I keep two little plastic bottles in my medicine cabinet. One contains 50 mg tablets of sertraline (a.k.a. Zoloft), and the other 15 mg tablets of mirtazapine (a.k.a. Remeron). I take three of the former every morning, and at night, I break one of the latter in half. For years, depressive episodes came and went for me like thunderstorms—and that was even before I knew the world was approaching a climate crack-up. This sort of condition is sufficiently common that I’ve joked about starting a subscription box service à la Blue Apron targeted at graduate students. Every month you’d get a bottle of Prozac and a carton of American Spirits. In a particularly fun twist, when I pick up my prescriptions from the university pharmacy, the bottle is in my school’s colors.
Even if you’re not taking antidepressants, you’re still taking them. In a Silent Spring reboot for our calamitous moment, trace amounts of these medications can be found in streams, drinking water, the oceans, and animal tissues. The particular chemicals in antidepressants are not always entirely absorbed by the body, and may not biodegrade after they’re passed. When I piss, little traces of misery leach out into the world. For any one of us, the angel’s share is infinitesimal. But even without factoring in worldwide use, because over ten percent of Americans are taking these every day (a number equivalent to the entire population of Peru or Malaysia), a critical mass has been reached.
Antidepressants are prescribed to house pets for various maladies: lack of appetite, pissing outside the box. I have a 25-pound orange cat who does the latter. We both take mirtazapine. My dog takes trazodone for her separation anxiety. The biosphere is steeped in a wash of ambient serotonin manipulators. It is no longer a question of whether one takes antidepressants, but rather how much one is taking, and whether it’s active or passive.
It wasn’t that long ago that Thoreau heard trains going by Walden Pond and wondered despondently whether someday we’d also ruin the skies. Ambient noise from highways and airports bleeds into almost every square mile of the populated United States. Radioactive isotopes, residues from nuclear testing, can be found in the bones and tissues of virtually every living being. Trace amounts of plastic circulate in bloodstreams, resurfacing un- or partially digested in the carcasses of birds and marine animals. Settled particulates from fossil fuel combustion can now be read in the fossil record. Humanity has spread across the globe, and in so doing, has permanently altered the very substance of the planet. When other life forms do this, we call them viruses; when humans do it, we call it the Anthropocene: life as we know it.
Originally proposed by geologist Paul Crutzen, the term ‘Anthropocene’ has been fiercely debated and criticized. Some contend that the prefix “anthro” elides the degree to which Westerners in capitalist countries are specifically responsible for emissions and environmental degradation; others rightly point out that, far from discouraging humanity’s anthropocentric bias, naming a geological era after ourselves might be one of the most anthropocentric gestures possible. Along with the neologism have come a host of companion terms of varying clumsiness: cthulucene, capitalocene, plantationocene. Still, symbolic implications of the term aside, the fact remains that antidepressants are so widely used that, like plastic, like Strontium-90, they have infiltrated the entire world—just another way that modernity has collapsed the distances between us.
When antidepressants fall like the snow in Joyce’s The Dead, upon all the living, something about the way we regard mental illness suddenly seems very odd. That is: if your antidepressants are now everyone’s business, when you ideate, does the world ideate with you? Perhaps we might still loosen of the tether that binds negative affect to the soul of the afflicted. Maybe there’s an invitation here—albeit a poison-penned one—to consider what a post-personal model of mental illness could look like.
Mental health, like everything, is historical. Models have come and gone: the black bile of melancholy, individual moral turpitude, negative thoughts, “brain chemistry.” The precise mechanism behind antidepressants is still unknown. Mark Fisher, likely one of the first names on mental health and neoliberalism, helps illustrate this fundamental continuity. Depression, he argues, should be seen not as nature but as nurture—a “deliberately cultivated” phenomenon, produced by austerity and serving to perpetuate it. It is in this sense that antidepressants represent only a palliative, treating the symptom while leaving untouched a grey bedrock of despair. In this despair, we accept:
…that things will get worse (for all but a small elite), that we are lucky to have a job at all (so we shouldn’t expect wages to keep pace with inflation), that we cannot afford the collective provision of the welfare state… that we are not the kind of people who can act.– Mark Fisher, “Good For Nothing”
Sadness exists as a subjective experience or an emotion, yes, but depression as a cultural category is an altogether different kind of entity. What Fisher zeroes in on is the way that, whatever its cause, depression is politically expedient for preserving and maintaining the bleak status quo of flex-time, freelance, gig economy precarity. However, the inability to break this deadlock isn’t for lack of trying, “any more than an individual depressed person can ‘snap themselves out of it’ by ‘pulling their socks up.’” Fisher, therefore, makes two important moves. First, he rejects the establishment assertion that brain chemistry is the primary cause of depression. Second, he recasts depression as a specific kind of political affect. Our “there is no alternative” politics of the present produce a positive feedback loop of apathy, futility, and boredom.
Critically, however, Fisher’s analysis makes clear that depression is something produced. Locating the noxious root in the social—rather than neurotransmitters or the soul—makes it contingent and mutable, rather than inborn and eternal. Like anything else, depression is a commodity, the fetishism of which must be rejected.
This formulation, though, would seem to imply the existence of depression products, or a labor process which churns out depression. Perhaps it’s pushing the metaphor a bit far to start talking about depression factories (we just call them “jobs”). Sadness comes and goes for a variety of reasons; depression, as a specific combination of sadness, apathy, passivity, hopelessness, etc., is a complex assemblage of social and biological factors. Though undoubtedly, we all have brains, and some of them are out of balance—A. What is “balance?” and B. There’s nothing inside your brain that doesn’t come from the outside. It may be true that your brain is in some way chemically miscalibrated; it might also be true that your boss is a real bastard and makes work miserable and alienating. It’s probably a mix of both. Work sucks.
