, and this thing that your own body has produced is actually trying to kill you. Depression is a lot like that: Slowly, over the years, the data will accumulate in your heart and mind, a computer program for total negativity will build into your system, making life feel more and more unbearable. But you won't even notice it coming on, thinking that it is somehow normal, something about getting older, about turning eight or turning twelve or turning fifteen, and then one day you realize that your entire life is just awful, not worth living, a horror and a black blot on the white terrain of human existence. One morning you wake up afraid you are going to live. In my case, I was not frightened in the least bit at the thought that I might live because I was certain, quite certain, that I was already dead. The actual dying part, the withering away of my physical body, was a mere formality. My spirit, my emotional being, whatever you want to call all that inner turmoil that has nothing to do with physical existence, were long gone, dead and gone, and only a mass of the most fucking god-awful excruciating pain like a pair of boiling hot tongs clamped tight around my spine and pressing on all my nerves was left in its wake. That's the thing I want to make clear about depression: It's got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal -- unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature's part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead. And the scariest part is that if you ask anyone in the throes of depression how he got there, to pin down the turning point, he'll never know. There is a classic moment in The Sun Also Rises when someone asks Mike Campbell how he went bankrupt, and all he can say in response is, 'Gradually and then suddenly.' When someone asks how I love my mind, that is all I can say too

That’s the thing I want to make clear about depression: It’s got nothing at all to do with life. In the course of life, there is sadness and pain and sorror, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.

And she keeps saying, how can you do this to me? And i want to scream, what do you mean, how can I do this to you? Aren't we confusing our pronouns here? The question, really, is How could I do this to myself?

Depression is all about if you loved me you would. As in, if you loved me you would stop doing your schoolwork, stop going out drinking with your friends on a Saturday night, stop accepting starring roles in theater productions, and stop doing everything besides sitting here by my side and passing me Kleenex and aspirin while I lie and creak and cry and drown myself and you in my misery.

If I were another person, I go on, I wouldn’t want to deal with me, I don’t want to deal with me, It’s so hopeless, I want out of this life. I really do. I keep thinking that if I could just get a grip of myself, I could be all right again. I keep thinking I’m driving myself crazy, but I swear, I swear to God, I have no control. It’s so awful, It’s like some demons have taken over my mind. And nobody believes me, Everybody thinks I could be better if I wanted to. But I can’t be the old Lizzy anymore, I can’t be myself anymore, I mean, actually, I am being myself right now and it’s horrible.

That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and its compounds daily, that it’s impossible to ever see the end. The fog is like a cage without a key.

Getting help for substance abuse can be reduced to the deceptively simple focus of ‘keeping away from the dope.’ But what does getting help with depression mean? Learning to keep away from your own mind?

How can you hide from what never goes away?

I start to get the feeling that something is really wrong. Like all the drugs put together – the lithium, the Prozac, the desipramine, and Desyrel that I take to sleep at night – can no longer combat whatever it is that was wrong with me in the first place. I feel like a defective model.

I know by now, only too well, that you can never get away from yourself because you never go away.

The atypically depressed are more likely to be the walking wounded, people like me who are quite functional, whose lives proceed almost as usual, except that their depressed all the time, almost constantly embroiled in thoughts of suicide even as they go through their paces. Atypical depression is not just a mild malaise...but one that is quite severe and yet still somehow allows an appearance of normalcy because it becomes, over time, a part of life. The trouble is that as the years pass, if untreated, atypical depression gets worse and worse, and its sufferers are likely to commit suicide out of sheer frustration with living a life that is simultaneously productive and clouded by constant despair. It is the cognitive dissonance that is deadly. Because atypical depression doesn’t have a peak- or, more accurately, a nadir, like normal depression, because it follows no logical curve but instead accumulates over time, it an drive its victim to dismal despair so suddenly that one might not have bothered to attend to treatment until the patient has already, and seemingly very abruptly, committed suicide.

