Letters

[Read "Van Gogh on Prozac," by Laura Miller.]

As a writer who's suffered from depression most of his life, I feel like I should send Peter Kramer a box of cigars, or a basket of fruit or, at the very least, my gratitude.

Anyone who thinks depression equals depth, creativity or humanity has no idea what they are talking about. Depression makes you shallow, uncreative and more slug than person. When I'm depressed, I can barely put together a sentence. When I'm not, I can come up with ideas and turns of phrase that delight, excite or surprise me and (hopefully) my readers.

"What if van Gogh had taken Prozac?" He might have been even better. He might have scrapped painting and been an accountant. Chances are he would have been happier. Non-depressed people who ask the van Gogh question don't seem to grasp the selfishness behind it. It implies that depressed artists should just "suck it up," and hopefully they'll turn out an immortal work the rest of us can enjoy.

-- Tom Coombe

To discount the very real personality changes that do occur in many individuals as a result of SSRIs is brazen! What we depressed artists, a group for which I have my bona fides, fear in taking antidepressants is not that we will no longer feel sadness. Nor, as both Ms. Miller and Dr. Kramer emphasize, do we feel particularly romantic about our afflictions. No, what we fear is the glazed-over, disassociated look we see in the eyes of our friends taking drugs like Prozac and the impact that would have on our creative output!

What remains unsaid in nearly all articles written on the subject is that researchers are still fairly clueless about how these drugs really work. Additionally, the myriad causes, effects and interrelations of mood, personality and the creative temperment defy a reduction as simple as a pill. Dr. Kramer's assertions of this disease's toll on individuals is certainly spot-on, but by tying his arguments to incompletely understood medications and their "benefits" to all rings false.

While I do not deny the power of these drugs in conjunction with traditional talk therapies, it seems ridiculous and mildly irresponsible to draw the conclusion that there is no validity to the question of whether or not van Gogh or any other serious artist could or would produce the same caliber work if on Prozac. Quality of life is measured by different, and arguably more, factors than Ms. Miller entertains when the patient in question is a professional, sensitive and working artist.

-- Chris Panagakis

In my late 20s, as I was just launching a precarious career in film, I discovered what depression was, and this question was much with me. First of all, there is nothing creative about depression. It is the antithesis of creativity. Had Prozac existed at the time I was depressed, I would have taken it in a heartbeat.

But there is something to the "co-incidence" of depression and the lives of the great artists. I think it's this: an artist leads life naked, without the social rationales that the rest of humanity has. You really have no validation when you face the blank canvas or the unexposed film except your faith in yourself, which is getting profoundly tested; it is literally, for a young artist, a matter of life and death.

When people take this kind of adventure, it's no wonder if inborn tendencies toward depression get triggered. It's a professional hazard. That is not to fetishize the depression of many artists as the goal of their endeavor. What the lives of great artists demonstrate is the greatness of their souls as they overcome the demons they unleash by daring to be artists. It's not surprising that Daedalus plummets to earth. What's glorious, and untold in the Greek myth, is that Daedalus picks himself up, improves the design of the wings, and takes off again.

-- Jim Hassinger

Thank you for your sensitive and insightful look at our culture's two-faced approach to the condition and treatment of depression. As someone who has been suffering from depression for years and (at the same time) proceeding through graduate education in the humanities, I can testify to our Western intellectual fixation on the "genius" of the depressed (though, as with many things, we do not usually outright call it that). Genius is by its very nature singular and, hence, distant. We act like we are lauding the state of depression while at the same time we are exoticizing the depressed; whispering sweetly in their ears while holding them at arm's length.

The fact is that depression for most people, even very educated people at top universities who ought to know better, is not really a disease. It is some amalgamation of a personal, social and moral state for which victims are, however subtly, and however positively or negatively, held responsible. Active treatment of it, and demands for accommodation of that treatment, often carry a terrible stigma even (or perhaps especially) where that stigma is most vehemently denied.

