Content and style are fused in Prozac Nation as the author textually enacts her depression, resulting in a book that wears the reader down with its self pity, despair, and an endless struggle simply to live--an experience much like living with a chronically depressed person, which makes the book work. Wurtzel uses extraordinary language to describe her depression--always running from a huge black wave about to crash over her; feeling like "the walking, waking dead"; having skin like "thin gauze bandages."

The chronology is also effective, with each chapter focusing on a very specific time in her life beginning at age 11, "full of promise," when depression hit her not as a "sudden disaster" but as "accumulated data." With each subsequent chapter, Wurtzel discloses the intensity and enormous variations of depression, along with the differences in treatment styles in this "pre-Prozac" period.

The suicide attempt, which readers keep expecting in each chapter, finally occurs toward the end of the memoir: "I am doing exactly the thing I don't want to do, committing the act I believed I was above: making a wimpy attempt that is bound to fail." With her failure comes euphoria, however, as she discovers she has survived an "attempt on [her] life," which she characterizes as "the purest and most deliberate act of hatred [she] has ever committed."

The final chapters provide intriguing, knotty questions about psychopharmacology as Wurtzel on one hand characterizes Prozac as a national joke, trendy, a silly drug for crybabies, cosmetic pharmacology for the U.S., which is in "one big collective bad mood"; and on the other, as a drug that literally saves lives. Her writing complicates the issues surrounding psychopharmacology and therapy, and her attempt to "write a book that felt as bad as it feels to feel this bad . . . to be true to the experience of depression" hits the mark.