On Shaky Ground: Stigma and Otherness in Direct-to-Consumer Advertising for Bipolar Disorder Drug Treatments

Abstract

Along with rising diagnoses for bipolar spectrum disorders, direct-to-consumer (DTC) advertisements for bipolar disorder treatments have increased in recent years. This study textually analyzes 25 ads from the brands Vraylar, Caplyta, and Latuda based on the theory and method of Hall, and supported by the work of Goffman and Thoits on stigma. Findings show that ads embodied the ambivalence associated with the spectacle of the other. Additionally, ads largely ignored the stigma of bipolar disorder, placing emphasis on the “in-between” phase where protagonists receive treatment. This emphasis on the “in-between” often creates a fetishized view of the protagonist with ill mental health.

Keywords

direct-to-consumer advertising textual analysis Stuart Hall bipolar disorder stigma

Get full access to this article

View all access options for this article.

References

Kang

(2011). Stigma-reducing components in direct-to-consumer prescription ads: Onset controllability, offset controllability, and recategorization. Health Communication, 26(5), 468–478. https://doi.org/10.1080/10410236.2011.554169

Angst

Gamma

Benazzi

Ajdacic

Eich

Rossler

(2003). Toward a re-definition of subthreshold bipolarity: Epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. Journal of Affective Disorders, 73(1-2), 133–146. https://doi.org/10.1016/S0165-0327(02)00322-1

Appignanesi

(2008). Mad, bad and sad: Women and the mind doctors. W.W. Norton & Company.

Applequist

Ball

J. G.

(2018). An updated analysis of direct-to-consumer television advertisements for prescription drugs. Annals of Family Medicine, 16(3), 211–216. https://doi.org/10.1370/afm.2220

Arney

Menjivar

(2014). Disease Mongering in direct-to-consumer advertising and the expansion of the antidepressant market. Sociological Inquiry, 84(4), 519–544. https://doi.org/10.1111/soin.12062

Arney

Weitz

(2012). Gendering affective disorders in direct-to-consumer advertisements. In Jacobs Kronenfeld

(Ed.), Issues in health and health care related to race/ethnicity, immigration, SES and gender (research in the sociology of health care) (Vol. 30, pp. 61–180). Emerald Group Publishing Limited. https://doi.org/10.1108/S0275-4959(2012)0000030010

Bell

R. A.

Taylor

L. D.

Kravitz

R. L.

(2010). Do antidepressant advertisements educate consumers and promote communication between patients with depression and their physicians? Patient Education and Counseling, 81(2), 245–250. https://doi.org/10.1016/j.pec.2010.01.014

Calfee

(2002). Public policy issues in direct-to-consumer advertising of prescription drugs. Journal of Public Policy and Marketing, 21(2), 174–193. https://doi.org/10.1509/jppm.21.2.174.17580

Coffey

Atkinson

(1996). Making sense of qualitative data: complementary research strategies. Sage.

10.

Conrad

Leiter

(2008). From Lydia Pinkham to Queen Levitra: Direct-to-consumer advertising and medicalisation. Sociology of Health and Illness, 30(6), 825–838. https://doi.org/10.1111/j.1467-9566.2008.01092.x

11.

Corrigan

P. W.

Kosyluk

K. A.

Konadu Fokuo

Park

J. H.

(2014). How does direct to consumer advertising affect the stigma of mental illness? Community Mental Health Journal, 50(7), 792–799. https://doi.org/10.1007/s10597-014-9698-7

12.

East

(2003). The Effect of Advertising and Display: Assessing the Evidence. Kluwer.

13.

Eaton

M. L.

(2004). Ethics and the business of bioscience. “Advertising Prescription Drugs Directly to Patients.” Stanford University Press.

14.

Goffman

(1963). Stigma: Notes on the Management of a Spoiled Identity. Prentice Hall.

15.

Greenberg

(2010). Manufacturing Depression. Simon & Schuster.

16.

Grow

J. M.

Park

J. S.

Han

(2006). Your life is waiting! Journal of Communication Inquiry, 30(2), 163–188. https://doi.org/10.1177/0196859905285315

17.

Hall

(1975). Introduction. In Smith

A. C. H.

Immirizi

Blackwell

(Eds.), Paper voices: The popular press and social change 1935–1965 (pp. 11–24). Chatto and Windus.

18.

Hall

(1980). Encoding/decoding. In Hall

Hobson

Lowe

Willis

(Eds.), Culture, media, language (pp. 128–138). Hutchinson.

19.