I have simply stopped asking questions like "if this were diabetes would they still be saying/acting like this to me." Down that path lies even deeper madness. And I simply ignore comments like "many other scholars have suffered from deep sorrow, and this is what gives their work such insight into human suffering." Depression pulls me into myself, making me so focused on daily survival that I become entirely selfish and self-centered. It is a state of inner paralysis, not a standpoint of superior human vision.

I know when I can work and when I can't. My personal genius awakes when the depression subsides. And it comes back with such fervor, such a desperate longing to stay free from depression's relentless numbing of life, that for a while I triumphantly know just who I am. But in depression, there is no genius for me, only emptiness. Can I, or any other victim of this disease, be blamed for taking the path that science has forged for us to return to that place where genius really can be fostered in us?

-- Jennifer Heisler

I would like to thank Laura Miller and Salon for this article. As a major depressive who swears she would leave this world if it weren't for her young son, who just today raged her life was a "quagmire of shit," this article gave me a moment of clarity, rational thought and most importantly for the depressive ... hope. Thank you again.

-- Anonymous

Having read only "Listening to Prozac" and not Kramer's new book, I am willing to give his compassion the benefit of the doubt. I also believe in the existence of clinical/organic depression. However, I'm afraid I don't have any such faith in pharmaceutical corporations, and that's where my problems with "Against Depression," at least as reviewed, pop up.

As pharm-tech has grown over the past decade, and pharmaceutical industries have ascended on Wall Street, the DSMV-IV [the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders] has also swollen with new diagnoses, many of which recommend treatment with Prozac and its ever-growing family of chemical siblings. It sometimes seems that every human eccentricity is now a diagnosable disorder, and Pfizer has the cure.

Sure, some depression is severe enough to require chemical treatment, but is American society, at least at this point in history, wise enough to navigate a sensible course between treating the sick and the "happy pill"? We are obsessed with the quick fix. Obesity is another medical condition currently plaguing the U.S. Many overweight Americans would rather "have the surgery" than exercise and eat better, even though the latter solution is the healthier and more effective long-term strategy. I think in many cases depression is treatable through numerous non-pharmaceutical practices as well. Psychotherapy, for instance, a process that has fallen from grace recently, mostly because it doesn't work quickly enough. Diet and exercise. Working, like van Gogh, on a creative project. All these can be effective treatments for less severe forms of depression.

As someone who is sensitive enough to the way the world works to feel the soul grind on a regular basis, as someone diagnosed with obsessive-compulsive disorder, as someone who has taken Prozac and Paxil and several other antidepressants, I have come to the conclusion that they are over-prescribed. In my case, Paxil was effective enough against my OCD, however it seemed that while I was no longer latching onto a given fearful thought and driving myself mad obsessing over it, I also lost the ability to choose a thought and "obsess" over it at will. In other words I lost the drive to be a problem solver, which is a skill I actually treasure. Sure, I could have tried adding another pill to the mix, to treat the attention deficity disorder brought on by my OCD treatment, but I decided to go the other way. I still keep Xanax around to interrupt any anxiety attack my OCD might bring on (rarely happens), but otherwise I'm off the pharms.

Now, when I start obsessing about something I stop and ask myself what real-life problem might I be dodging by worrying about this (mostly) imaginary one, a trick my therapist taught me back in the early '80s, and one that often bears fruit. I have also learned to "starve the monster," by letting the obsessive thought or fear talk for a while and then distracting myself by doing something else. Amazing how often it works.

I am not trying to belittle the fact that some people have extreme forms of depression, OCD or other mental disorders that might benefit from treatment by SSRIs. However, I do strongly believe that these drugs should be prescribed far more judiciously than they currently are, and tested more rigorously before being mass-marketed to the public with slick "Ask Your Doctor About..." ad campaigns. And I think the recent studies correlating teen suicide and Paxil back me up on this.

-- Gentry Johnson