The logic is simple: Prozac is for mental illness, but Sarafem is for PMDD, a physical illness, and most of us feel more comfortable being treated for physical illness than mental illness. In fact, the U.S. Surgeon General, the American Psychiatric Association, the pharmaceutical and managed-care industries, and the National Alliance for the Mentally Ill all agree that the way to destigmatize mental illness is to convince us that it is really a physical illness, just like diabetes.
But apparently we are not convinced because the stigma remains. Most would find it much harder to admit to being dependent on Prozac than on insulin. We have an uneasy sense that mental illness reveals something bad, shameful or threatening about us that we need to keep hidden, even from ourselves (for instance, by telling ourselves that Prozac is Sarafem).
Before Prozac, being mentally ill used to mean being "emotionally disturbed" - unsettled, unbalanced, overwhelmed by passionate fears, excitements, joys and griefs that we would rather not feel but are unable to control or ignore. Following Freud, we understood psychiatric symptoms as a failure of repression, our unconscious emotional "dark side" trying to force its way into consciousness against our will.
But Prozac made it so much easier to control, ignore and repress all disturbing emotions. By making our symptoms go away, it made it easier to believe that mental illness was chemical rather than emotional; maybe the Freudian unconscious didn't even exist. Well, almost. Prozac could never make the stigma go away. It remains as a stubborn reminder of what we are just as stubbornly trying to hide from: the powerfully disturbing but vitally passionate dark side of our own inner lives.
