Listening to Prozac

I’ve been away at the Billy Club’s Halloween gathering this weekend; I come home today, probably calmer and more in balance. I’ve spent a fair amount of this gathering off on my own, taking walks and meditating and reading. I wrote a short poem (three quatrains) yesterday, and on Thursday night after a long meditation I had what still seems three mornings later like a very good idea for a new opera adaptation.

One book I’ve been reading — as ever keeping up with the very latest in best sellers — is Peter Kramer’s 1993 Listening to Prozac. I have been diagnosed as having a dysthymic personality myself, and I started taking an antidepressant a few years after my brain surgery, to pull myself out of a long dark funk that had developed after the surgery and that I hadn’t been able to shake, despite my recovery going well enough that I was not only working again after eight months but soon making half again as much money as I had been before the tumor. So for me, reading a book like this isn’t just a dispassionate interest in psychology (though there’s certainly that, too); it’s also seeing whether I recognize myself in any of it, and whether it has any useful or helpful insights for me.

The book is about what we can learn about personality and human behavior from watching the effects that Prozac and other antidepressants have on various people. I’ve only read a few chapters so far, but the chapter titled “Sensitivity” in particular contains a lot of stuff that is fascinating as an insight into how our brains and personalities work, and that also seems personally very relevant. The gist of the chapter is that it looks as though a lot of things we think of as personality disorders are maybe better thought of as the normal adaptive behaviors that you would expect from someone who is more sensitive than usual to the pain of loss or rejection; that if someone is experiencing a more acute pain from certain things than most people do, you can only reasonably expect them to develop different coping behaviors from others. If Event X causes a mild, brief feeling of disappointment in one person but three days of intense and crippling emotional pain in another person, it’s only to be expected that the second person will develop more extreme ways of behaving so as to avoid all risk of Event X happening at all costs, and those behaviors might look like a behavioral problem or personality disorder to someone like the first person.

An antidepressant, then, can be thought of as something that lessens that senstivity, with the result that the personality slowly changes, sort of in the way a lifelong limp would gradually disappear if a surgery removed whatever it was that was making it painful to put much weight on that foot. It’s a hypothesis than explains a lot of unusual things about how the drugs work on people.

I can see myself reflected in this chapter in a lot of ways — a number of the patients Dr. Kramer writes about remind me of myself, such as in my shyness and difficulty in approaching other people in certain situations where I fear I won’t be able to take a rejection in stride; the very long time I grieved, and very painfully, for my friend David Sherblom (Dr. Kramer writes about someone who grieved three years for a loved one, which was more or less my situation); the painful feelings of rejection I sometimes experience over things that even I can see are objectively no rejection at all. Over the decades I’ve learned to deal with these painful feelings in more useful ways, and I’m usually pretty good now at not letting the fear of the painful feelings or even the painful feelings themselves govern too much how I behave; I can do a passable imitation of a gregarious person if I need to (and I don’t have to keep it up too long!) or let myself feel emotional pain without feeling driven or controlled by it, recognizing and subverting the negative patterns of thought I can slip into in times of stress.

But it’s also true that it feels as though the effect of the antidepressant I take has been to lessen the intensity of those painful emotions, which is what the chapter is about; and over time, as I’ve grown better accustomed to being sent merely into a mild downer by things that used to send me into a tailspin, I’ve become more confident in certain kinds of situations. It may well be that that’s been because my fear of those downers has lessened as the downers themselves have lessened in intensity.

So that chapter has given me an interesting new way of looking at what goes on within myself.

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