It’s common for behavior to only become a capital-letter Mental Health Problem when it starts to impact your work. (As far as your employer is concerned, you are entirely free to be depressed on your own time if you like.) At this point, you might go see a therapist or begin a prescription cocktail. Perhaps one or both of these will work for you; perhaps they won’t. In either case, is there not a remarkable symmetry that the remedy for living in a commodified world should be highly profitable commodities? These treatments are desirable precisely insofar as they restore individuals to labor, or make new segments of the population ready for it—applying lubricant to a rusted gear for the overall good of the machine. It is, perhaps, in this sense that antidepressants are truly palliative: a society which immiserates in pursuit of value finds a way to valorize the immiseration.
Admittedly, if they were decommodified, antidepressant prescriptions might even rise. Aetna delenda est, of course. But what is in question here is not only the profit mechanism currently built into mental healthcare. It’s also the fundamental status of mental illness, since regimes of treatment for mental health depend, in part, on how we conceptualize mental health itself. When someone has depression, who actually has it, and where are they keeping it?
If mental health is a matter of melancholic humors or of subjective individual character, unfortunately, there’s not much that can be done about it—it’s too bad that your black bile is out of whack, but maybe try to get more fiber and you’ll feel a little better. On the other hand, if “it’s just your brain chemistry,” then take these for a few weeks and come back for a check-in, pending payment. A remarkably private portion of your life becomes the province of a doctor, who can divine your symptoms and provide a salve. Like sex, misery is hardly a dirty secret—it’s everywhere, and precisely for that reason, everyone wants to know about it.
Isn’t it a bit odd that depression has social roots—that it comes from the outside world we hold in common—and yet the resulting “condition” is construed as your private property? If it is in fact the case that the conditions of the commons produce desirable mental states for some and negative ones for others, why do we regard either as being somehow uniquely stamped on the soul? If we could separate a person out into the smallest possible constituent pieces, we wouldn’t find “depression” anywhere.
At the same time, however, it is also not to be found in work, in the environment, or anywhere else—it’s here, now it’s there, like a spring rain. Lose your job, get another; feel lonely, find a friend; feel depressed, don’t feel depressed. Affects come and go, circulating as the composition of your psyche changes. Since everyone’s already on some dosage—even just a trace—it seems just as weird to say “your” depression as it does to say “your” prescription.
From this change in perspective comes a change in practice—or, at least, it ought to. Untethering depression from the individual, and regarding it instead as a free-floating phenomenon with material causes, suggests a need to rethink treatment. We are all patients in Samuel Fuller’s 1963 drama Shock Corridor, where politics and psychosis are strung together on a seamless Möbius strip. Tensions spill into patient fights, which themselves only happen because the patients are already ill, and so on. If your prescription is, in a sense, everyone’s business, why should the condition itself be different?
What would it look like to consider mental health to be a matter for the community, rather than an individual concern? I have another cinematic (though slightly perverse) answer. Ari Aster’s Midsommar depicts one possibility. Towards the end of the film, Florence Pugh’s Dani stumbles into a chapel and witnesses some sort of horrifying breeding ritual, the subject of which is her awful boyfriend Christian. Fleeing the chapel to a bunkhouse, she collapses on the floor, sobbing hysterically. Identically dressed members of the commune encircle her, mimicking Dani’s cries until the entire group is rhythmically screaming in unison.
And it is here that the thing flips—when distributed across all of the women, Dani’s cries suddenly start to feel a little strange. Copied and beamed back in this unconventional way, her pain is decontextualized, uncoupled from an internal emotion and distributed. Regardless of whatever ontological status we assign to her emotions, they’re now being picked up by others and held in common. The group appropriates and reorganizes the burden. It is as if, simply by virtue of hearing and seeing it externalized, it suddenly becomes odd and foreign, in the way that saying a word thirty times will make it unfamiliar and strange in your mouth.
Midsommar is no blueprint for coping with depression, but it does speak to the porousness of the boundary between self and world, in stark contrast to the way we conceptualize and treat mental health. An individualized model of mental health, whether medical or moral, is far from universal. Collective affect is a constant across cultures; what distinguishes one from another is where it’s considered proper and improper. Could we postindustrial, postmodern Westerners use the collective affect typically reserved for sporting events to exorcise melancholy by making it common property, reducing its burden on any one person? What, in short, would it mean for your depression to truly become a group concern, handled collectively and not delegated to a specialist on the installment plan? Would this not force a rethinking of everyday life in virtually all of its forms—work, home, leisure, love, and all the rest?
Of course, it’s true that the medical apparatus and pharmaceuticals are collective solutions of a kind. The separation of industrialized life isn’t actually separation; it’s just relations with objects instead of people. In this way, we’re less undergoing a paradigm shift than we are the kind of moment where someone in a group setting finally acknowledges a bad smell. Perhaps, then, it is analogous to climate change itself—reckoning properly with either one calls the structures of society into question at such a deep level that one can scarcely remain loyal to any part of them. We should not wait for this world to end, because it has already ended. All that’s left is to discover what kind of beginning this is. ♦
D. Kulchar (Twitter: @dkulchar) is a Ph.D student at Penn State University working on Rhetoric, Information Theory, and Cybernetics. His dissertation research is available at dkulchar.substack.com.