Patients told they needed drug to cope with everyday life
Sharon Kirkey
CanWest News Service
Sunday, September 28, 2003
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Like '60s housewives, women today are being led to think they need
mind-altering drugs to cope with normal life events, a new study suggests.
U.S. researchers who analysed the media's coverage of depression over the
first 13 years of the Prozac phenomenon discovered a major shift in how
magazines and newspapers portray mental health problems, especially among
women.
In the two years before Prozac hit the market in 1987, few newspaper and
magazine articles used non-medical terms to describe depression.
By 2000, only 32 per cent of articles included recognized symptoms such as
"lack of energy," while more than 90 per cent of stories aimed at women used
emotional phrases, such as "being a bad mother" and "feeling fat" as signs
they might need one of the newer anti-depressants.
"There really was this division. (There were) all these articles of a woman
who was crying and couldn't make breakfast for the kids and couldn't do the
laundry, so she took Prozac and it helped her out," says lead author Dr.
Jonathan Metzl of the University of Michigan Depression Center.
But the descriptions of depression in men did not shift in nearly the same
way. "For a man, there was nothing like he was feeling sad, and he couldn't
relate to his wife or his children," Metzl says.
Instead, most of the coverage targeted at men focused on the "depression" of
not performing well on the job "or the playing field."
"It's not that the media are doing a bad job of covering these issues, but
rather that gender stereotypes are pervading the way we talk about mental
illness for better or for worse," Metzl says.
In fact, while the mass media may be making women think otherwise "normal"
problems with marriage or motherhood can be cured with a drug, doctors and
drug companies are at least as culpable. Up to three times as many women as
men are getting prescriptions from their doctor for Prozac and related
drugs, suggesting many are getting antidepressants whether they need them or
not.
What's more, Metzl notes that many studies rightly blame drug companies for
medicalizing "womanhood." For example, soon after stories about a severe
form of premenstrual syndrome began appearing in magazines, the makers of
Prozac got U.S. government approval to repackage their drug under the name
Sarafem for women suffering from so-called "premenstrual dysphoric
disorder."
"I just think doctors and patients need to ask questions when all the forces
in the world try to tell them, 'Come in and see your doctor and get Prozac,'
" says Metzl, whose study appears in the journal Social Science and
Medicine.
Metzl is also the author of a new book, Prozac on the Couch: Prescribing
Gender in the Era of Wonder Drugs, which takes a historic look at drug ads
for psychiatric medications.
In the postwar 1950s, tranquillizers such as Miltown were pitched as
"treatments for women who didn't want to be mothers, or didn't want to do
their housework or, God forbid, should want to work outside the home," he
says.
In the 1970s, when the women's movement was hitting the national scene "and
the single woman became the empowered woman," drug companies countered with
ads that portrayed unmarried women almost as "the vector" of mental illness,
says Metzl, an assistant professor of psychiatry and women's studies at the
University of Michigan. "I've got these Valium ads that show intimidating,
feminist-looking women who are kind of tamed by the drug.
"The question I had was, what are the assumptions that people 50 years from
now are going to make about this point in time that seems invisible, or
second nature to us?"
He and his colleague, Joni Angel, examined 261 articles in leading U.S.
newspapers and magazines from 1985 to 2000.
They tracked how many standard, "gender-neutral" symptoms of depression were
mentioned in each article that fit with terms used in the Diagnostic and
Statistical Manual of Mental Disorders, the so-called "bible" psychiatrists
use to diagnose mental illness. Next they recorded how often the stories
included non-DSM criteria -- for example, terms related to marriage,
friendship, aggression, sex, body image, athletic performance and
menstruation.
The team discovered that, as Prozac moved from a virtually unknown drug to a
popular icon, stories about the drug and depression "moved from the health
section to the fashion section to the sports pages," Metzl says.
Metzl stresses that, overall, depression is under-diagnosed and that the
media can help people "recognize depression and de-stigmatize mental
illness.
"But on the other hand, there are many other things that could be at work
and not merit an SSRI prescription."
� Copyright 2003 Edmonton Journal
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