The Wake

According to a recent study, depression seems to affect women with more prevalence than it affects men. But the real question is why?

When discussing the phenomenon of increasing medicalization (the practice of immediately categorizing a problem as a disease, including natural processes such as birth and aging) cultural scholars deal with the classic chicken/egg dilemma. What drives medicalization: the advertising of drug companies or the long-held beliefs of doctors and patients? It’s impossible to ignore the real effects that the media – ads in particular — have on society. What then, has been the result of the ever-growing prevalence of ads for antidepressants in print and on television? Additionally, how will such advertising, when aimed at different demographics (different genders for example), affect the perceptions of mental illness among different groups of people? But are these perceptions the result of the stereotypes and ideas present in advertising or is the advertising simply a reflection of established cultural views?

In order to help find answers to these questions, the U brings in the experts. In a presentation given on Sept. 29 entitled “Gender, Culture, and Medicalization: The Lessons of Prozac,” Jonathan Metzl discussed the gendering of depression diagnosis and the prescribing of antidepressants, particularly Prozac. Metzl is from the University of Michigan’s Department of Psychiatry and Women’s Studies Program and author of Prozac on the Couch. Metzl’s presentation was part of the Feminist Studies Colloquium Series, which is the yearly spotlight event for the Center for Advanced Feminist Studies (CAFS), a division of the Department of Women’s Studies.

As the focal point of his lecture, Metzl presented a quantitative analysis study he conducted on the last two decades of American popular culture. The study looked at representations of Prozac, depression and antidepressants in popular print media as well as in doctors’ dictations and medical charts.

Metzl’s study consisted of a systematic content analysis of 180 newspaper articles and 81 magazine articles from 1987 to 2001. Metzl and his research team used coding for certain words in the articles and systematically narrowed down their sample. They focused on the descriptions given to people who were supposedly depressed or on antidepressants. Women were described as being depressed almost twice as many times as men were. For men, depression was in tune with aggression and men’s performances in sports and athletics. For women, depression was the result of problems with one of the “four M’s: marriage, menopause, menstruation, motherhood.” A second study on doctors’ dictations and the comments made on medical charts reflected similar views on gender and depression.

Metzl described these differences as reflecting not only the ideas of gender that have been present in medical advertising since the 1950s (he also reviewed a brief history of gender stereotypes in such ads), but also as fitting into the larger social context of gender stereotypes and gendering depression. “It’s no doubt true that drug companies drive medicalization, but it’s important not to overlook the context – the very patients and doctors who create this reality,” said Metzl.

He stressed the importance of understanding how culture, and not just advertising, works on individuals. “This is important for doctors and patients so that they can have different kinds of conversations. I’ve had clinical experiences where patients have come into my office holding drug ads, saying ‘I really feel like this would help me,’” said Metzl, “And at that moment, I guess it would probably be malpractice for me to say ‘well, really what you’re looking at is a socially constructed problem and what we really need to do is change cultural values.’ I think that would really be the wrong answer. I think the right answer is to start a conversation that uses this information about the culture.”