What Should We Do with Our Depressions? Feelings, Biology, Politics

“Our bellies have never been more put to the test.” This is, roughly and quite literally translated, what I read every time I went to take the subway during the last stressful weeks of 2023—in a billboard for Buscapina, an over-the-counter medication for abdominal pain and cramps that promises to “get rid of spasms.” “Stressful” is a huge understatement here, but it is simply too hard to describe the sheer amount of disorientation, uncertainty, worry, and grief that affected pretty much everyone I knew in the face of that November’s presidential elections in Argentina, my country, which put a far-right media personality in power (whom I also find hard to describe, by the way). But I doubt the ad meant to draw a connection to the political circumstances, at least not explicitly. I look into it now and find that, under the title “Stories Based on True Bellyaches,” the campaign featured different characters, each with a different bellyache story: two out of three have a clear-cut emotional background. I also learn that it grew out of a previous campaign, which pivoted on the national emotions during the 2022 FIFA World Cup, feelings of nervousness and anxiety then, yes, but also of relief, euphoria, national pride, and cohesion. If anything, football seems to be the most patent reference here, not politics—still, I don’t think they tried to dispel the association either. “We are always put to the test in Argentina,” stated Buscapina’s regional brand manager.¹ 

Andrew Lakoff argued, in his study of antianxiety and antidepressant medication campaigns in Argentina during the 2001 crisis, that national pharmaceutical companies were quick to harness social explanations of distress: “The social analysis of psychopharmaceutical sales patterns was almost second nature to market strategists.”² Argentine companies knew well, still do, how to turn pain into profit without denying its public, political nature. Yet, the Buscapina line also rings true. Why deny that stress, social stress too, affects our bodies, our guts? And then, a while later, I posted a picture of the ad on my social media because I had a paper published in which, among other things, I drew on Lakoff’s arguments to discuss the political nature of depression.³ A stranger, presumably annoyed, saw fit to ask: “You didn’t have spasms before?” I have felt bad before, sure. It’s not my first day on Earth. I never meant to say that the total sum of our feelings of distress was Javier Milei’s fault, as I would not say that the total sum of depression and anxiety diagnosis, which rose fast here in the first few months of the pandemic,⁴ were all directly the fault of COVID-19. But does that negate the quite obvious political dimensions of these particular feelings of distress? 

Depression is uncomfortable—this is of course another huge understatement. First of all, depression is uncomfortable because it is so evidently painful. It is part of the definition: depression hurts, a lot, and in a quite particular way. It can feel like being helplessly stuck, where you “simply cannot see where there is to get to,” as Sylvia Plath once put it.⁵ I’ve been feeling a lot of this lately, politically, and I bet I’m not alone. But maybe part of this felt negativity also derives from added layers of discomfort. While we talk more and more about mental health in general and about depression in particular—about depression rates, about depression treatments, about depression stories—none of those talks is either casual nor straightforward. We would like to think all stigma is over, that mental health issues are out of the closet now, for good. But these feelings are still hard to deal with, as are the issues that revolve around them. Depression is not only the site of fathomless suffering, but the subject of heated debates, and the two may not be wholly unrelated. 

Here I want to focus on the recurring tensions between biology and politics in the realm of feelings of distress, revisiting some crucial controversies of the deeply intertwined affective, material, and reparative turns through the lens of depression. While one of the crucial drives of affect theory and new materialism has been a certain sense of enthusiasm (about the capacities of affect, the vitality of matter, the promises of reparative reading),⁶ these fields are no stranger to controversy, to feeling stuck, even to depression. Indeed, they emerged as such in the 1990s, during a time of heightened attention to depression and antidepressants. And, when decades later they turned more fully to a discussion of depression, they did so largely along the lines of those earlier divides, such as hotly contested issues surrounding diagnostic trends or antidepressants’ efficacy and safety, or the questions of whether depression belongs to the body or to politics, to matter or to language, to the realm of affect and individual experience or to that of power and public structures of inequality and oppression. In this essay, my main goal is to historicize these tensions, foregrounding their connections to wider debates on depression, in order to dwell on how they may affect our current public feelings of despair. Over the past three decades, within affect theory, new materialism, and in the public sphere, depression has become an arena in which to gather,⁷ although not always politely (arenas are, after all, sites of struggle). It has been a crucible of many different conflicts, and maybe this is partly why we got stuck in them for so long. Getting stuck is sure uncomfortable, even painful, but—is that always only a bad thing?