Forget about the scant hours in her brief life when Sylvia Plath was able to produce the works in Ariel. Forget about that tiny bit of time and just remember the days that spanned into years when she could not move, couldn’t think straight, could only lie in wait in a hospital bed, hoping for the relief that electroconvulsive therapy would bring. Don’t think of the striking on-screen picture, the mental movie you create of the pretty young woman being wheeled on the gurney to get her shock treatments, and don’t think of the psychedelic, photonegative image of this sane woman at the moment she receives that bolt of electricity. Think, instead, of the girl herself, of the way she must have felt right then, of the way no amount of great poetry and fascination and fame could make the pain she felt at that moment worth suffering. Remember that when you’re at the point at which you’re doing something as desperate and violent as sticking your head in an oven, it is only because the life that preceded this act felt worse. Think about living in depression from moment to moment, and know it is not worth any of the great art that comes a its by-product.

Depression gave me more then just a brooding introspection. It gave me humor, it gave me a certain what-a-fuck-up-I-am shtick to play with when the worst was over..the side effects, the by products of depression, seems to keep me going. I had developed a persona that could be extremely melodramatic and entertaining. It had, at times, all the selling points of madness, all the aspects of performance art. I was always able to reduce whatever craziness I’d experienced into the perfect antidote, the ideal cocktail party monologue...I thought this ability, to tell away my personal life as if it didn’t belong to me, to be queerly chatty and energetic at moments that most people found inappropriate, was what my friends liked about me.

Affection as medicine is highly overrated...a person who is as sick with depression as I most certainly was cannot possibly be rescued through the power of anyone's love.

You don't need an excuse to be depressed.

Depression is a very narcissistic thing, it's a self involvement that is so deep and intense that it means the sufferer cannot get out of her own head long enough to see what real good, what genuine loveliness, there is in the world around her.

And I always feel so stupid sitting in therapy talking about my problems because, Jesus Christ, so what? I can't equate the amount of pain and misery and despair I have suffered and endured as a depressive with the events of my life, which just seem so common.

In order for therapy to be effective, a patient must be prodded and provoked, forced into confrontations, given sufficient incentive to push herself out of the caged fog of depression.

I hated him for not being depressed. He seemed a fool-- everyone who didn't feel like me was a fool. I alone knew the truth about life, knew that it was all a miserable downward spiral that you could either admit to or ignore, but sooner or later we were all going to die.

No one who had never been depressed like me could imagine that the pain would get so bad that death became a star to hitch up to, a fantasy of peace someday which seemed better than any life with all this noise in my head.

Sometimes I wish there were a way to let people know that just because I live in a world without rules, and in a life that is lawless, doesn’t mean that it doesn’t hurt so bad the morning after.

Lying in bed for a few days wouldn't help enact the kind of personality overhaul it would take to pull me away from my well-established pattern of mapping out escape routes, clinging to them like vines, and then watching as these lifeless forces suddenly pushed me away, though I continued to hold on for dear life.

Depression gave me extreme perspicacity; rather than skin, it was as if I had only thin gauze bandages to shield me from everything I saw.

...sometimes they almost made me feel glad that I had a few extra years to play my depression out with therapy and other means, because I think its useful in youth- unless suicide or drug abuse are the alternatives- to have some faith in the mind to cure itself, to not rush to doctors or diagnosis's...I sometimes worry that part of what creates depression in young people is their own, and their parents, and the whole worlds impatience with allowing the phases of life to run their course. We will very likely soon be living in a society that confuses disease with normal life if the panic and rush to judgment and labeling do not slow down a bit. Somewhere between the unbelievable tardiness that the medical profession was guilty of in administering proper treatment to me and the eagerness to with which practitioners prescribe Ritalin for 8 year old boys and Paxil for 14 year old girls, there is a sane course of action.

