The Zombi, the Monk and the Egg

       “How have you been feeling these past few months?”
       “It’s hard to tell...I’m taking so many pills right now. I’d really like to lower my dosage. I’ve been feeling fine lately, really.”
       “Well, treating a volatile condition like yours is a delicate process. If we lower the dosage of your medications too quickly, it could trigger another depressive episode. Besides, it may very well be because you’re taking medication that you feel fine. If you’d shown up for your last appointment, I might be more willing to work on tapering off your meds.”
       Damn. I’ve been trumped. The middle-aged blonde woman I have come to refer to as “the pill lady” stares at me over the top of her reading glasses for a moment and goes back to her list of questions.
       “Any suicidal thoughts or actions?”
       “Uhm, no.”
       ‘How much sleep are you getting each night?”
       “Between seven and nine hours; it depends what I have to do that day.”
       “Mmmmmm.....”
       The “pill lady” is the only staff member of this clinic who is qualified to write prescriptions; she spends her days handing out Prozac to gloomy college students. I see her only about once a month now. Our relationship is not unlike that of the drug addict and his dealer; I come in, she tells me about this new stuff she’s got that’ll make me feel gooooood, and she sends me out the door with a free sample and a piece of paper in my hand. I’ll be back; she knows it and I know it. If I don’t come back, I’ll be fine for a day or so, but then I’ll get that rotten cotton ball taste in my mouth and start feeling dizzy, and through my blinding headache I’ll get the feeling that something’s not quite right today.
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A common side effect of Paxil CR is nausea, which may be lessened by taking it with food. Other side effects may include injury, infection, diarrhea, constipationdecreased appetitesleepinessweaknessdrymouthinsomniadizzinesstremoryawningsweatingabnormalvision and sexualsideeffects. If you should experience any side effects, be sure to report them to your healthcare provider as soon as possible and follow his/her advice.
(http://www.paxilcr.com/Paxil_CR_Side_Effects.jsp#faq3)
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Vodoun (commonly known among Americans as voodoo) is one of the two official religions of Haiti. The other is Roman Catholicism. Catholic officials have made attempts through the years to stop Vodoun in Haiti, with very little success. In 1843, after a sighting of the Virgin Mary above the waterfall of Saut d’Eau, local Catholic priests rushed to have the sighting verified by the Vatican, hoping to override Saut d’Eau’s status as a popular vodoun pilgrimage site. But before long, priests began to notice offerings of food and vodoun charms alongside statuettes of Mary left by travelers; the Church’s recognition of the apparition had only strengthened the peoples’ belief that Saut d’Eau was inhabited by loa (vodoun gods), not repudiated it. Similarly, the official police force of Haiti is mirrored by another justice system. Secret societies known by various names- the Sect Rouge, Vinbrindingue, the Cochons Gris- patrol the Haitian countryside by night, holding secret tribunals heavily flavored with vodoun ceremony in graveyards, trying and punishing those who have committed crimes against their families and communities. The harshest of these secret societies’ punishments is a unique form of the death penalty- the convicted is made into a zombi.  (Davis, Wade, The Serpent and the Rainbow, p. 204-205, p.255-258)
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There are millions of Americans on antidepressants, and I am one of them. It’s been a colorful process- I’ve been on little white pills, little blue pills, slightly larger blue pills, medium-sized green pills, big red pills, little pink pills, and another, spherical brand of little white pills.
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In a newly minted 1950s American suburb, a female college graduate with a M.R.S. degree and a brand new Kenmore washing machine visited her family physician. She complained of a vague sense of emptiness and despair (the same feeling that Betty Freidan would later deem “the feminine mystique”).
“Don’t worry; I’ve got a new medication for you,” her doctor said. “Take two Valiums every morning and you’ll feel better in no time.”
And thus a member of the most privileged class of women in the world began systematically drugging herself. She did it to endure the infinity of identical days that made up her life.
The result was a much calmer specimen of American womanhood, one that never complained about the monotony of washing dishes or chided a husband who came home at 11 pm every night, one who seemed content to vacuum every day and scrub down the blinds with a toothbrush. She might not have been much of a conversationalist- who is with a belly full of vodka and barbiturates? - but the more doll-like the housewife became, the closer she came to the divine glow of feminine perfection. If she closed her eyes, she could imagine herself in flowing white robes, crying tears of blood, rays of light emanating from her palms. Someday she would float out of her kitchen window and ascend like the Virgin into Heaven, where her years of silent anguish would be rewarded tenfold and she would sing with the heavenly choir.