Prozac Wars: Biology versus Language

Let’s go back to the 1990s, where it all began. And, by all, I mean mainly affect theory—at least in its current incarnation (we know people have been thinking about feelings ever since the dawn of thinking and feeling)—but also debates around depression, antidepressants, and the role of science and Big Pharma in matters of feeling and distress. Because, more broadly, the 1990s were also the so-called Decade of the Brain, of the Prozac boom and the Prozac wars. Along with a steep rise in depression diagnoses and antidepressant prescriptions, there was a burst in popular representations and controversies, which were instrumental in cementing depression’s definition and status as a common mental disorder.⁸ And this was the backdrop against which some of the most seminal essays of the affective turn were published, like Brian Massumi’s “The Autonomy of Affect” (1995), and Eve Kosofsky Sedgwick and Adam Frank’s “Shame in the Cybernetic Fold” (1995).⁹ Depression debates, that is, informed this turn to affect. To be sure, public and scholarly discussions have different frames, tones, and aftermaths, and should not be collapsed into one another. Still, they are not isolated—no scholar is an island. 

In fact, the tensions between biology and language that so inform the foundational texts of affect theory resonate strongly with those wider controversies. Each in their own way, both Massumi and Sedgwick and Frank argued that a turn to affect should imply turning away from the lessons of the linguistic turn to embrace the biology of the body. In a review essay, also published in 1995, on three of the Prozac best-sellers of the time,¹⁰ Judith Kegan Gardiner outlined a compelling scene, one that probably would not strike as too strange even today, which speaks volumes about this resonance. A group of women attend a feminist conference: In the panels, they discuss the socially constructed nature of gender, identities, and ways of being, while during coffee breaks they exchange data and impressions about their use of Prozac and other related drugs, in a way that belies “a view of personality as biochemically influenced.”¹¹ Through this story, Gardiner pointed out the seeming contradiction between private uses and public stances, which she ultimately saw as symptomatic for a wider “ambivalence about biology and social constructionism.”¹²

It is hard to deny that there is a certain feminist established common sense—and maybe also within the humanities more widely—according to which the crucial intervention is to show that what seems natural is actually not. Our genes, our hormones, our brain chemistry are not the problem—it is the world that is unjust, unbalanced, and broken. This is an important, hard-won lesson, which unfortunately still bears reminding. But it is also too simple, when taken by itself. And, it seems fairly safe to venture, it was precisely the flagrant but often unnoticed bifurcation so vividly portrayed in Gardiner’s story that motivated Massumi’s or Sedgwick and Frank’s passionate arguments. There is more to biology than meets the eye, they argued—somewhat paradoxically, since the critique of anti-biologism was regularly paired with a disavowal of the “hermeneutics of suspicion,” a critique of critique.¹³ Or, better yet, there is more to biology than words can tell. Biology and affect are before or beyond language, and cultural studies needs to stop being wary of that: we should be able to listen more openly to the intensities, textures, moods, and agencies of biology and affect, instead of making them fit in the same old tired boxes of language, culture, or power.

Although depressive affects would be the exact opposite of the exciting picture of affect as transgressive, unassimilable, unpredictable intensity, affect theory and mainstream psychiatry were, all of a sudden, strangely in tune in their call to biology. How should we understand this eerie alliance? Of course, I do not mean to simply equate them. For example, I do not believe Sedgwick ever meant to simply pathologize depression, like Peter Kramer very unequivocally and influentially did.¹⁴ She wanted to learn from depression, to make room for it: the opposite of paranoid reading is not a chirpy, happy-go-lucky one, but a practice inspired by Melanie Klein’s depressive position.¹⁵ Nevertheless, this turn to affect and to biology was also boosted and shaped by those very public and very polarized Prozac wars—which might mean, for instance, that behind or beneath or even nurturing its calls for a more reparative and capacious way of thinking were also the lust of battle, the moral weight of dichotomies, the power and appeal of conflict. And, through controversy, the divide between biology and politics was mostly reinforced, not dissolved. 