The trouble is that when we get around to solutions, it always seems to come down to Prozac. Or Zoloft. Or Paxil. Deep clinical depression is a disease, one that not only can, but probably should, be treated with drugs. But a low-grade terminal anomie, a sense of alienation or disgust and detachment, the collective horror at a world that seems to have gone so very wrong, is not a job for antidepressants. The trouble is, the big-picture problems that have so many people down are more or less insoluble: As long as people can get divorced they will get divorced; America=s shrinking economy is not reversible; there is no cure for AIDS. So it starts to seem fairly reasonable to anesthetize ourselves in the best possible way. I would like so much to say that Prozac is preventing many people who are not clinically depressed from finding real antidotes to what Hillary Clinton refers to as 'a sleeping sickness of the soul,' but what exactly would those solutions be? I mean, universal health care coverage and a national service draft would be nice, but neither one is going to save us from ourselves. Just as our parents quieted us when we were noisy by putting us in front of the television set, maybe we're now learning to quiet our own adult noise with Prozac.

...if you ask anyone in the throes of depression how he got there, to pin down the turning point, he'll never know. There is a classic moment in The Sun Also Rises when someone asks Mike Campbell how he went bankrupt, and all he can say in response is, 'Gradually and then suddenly.' When someone asks how I lost my mind, that is all I can say too." -Elizabeth Wurtzel, Prozac Nation

I don't mean to sound like a spoiled brat. I know that into every sunny life a little rain must fall and all that, but in my case, the crisis-level hysteria is an all-too-recurring theme. The voices inside my head, which I used to think were just passing through, seem to have taken up residence And I've been on these goddamn pills for years.

I can’t quite shake this feeling that we live in a world gone wrong, that there are all these feelings you’re not supposed to have because there’s no reason to anymore. But still they’re there, stuck somewhere, a flaw that evolution hasn’t managed to eliminate yet. I want so badly to feel bad about getting pregnant. But I can’t, don’t dare to. Just like I didn’t dare tell Jack that I was falling in love with him, wanting to be a modern woman who’s supposed to be able to handle the casual nature of these kinds of relationships. I’m never supposed to say, to Jack or anyone else, ‘What makes you think I’m so rich that you can steal my heart and it won’t mean a thing?’ Sometimes I think that I was forced to withdraw into depression, because it was the only rightful protest I could throw in the face of a world that said it was all right for people to come and go as they please, that there were simply no real obligations left. Deceit and treachery in both romantic and political relationships is nothing new, but at one time, it was bad, callous, and cold to hurt somebody. Now it’s just the way things go, part of the growth process. Really nothing is surprising. After a while, meaning and implication detach themselves from everything. If one can be a father and assume no obligations, it follows that one can be a boyfriend and do nothing at all. Pretty soon you can add friend, acquaintance, co-worker, and just about anyone else to the long list of people who seem to be part of your life, though there is no code of conduct that they must adhere to. Pretty soon, it seems unreasonable to be bothered or outraged by much of anything because, well, what did you expect?

I know I want out of this mess. I want out. No one will ever love me, I will live and die alone, I will go nowhere fast, I will be nothing at all. Nothing will work out. The promise that on the other side of depression lies a beautiful life, one worth surviving suicide for, will have turned out wrong. It will all be a big dupe.

You know you’ve completely descended into madness when the matter of shampoo has ascended to philosophical heights.

People talk about the way disembodied spirits roam the world with no place to park themselves, but all I can think is that I am a dispirited body, and I’m sure there are plenty of other human mollusk shells roaming around, waiting for some soul to fill them up.

No man is going to solve my problems, no one can rescue me, because I am too sick.

Just as our parents quieted us when we were noisy by putting us in front of the television set, maybe we’re now learning to quiet our own adult noise with Prozac.

The idea of throwing away my depression, of having to create a whole personality, a whole way of living and being that did not contain misery as its leitmotif, was daunting.

I need love. I need the thing that happens when your brain shuts off and your heart turns on.

Homesickness is just a state of mind for me. I’m always missing someone or someplace or something, I’m always trying to get back to some imaginary somewhere. My life has been one long longing.

