It’s Not That Simple

I’ve bitched before about the ads on TV for psychotropic drugs, and I’m about to do it again. The first ones that caught my eye were the ones that compared depression to holding up a smiley face mask in front of their face, while the person’s actual face exhibited sadness.

But it’s not that simple. Smiling depression is a thing, of course, but treating it is not as simple as taking away the mask and replacing it with a real smile. Psychotropics don’t work that way. Of course, since the ads are for psychotropics that are supposed to work quickly (though not as quickly as the ads imply), we can’t expect them to mention the years of struggle and therapy that go into improving the condition.

The next kind of commercials are a tiny bit better. They mention actual symptoms of depression: sadness, loss of focus, lack of interest in fun things, or an inability to do chores.

But it’s not that simple. Personally, I don’t think it’s a tragedy if the barista has to wait two seconds while I remember whether I want oat milk or if the family has to put away the laundry. These are obvious but probably not major symptoms of depression or symptoms of major depression. What about not getting out of bed for three days or not showering for a week or more? Crying all day about nothing or everything? Thoughts of self-harm or suicide? They just don’t make for good 60-second television. The long, lingering effects of depression are glossed over or ignored.

There are also ads for treatments for bipolar disorder, both types I and II. Most of them concentrate on the mania or hypomania side of the problem. Most of the ads use metaphors — climbing a tower of cards or going from darkness to light. Overspending is the issue most illustrated in regard to bipolar if you don’t count all the depression ads. I recall one that showed a woman who had bought a lot of expensive cameras and came to realize that she had overdone it.

But it’s not that simple. Bipolar disorder is a complex disorder that metaphors just can’t capture. Like depression, the ads concentrate on only one symptom, and don’t do a good job of creating those metaphors. (I’m just glad they don’t use a metaphor of someone on a swing.) I realize that it’s not likely that ads on TV will address hypersexuality, but what about the pressured speech, euphoria, irritability, bad decisions, and reckless behavior that go with mania?

Schizophrenia is probably the worst. The ads show not the disorder, but the lack of it — women saying, “I’m glad I don’t hear voices anymore” and “I’m glad I don’t still think everyone is looking at me” or men playing guitar to illustrate how “normal” the drugs make them.

But it’s not as simple as that. I admit that it’s not possible to portray some of the more frightening aspects of schizophrenia, which would probably only add to the stigma surrounding schizophrenia. But making it seem like one pill will cure it isn’t reasonable or accurate.

Then there’s tardive dyskinesia, also called TD. The ads do a competent job of giving examples of uncontrolled movements and how they interfere with a person’s life. The drug being advertised may indeed help with those.

But it’s not that simple. If you read the fine print at the bottom of the screen or listen to the rapid-paced list of possible side effects, you’ll notice that one of them is uncontrolled movements. WTAF? It gets rid of uncontrolled movements but may cause uncontrolled movements? Why take it and take the chance?

The ads I may hate the most are the ones that emphasize family. We see a woman folding the family’s laundry, grandparents romping with the kids at a park, and other idyllic scenes.

But it’s not that simple. Treating a mental illness is not something you do for the benefit of other people. It’s something you do for yourself, even if you don’t have a nuclear family or grandchildren or a large circle of friends. Granted, the people around you may be happy that you’ve found a therapy that works (and the ads almost never show a combination of drug therapy and talk therapy). That’s a side effect — a good one, but still not the intended effect of the psychotropic drug.

I attribute this primarily to the lack of inventiveness and understanding shown by people at the advertising agencies, as well as the tiptoeing around the whole subject of SMI. But what happens is that the viewers get an unrealistic view of both the disorders themselves and what the drugs can do to relieve them. It’s not simple, and the ads simply don’t reflect that.