Book Review

Poets on Prozac: Mental Illness, Treatment, and the Creative Process

N Engl J Med 2008; 359:214-215July 10, 2008

Article

Poets on Prozac: Mental Illness, Treatment, and the Creative Process
Edited by Richard M. Berlin. 181 pp. Baltimore, Johns Hopkins University Press, 2008. $21.95. ISBN: 978-0-8018-8839-7

Aristotle famously asked, “Why is it that all men who have become outstanding in philosophy, statesmanship, poetry, and the arts are melancholic?” The question persists today, as investigators in the humanities and the health sciences attempt to understand how psychiatric illness — affective disorders, in particular — may be linked to creative ability. Although statistical research by Arnold Ludwig, Kay Redfield Jamison, and others has identified a relatively high incidence of depression and manic depression in artistic communities, the precise effects of these afflictions on creative production remain unclear. Is the disordered mind a uniquely inventive and perspicacious mind? Or is creativity ultimately thwarted by psychiatric ailments that distort thought and stem motivation? These questions are at the center of Poets on Prozac, a collection of essays written by poets whose creative practices have been shaped by the symptoms of a mental illness or the effects of its treatment. Edited by psychiatrist and poet Richard M. Berlin, the book contains remarkably detailed and frank descriptions of what it is like to possess a mind that can sometimes build cathedrals with language but at other times cannot put together the simplest of sentences. At once instructive and poignant, Poets on Prozac constitutes an important addition to the literature on creativity and mental illness.

Berlin explains that he chose to focus on the experiences of poets because they are “among the most fearless . . . when it comes to self-revelation.” Perhaps more than any other art form, poetry is an attempt to render the truth — of an emotion, an event, or an object — in a condensed, crystalline manner that is precise, elegant, and universal. In representing a broad range of maladies — from obsessive–compulsive disorder to postpartum depression, from acute psychosis to post-traumatic stress disorder — Poets on Prozac conveys the complexity and unpredictability of psychiatric conditions and refines cultural assumptions about art and madness. Gwyneth Lewis, the first National Poet of Wales, affirms that “there is a very close connection between depression and creativity, but it's not of the crudely compensatory kind usually described by casual observers.” Indeed, several contributors to the book express the generative aspects of various mental disorders. Ren Powell, a poet and dramatist with bipolar disorder, explains that manic energy can galvanize the imagination, while David Budbill states that the “emptiness” of depression offers him an important period of “creative gestation.” However, it is psychiatric treatment, rather than illness, that is most keenly associated with creative acts. Most of the essayists in the collection describe how pharmacologic or psychotherapeutic intervention has provided them with greater cognitive clarity and emotional stability, which have in turn enhanced their creative development and output. As contributing poet Thomas Krampf succinctly puts it: “One can have a vision, but no vision is worth anything if one is too sick to implement it.”

In emphasizing the productive effects of treatment, Poets on Prozac dispels the long-standing myths that creative genius requires a degree of madness and that the alleviation of mental illness suppresses the inventive person's vision and drive. This corrective is, perhaps, the book's greatest accomplishment. Artists too often refuse treatment for disorders that are perceived to be synonymous with great insight; Rainer Maria Rilke, a modernist poet who suffered from bouts of psychic anguish, refused therapy, claiming, “If I lose my demons, will I lose my angels as well?” In Poets on Prozac, Jesse Millner reiterates this concern: “I was afraid that Prozac might stifle me . . . subtly change the mental structure of my brain in a way that would keep me from the wild, intuitive jump.” Judging from the accounts that Berlin has collected, however, the opposite is true. J.D. Smith, for example, reports that his poetry displayed an increased “playfulness” and a greater social and moral consciousness after he began a course of medication and talk therapy. Both Smith and Jack Coulehan, a poet and professor of medicine, found that treatment enabled them to take on the challenges of formal verse — that is, poetry that adheres to rigid patterns in rhyme, line length, and other structural properties. Caterina Eppolito states that her writing “gained emotion, intimacy, and openness” after she received treatment, and Andrew Hudgins observes, “Pleasure spreads through my work in a more and more discernible way.”

Of course, there are no absolutes when it comes to mental illness or its treatment. But given the considered quality of these essays, Poets on Prozac will be an illuminating read both for mental health professionals who work with creative people and for artists who are contemplating treatment options.

Kiki Benzon, Ph.D.
University of Lethbridge, Lethbridge, AB T1J 1N3, Canada
kiki.benzon@uleth.ca