Situating Depression Memoirs’ Effects Deeper Inside our Biology and Further Outward Within Circuits of Culture: Exploring the Roles of Antidepressants and Pharmaceutical Marketing

A primary intention of our original manuscript was to provide examples of both harmful (sanist; sexist) and helpful influences of one cultural artifact—depression memoirs—on who female readers take their selves to be (their self-narratives), and who they may actually end up being (their self-constitutions) (Hoffman & Hansen, 2017, pp. 285.). Bradley Lewis beautifully articulated our strategy as “chart[ing] out … conflicting vectors” (2017, p. 303): that is, delineating select examples of how certain outer narratives conveyed in depression memoirs may kindle sexist and sanist modes of being. Our hope was that making these vectors explicit could ultimately be liberating for some individuals by “opening up narrative identities around psychic difference to a range of stories outside the current norms” (Lewis, 2017, p. 306).

We believe that both Anne Johnson’s and Bradley Lewis’s insightful commentaries have enriched our work by extending it to domains both “deep inside” our biological selves (Johnson) and outside to the wider reaches of society, economy, and politics (Lewis). Our response to their thoughtful reflections is animated by our gratitude for their extension of our ideas, and a desire to show how our claims are, for the most part, compatible with theirs. In this response to their commentaries, therefore, we: (1) chart out a way to affirm Johnson’s main point while simultaneously retaining our own, and (2) describe how one of Lewis’s own vectors illuminates an important ramification arising from our proposed equipoise with Johnson.

Johnson’s Vector: Creative Genius’s Restrictiveness

As we understand it, Johnson’s main aim is to “identify ways in which antidepressants and a biomedical approach to depression can be resourceful for depressed women” (Johnson, 2017, p. 299). Prima facie, this may seem opposed to our original message that “biomedically inspired” narratives, when adopted to the exclusion of the theme of “creative genius,” can be restrictive for depressed women. We say in our original piece: “the retreat to a biomedical model that haunts many women’s memoirs may encourage female readers to author self-narratives wherein the only explanation of their distress is biochemical” (Hoffman & Hansen, 2017, p. 300). However, we aim to show that this apparent tension between Johnson and ourselves can be largely dissolved by adopting a simple distinction. But before explicating this distinction, it is worth examining Johnson’s claim in more detail.

Johnson rightly draws attention to the fact that antidepressant medications can serve as welcome (and, for some people, perhaps indispensable) facilitators of release from the shackles of depression. And, as Johnson points out, narratives that discourage or shun antidepressant use can be restrictive in this sense:

I would argue that … the rejection of the biomedical model of depression in the service of perpetuating the ‘long-held romantic view’ of the tortured genius is actually far more restrictive than the uncreativity message itself. It glamorizes shutting oneself off to avenues of potential help.

(Johnson, 2017, p. 300)

We have no argument with Johnson that “shutting oneself off to avenues of potential help” is restrictive (as Johnson points out, this is basically the very definition of “restrictive”). Thus, if and when a certain theme (such as the creative genius theme) prompts such a shutting off, we agree that it can be restrictive in this sense. We also agree that a biomedical theme can be resourceful insofar as it promotes an additional treatment option.

However, our agreements do not imply that we envision biomedical themes as always resourceful, nor creative genius themes as always restrictive. And in fact, we believe that Johnson would (for the most part) concur. To elaborate on the specifics of our alignment with Johnson, we introduce a distinction between possible targets to consider when assessing the effects of the incorporation of biomedical and creative genius themes into readers’ self-narratives:

Target 1. Effects on self-narrative. These can include effects on one’s self-image, levels of self-esteem and self-acceptance, levels of agency and autonomy, beliefs...