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Her daughter makes bi-weekly visits to a psychologist on Wednesdays between three and four, before she goes to pick up her children from practice. She feels nervous, stressed, and can’t sleep at night. She can’t stop obsessing about her paperwork, her children’s lunches, her husband’s suit, her broken blender, her mismatched duvet covers…. Her doctor hands her a pamphlet about obsessive-compulsive disorder.
“Don’t worry; I’ve got a new medication for you,” her doctor says. “Take two of these Effexor every morning and you’ll feel better in no time.”
He checks his watch. “We’ve got twenty minutes left,” he says. “Tell me about your relationship with your mother.”
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The literature that accompanies antidepressants is always full of shiny pictures of black-and-white sad people juxtaposed with full-color smiling people. There’s something vaguely ominous about the language of these brochures; it’s simple, accommodating, and so optimistic that it sounds as if a kindergarten teacher wrote it. My favorite has always been Zoloft’s brochure: it begins with a frowning cartoon egg sitting inside in the dark, moves on to the same egg, halfheartedly smiling at a butterfly, and ends with a grinning egg bouncing off to play with its egg friends.
I hate that stupid egg.
I hate its smug smile, which fails to soothe me and make me understand that “depression is an illness. It is not who you are.” I see it instead as the face of the Pfizer Corporation that controls every step of this process, right down to the Zoloft pen with which the pill lady writes my prescription. They sponsor the conferences where she learns about biomedical ethics and the newest innovations in psychopharmacology.  They sent her home from that very same conference with enough free trial packets to fill an entire closet. If the “pill lady” is my street corner pusher, then they are the drug kingpins counting their money, a mountain of coke on the table in front of them. Worldwide sales of Zoloft totaled $845 million in the first quarter of 2005 alone.
Ask for it by name!
(Kirmayer, Laurence, “Prozac in Japan,” Prozac as a Way of Life, ed. Carl Elliott, p.186)
(http://www.pfizer.com/pfizer/are/investors_releases/2005pr/mn_2005_0419.jsp)

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Sophie Freud, granddaughter of the legendary Sigmund Freud, once suggested at a hospital conference that, while all people have a sense of empathy, depressive people may in fact be overly sensitive to the actions of others. Therefore, one of the physician’s goals for therapy should be to make these people less sensitive, less perceptive of the world around them.
Perhaps the cure for depression is to stop reading the newspaper.
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Zombies as we know them from horror films- people who literally come back from the dead with a curious hunger for brains- are a perversion of the vodoun idea of the zombi. Occasionally in Haiti, someone who has been dead and buried for a number of years will be found roaming aimlessly through the countryside, glassy-eyed and unable to speak. These people display a set of symptoms similar to those of catatonic schizophrenia- amnesia, great difficulty speaking or moving, chronic stupor, no spontaneous emotion, and “dead” eyes. Some of these reputed zombis are returned to their families, but many are rejected by their relatives and sent to mental institutions. Few ever recover.  
(Davis, Wade, The Serpent and the Rainbow, p.61-64)
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During marketing of Zoloft and other SSRIs and SNRIs, there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g. paresthesias such as electric shock sensations), anxietyconfusionheadachelethargy emotionallabilityinsomniaandhypomania.
While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.
(Pfizer, Inc, Zoloft Full U.S. Prescribing Information, PDF file obtained from http://www.pfizer.com/pfizer/do/diseases/mn_depression.jsp)
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The Zoloft haze rolls in slowly, like a particularly heavy thunderstorm. At first you barely notice it; the edges of your consciousness blur like the soft focus in an old romantic movie. A few days later you start to feel a strange pressure behind your eyes and a lightheaded feeling, like your skull is being filled with helium. Without constant sensory stimulation your mind fogs up and you find yourself spending long minutes staring off into space, not thinking about anything, groping blindly in a soupy chemical fog. You begin to go on autopilot at inappropriate moments, like when you’re driving or talking to your boss.
You’re tired but can’t sleep; your reaction time slows.
You realize one day that you don’t feel sad, but you don’t feel happy either.
You start drinking just to feel something.
You don’t know if this is your mind or the medication.
It doesn’t really matter, because they’re becoming the same thing.
After a while you stop caring, which is the most disturbing symptom of all.
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“Narcisse explained that he had been sold to a bokor (A vodoun priest who practices black magic; not to be confused with a houngan, a white magic vodoun priest)named Josef Jean who held him captive at a plantation near Ravine-Trompette...Together with many other zombis, he had toiled as a field hand from sunrise to sunset, pausing only for the one meal they received each day... He remembered being aware of his predicament, of missing his family and friends and his land, of wanting to return. But his life had the quality of a strange dream, with events, objects, and perceptions interacting in slow motion, and with everything completely out of his control. In fact, there was no control at all. Decision had no meaning, and conscious action was an impossibility.”
