By Cornelia Read

When I was a little kid, I used to wonder if I was missing some essential vitamin or mineral, compared to everyone else I knew. I come from a long line of bubbly, enthusiastic women, on my mother's side–a matriarchy of outgoing charmers with mad skills for generating effortlessly effervescent small talk at cocktail parties.

By comparison, I was an achingly serious child, with an affect flatter than the chest of a pre-teen Judy Blume protagonist. Besides which, gothic things that got stuck in my head for days never seemed to faze anyone else in my vicinity. 

When my most odious stepfather announced over dinner one night that the world was going to be fried to a crisp by solar radiation within ten years because fluorocarbons in aerosol-spray propellants were destroying the ozone layer, nobody else at the table seemed to mind all that much. 

I, meanwhile, spent the next three days silently dispensing an interior monologue of Goodnight-Moon-style farewells to every person and object I saw ("Alas, loyal toaster oven, you've served us well… Take care, o most ill-behaved rental horse we ride in Pony Club, for soon your poignant bones will lie bleached on the sun-charred loam that was once the polo field…  Adieu, watermelon Jolly Ranchers, my favorite candy, and may all who make you possible fly on to the afterlife with my heartfelt gratitude…  Ciao, sixth-grade cheerleading bitches–bet you won't be such nasty hags to everyone on the field-trip schoolbus just because you have five pairs of Dittos each when you're DEAD…)

In short, I was a child suffering from depression, and I have little doubt that this has something to do with my early bent for writing–not least since the first time I ever used up-and-down binder paper instead of the pulpy beige landscape stuff with room for a picture on top was to pen an impassioned essay decrying the government's hideously unfair treatment of Angela Davis and the Christmas carpet-bombing of Hanoi. In second grade. (noir much?)

Oddly enough, though I was urged to see a number of therapists over the years (the on-campus counselors in boarding school, and college, and finally at the institution where I taught high school history and English), none of these clinicians ever mentioned depression.

I spent a couple of decades wondering whether I just lacked the willpower to manufacture an appropriate level of good cheer, or maybe had iron-poor blood. I spent a lot of time thinking I should be as chipper as people in Geritol commercials, or smiling as hard as contestants in the Miss America pageant (not yet knowing they smeared their teeth with Vaseline so their lips didn't get stuck, etc.)

I remember a week during which I popped two chewable Flintstone multis a day, wondering if it would help. In eighth grade, I discovered caffeine pills, which seemed to produce a little more of the enthusiasm I was after for a week or so–until the vice principal busted me for the bottle of Vivarin in my locker, since Heather Douglas narked on me because she'd seen the V's on the tablets and assumed I was popping Valium. (I suppose I should be grateful that Viagra had yet to be invented.)

It wasn't until December of my twenty-sixth year that anyone brought up the D word. I was in my weekly faculty group-therapy session at the crazy school, and our regular shrink had been out sick for a while so the head guy stepped in to cover for her. The school was a horrible place (see my second novel), so I took my seat on the office sofa between the two fellow teachers I shared the hour with in a morose frame of mind, and shortly burst into tears once it was my turn to talk about how everything was going.

The Big Shrink looked at me for a minute and said, "do you usually feel like this?"

I told him I did.

He asked, "for how long?"

I said since I was about seven years old.

He said, "you're clinically depressed. They have a great new medication for that."

I said, "No shit… What's it called?"

He said, "Prozac."

I handed in my resignation a week later and found a shrink willing to prescribe me some.

Hosanna.

About a month in, I named my little buttercream-and-celadon capsules "Vitamin P," at long last having found the elusive ingredient I'd hankered after for all those years beforehand.

That was in the Fall of 1989. I've pretty much taken prescription Selective Serotonin Re-Uptake Inhibitors (SSRIs) ever since–the class of drugs which includes Prozac, Celexa, and Paxil, among others.

I'm pretty up front about it. Mostly because it would've been damn helpful to me if someone had mentioned depression and the potential medications for it to me years earlier, so I'd like to do my bit to share how it's been for me.

I also tell people about it because I think there are a number of really idiotic medication fallacies floating around, which can keep people suffering from depression from giving these things a try. I don't mean to say that they're perfect for everyone, or that we should spike the nation's drinking water with Eli Lilly products or anything, but since depression can fucking kill you, the bullshit pop-"science" myths about medications that can help alleviate it in a great number of affected people really piss me off.

Myth # 1: Prozac will tranquilize you into becoming a cheerful fascist zombie, so just say no to Big Pharma and fight the power, man!

