Psychiatry and Generational Memory in Iran by Prozak Diaries (review)

Prozak Diaries offers a nuanced ethnographic examination of how psychiatric disease categories and their pharmaceutical treatments have been culturally assimilated in Iran, yielding new forms of being and, crucially, new modes of sociality. As the Persian transliteration of Prozac in the book's title suggests, the global rise of biomedical psychiatry cannot explain the regionally and historically specific lived experience of mental illness. Proposing an alternative to top-down research methods that Orkideh Behrouzan groups under the rubric of "post-Foucauldian" cultural critique, Prozak Diaries investigates the personal narratives of people living with depression and attention deficit hyperactivity disorder (ADHD), as well as the clinicians working to understand and treat these conditions. Behrouzan brings together testimonies from interviews, blogs, and artistic productions to argue that depression and ADHD have informed "psychiatric subjectivities" mediated by affective attachments to postrevolutionary generational identities in the Islamic Republic (110).

Clinical depression is a pathology codified and circulated transnationally through the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). Departing from the DSM's universalizing logic, Behrouzan transliterates the Persian term depreshen as a condition specific to Iranian social existence, particularly since the Iran-Iraq War. Behrouzan's informants frame their depreshen as a feature of the 1980s generation (daheh-ye shasti-ha), referring broadly to those born or raised in the immediate aftermath of the revolution. Her study reveals the inadequacy of "depression" as a universal category of lived experience and the agential ways in which the category has been appropriated and vernacularized to address specific concerns in contemporary Iran. Behrouzan approaches Prozac as a powerful affective object with ambivalent cultural implications when rendered contextually as Prozak. For some consumers belonging to the 1980s generation, ingestion of the pill provides a collective means of coping with national history: "As if the inner voice of longings and desires, Prozak becomes the physical device, the technology, through which and with which individuals think and interpret the world around them" (116). In Iran, Behrouzan argues, depreshen and Prozak, along with ADHD and Ritalin, have become part of a collective effort to manage the trauma and loss of political violence, as well as the socially fragmenting effects of modernization. Taking Prozak can also indicate an embodied aspiration toward Western modernity's liberal individualism, rooted in biomedical accounts of mental illness.

Behrouzan separates the book's chapters with brief interstitial vignettes, a formal strategy tethering her broader ethnographic claims about the medicalization of mental illness to the specific subjectivities shaped by psychiatric discourse: "The Anthropologist," "The Counselor," "The Blogger," "The Mother," and so on. In "The Student" a recent graduate of a prestigious engineering school situates her initial reluctance to treat her depreshen pharmaceutically in the context of intergenerational tensions surrounding the moral implications of psychic suffering: "[My parents] keep asking what's wrong with me and blaming me for being down, as if I don't want to be happy, as if it's my fault that life sucks. . . . I'm depress. . . . Daru [medication] is helping. That's what I need now. I can't change anything else, you see" (92; the second pair of brackets is Behrouzan's). In testimonies like these, Prozak Diaries illustrates the increasing deployment of biomedical discourse to destigmatize moral judgments surrounding mental illness in Iran. Behrouzan argues that by locating and treating mental suffering in the brain, psychiatry and neuroscience "validate" individual experiences of depreshen, enabling the depressed subject to consider the historical events implicated in his or her feelings of distress, particularly childhood memories of war. Behrouzan claims, moreover, that in destigmatizing depreshen the biomedicalization of mental illness produces new modes of social relation, heightening the depress subject's capacity to reach outside her own mental world. Psychiatry provides a language through which to articulate both biological and social causality, contributing to the development of new generational solidarities in contemporary Iran.

By demonstrating that psychiatric discourse can generate communities, group identities, and shared affective attachments, Behrouzan's analysis moves...