I think the closeness that you’re able to experience when you’re with Rafe is something you’ve been deprived of and something you’ve needed for so long that it’s causing you to go to these extremes of emotion every time you feel him slipping away,

Yes, there was a certain beautiful honesty to my depressed state—I miss it sometimes now. I miss having so little stake in maintaining the status quo that I could walk out of rooms in tears at times that other people would have deemed inappropriate. I liked that about myself. I liked that disregard for convention.

sometimes i wish i could walk around with a HANDLE WITH CARE sign stuck to my forehead. sometimes i wish there were a way to let people know that just because i live in a world without rules, and in a life that is lawless, doesn’t mean that it won’t hurt so bad the morning after. sometimes i think that i was forced to withdraw into depression because it was the only rightful protest i could throw in the face of a world that said it was all right for people to come and go as they please, that there were simply no real obligations left. certainly deceit and treachery in both romantic and political relationships is nothing new, but at one time, it was bad, callous, and cold to hurt somebody. now it’s just the way things go, part of the growth process.

if there is no proof that a depressed person has a chemical imbalance, and you choose nevertheless to put that person on a medication that will alter neurotransmitter levels in his or her brain, then in effect you are causing a chemical imbalance rather than curing one. According to Steven Hyman, a neuroscientist and former director of the National Institute of Mental Health, all psychotropic drugs cause “perturbations in neurotransmitter functions.” And this is Whitaker’s main point. We are subjecting millions of brains to drugs that change natural neurotransmission, sometimes radically, disturbing and upsetting the complex interplay inside our heads, clogging neural pathways with excess chemicals, and sometimes causing the entire brain, which is intricately interlinked, to malfunction in ways we do not yet understand. An unmedicated depressed patient does not have a known chemical imbalance in his brain, but once he ingests Prozac, he will. The drug crosses the blood-brain barrier and gets to work, jamming serotonin into the synaptic cleft. Whitaker explains the result this way: “Several weeks later the serotonergic pathway is operating in a decidedly abnormal manner.

Some consider this a paralyzing moral dilemma. I don't. For me, having lived through episodes of major depression, this is a no-brainer. If there is a pill that will make you well, or make it less likely you will get sick, you take it. If Prozac hasn't saved my life, it has profoundly changed it.

I had a moment of what I can only call clearheadedness. The suffocating anxiety was gone, momentarily, and I felt a deep relief, a sense of sudden calm after eons of warfare inside my head. I had gotten so used to the noise that the quiet was unfamiliar. It was as if the evil beast that had been holding my head under water, trying to drown me, had suddenly let go.

I find myself praying, wishing, hoping that God could just give me whatever it is that makes girls attractive to boys my age.

I can't equate the amount of pain and misery and despair I have suffered and endured as a depressive with the events of my life, which just seem so common.

I was, after the breakup, what you call a complete wreck. For the first time in my life, my pain had a focus.

There was no way the head counselor or anyone else would ever understand that I didn't like being this way. How jealous I was of all the other girls who were boy crazy and loud and fun. How much I wanted to flip my hair and flirt and be rowdy but somehow just couldn't -didn't dare- even try anymore.

I mean, I was kind of weird as thirteen-year-olds go, but it's not like I needed to be relocated to another planet in order to fit in. Or maybe I did. I was starting to feel that way.

I want so badly to have my life circumstances match the oppressiveness I feel internally.

I am so caught up in the idea that nobody would actually try to save me if I were to slit my wrists or hang myself from one of the rafters in the bunk. I can't believe anyone might care enough to try to keep me alive.

I am crying about the elusive nature of love, the impossibility of ever having someone so completely that he can fill up the hole, the gaping hole that for me right now is full of depression. I understand why people sometimes want to kill their lovers, eat their lovers, inhale the ashes of their dead lovers. I understand that this is the only way to possess another person with the kind of desperate longing that I have to take Rafe inside of me.

I, on the other hand, had taken a small overdose of pills and scarred my legs with razor blades, and still no one seemed to be rescuing me. Because, on paper, there was no actual problem.

Mommy, if you could only know how far gone I am, you would find another choice.

And it came as a relief to know that I truly had no one, nowhere, and nothing, that my belief that this whole life thing was just a big sham had been confirmed completely. I could now safely sink into the surrender of what little was left, I could experience the leisure of borrowed time and the pleasure of free-falling. And once I had decided that I was going to commit an act of self-destruction, if that were necessary, I felt necessary, I felt released from the harshness of the pain.

It seems like no amount of reassurance from him can convince me that he's really mine.

Nothing is real to me unless it's right in front of me.