Prozac Wars, Round 2

Some twenty years later, affect theory and new materialism went back to discussing depression, this time in book-length form, and again, thorny issues about the biological or cultural nature of our feelings came right up. The context was very different, though. Regarding antidepressants and the medical model of depression, the zeitgeist was no longer belligerent. Even in feminist contexts, skepticism had given way to a more musical-comedy attitude of acceptance, as in the catchy tune of the television series Crazy Ex-Girlfriend (2015–2019): “Antidepressants are so not a big deal!”

This shift in tone is actually featured in Ann Cvetkovich’s Depression: A Public Feeling (2012), given that the book chronicles her descent into depression twenty years prior, while finishing her dissertation, entering the job market, and writing her first book—aptly titled Mixed Feelings (1992, and featured, incidentally, in Sedgwick and Frank’s essay as a glaring example of the “reflexive antibiologism” of theory).¹⁶ Sometime in the two intervening decades, Cvetkovich drafted what she called her “Depression Manifesto”: “This is my version of a Prozac memoir, bad connotations included. But I want to write it because I don’t believe in Prozac.”¹⁷ There she dubbed it a “scam,” “trivial,” a “drug that masks the symptoms of a response to a fucked-up world”—but then she moved on. The manifesto lines are cited in the book as testimony of a past time, an earlier voice, but are distinct from the book’s argument, and she clarifies right away: “I’m not against pharmaceuticals for those who find they work.”¹⁸ In fact, the memoir describes and acknowledges the effects that antidepressants had on her, even if she is determined not to make too much of it. She does not need to be either for or against Prozac to make her case: that depression is a public feeling, an entry point to “how capitalism feels.”¹⁹ The book grew out of an anti-Prozac rant, but it also outgrew that rant. 

This is not acknowledged in Elizabeth A. Wilson’s Gut Feminism (2015). She is plainly dismissive of Cvetkovich’s book on depression, retelling Gardiner’s anecdote to argue for a “mismatch” between critique (which she quite problematically equates with anti-psychiatric critique) and “the post-Prozac landscape,”²⁰ without stopping to ponder over the fact that two whole decades elapsed since Gardiner’s text. Her central claim is that depression is visceral, and that feminist and cultural critics such as Cvetkovich, routinely worried about oppression and capitalism, have ignored that. Wilson picks up the Sedgwickian argument against anti-biologism by the letter, but she clearly drops Sedgwick’s call to a more reparative mode of arguing.²¹ That is, Gut Feminism addresses depression to wrestle biology from the anti-biologism of theory and feminism, but also to explicitly defend the role of negativity and aggression in theory and feminism. The critique of critique, however, still comes in handy to dismiss all criticism of antidepressants and the potential errors and abuses of the pharmaceutical industry.²² 

While the clash between Cvetkovich’s and Wilson’s books seems at first glance to replay the 1990s controversies that pitched biology and language, materiality and critique, body and power, these binaries tend to unravel on a closer look. It is not only that Wilson uncouples her defense of biology from the call to reparative reading, at least partially. Cvetkovich is also much more attentive to the embodied experience of depression than what Wilson grants her: bodily experiences, even pharmacologically mediated, are crucial in her discussion of what depression feels like, as they are in her lengthy account of the everyday habits that allow her to navigate and overcome depression, such as swimming, dancing, and crafting. In this, actually, Cvetkovich’s attunement to the embodied experience of depression is perhaps even keener than Wilson’s, whose arguments often depend on cultural and linguistic matters, like her discussion of bitterness and “biliousness” in abdominal migraine in children or in melancholy and depression.²³ Crucially, the “data” about serotonin’s role in depression Wilson claims to take “seriously, but not literally” are in fact not at all firmly established,²⁴ so she ultimately uses them not literally but rather literarily, as suggestive ideas, but not as access to some real, material world. 