Here's the deal… Prozac does NOT make you feel like this:

Or make you love everything cute and cuddly and vapid:

And you will not take one pill and wake up oblivious in Stepford, wearing a frilly plaid apron:

Though it may help you stop feeling like this:

It's not a happy pill, and it's not a tranquilizer–or methadone or valium or thorazine. It's a drug that is helpful to people who have low levels of a specific neurotransmiter in their brain chemistry. If you're prone to depression, it won't make you perfect, but it might well provide a bit of a floor to the depths of abyss you find yourself sinking into.

Myth # 2: Depression is for wimps, so you should just pull yourself up by your bootstraps and stop whining, because life is pain, princess, and medication is the coward's way out.

People with broken arms often benefit from wearing a cast for a few weeks. People with Type I Diabetes have pancreases that don't produce enough insulin. Most people with depression have brains that aren't making enough serotonin. Why is seeking treatment for the third option the only one of these seen as a moral failing? That's just fucking stupid.

Meanwhile, here's a bullshit depiction of what Prozac does:

(hint: it is an anti-DEPRESSANT, not an anti-PSYCHOTIC. It has no magic powers that will make invisible car passengers disappear. Sorry.)

It also doesn't act like this, in regards to one's neurochemical balance:

It's not like you'll try the stuff and suddenly never feel sadness or any other emotion again, it's more like you can experience sadness without feeling like you want to lie on your sofa for a year with the shades drawn, doing shots of codeine cough syrup with potato-chip crumbs ground into the front of your ex-boyfriend's college sweatshirt, hacking up the detritus of three packs of Camel non-filters a day. (Your mileage may vary. That's just what it feels like to me, curled up in a fetal position down here under the bed with the dust rhinos.)

Here's the best visual depiction I've ever seen of what the stuff does:

It's still you, you just have the option of stepping back ONTO the cliff, and possibly not dying while you try to make up your mind whether or not that would be a good idea.

Myth # 3: Dude, drugs like Prozac aren't "natural"–your body is a temple and nothing should go into it but herbs and tofu.

News flash: St. John's Wort doesn't work for shit. And even if it (or Vitamin B-12 shots or CoQ-whatever or beet-juice-and-fairy-dust) were effective against depression, chances are good it would be because it had a similar chemical effect on the brain.

Just because something costs forty bucks a bottle and has a picture of alpen meadows on the label down at the granola store doesn't mean it's morally superior to the stuff you need a 'scrip for, mkay? And hey, if yoga and valerian-root work for you, awesome. They don't do bupkes for me.

Plus which, opium is "natural" too–ask the Taliban. Doesn't mean the shit is good for you.

(And why is it the last three people who told me I shouldn't "take drugs" had just finished doing bonghits?)

Myth #4: Depression doesn't cause writing, writing causes depression.

If you Google "writing and depression," you'll find an awful lot of pronouncements like the following:

Yes, writers do suffer from depression at a higher rate than the
rest of the population…. In
fact, if you wanted to make a cheery person with no predisposition to
depression depressed, you could stick him in front of a typewriter or
computer for hours a day–feed him a typical writer's diet–forbid him
to exercise, isolate him from friends, and convince him that his
personal worth depended on his "numbers." Make him live the writer's
life, in other words, and watch him sag.

(This was Nancy Etchemendy's* synopsis of
an apparently widely held opinion, though not her thesis in the
remainder of the essay.)

And, yes, the writing life can do an awful
lot to prolong or deepen depression. Hell, it's scary, right? You have
no idea whether you're God or wormshit, most days. Plus all that other
stuff.

Still, I don't think this is a chicken-or-the-egg thing.

It sure wasn't in my case. The depression showed up way before I was even vaguely literate. (Again, your mileage may vary.)

When you get right down to it, does it matter which came first? It still sucks.

Myth # 5: Taking happy pills will destroy your creativity–all great art is born of suffering. The real problem is bourgeois society demanding that those touched by the muse be chipper automatons, instead of according their divine angst the worship it so richly deserves.

This is the biggie, but it's a little more nuanced. Look, there is definitely a connection between depression and creativity… here are some of the stats I referenced in my ADD post, a couple of weeks ago:

• Kay Jamison, a professor of psychiatry at Johns Hopkins University and
  the author of "Touched With Fire: Manic-Depressive Illness and the
  Artistic Temperament," said writers were 10 to 20 times as likely as
  other people to suffer manic-depressive or depressive illnesses, which
  lead to suicide more often than any other mental disorders do…. —NY Times

• Almost everyone becomes clinically depressed at least once. Over half
  the general population will experience two or more episodes of serious
  depression during a lifetime. Statistics gathered in a recent article
  in Scientific American indicate that the incidence of clinical
  depression among writers and artists may be as much as ten times
  greater than that among the general population. The incidence of
  suicide is as much as eighteen times greater. —Blogger Nancy Etchemendy*