Jesus, I wondered, what do you do with pain so bad it has no redeeming value? It cannot be alchemized into art, into words, into something you can chalk up to an interesting experience because the pain itself, its density, is so great that it has woven itself into your system so deeply that there is no way to objectify it or push it outside or find its beauty within. That is the pain I'm feeling now. It's so bad, it's useless. The only lesson I will ever derive from this pain is how bad pain can be.

I began to cry because I couldn't understand what my mother thought she would accomplish by saying these things to me. I was the one depressed, and somehow she managed to make it sound like I was supposed to feel sorry for her.

I'm effectively taking time off without actually taking time off, which for some reason assuages my conscience and makes me think I'm less sick than I am.

No matter what Dr. Sterling or any of the other mental health practitioners ever said, I never felt I had a right to be depressed. I always felt like: Really, if I wanted to, I could snap out of this.

I tell myself I'm not scared, I tell myself I really want to die, and it never occurs to me until the last possible moment that what I really want is to be saved.

... but they don't know how enormous my need is. They don't know how much I will demand of them before I even think about getting better.

At first, the idea was to get me going so I could respond to talk therapy, but now it seems clear that my condition is chronic, that I’m going to be on drugs forever if I just want to be barely functional.

Consider, for example, the landmark 2004 study that followed several hundred patients treated with one of three popular antidepressants: Zoloft, Paxil, or Prozac. Among those who took the drugs as prescribed, only 23% were depression-free after six months of treatment. (As you might expect, patients who failed to take their meds did even worse.) And all three medications yielded roughly the same dismal results. A fluke result, perhaps? It’s actually pretty typical. The recovery rate with antidepressants in similar studies usually falls somewhere between 20% and 35%. Clinical researchers at forty-one treatment sites across the country have just completed the largest real-world study of antidepressants ever conducted, and the results fit the same overall pattern. This multimillion dollar project, sponsored by the National Institutes of Mental Health, followed about three thousand depressed patients who initially took the drug citalopram (marketed under the trade name Celexa) for about twelve weeks. By the end of that short-term treatment period, only 28% of study patients had fully recovered. The study’s 28% response rate might even be an overestimate of the medication’s true effectiveness, because patients received higher drug doses and had more frequent doctor’s visits than people do in everyday clinical practice. (In real life, insurance companies sharply restrict the frequency of “med check” follow-up appointments). Remarkably, the study’s authors—a veritable All-Star team of clinical researchers—noted that the observed 28% recovery rate was about what they had expected to see based on comparable studies. That’s right: They weren’t surprised to find that the majority of study patients failed to recover on an antidepressant. In the study’s published write-up, the researchers also raised a provocative question: What percentage of their patients might have recovered if they had received a sugar pill—a placebo—instead of the medication? Could it possibly have been as high as 28%?

And I’m starting to wonder if I might not be one of those people like Anne Sexton or Sylvia Plath who are just better off dead, who may live in that bare, minimal sort of way for a certain number of years, may even marry, have kids, create an artistic legacy of sorts, may even be beautiful and enchanting at moments, as both of them supposedly were. But in the end, none of the good was any match for the aching, enduring, suicidal pain.

Of course, there are some guys who really will fuck anything. Even me.

Rock bottom is everything out of focus. It’s a failure of vision, a failure to see the world as it is, to see the good in what it is, and only to wonder why the hell things look the way they do and not—and not some other way. As if there were any way that might look right from behind that depressive fog.

I believe there is an integrity to my intolerance: Why does the rest of the world put up with the hypocrisy, the need to put a happy face on sorrow, the need to keep on keeping on?

Then there’s Prozac. It is so new at this point that Dr. Sterling still refers to it as fluoxetine. Prozac, like Zoloft, Paxil, and other drugs of its type which were not yet available as I lay in Stillman in 1988, acts only on serotonin. It is very pure in its chemical objectives. Its drug family will come to be known as selective serotonin reuptake inhibitors (SSRIs), and it can act very powerfully and directly within its narrow domain. Since fluoxetine’s aims are less scattershot than those of its predecessors, it tends to have fewer side effects.