More troublingly, perhaps, Wilson’s approach to depression can seem at times even instrumental, weirdly insensitive to the suffering it entails. This is particularly apparent in the second half of the book, devoted to antidepressants, where she seems to care more about what the body does to the drug than the other way around.²⁵ Her final chapter opens with a discussion of the relationship between antidepressants and increased suicide rates in children and adolescents, drawing on Jacques Derrida’s pharmakon to argue for the ultimate impossibility to dissociate the bad from the good, poison from cure. Through it all, the gravity of the subject seems forgotten. But as I see it, Derrida’s pharmakon was never about indifference to suffering; the fact that violence is unavoidable does not mean we should not strive tirelessly for an economy of violence as just as possible, and beyond. Tellingly missing from Wilson’s approach to antidepressants are their felt effects (which, as I mentioned, do show up in Cvetkovich’s memoir). She faults “conventional” critiques of antidepressants with “insensitivity to the materiality at hand,”²⁶ but what about the people who take them?

After clarifying her stance towards antidepressants, Cvetkovich specified: “I do, though, want to complicate biology as the endpoint for both explanations and solutions.”²⁷ Wilson’s book could be seen to do this exact same thing: her aim is to show that “biology is not a synonym for determinism,” that “nothing is comprehensible in purely biological terms—especially not biology itself.”²⁸ It’s true, the path Cvetkovich chooses to “complicate biology” does turn away from the life sciences, like Wilson chides her,²⁹ but not from all bodily matters. In turn, Wilson’s way of approaching the “data” doggedly sidelines cultural, social, historical, political, and epistemological discussions, all of which continue to be essential for depression and antidepressants. In any case, we do need a better, fuller engagement with the body and the life sciences. And maybe, taken together instead of apart, both their insights as well as their limitations could help us find the way—after all, they are both trying to overcome what they see as a confounding, hurtful divide. Ultimately, from different angles, both Cvetkovich and Wilson show the powerful entanglements of biology and politics and of matter and language in the problem of depression.³⁰ Depression is, then, both a gut feeling and a public feeling. That there are so many routes to this entanglement only makes it matter more. 

On Being Stuck (Still)

But clearly just saying this—depression is both visceral and public, both biological and political—does not make the problem go away. Issues of medicalization of distress or the efficacy, safety, and mechanisms of antidepressants are still hotly contested.³¹ Moreover, if COVID-19 has taught us anything, it is that our mental health is highly attuned to the world, but also that biological issues are deeply embedded in political matters. Actually, these lessons are not new. “This chestnut in the fire of contemporary discourse is the easiest to crack,” wrote Gardiner almost thirty years ago, “but only to make the simplest puree.”³² Why then is depression so compelling, so prone to controversy, still? Why are the questions it poses so difficult to solve, but also to dismiss? 

Evelyn Fox Keller’s The Mirage of a Space between Nature and Nurture tackled a similar conundrum: if we already know the divide between nature and nurture is a false one, why do we keep coming back to it? There’s the history of the dichotomy, sure, and yet exposing it fails to undo the charm. (Historicism and critique, in other words, fall short.) What keeps the debate alive, Keller suggested, is that it “does seem to capture a number of issues that many people want to know about,”³³ issues regarding the fixity or plasticity of human nature. So we need to change the question to one that makes sense, yes, but unless we reckon with those concerns, the mirage that promises to soothe them will keep showing up. 