• There is at least one piece of research which demonstrates that some
  (British) writers have a higher than average chance of being mentally
  ill. The research was carried out by Kay Jamison, Professor of
  Psychiatry at Johns Hopkins University School of Medicine. Her study
  showed that 38% of a group of eminent British writers and artists had
  been treated for a mood disorder of one kind or another; of these, 75%
  had had antidepressants or lithium prescribed, or had been
  hospitalised. Of playwrights, 63% had been treated for depression.
  These proportions are, as you will have guessed, are many times higher
  than in the population at large.–Blogger Grumpy Old Bookman

• Female writers were
  more likely than members of the comparison group to suffer not only
  from mood disorders but from drug abuse, panic attacks, general
  anxiety, and eating disorders as well. The rates of multiple mental
  disorders were also higher among writers…. The cumulative psychopathology scores of subjects… represented significant predictors of their overall
  creativity. CONCLUSIONS: The high rates of certain emotional disorders
  in female writers suggested a direct relationship between creativity
  and psychopathology. But the relationship was not necessarily a simple
  one. —Study by the University of Kentucky Medical Center, Lexington, psychiatry department

[If you're like me, you tend not to have episodes of depression, but a constant low-grade version {with occasional flareups that send you under the sofa with a bottle of dark rum and the dust rhinos} This is called dysthmia. Here's the wiki-synopsis:

The symptoms of dysthymia are similar to those of major depression, though they tend to be less intense. In both conditions, a person can have a low or irritable mood, lack of interest in things most people find enjoyable, and a loss of energy (not all patients feel this effect). Appetite and weight can be increased or decreased. The person may suffer from insomnia or excessive sleeping. He or she may have difficulty concentrating. The person may be indecisive and pessimistic and have a negative self-image. The symptoms can grow into a full blown episode of major depression. This situation is sometimes called "double depression"[2] because the intense episode exists with the usual feelings of low mood. People with dysthymia have a greater-than-average chance of developing major depression. While major depression often occurs in episodes, dysthymia is more constant, lasting for long periods, sometimes beginning in childhood. As a result a person with dysthymia tends to believe that depression is a part of his or her character. The person with dysthymia may not even think to talk about this depression with doctors, family members or friends. Dysthymia, like major depression, tends to run in families. It is two to three times more common in women than in men. Some sufferers describe being under chronic stress. When treating diagnosed individuals, it is often difficult to tell whether they are under unusually high environmental stress or if the dysthymia causes them to be more psychologically stressed in a standard environment]

So, if you treat the depression, will you automatically be less creative?

I can only tell you how it's worked for me, and my answer is yes and no. I started taking Prozac in early 1990, and continued doing so until I decided to have kids, in early 1993. I started up again when we moved from Manhattan to Boulder, Colorado, in January of 1995, and took it until my husband and I both lost our jobs and health insurance in mid-2001. Prior to to 1990, I wrote a lot of unpublished fiction, and a memoir that ran to several hundred pages (that I never finished.)

I gave up on the memoir in 1990. With one exception (an evening creative writing class I took at UC Boulder for a semester), I didn't write any fiction again until the summer of 2001.

This is not to say I didn't write. I worked as the restaurant and art critic for The Boulder Weekly for a year, before my husband's work took us to Cambridge, Massachusetts. For the next four years, I wrote for a developmental disabilities newsletter as a volunteer, and posted 100-odd product reviews at Epinions.com. It's just that fiction kind of faded out as a compulsion for me. I didn't think up phrases for stories that drove me to turn on the computer in the middle of the night anymore (though the advent of twins probably also had something to do with that).

When we moved to Berkeley in 2000, I scored a gig as a writer and editor at a child-development dotcom. When we were all laid off and I lost my health insurance, I stopped taking Prozac. Three months later, I ran across an ad for a mystery writing group on craigslist, joined it, and started my first published novel. I worked on it for two years, unmedicated, before my husband got a job with health benefits again. I finished it on Celexa, another SSRI.

I'm here to tell you that there's a definite connection between the abyss and the urge to create. The trouble is, the abyss can just as easily suck your artistic will bone-dry as enhance it–it's merely a matter of degree.

