SSRI for the Son of a Made Guy: Anthony, Jr. on "The Sopranos"It's not every week I click off The Sopranos feeling as if the episode took a cue from my own life. All my mommy issues disappeared without duck-induced fainting spells; I don't even wear an Adidas tracksuit to the gym; and the only mafia I've ever escaped from was Commentary. Still, A.J.'s exciting new subplot had me riveted to the screen like moist gabagule to provolone.

For those without HBO or something to talk about on Mondays: New Jersey don Tony Soprano's son A.J. was dumped by his girlfriend Blanca last week after he hastily proposed to her, she impulsively accepted, and then she realized she just wasn’t into him anymore. This week’s episode featured A.J.’s mounting depression at the loss of his beloved. He couldn’t eat, he couldn’t sleep, he looked as disaffected and cosmically bored as he did before he found his soulmate and grew Backstreet Boy facial hair. And rather than do what sheltered bourgeois boys do when they get kicked to the curb by heartless womanfolk – take it up with mom and sis – A.J. remained eerily silent throughout, issuing a few mild innuendos about suicide. He did at one point suggest that his breakup was due class conflict: it just wasn’t in the tax returns for a pizza-slinging Montague from an Italian crime family to make it work with single parent Capulet from a Puerto Rican barrio. In Jersey.

As this is The Sopranos, and sooner or later you wind up in the morgue, jail, or a shrink’s office, A.J. was swiftly dispatched to the some recommended Dr. Feelgood, the most stone-faced and maladroit therapist I’ve ever seen on television. (I still don’t understand why the writers are lauded for their realistic portrayal of doctor-patient kibitzes; I find Tony and Dr. Malfi’s interaction to be the most strained thing about the series.) After asking a few prosaic questions, even for an in-take session, the shrink hits upon a novel solution: A.J. should take Lexapro.

Shpritz Deficient: Bob SoutheyLexapro is the most current iteration of so-called SSRI (selective serotonin reuptake inhibitor) anti-depressants, in the family of industry pathfinder Prozac, yet the one psychiatrists prescribe first now due its relatively low occurrence of side effects. These may include fatigue, weight gain, stomach cramps, and anorgasmia in men. Anorgasmia, like anhedonia, is just what it sounds like. In the 19th century, the British – specifically Lord Byron, satirizing the neurotic poet Bob Southey – used to call a man who’d jackhammer away and never cum a “dry bob.” It’s enough to make you depressed all over again. Or so I’ve read on my packet of Lexapro.

Yes, not too long ago, I was hit with the liebestod for a Scandinavian beauty who said she liked me okay but would eventually want to sleep with other people. This posed a distinct dilemma for a romantic materialist such as your humble servant. Not to mix pop cultural genres, but might I call your attention to the line at the end of Eternal Sunshine of the Spotless Mind? Clementine warns Joel that what did in fact happen the first time they dated would happen the second time, too: “I'll get bored with you and feel trapped because that's what happens with me.” Better yet, remember Joel’s response? “Okay!”

Okay! I hope Joel’s round two went better than my round one. After much agonizing I realized it was just too painful to even entertain the prospect of being one among many, so I bailed. This is actually worse than getting dumped because you’re applying the cold steel to your heart all by yourself. The good news is, it was the most amicable break-up I’ve ever had: We talked about Kingsley Amis, whom she hated (bad sign there), and Rothko. And I kept her copy of The Female Thing, which I said I’d mail back to her but never did. Watch how the patriarchy does revenge.

The Spoils: Laura Kipnis's "The Female Thing"After a week or so of marinating in my own misery, both at home and at the office (ask Izzy), I decided I should talk to a shrink. New York Jews have an obligation to travel this route at least once in their neurotic lives, and I betray no embarrassment to report that you’ll find my psychic tire tracks on more than a few turnpikes.

