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Think Disease Mongering Started with Direct-to-Consumer Ads? Think Again

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The photo looks like John Travolta or Divine playing Edna Turnblad in Hairspray.

Under the bangs of a Dynel doll wig a "floozy" with nasolabial folds, male facial features and leathery skin mugs for the camera-coquettish hair bow, mod sunglasses and gaudy plastic jewelry adorning her "look." The only thing missing is a Miami Beach style cigarette holder.

"Lady, Your Anxiety Is Showing," is pasted across her nose to leave no doubt we are laughing at her. "Over a co-existing depression" is added in parentheses.

But it's not an ad for Hairspray, Tootsie or Charley's Aunt. It's not an ad for a camp new boutique, salon or restaurant.

The full page color ad is the Journal of the American Medical Association in 1970 and it's selling the antidepressant Triavil.

Dex

"On the visible level, this middle-aged patient dresses to look too young, exhibits a tense, continuous smile and may have bitten nails or overplucked eyebrows. Symptoms of anxiety are hard to miss. What doesn't show as clearly is the co-existing depression that often complicates treatment."

On another page in the Journal we meet "Sally Wilson," also showing leathery skin and inappropriate, gaudy jewelry.

"In the last week or so, Sally Wilson's year-old reputation as an unpredictable grouch has melted away," says the ad. "She's been coming in on time and turning out more work." You see, "Sally's menopause had triggered symptoms that hormone therapy by itself apparently hadn't helped," but now her doctor has her on Valium q.i.d.

Depersonalizing "she" ads-"Has She Become a Fixture in Your Office?" "She Hides Anguish Behind Arrogance" "Does She Call You Morning, Noon and Night?--were the norm when doctors, copywriters and drug makers were men and charged with getting women to behave. So was pathologizing everyday conditions, a phenomenon which did not start with direct to consumer advertising.

In the 1960s and 1970s, antidepressants were suggested for telltale bitten nails and overplucked eyebrows, antipsychotics for "excessive use of the telephone" (a real ad) and Dexedrine for "housewives" who were "crushed under a load of dull, routine duties."

Then there was empty nest syndrome (called Magna cum Depression in ads) and divorce for which antidepressants were also prescribed- and mothers who were "short tempered" with their kids who got antipsychotics.

Psychoneurotic women like "Jan" who were "unmarried with low self esteem" at age 35-"You probably see many such Jans in your practice"-were given Valium.

When women got to the arsenal waiting for menopause it was probably a relief!

Of course the Mephistophelean Marcus Welbys who treated the disease of Lack of a Husband and Kids with psychoactive drugs and the copywriters who mongered same are mostly gone today.

But today's top drugs like Seroquel, Pristiq, Lyrica and Cymbalta are still pushed for women and their notorious anxiety-that-is-really-depression, depression-that-is-really-bipolar-disorder, PMS-that-is-really-perimenopause and pain-that-is-really-fibromyaglia.

We won't even talk about what their kids really have.

Sure the ads now say "you" instead of "she" and let women tell their doctor what's wrong with them instead of the other way around.

Sure the doctor now wonders what the point of medical school was if patients now decide both diagnoses and treatments. (Thank you, pharma.)

But the message that age in a woman is a Disease To Be Treated still moves more script than perhaps in any other category.

Until hormone replacement therapy was found to cause not prevent heart disease, stroke and cancer in women in 2002-sorry about that, ladies-HRT made $2 billion a year for Prempro and Premarin manufacturer Wyeth. More recently it has been correlated with lung and ovarian cancer, urinary incontinence, asthma and Alzheimer's disease. See: fountain of youth; not.

Since 85 percent of women said you want us to take WHAT and dropped HRT, closing Wyeth plants and hopefully Premarin ranches, pharma has scrambled to replace the Wall Street bonanza.

Thanks to actress Sally Field, an aging bones campaign is underway pushing bisphosphonate drugs for "osteopenia" even though the term was said to be made up by pharma when it installed bone density machine in doctor offices.

And with Prempro and Premarin in the dog house, pharma is now pushing psychoactive drugs for the "pathophysiology of menopause and the consequences of long term estrogen deprivation" as the journal Menopause succinctly puts it.

They say the drugs are also good for eyebrow plucking.
Martha Rosenberg is a columnist and cartoonist, who writes about public health

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