Author Elizabeth Moon put it beautifully:

Speaking
from experience (several bouts of clinical depression), I can guarantee
that depression beyond the very mildest level (which makes you just
miserable enough to stay home and finish the book rather than go out
and have fun) destroys creativity–and that treating depression
enhances it. Why? Well, depression doesn't just make you miserable.
When you're depressed, you have no energy–and writing books takes hard
work, which takes energy. When you're depressed, you find it hard to
start new things (like books, chapters, the day's work), and hard to
make decisions (like which book, or which character, or even which way
Albert will turn when he leaves the throne room…) When you're
depressed, everything seems futile–you are sure the book will be lousy
even if you do write it. When you're depressed, you have less courage,
less resilience, less ability to handle ordinary stressors. So…you
can't summon the energy or the courage to write…every little comment
throws you back into your misery…and the next thing you know you're
in the midst of a full-fledged writer's block.

To put it another way, would Van Gogh have been a great painter if he weren't shithouse-rat crazy?

Well, guess what–we can't know. Maybe he would've been a really mediocre stockbroker, instead. Or maybe he would've produced an extensive oeuvre of dogs playing poker. Had he been treated, however, it's a good bet he would've LIVED quite a bit longer.

Would Prozac have helped Hemingway, Plath, or Virginia Woolf produce more great art? Well, it's hard to produce ANYTHING if you're dead, so I'd give that a qualified yes. 

All I know for sure is that I probably STARTED A Field of Darkness because I was off my meds and my life and marriage and financial prospects sucked hugely, but I FINISHED it and had the mojo to attend conferences and go after getting an agent and a publisher because I was back *on* the stuff.

And hey, if I hadn't lost my job, I'd probably still be a very smugly complacent $40-an-hour editor at escore.com, too, instead of prospecting for loose change in my sofa so I could attend Bouchercon and LCC every year. Granted, I miss being able to afford the '84 Porsche I scored in my dotcom blaze of financial glory–not to mention the sushi and non-second-hand clothing–but I wouldn't trade having two novels out in the world for that, you know?

And then there's the whole thing with self-medication, which I think is the basis for the incredibly high rates of alcoholism among writers.

(William Styron was hospitalized for depression shortly after he had to give up his evening cocktails, due to an unrelated medical condition. He'd never suffered from the "black dog" before. Coincidence? I think not.)

I tried the alcohol route myself, in college, along with a variety of other distractions. There are probably a great number of my Sarah Lawrence classmates who imagine that I died under a park bench somewhere, of either acute beer poisoning or syphillis or both. Enough said.

The Down-Side(s) of SSRIs

Like any drug, these things have side effects (these can of course strike in different guises, and affect people in different ways Some of the major ones to look out for are sexual dysfunction (often lack of interest in women, occasionally priapism in men–the same stuff they warn you to go to the ER for after four hours of non-stop Viagra effect).

There's an increased risk of suicide for teenagers and people in their early twenties, on SSRI's. EVERYONE should pay attention to whether or not they feel more depressed or anxious on these drugs, especially during the first month or so.

If you're bi-polar, rather than depressed, SSRI's hugely increase your chance of having a manic episode. A friend of mine who didn't realize she was manic-depressive ended up in McLean's hospital outside Boston for a month, after taking Prozac. Another had to do a 72-hour involuntary stint at a mental hospital here in California. If anyone in your family has bi-polar disorder, please have a thorough workup done by someone who knows what they're doing before trying this class of drugs.

(Even if you don't have relatives suffering from that disorder, it's a good idea to consult with a reputable psychiatrist or psychopharmacologist about getting a prescription for any anti-depressants, rather than your family doctor. Yes, a lot of people take them, and yes, they're generally very safe, but that doesn't mean they can't really mess with you under certain circumstances a GP might not be familiar with.)

Also, different people respond differently to each of the drugs within this class.In some cases, you may have to try more than one to find one that works the best for you. (If someone who's a close relative is taking a specific SSRI and has had a good response to it, that might be the first one to try.)

             *           *            *

At the end of the day, if you've tried scrubbing, soaking (those dirty rings!) and still feel like crap and are having trouble getting off the sofa, medication might be something you want to try. If you have hardcore depression–especially ANY thoughts of suicide, it's something you definitely should try. (Here are some more good resources for depression of that severity–whether it's yours or someone you know's.)

On a far more serious note, I am one degree of separation from three people who took their own lives last week, and these are perilous times for people with a tendency toward depression. Depression can kill you, or those that matter to you. Let's all take it seriously, okay? Not with judgments, not with discouragement or dismissive attitudes or half-assed advice.

Let's just look out for each other, the best we can, all right?

Since I'd like to end this on a positive note, here's a link to what is officially my new favorite meal: Sherry Miller's recipe for…

http://www.sherryart.com/prozac.html

Dude… awesome.

So, Murderati peeps… what bums you out? What cheers you up? How do you fight off what Winston Churchill called "the black dog"? Share, please.