Advertisers should leave diagnosis to experts

(U-WIRE) COLLEGE PARK, Md. — And now, a word of advice from your friendly neighborhood columnist: Please do not mistake the TV for a qualified mental health diagnostician.
Despite the incredible amount of reliable information the TV dispenses regarding Britney Spears, the “Survivor” castaways and the relative merits of Denver Broncos running backs, the TV still cannot determine whether or not you’re mentally ill. If the TV tries to represent itself as a mental health diagnostician, please switch over to something that trades on less suspect inference-making, like Hard Copy.
Wondering why this is a problem? Then read on. Since the introduction of Prozac, Eli Lilly has run print ads which give both a little depression self-inventory to fill out and the distinct impression that, if the self-inventory comes up positive for depression, Prozac is ready and able to be your savior. In the grand tradition of shampoo ads, Lilly implicitly promises instantaneous transformation — in this case, from Gloomy Gus into Happy Harry. Frankly, such promises are irresponsible at best and dangerous at worst. However, Eli Lilly (at least to my knowledge) never made it onto the TV with such promise-making.
Enter SmithKline Beecham and Paxil. Last Saturday night, I had the awesomely unpleasant experience of viewing an ad for Paxil whose first half attempts to diagnose social anxiety disorder (SAD — such an acronym) in the viewer, and whose second half promises that Paxil is the solution to your just-diagnosed mental illness without explicitly guaranteeing anything. As is de rigueur for such ads now, the first half features a quickie voiceover inventory illustrated by scenes of alienated people shunning families and coworkers, while the second half features Paxil-extolling voiceover and scenes of people playing happily with their children and accepting awards from crowds of admiring compatriots.
Sure, the ads say to “talk to your doctor,” but after all the Paxil worship, it sounds like a mere formality before you can grab your meds. Instant alleviation of insecurity and low self-esteem, all by popping a pill! What could be better?
Of course, SmithKline Beecham’s motives are impure. The ad neglects to mention Paxil is the only drug approved by the Food and Drug Administration to treat SAD; SmithKline Beecham presumably feels every new diagnosis puts money in their pocket. And of course, the ad neglects to mention SAD is one of many anxiety disorders, which as a class respond to lots of different medications, not just Paxil.
But as a gigantic profit-seeking company, there’s no reason they would mention any of that, right? After all, SmithKline Beecham is ultimately all about the Benjamins, not the mentally ill persons of the world. And we all know expecting ethics from advertisers is like expecting milk from bulls. That’s why drug companies should not be allowed to advertise mental health medications directly to the consumer.
Truth be told, I have a problem with all direct advertising of drugs. Such ads attempt to interpose themselves in the doctor-patient relationship, ignoring the fact that (a) both the doctor and the patient know more about the patient’s health than an ad does, and (b) these ads mostly promise a level of improvement that we can kindly characterize as “unrealistic.” Still, one can argue that in most cases both doctor and patient know what’s going on and could presumably reject the ad’s advice if it seemed unwise.
When drug companies pitch drugs directly to mentally ill people, however, they are pitching to people who by definition are not in the best shape to judge or reject advice. They are pitching to people who, more often than not, are desperate for some sort of miraculous, work-free cure and will consider anything that might be one. They are playing on the insecurities of people who are by definition insecure, actually hoping that they fixate on the drug as a solution to all their problems, even if it isn’t or can’t be. This practice is predatory, callous and immoral.
Social anxiety disorder does need some attention called to it. SAD is the third most common psychiatric disorder in our fair country and affects about 7 percent of us, according to the Archives of General Psychiatry (which makes great bedtime reading, let me tell you). It’s safe to say awareness of SAD lags way behind incidence; I personally had SAD for about seven years before anyone acquired a clue as to what was going on, and if someone had acquired a clue earlier, I might have had a more fun adolescence.
But SmithKline Beecham’s ads, with their glib diagnosis-making and equally glib solution-offering, won’t improve the situation. If people get the impression the only time they need to see a psychiatrist to “solve” SAD is to get their Paxil prescription, no one is going to get much real help in working through a difficult illness, no matter how much fatter SmithKline Beecham’s pockets grow in the process. During recovery from SAD, there is no substitute for a qualified therapist, and neither the TV nor Paxil can be that to anyone, no matter how much SmithKline Beecham wants them to. SmithKline Beecham and everyone else who advertises mental health medications need to stop the ads and leave diagnosis and treatment to those who actually know what the hell they’re doing.
Andrew Lindemann Malone’s column originally appeared in the University of Maryland’s newspaper,The Diamondback on Aug. 18.