Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, February 19, 1995 TAG: 9502170019
SECTION: EXTRA PAGE: 3 EDITION: METRO
SOURCE: JULIE DEARDORFF CHICAGO TRIBUNE
DATELINE: LENGTH: Long
On a snowy Friday night, 27-year-old Elizabeth Wurtzel is perched behind a small table at Waterstone's Bookstore in Chicago, her hands shaking slightly from the lithium she ingests to combat depression.
She's supposed to be signing copies of her memoir, ``Prozac Nation: Young and Depressed in America.'' But Wurtzel, who has written what one unimpressed critic called ``a vomitously confessional'' book about her ongoing struggle with depression, isn't in any hurry.
Everyone here, it seems, has a story or a question for her, and Wurtzel graciously indulges in longer conversations than most authors at book signings. Patiently, book buyers wait in line for some sort of contact with the woman who has voiced their hazy, undefinable pain.
``You look like Stone Gossard,'' Wurtzel tells the second man in line, who has shoulder-length brown hair and is wearing a black turtleneck sweater, torn Levis and long underwear that shows through the gaping but fashionable hole in his knee.
``Who?''
``The guitarist from Pearl Jam.''
``Oh,'' says the Stone Gossard look-alike. He tells Wurtzel he's a bike messenger and model, then crouches down and lowers his voice so others can't hear.
``Have you ever heard the line `Death is lighter than a feather, heavier than a mountain?' '' he asks. ``I thought of that when I read your book. It's so easy to sink into oblivion. It could have been so easy to die and end it all, and you showed me what strength you have.''
``This may sound unorthodox,'' he adds, his voice growing even softer, ``but would you like to go for coffee?''
Wurtzel, petite and twenty-something hip, with a tiny, subtle stud in her nose, long hennaed hair, faded frayed Levis, cowboy boots and a revealing black silk shirt messily knotted at her waist, eyes him curiously. Then she starts signing his book.
She follows the same procedure every time she signs; first she writes a Hebrew expression meaning ``with the help of God'' in the upper right-hand corner, then she asks the buyer's name and writes a personal note after a brief conversation. She crosses out her own printed name, autographs the book and adds ``FTW'' (F--- the World), the three letters tattooed on her shoulder.
In the book of the man who has asked her out, she writes, ``I'm thinking about it.''
``Usually they write notes,'' Wurtzel says after he has gone to the back of the store to wait for her. ``They're much less obvious.''
They don't all ask her out, but many strangers do feel as if they know Wurtzel after reading ``Prozac Nation'' (Houghton Mifflin, 1994), which has little to do with Prozac, the antidepressant manufactured by Eli Lilly & Co., the Indianapolis-based pharmaceutical company, since 1988.
Instead, it's a book that offers unsparing details about Wurtzel's recurrent bouts with chronic, debilitating depression that began at age 11, when she took her first intentional overdose (using the allergy medicine Atarax while at summer camp).
At 12 she was carving her legs with razor blades, and by age 13, Wurtzel wouldn't get out of bed. Torn apart mostly by her divorced parents who separated when she was a baby, the rest of her high school and college years were marked with hysterical crying, visits to psychiatrists and doctors, and suicide attempts until she became one of the first people to be given the antidepressant fluoxetine, brand name Prozac.
For a while, Prozac worked. But Wurtzel, sadly, still isn't in the clear, and doesn't know if she ever will be. She still carries around a front pocket full of a variety of pills and in the beginning of December her doctor almost sent her back to the hospital for another stay.
``Whatever it was that was stabilizing me seemed to have stopped working and I was doing cocaine and other recreational drugs [at the time] to make myself feel better,'' Wurtzel said in a recent interview. ``My doctor thought I had developed a drug habit, and she thought I needed to clear my system out of this stuff and figure out what was wrong with me. In the end, I switched from Prozac to Zoloft,'' a similar antidepressant.
Her book has been marketed as Generation X's answer to ``Darkness Visible,'' William Styron's recent memoir of depression, and it also has been unmercifully attacked by book critics.
Recommended a sardonic Ken Tucker in The New York Times: ``Instead of prescribing Prozac to depressive patients, doctors might now want to try something else first: give them a copy of `Prozac Nation' and say, `Read this; if you don't watch out, you could end up sounding like her.' ''
Tucker also called Wurtzel ``A Sylvia Plath with the ego of Madonna'' and suggested that ``the reader may well begin riffling the pages of the book in the vain hope that there will be a few complimentary Prozac capsules tucked inside for one's relief.''
Wurtzel, who said she was rather shocked by the caustic attacks, worries that negative reviews will keep her book from reaching the people it's intended for, those living with chronic depression.
``I set out to write a book which was true to being depressed, which is extremely self-involved,'' said Wurtzel. ``I really wanted it to feel as bad as depression feels and not write a bubbly, less revealing job, which I think Styron did.
The book ``did astonish people either with its honesty or the extent which someone can be confessional. It took a certain amount of nerve and it's the kind of nerve that some people think is just great and others think is really annoying.
