How one writer changed the way we talk about mental health

How one writer changed the way we talk about mental health


When Elizabeth Wurtzel published her wildly influential first book, Prozac Nation, in 1994, the critics hardly fell over themselves to praise it. Wurtzel, who this week died from cancer aged 52, was one of the first people in America to be given the drug Prozac, and her memoir, written when she was 26, splurged with unashamed abandon the wayward details of a childhood blighted by depression, an adolescence blighted by drugs and a period at Harvard blighted by extreme combinations of both. No one had read a book like it before, and some wished never to again. Sentences such as "My gifts are for life itself, for an unfortunately astute understanding of all the cruelty and pain in the world", led one New York Times reviewer to wish for some Prozac in order to ease the pain of reading them.

Wurtzel on the cover of her seminal 1994 memoir, Prozac Nation.

Yet history would prove such criticisms to have missed the point. Quite simply, Prozac Nation changed the way we talk about mental health. In fact, it was arguably the first book to properly talk about it at all. Wurtzel wrote about her personal experiences of clinical depression in a way everyone could understand, and democratised the conversation in the process.

She was not the first woman to write confessionally about mental health – the American poets Sylvia Plath and Anne Sexton blazed that trail in the 1960s, while Susanna Kaysen's Girl, Interrupted, a bestselling account of a stay in a '60s psychiatric ward, was published in 1993. But she was the first to take the subject away from the rarefied preserve of tortured geniuses such as Plath. She made it relatable for the girl next door. She might not have had the sociological insights of Joan Didion but lines such as "the one thing that justified my existence at all was my agony" both understood and gave literary voice to the "I feel, therefore I am" mantra of grungy, confessional '90s American pop culture. Prozac Nation was to words what Nirvana's Nevermind was to song.

Prozac Nation is not perfect – the charges of extravagant solipsism are fair; its ostentatious flaunting of a traumatised, self-sabotaging pathology border on the fetishising. But its unedited excess is also the book's strength. Wurtzel was the messier, brasher, less palatable iteration of The Catcher in the Rye's Holden Caulfield; crucially, she was also female. She democratised the notion of female writers taking back control of the mad woman in the attic narrative, glorified most potently by the Victorians, and reshaping it on their own deeply personal terms. Those terms were often ugly. Extreme. Unseemly. Unfeminine. In Wurtzel's case, game-changing.

You can trace the creative legacy of Prozac Nation's bruisingly candid, feminine exhibitionism most easily on screen: ground-breaking works such as Sex and the City, Lena Dunham's Girls and Fleabag all owe it a significant debt.

Less welcome, it is also arguably the most high-profile forerunner to the literary commodification of personal (but usually female) experience, in which no intimate detail, no moment of unhappiness or struggle is now deemed too trivial to print.

Yet while Wurtzel harnessed the literary power of narcissism better than most, she was always one step ahead of her critics. "I am the woman who made you scream that it's a good thing New York City has gun control," she wrote in 2018, on receiving her cancer diagnosis. "I'm the one who made you yell that there oughtta be a law – a law to stop me from being my wretched self."

The Telegraph, London

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