Movies and the Mind

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Listening to Prozac While Watching 'Side Effects'

Reflections on a pharmaceutical psychological thriller

Poster for Side Effects
visualhollywood.com
In the recent psychological thriller, Side Effects, director Steven Soderbergh does for psychiatric medications what he did for deadly viruses in his earlier film Contagion. He tells a story based on a current medical reality and exaggerates it just enough to evoke anxiety and fear.

Here is the basic plot: Emily (Rooney Mara) is a young woman who becomes increasingly depressed and suicidal when her husband (Channing Tatum) is released from prison after serving several years for insider trading. She goes to a psychiatrist (Jude Law) and is eventually prescribed a newly released variety of anti-depressant. The audience can tell Emily is getting better because she laughs a lot and has great sex with her husband—kind of like an explicit TV commercial. But instead of a long list of possible side effects, the audience is warned when a very bad thing does indeed happen.

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The first hour of Side Effects challenges the viewer to reflect on some of the same issues raised by Peter Kramer's book Listening to Prozac, first released 20 years ago (the second half of the movie shifts to a more traditional psychological thriller that merely challenges the viewer to reflect on standard genre themes—sex, power, and revenge—that will have to be the subject of another blog). The movie mirrors the deep ambivalence that Americans have about psychiatric medications. On one hand, these drugs are widely prescribed, and pharmaceutical empires have been built on the likes of Prozac. New and improved variations are constantly flooding the market, and the list of problems and populations (e.g., children) for which they are being used is always growing.

On the other hand, Side Effects dramatizes the suspicions many people have about the possible negative consequences of taking all these pills. Some extreme voices condemn psychiatric medications as poison. Other critics argue that taking medication is a sign of weakness and amounts to an attempt to avoid life’s hard issues. Some people resist taking these medications, even when medically recommended, because they fear that they may behave in a bizarre way (as depicted in the movie).

Kramer’s Listening to Prozac raised many of the same issues just at the historical moment when Prozac (the first of a now-plentiful family of medications called SSRIs—Selective Serotonin Reuptake Inhibitors) was becoming widely available. Kramer’s book has been criticized for being an advertisement for Prozac. From this perspective, the title is interpreted as a declaration that we should uncritically “listen” to Prozac and do whatever it "says." Indeed, from the hindsight of twenty years, there are passages where Kramer, a psychiatrist who prescribed the medication during some of its early trials, overstates its power.

The central question Kramer poses is still provocative however. What should be our individual and societal response to pharmaceutical technologies that promise a variety of improvements in our day-to-day emotional and interpersonal lives? What do we do with drugs that not only heal illness but make us feel, in the words of one of Kramer’s patients, “better than well”? (Note that this proposal should not sound bizarre to anyone who has ever looked to a can of beer or a martini glass to relax a little or to grease the wheels of social interaction.)

On the other hand, Kramer also expresses reservations about what he correctly predicted could be the widespread applications of Prozac. The possibility of side effects is one reason to be concerned. Not only are there the “ordinary” side effects (dry mouth, weight gain, diminished sexual desire, etc.), there has also been controversy as to whether Prozac is capable of provoking some users, particularly young people with manic tendencies, to commit suicide. More than that, Kramer wonders about the impact on individual identity and responsibility if medications can be used to alter personality and enhance ordinary performance.

Listening to Prozac doesn’t claim to have the answers to these issues, and neither does Side Effects. While watching this movie, I realized how few films seriously consider the complex psychological and sociological implications of medication. Even an otherwise interesting film like A Beautiful Mind tends to downplay the role of medication in treating mental illness. For this reason alone, Side Effects is worth checking out.

(Skip Dine Young's Psychology at the Movies is available at amazon.com)

Skip Dine Young, Ph.D., is a Professor of Psychology at Hanover College in Indiana and a licensed clinical psychologist.

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