What Drug Commercials Get Wrong About Depression

From the ads, you’d think depression was no worse than the flu or a hangover. You can’t concentrate at your job or just don’t want to be there. You live in your sweatpants. You don’t feel like doing the laundry or you can’t remember how to program your high-tech washer. You don’t want to frolic with your husband and kids or go out with your friends. You have resting sad face.

And the cure for all those is a pill! You’ll remember how the washer works. You’ll spend time with friends and family. You won’t wear sweatpants. You’ll have resting happy face.

Well, sorry, that’s not how it works, or at least not how it works for most people.

You see, those commercials don’t show the reality of what depression can be. They acknowledge that depression is not “just being sad,” that it is “a range of symptoms,” but what they show is mostly people just being sad and distracted. And depression – clinical, endogenous, major depression – the kind these powerful medications are intended for – is far worse than sadness and distraction.

Yes, many people get a kind of low-grade depression that is no worse than what the commercials show. But major depression and bipolar depression are serious mental illnesses (SMI). They’re not inconveniences. They’re not something you get over with a single pill.

They can be lifelong. They can be life-altering. And they can be life-threatening.

What the commercials don’t show is anyone suffering, really suffering, from depression. They don’t show the depths of sorrow, fear, and hopelessness, the nights awake and crying, the days unable to get out of bed, the absolute misery.

Of course, those are difficult things to portray in 30 or 60 seconds, even by talented actors and skilled directors. But not even to try is to lie about what depression is and can do.

Depression can immobilize you, make it impossible to hold a job or care for yourself, much less a family. It can make you feel hopeless, as if nothing matters, not even yourself. It can make you feel worthless, unloved, unworthy of love. It can make you question every thought and feeling you have. It can erupt at any moment, day or night, without warning. It can last for weeks, months, even years, relentlessly, without letup. It can tear you apart or leave you feeling like an empty shell.

It can make you believe that life isn’t worth living anymore. It can lead to death.

And what about the medications the commercials are trying to sell? What aren’t they telling you about those?

First of all, they present the pills as a rapid cure. Just ask your doctor if X drug is right for you. Well, your doctor may not know if it is the right one. A lot of medicating depression is trial and error. What is right for another person, what alleviates their symptoms and lessens their misery, may do nothing for you. Then it’s time to try another med. And maybe another and another. Maybe a combination of medications. There are lots of different combinations to go through. And lots of side effects, which you may or may not be able to tolerate, some of them much worse than weight gain. All that takes time, and may not get you back to functioning fully and joyously. If you’re lucky enough to find a med or meds that work for you, you could be taking them for the rest of your life.

Then there are the kinds of depression that medication may not solve or resolve at all – treatment-resistant depression. There are different kinds of treatments for those, ones that never get mentioned on television because they don’t come in a convenient, sell-able pill that makes money for a pharmaceutical company. You won’t see ads for electroconvulsive therapy or transcranial magnetic stimulation, even though these therapies can restore some people with depression to better function.

Another thing the drug commercials don’t show is that treatment with psychotropics requires careful monitoring by a doctor. You don’t just get your prescription and go home to your loving family. A psychiatrist will know to look for signs that the drug isn’t working or that it is “activating” a depressed person just enough to allow her or him to act on suicidal thoughts. Will your family doctor know to do that? You might also need time with a therapist or counselor to discuss, for example, what can trigger your depression, coping mechanisms you can try, and ways to repair relationships that have been affected by your symptoms.

If it sounds like I’m angry, I am. These commercials, though they seem to offer hope and healing, really spread false impressions of what depression is, how it affects people, and what treatment for depression is actually like. I’m not denying that the “soft-sell” approach has helped people, especially those with mild or high-functioning depression. But I know too many men and women whose experience is not conveyed in those ads and who desperately need the kind of help that may or may not be available in pill form. Until they can see themselves in the ads and say, “That’s me. That’s what my life is like,” they may not realize that they, too, can be helped and that they desperately need to and deserve to be.

It’s not about the sweatpants. It’s never about the sweatpants.