Anyway, this shrink seemed well poised to treat me because she’d already treated my older sister and had a rather serviceable family history to hand. I told her (always see a female psychiatrist by the way) my girl trouble and how I was in a state of mind-lock over every perceived faux pas or fatal act I may have committed in the course of the relationship.

It hardly mattered that I’d been given the other person’s agenda upfront, and that her forecast of how things would end up merely came to pass. If only I’d done X, or waited a while longer before doing Y… Like Stephen Jay Gould’s fossil record played backwards, I was hopelessly tethered to an infinity of existential what-ifs.

I knew before my first session with Dr. S that I’d had a mild case of obsessive-compulsive personality disorder, or OCP. This doesn’t mean I return to the perpetually lit gas stove or have to flick light switches 80 times a day. My obsessionalism is manifested internally, and only becomes behaviorally problematic when the bulk of my cerebral energy goes toward operating the loop-de-loop of a single idea or concept instead of, say, updating the Shvitz. But it never really occurred to me just how telling OCP was to a professional trained to spot it within minutes. The guardedness with which I approached therapy with the doc who initially diagnosed me made what should have been my shock of recognition more like a gradual, bathetic realization.

Here’s what I do: I try to relive every footling nuance and non-consequential detail of every memory until I’m convinced my listener is emotionally there, experiencing it with enough vividness to draw the same conclusions about it as I do. My frustration is in feeling that I may have left out some cinching piece of evidence or that I’m misrepresenting myself in some way. Always, however, the elusive end goal is the same: certified determinism. I don’t want to just be told there was no other way things could have transpired; I want to know it intuitively and unwaveringly.

Little, White, Different: Actually, similar to all SSRIs, except with fewer side effectsWell, an hour later I had my first trial packet of Lexapro, known to cure what ails me and courtesy of psychiatrist who, thirty years ago, was highly skeptical of the transformative power of SSRI drugs. I didn’t have a cabinet full of auspicious patient histories to bolster my confidence, so I was still skeptical.

According to Wikipedia (always take drugs according to Wikipedia) Lexapro works by “increasing intrasynaptic levels of the neurotransmitter serotonin by blocking the re-uptake of the neurotransmitter into the neuron.” So it fucks with your brain chemistry in a way that would have taxed Dr. Huxtable’s inventory of medical euphemisms on the Cosby Show.

But whereas A.J. is said to have shown signs of marked mood improvement after only a week on the pill, the average patient doesn’t detect changes in his disposition until after a month or two of usage. (Good thing, too. In A.J.’s case, his happy fix had him helping goomba friends pour sulfuric acid on the foot of a college gambling debtor. Lexapro: Your low-life is waiting.)

So has it worked? Am I different person? Pretty much. It's been about six months on the drug, and while I find mind-lock still occurs, it doesn’t last as long as it used to. More significantly, the dire anticipation of it occurring – usually this was worse than the event itself – is now almost nil. Imminent conflicts or bummers are received with all the sangfroid of Churchill's definition of history: one damned thing after another. I suppose I should count myself a Lexapro success story.

Don Juan in Hull: Philip LarkinThe alternative explanation for my alteration (I do love to sound grandiose about something that costs $80 a month, sans co-pay) is one that my shrink doesn’t discount: sentimental education. It’s almost a certainty that the next spoiled love affair won’t be as profound or profound-seeming as the last one. As ever, Philip Larkin understands the learned stoicism that comes with romantic experience. If you can’t afford Lexapro, you can always swallow poetry:

Love, we must part now: do not let it be
Calamitous and bitter. In the past
There has been too much moonlight and self-pity:
Let us have done with it: for now at last
Never has sun more boldly paced the sky,
Never were hearts more eager to be free,
To kick down worlds, lash forests; you and I
No longer hold them; we are husks, that see
The grain going forward to a different use.

There is regret. Always, there is regret.
But it is better that our lives unloose,
As two tall ships, wind-mastered, wet with light,
Break from an estuary with their courses set,
And waving part, and waving drop from sight.