On that note, I would like to end on the suggestion that depression matters so much, both in its confusing entanglements of mind and body and in its polemical nature, because it brings to the fore important issues of agency and, in particular, of blocked agency.³⁴ This is after all what depression is all about, the intractable feeling of being stuck. Ultimately, of course, this is also the main allure of antidepressants, their promise to get you out of bed in the morning, regardless of all of the other factors—personal, political—that keep getting you stuck: “Depression hurts” was Eli Lilly’s crucial tagline, followed by “Prozac can help.”³⁵ The Public Feelings project captured this well through their idea of political depression, which is, “the sense that customary forms of political response, including direct action and critical analysis, are no longer working either to change the world or to make us feel better.”³⁶ But this particular branch of desperation, which by the way is still alive and well,³⁷ is also what the turn to biology was responding to.³⁸ This was, for instance, the motivation behind two of Sedgwick’s major interventions: her argument to overcome paranoia came from her grappling with a perceived impasse in AIDS activism,³⁹ and her case for an approach to biology was spurred by a desire to think about negative affects in a less negative, oppressive way.⁴⁰ 

But does this really help? Does a turn to biology actually foster, widen, or free up agency for negative feelings? On the one hand, alas, I think it is rather a trap. Biological approaches to depression do not tend to destabilize the negative understanding of it, quite the opposite. The life sciences routinely pathologize depression, and they mostly do so in an overtly reifying way, by turning depression into a stable entity.⁴¹ So whatever power this approach affords, it has nothing to do with a potency of affect, much less of depressive affects, which are seen as always and only negative, disordered, and private. Rather, I think, the efficacy of appealing to biology comes from biology’s authoritative place—something particularly evident in the whole Prozac affair. Whatever their “real” effects and their chemical workings might be (and let us remember, again, that neither is firmly established nor understood) the success of antidepressants constitutes a blatant example not only of the powers of marketing, but more specifically of the allure of the scientific discourses the marketing strategies relied and rely on.⁴² I am not saying this makes them fake or useless, and I am also not saying that those powers can’t be used in strategic, devious ways. (For instance, the Feel Tank Chicago’s slogan “Depressed? It might be political,” pivoted crucially on the rhetoric of pharmaceutical advertising.) All I am saying is we should be aware of and alert to where pharmaceuticals’ power comes from—in using that power, we may also reinforce it.

On the other hand, however, I also feel these arguments, through their blockages and perhaps even in their most hotly confrontational moments, are in fact leading somewhere. Depression is uncomfortable, and the controversies deepen the discomfort—but we can learn from this. This is, as Clare Hemmings reminded us, one of the lessons of standpoint feminism: “critical knowledge is accessed through the feeling of ill fit.”⁴³ Feeling stuck, staying with the trouble, not knowing where there is to get to—all different ways of describing aporias, by the way, the Greek word for a lack of paths—can sometimes be instructive experiences. I don’t mean to simply valorize the relentless negativity of depression, as if it could be turned into something productive, purposeful, or positive.⁴⁴ There is a certain intrinsic negativity to depression that should be acknowledged. Depression hurts, yes. A lot. It can hurt even more when we try to shun it; when we add unfair and unnecessary negativities to that intrinsic one. And maybe, to avoid this, the turn to biology could be helpful, insofar as it points to the complicated, entangled, widespread ways in which agency is distributed. 

There is no easy, ready formula to get out of bed, nor to change the world. What is certain, though, is that sheer will alone will not do. If the customary forms of agency are not working anymore, maybe it’s because they never really did. And, to reinvent them, we might need to let go of the false choice between biology and politics, which need not be understood as mutually exclusive. Depression might be a way in which society gets under our skin, a way in which we bodily and affectively register, digest, and even resist what the world puts on us. And pills can have a social life too, not only as discourse and cultural circulation, but also in terms of the ways in which they are experienced and the material, felt effects they produce. To reinvent agency, we might need to embrace and foster ties more openly with very disparate actors and things and forces, both in the realm of “culture” and of “nature,” some of which may not always be easy to understand or to live with. And we might even need our depressions—even in, or for, the inescapable vulnerability, awkwardness, and negativity they entail. 

Acknowledgments

I am grateful to Mariela Solana, Candela Potente, and Tania Espinosa, as well as the editors and anonymous reviewers at Lateral, for their attentive reading and helpful feedback. I would also like to thank the whole of SEGAP (Seminario sobre Género, Afectos, Política), under Cecilia Macón’s guidance, for the many thought-and-feel-provoking conversations on these matters.