``The thing I've been glad about is that someone came up to me and said, `As soon as I read the review of your book in Newsweek I ran out and bought it,' '' Wurtzel added. ``I said the review was terrible, and she said, `No, I knew it was perfect. I knew that [the reviewer] just didn't get it.' ''
More than 9 million Americans are clinically depressed, according to a 1993 estimate by the National Institute of Mental Health in Bethesda, Md., the most recent figures available, though the number varies. Wurtzel says 12 million in her book.
And according to Dr. William Potter, chief of clinical pharmacology at the National Institute, only one-fourth of the people who might benefit from medication such as Prozac are currently taking it.
Wurtzel worries that's because of the attention mental illness and depression has been receiving, the trivialization of Prozac and the jokes. (A New Yorker cartoon showed Karl Marx on Prozac declaring, ``Sure capitalism can work out its kinks!'')
Writes Wurtzel in the book's epilogue: ``It seemed that suddenly, some time in 1990, I ceased to be this freakishly depressed person who had scared the hell out of people for most of my life with my mood swings and tantrums and crying spells, and I instead became downright trendy.
``This private world of loony bins and weird people that I had always felt I occupied and hid in had suddenly been turned inside out so that it seemed like this was one big Prozac Nation, one big mess of malaise.''
She's not the only one concerned, however. Eli Lilly, which estimates that 10.5 million Americans have taken Prozac since it was introduced in 1988 and 15 million worldwide, ran ads in Psychiatric News and medical journals last year declaring that ``much of the attention [to Prozac] has trivialized the very serious nature of the disease Prozac was specifically developed to treat - clinical depression.''
When two Eli Lilly employees recently handed out brochures on Prozac at a seminar for depression at a Maryland high school, they were disciplined by the company for commercializing the event. A spokeswoman would not comment on whether they were fired or suspended. And Peter Kramer addressed the issue in his best-selling book ``Listening to Prozac'' (Penguin, 1993) saying he was uneasy about what he called ``cosmetic psychopharmacology'' when people take a drug like Prozac simply to enhance their personality.
``Our numbers do not address the question of people who are on medication and don't need to be,'' Potter said. ``That's where we don't have good data and it's where we have the greatest uncertainty right now.''
According to Potter, depressed people don't actually complain of a ``depressed mood.'' Instead, they claim they're anxious, irritable, have trouble sleeping and concentrating on work or reading. They also can't make simple choices and lose interest in sex.
But there are also atypical depressives, as noted in the book ``Understanding Depression'' by Drs. Donald Klein and Paul Wender (Oxford, 1993). These are people who ``respond positively to good things that happen to them, are able to enjoy simple pleasures like food and sex and tend to oversleep and overeat.
``Their depression, which is chronic, rather than period, and which usually dates from adolescence, largely shows itself in lack of energy and interest, lack of initiative and a great sensitivity to periodic - particularly romantic - rejection.''
Wurtzel, who graduated with a bachelor's degree in comparative literature from Harvard, spent a semester in London (thinking a change in scenery might help her to overcome her depression) won the 1986 Rolling Stone College Journalism award for essay writing, landed an internship with the Dallas Morning News, wrote briefly for New York Magazine and The New Yorker and has published articles in Mademoiselle, Rolling Stone and People, seemed to fit the atypical category. And she has had to constantly explain how she excelled while in a walking state of despair.
``It's very hard to understand that depression is very close to normal life,'' she said. ``A schizophrenic you just can't miss, but with depression you can go on for a very long time feeling just awful.''
``Many successful people are depressed,'' added Kramer, who maintains a private practice and is the associate clinical professor of psychiatry at Brown University. ``Depressives don't have much energy, but the energy they have, they use.
``I think Elizabeth is saying there's another sort of depression, an active sort of young adolescent depression. Some people might give her a different diagnosis of a personality disorder. That is one of the debates within modern psychiatry. Whether erratic personality traits are the same as depression or not.''
Many of the people who have come to see Wurtzel at Waterstone's seem to be able to relate. The crowd, evenly split between men and women in their 20s and 30s, all seem to have a personal story they want to share with her.
One woman nearly didn't get to the reading because she was almost too depressed to leave her house. Another wonders why she feels depressed when everything in her life seems to be going well. A third says she read a terrible review of the book in Spin magazine but bought it anyway because, she says, ``I didn't think any book could be that bad.''
``Well, thanks, I guess,'' says Wurtzel, who ends up staying two hours later than scheduled, talking to a group of people about depression, makeup and her cat, Zap, while signing more books.
Finally, Waterstone's closes, the Stone Gossard look-alike, who has waited hopefully for two hours, is politely asked to leave by store employees, and Wurtzel, still fighting her own personal demons, swallows more of her pills.
``I don't know if there is any solution,'' she says, looking tired. ``It sometimes seems there's nothing we can do, and if there's nothing we can do, we might as well take drugs.''
by CNB