Peter D.
Kramer, M. D. tells of his first experience with Prozac involving awoman named Tess. Tess was the eldest of 10 children, born to a passive motherand an alcoholic father. Tess was physically and sexually abused as a child. When Tess was 12 her father dies and her mother entered a clinical depressionfrom which she never recovered.
Tess was then left to take over the family. Later in life Tess made a business career out of her skills at driving,inspiring, and nurturing others. She was very unhappy in her personal life. Tessstruggled from one abusive married man to another.
Despite psychotherapy, shewas progressively less energetic and more unhappy. Dr. Kramer’s first visit withTess showed she had all the symptoms of clinical depression and she wanted toend her life. Dr. Kramer prescribed Prozac for Tess to terminate her depressionand return her to her “premorbid self.
” Dr. Kramer’s goal was to nottransform Tess but to restore her. Two weeks after using Prozac, Tess reportedshe was no longer feeling weary. She confessed she had been depleted of energyfor as long as she could remember and realized she had been depressed all herlife. Tess once again was able to get her social life back.
Dr. Kramer took Tessoff Prozac after nine months and she continued to do well. Tess did admit shedidn’t seem as sharp or energetic after discontinuing the medicine. Then, afterabout eight months off Prozac, Tess felt she was slipping. She liked the feelingof stability that Prozac gave her.
Dr. Kramer was then left to decide whether ornot to prescribe Prozac to a patient who was not depressed. Again on Prozac,Tess responded as she had hoped, self-assurance, renewed confidence, and socialcomfort. Not all patients on Prozac respond this way.
Some are unaffected, somemerely recover from depression as they might on any medication. But a few aretransformed.
