During the 1990s, depression captured the imagination of the United States. In the decade prior, the American Psychiatric Association (APA) had reformulated depression into ‘major depressive disorder’ (MDD), an entity more tractable, more measurable and, so hoped reformers, more manageable. MDD reflected the professional strivings of a new breed of psychiatrists who were seeking to reassert psychiatry's credibility as a medical specialty. MDD commandeered the American zeitgeist, not merely because so many people purportedly had the reconstituted diagnosis, but also because it suddenly seemed so curable. On the heels of the diagnostic change, the antidepressant Prozac came to market in 1987. Other medications in the selective serotonin reuptake inhibitor (SSRI) class soon followed: Zoloft in 1991, Paxil in 1992, Luvox in 1994. But it was Prozac that signalled a new dawn in psychiatry, and the hype surrounding it was breathless.

Hitched together, MDD and Prozac became cultural icons. Magazine covers heralded Prozac as the ‘Breakthrough Drug for Depression’ (Newsweek, 1990) that led those who took it ‘out from the darkness’ (Time, 1992), declaring ‘Bye, Bye Blues’ (New York, 1989). Cultural depictions of depression proliferated, reaching a high point in the year between September 1993 and 1994, a period bookended by two best-selling books. Peter Kramer's Listening to Prozac attested to the ‘transformative power’ of Prozac, which not only seemed ‘to flip a switch, to turn black and white into Technicolor’ for those with depression, but also had the potential to make people ‘better than well’. A year later, Elizabeth Wurtzel published her memoir Prozac Nation, which spoke to the experiences of a depressed generation. Noting ‘the widespread nature of depression – particularly among people my age’, Wurtzel recounts her depression and eventual recovery facilitated by Prozac. By the mid-1990s, MDD had solidified its place as the framework through which the American public made sense of its distress, and Prozac became its solution.

Epidemiological data seemed to confirm the overabundance of depression in the US. The prevalence of the disorder skyrocketed in the 1980s. While the dominance of MDD and Prozac in American cultural discourse has ebbed since its peak in the 1990s, MDD remains epidemiologically prevalent. The 12-month prevalence of MDD is 10 per cent of the US population, and 1 in 5 Americans will experience depression over the course of their lives. And those with MDD get prescribed medications at high rates.