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“Suddenly those intimate and consistent traits are not-me, they are alien, they are defect, they are illness- so that a certain habit of mind and body that links a person to his [sic] relatives and ancestors from generation to generation is now “Other.”
(Kramer, Peter, Listening to Prozac, p. 19)  
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“EFFEXOR XR may cause side effects in some people. In clinical studies, some people had to stop taking EFFEXOR XR because of side effects. In clinical studies, the most common side effects included: nausea, dizziness, sleepinessabnormalejaculationsweatingdry mouthgasabnormalvisionnervousnessinsomnialossofappetiteconfusion/agitationtremor, and yawning."
(http://www.effexorxr.com/faqs.asp)
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       Zombis are made, it is generally agreed, with the aid of a poison prepared by a bokor that paralyzes its victim and slows his or her heartbeat and breathing to levels so low that a doctor will declare the person dead. However, the person still lives, and is fully conscious but not able to speak until his or her brain begins to lose blood and oxygen and he/she passes out. Here is where the skill of the bokor is tested; if the poison was not prepared correctly, the person will wake up too soon and suffocate in his or her coffin, or he/she will never wake up at all. Sometimes the dosage is perfect, and up to 72 hours after the funeral, a bokor and his attendants can go to the cemetery and dig up the newly deceased’s grave. What emerges is human, but is not a person. It is a zombi. The bokor feeds the newly minted zombi a hypnotic drug to ensure that they remain in a stupor; and thus it shall be for the rest of the zombi’s “life.”  In this way, vodounists say the bokor controls the zombi’s soul, rendering him or her “a body without a complete soul, matter without morality.”
(Davis, Wade, The Serpent and the Rainbow, p. 140, p. 226 )
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The side effects that people taking PROZAC experience most include nausea, difficulty sleeping, drowsiness, anxietynervousnessweaknesslossofappetitetremorsdrymouth sweatingdecreasedsexdriveimpotenceand/oryawning.
These tend to be mild and usually go away within a few weeks of starting treatment. These side effects generally aren't serious enough to make most people stop taking PROZAC.
(http://www.prozac.com/how_prozac/max_recovery.jsp)
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Biologists have attempted to identify the ingredients of zombi poison; its effects resemble those of tetradoxin, a chemical found in the puffer fish. However, no outside observer has been able to produce a surefire recipe for zombi poison, because it is made differently in different parts of the country, and even by different bokor in the same area. The explanation for this phenomenon probably lies in the concept of the “placebo effect.” Just as a sugar pill can make someone feel better through the power of belief, so can the belief in zombis assist in the demise of a Haitian afflicted with a mysterious, paralyzing illness.
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Despite its toxicity, the puffer fish, or fuku, is an expensive delicacy in Japan; the price of a meal runs in hundreds of U.S. dollars, and chefs must obtain a government license to serve it. The fuku is said to give the eater a warm buzz accompanied by numbness of the lips, flushed skin, and a slight sense of euphoria. Still, there are a reported 30 to 100 cases of puffer fish poisoning in Japan each year, mostly from unlicensed chefs preparing the dish at home . (http://www.bbc.co.uk/dna/h2g2/A752429 ) Eating fuku is one way to express one’s gaman, the sense of fortitude and quiet endurance that is one of the most admired of Japanese personality traits. Many buy dolls, called okiagari koboshi, of the bodhisattva Daruma as good luck charms to promote gaman. Daruma, the founder of the Japanese Zen sect of Buddhism, attained enlightenment by meditating for nine years. He was still for so long his arms and legs atrophied off and he turned to stone . (http://www.onmarkproductions.com/html/daruma.shtml)Indeed, according to Zen, the sort of sadness and thoughts of death attributed to depression in the West should be welcomed as a reminder of the impermanence of the material world. (Kirmayer, Laurence, “Prozac in Japan,” Prozac as a Way of Life, ed. Carl Elliott, p.174) The temptations of the material world are essentially empty, Zen teaches, and the path to enlightenment is leaving them behind.
