Title: Coming of Age on Zoloft: How Antidepressants Cheered Us Up, Let Us Down, and Changed Who We Are
Author: Katherine Sharpe
ISBN: 9780062059734
Pages: 336
Release date: June 5, 2012
Publisher: Harper Perennial
Genre: Memoir/Nonfiction
Format: Paperback
Source: Personal collection (book club)
Rating: 3 out of 5

Once, I sat in the office of a new psychiatrist, who asked about a very personal incident in my childhood. As if she’d pushed upon a bruise, I felt the pain all over again, and immediately began crying. She picked up her prescription pad and said, “I’m prescribing an antidepressant.”

I was surprised. “You think I’m depressed?” I asked. “But I’m here for anxiety and OCD.”

“You’re crying,” she said, looking equally surprised that I would ask such a thing. “Of course you’re depressed.”

In Coming of Age on Zoloft, Katherine Sharpe had similar issues with her diagnosis of depression in college. Unlike me, she didn’t trash the prescription as soon as she walked out the door and call someone who would listen before diagnosing; instead, she embarked on nine years of antidepressants.

In this book, Sharpe focuses particularly upon young adults, particularly those who recently completed college, who struggle to understand their depression in the context of their identity. Who am I without my pills? How much of this is me, and how much is it the medication? What are the long-term personal effects of medicating emotional issues?

While Sharpe does not discount the value of medication for some people, she firmly believes, based on her own experience, that talk therapy is much more effective, and that medication should always be accompanied by non-pharmaceutical therapy. “Antidepressants had gotten me moving, but they hadn’t given me the sense of direction I craved,” she writes. “They had picked me up, but they hadn’t made me more self-confident in any meaningful way.” Therapy did.

Sharpe makes a lot of excellent points about the over-diagnosis of depression and anxiety. But, it seems to me, in her pursuit of that thesis, she overlooks the many people who have found solace in medicating mental illness.

This book doesn’t fit neatly into one genre–is it memoir? reporting? a collection of interviews?–and so to some extent it suffers from the identity crisis. I was never quite sure what to expect from a chapter; I would find myself pulled in by a study, and feel frustrated to move on to Sharpe’s specific experiences and conclusions.

My frustration, I think, stems from the limitations of those experiences and conclusions. Because this is a memoir, she’s able to guide her reporting according to her experiences. CBT didn’t work for her, and so she speaks of it almost snobbishly: “My sense now is that CBT and psychodynamic therapy cover a lot of the same ground, but pyschodynamic therapy tills deeper.” It left me wondering about the many people who have benefitted from CBT–not to mention those who are alive and well today because of their (often long-term) use of antidepressants. Just because something didn’t work for Sharpe, doesn’t mean it’s not a lifesaving intervention for someone else–a point that she acknowledges throughout the book, but then moves on to make often strong conclusions about mental health based on her experiences.

At first, I wasn’t sure about the extensive use of interviews–I was surprised to see them in what I thought was a memoir. But soon, the varied experiences of other people, in their own words, became the best part of the book for me. So often, depression is an isolating experience, and so hearing from so many different people about their interpretation of the same condition was very heartening.

Of all the interviews Sharpe recounts, her conversation with James, a 32-year-old web developer, displays my thoughts about this book the best. When he recounts his crippling experience of depression, Sharpe reflects that the main questions she’s pursuing in the book–Do antidepressants shape who I am? Am I really sick?–are “luxury questions.” She writes:

Worrying about the finer points of antidepressant use, like what it means to your sense of self, is a privilege denied to those for whom the pills never fulfill their basic promise in the first place. And they are not likely to be top concerns for people who are dealing with a whole other order of problem.

I’m glad Sharpe relates this insight. I’m the last person to judge whether Sharpe was “really” depressed and whether she “needed” to go on antidepressants. But often, as she made sweeping statements about the value of pills, particularly compared to talk therapy, I wondered about those who are truly, deeply paralyzed by depression. This book, I’m afraid, would be rather off-putting for them; it is, Sharpe points out, geared more toward those who fall somewhere between sick and well–not so depressed such that medication is the only clear answer, but not so well that they don’t question whether a pill might help.

When she writes about uncertainty knowing your “true self” on antidepressants, she gives short shrift to those for whom antidepressants have been a vehicle to discover themselves more fully. She mentions that her respondents might be skewed in a similar direction to herself–after all, she’s asking all the questions, and she clearly has a certain point of view. But I thought she could have spent more time on the way depression–not medication–can obscure one’s personality and interests. I wanted to here more from the other side, of those who felt a new freedom on medication to explore who they really are.

Furthermore, when she interviews those who say antidepressants made them feel isolated and unknowable, I couldn’t help but wonder how much of that is adolescence itself. Who doesn’t feel estranged from the rest of the world in high school?

I found the discussion of pharmaceutical marketing fascinating. I hadn’t realized that before 1997, drug companies could not market directly to consumers in the U.S., and that in Europe direct-to-consumer marketing is still illegal. In fact, I wondered if perhaps Sharpe should have written a book about pharmaceutical marketing–that seems to be her main beef with easy diagnoses of depression, and she comes across as quite cynical about pharmaceutical companies.

Yet I found myself agreeing more with the words of one of Sharpe’s interviewees, Anastasia:

“I mean, I think that pharmaceutical companies are very interested in f***ing people; I don’t believe they’re these benevolent forces. On the other hand, I’m looking out for myself… if my goal is to function, then I’m going to use what I can from them to the best of my ability.”

As I discovered in my encounter with the prescription-happy psychiatrist, some doctors are more eager to prescribe pills to solve problems than to talk through the issues at heart–and that can be a serious problem, especially as antidepressant use rises.

It is good and useful to question an orthodoxy of medication in psychiatry, especially as concerns children and young adults who are still developing both physically and emotionally. But the blend of the personal and the factual in this book constantly made me question the limits of Sharpe’s experience and the prevalence of her opinion throughout the book.

However, it was plenty of food for thought, and I particularly enjoyed discussing this book at book club!

Don’t just take my word for it! Buy Coming of Age on Zoloft for yourself from an independent bookstore. Each sale from this link helps support Melody & Words.