Zoloft’s “Depression Checklist” includes, among others, the following two symptoms:
Little interest or pleasure in doing everyday things
Moving or speaking so slowly that other people notice
(http://www.zoloft.com/zoloft/zoloft.portal?_nfpb=true&_pageLabel=depr_checklist)
So are Zen monks, who renounce the material world and sit still for hours, even days, at a time, depressed? To be fair, this is an extremely incomplete explanation of Zen, and a clinical diagnosis of depression requires more than two relevant symptoms. But it cannot be denied that psychiatric definitions of what is “abnormal” (there is no official psychiatric definition of “normal”) were developed by Westerners according to Western ideals. There is no exact Japanese equivalent to the English word “depression;” except for in the most severe cases, depression is viewed as a sort of common cold of the kokoro, or “heart-mind.” (Kirmayer, Laurence, “Prozac in Japan,” Prozac as a Way of Life, ed. Carl Elliott, p.174) Consequently, few antidepressants are approved for clinical use in Japan, and even fewer are prescribed. However, with Japan’s participation in the global economy has come a rise in the numbers of people taking antidepressants. Someday, people in all corners of the globe will be washing down their Prozac with a Big Mac and Diet Coke.
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I don’t cry for no reason anymore, I don’t think death is a good idea anymore, I am able to handle large crowds and sharing my feelings and I can concentrate on my schoolwork. So is this what normality feels like? Am I well? A psychiatrist would say no. I resent that fact that they will always say no.
But once you make that commitment, once you begin waking up every morning and swallowing a reminder that you’re not well, it’s damn hard to get out of it. You’ve got to consider the headaches, the vertigo, and the vacillating fear of what would happen to me without them. If I stop taking my meds, what if feel too depressed to get up and go to work and I get fired? What if I say something cruel to a friend without meaning it in a fit of manic intensity? What if I become an unlovable, unemployable madwoman with snakes in my hair?
In my terror, I cling to the belief that they work.
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I’ve been raised to have faith in the miracles of Western medicine, to have faith in the essential goodness of scientific progress. Mankind is forever marching towards an Eden of clinical trials and testable hypotheses where every man, woman, and child is never ill and never, ever sad. This is the epitome of human existence. If this is true, then why have psychiatrists replaced the more antiquated “diseases” in the DSM-IV (most notably homosexuality) with an ever-expanding penumbra of depressive illness? In the 1990s Dr. Hagop Akiskal created a new diagnostic category of people called dysthymics who are not clinically depressed but have inborn depressive traits . (Kramer, Peter, Listening to Prozac, p.166) Essentially, dysthymics are people who, throughout their whole lives, have been pessimistic, timid, and introverted. Some psychologists have hypothesized that being dysthymic might have been an evolutionary advantage in earlier, more dangerous, eras of human existence. In the 1930s, Carl Jung wrote: “”The one [extraversion] consists in a high rate of fertility, with low powers of defense and short duration of life for the single individual; the other [introversion] consists in equipping the individual with numerous means of self-preservation plus a low fertility rate.” ( Quoted in Kramer, Peter, Listening to Prozac, p.160) But in the aggressive environment of twenty-first century America, because of their lack of the salesman’s aggressive cheerfulness, these people are not likely to be high achievers in the social or economic spheres. Being single and stuck in a low-paying job is the classic sitcom definition of a “loser.”
But does this make them diseased?
Antidepressant drugs have been a critical factor in the incorporation of neuroses, once the realm of therapists, into the rubric of neurological depression. This is because individual antisocial symptoms- irritability, shyness, etc- respond to the same medications that effectively relieve the symptoms of major depression. Some psychiatrists say that the people who responded well to the medicine despite the lack of a diagnosis of depression were simply suffering from “undiagnosed variants of depressive disorder.” (Kirmayer, Laurence, “Prozac in Japan,” Prozac as a Way of Life, ed. Carl Elliott, p.172)
We all need meds; we just don’t know it yet.
When normal, functional citizens can seek a chemical fix for minor flaws in their behavior, shaping themselves trait by trait into a more perfect twenty-first century American, we enter a new medical era, the era of the psychiatric face lift . (Kramer, Peter, Listening to Prozac, p.97) The ideal medicated American will be eternally optimistic, even in the face of declining standards of living; incapable of strong emotions, especially outrage; wandering about blindly, oblivious to what is happening outside of their immediate surroundings; and most importantly, dependent on their pushers, their bokors, for the drugs they need to stay that way. Without their Paxil, Prozac, Effexor, Zoloft, Wellbutrin, they will be as the zombi that has been fed salt:
“Zombi are recognized by their absent-minded manner and their extinguished, almost glassy eyes...Their docility is total provided you never give them salt. If imprudently they are given even a grain of salt, the fog which cloaks their minds instantly clears away and they become conscious of their terrible servitude.” (Metraux, Alfred, Voodoo in Haiti, p. 283)