Hall

Evans

Nixon

(2013). Representation (2nd ed). Sage.

20.

Healy

(2006). The latest mania: Selling bipolar disorder. PLoS Medicine, 3(4), 0441–0444. https://doi.org/10.1371/journal.pmed.0030185

21.

Healy

(2008). Mania: A short history of bipolar disorder. John Hopkins University Press.

22.

Hoek

(2008). Ethical and practical implications of pharmaceutical direct-to-consumer advertising. International Journal of Nonprofit and Voluntary Sector Marketing, 13(February), 73–87. https://doi.org/10.1002/nvsm.319

23.

Hoek

Gendall

(2002). To have or not to have? Ethics and regulation of direct to consumer advertising of prescription medicines. Journal of Marketing Communications, 8(2), 71–85. https://doi.org/10.1080/13527260210137181

24.

Horwitz

A. V.

Wakefield

J. C.

(2007). The loss of sadness. Oxford University Press.

25.

ispot.tv (2023). Depression, bipolar and insomnia TV commercials. https://www.ispot.tv/browse/7k.2 V/pharmaceutical-and-medical/rx-depression-bipolar-and-insomnia https://www.ispot.tv/browse/7k.2 V/pharmaceutical-and-medical/rx-depression-bipolar-and-insomnia.

26.

Jamison

K. R.

(1993). Touched with fire: Manic-depressive illness and the artistic temperament. The free press.

27.

Liebert

(2010). Synaptic peacekeeping: Of bipolar and securitization. Women’s Studies Quarterly, 38(3 & 4), 325–342. https://doi.org/10.1353/wsq.2010.0008

28.

(2017). How the media cover mental illnesses: A review. Health Education, 117(1), 90–109. https://doi.org/10.1108/MRR-09-2015-0216

29.

Martin

(2007). Bipolar Expeditions: Mania and Depression in American Culture. Princeton University Press.

30.

Mastin

Andsager

J. L.

Choi

Lee

(2007). Health disparities and direct-to-consumer prescription drug advertising: A content analysis of targeted magazine genres, 1992–2002. Health Communication, 22(1), 49–58. https://doi.org/10.1080/10410230701310299

31.

Mayo Clinic Staff (2022). Bipolar Disorder. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961.

32.

Metzl

J. M.

(2002). Selling sanity through gender: The psychodynamics of psychotropic advertising. Journal of Medical Humanities, 24(1), 79–103. Retrieved from https://login.e.bibl.liu.se/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=11303214&site=eds-live&scope=site. https://doi.org/10.1023/A:1021361900397

33.

Mintzes

(2006). Disease mongering in drug promotion: Do governments have a regulatory role? PLoS Medicine, 3(4), 461–465. https://doi.org/10.1371/journal.pmed.0030198

34.

Moncrieff

(2014). The medicalisation of “ups and downs”: The marketing of the new bipolar disorder. Transcultural Psychiatry, 51(4), 581–598. https://doi.org/10.1177/1363461514530024

35.

National Institute of Mental Health (NIMH) (2023). Bipolar Disorder. https://www.nimh.nih.gov/health/statistics/bipolar-disorder .

36.

Preechavuthinant

Willis

Coustasse

(2018). Trends and effects of pharmaceutical DTCA. International Journal of Pharmaceutical and Healthcare Marketing, 12(1), 61–70. https://doi.org/10.1108/IJPHM-04-2017-0019

37.

Rosenthal

Donohue

(2005). Direct-to-consumer advertising of prescription drugs: A policy dilemma. In Santoro

M. A.

Gorrie

T. M.

(Eds.), Ethics and the pharmaceutical industry (pp. 169–183). Cambridge University Press.

38.

Ross

A. M.

Morgan

A. J.

Jorm

A. F.

Reavley

N. J.

(2019). A systematic review of the impact of media reports of severe mental illness on stigma and discrimination, and interventions that aim to mitigate any adverse impact. Social Psychiatry and Psychiatric Epidemiology, 54(1), 11–31. https://doi.org/10.1007/s00127-018-1608-9

39.

Scheff

T. J.

(1974). The labelling theory of mental illness. American Sociological Review, 39(3), 444–452. https://doi.org/10.2307/2094349

40.

Sharpe

(2012). Coming of age on Zoloft. Harper Perennial.

41.

Skyquest (2022). Global bipolar disorder market size, share, growth analysis, by drug class (mood stabilizers, anticonvulsants), by type (bipolar I disorder, bipolar II disorder) - industry forecast 2022-2028. https://www.skyquestt.com/report/bipolar-disorder-market.

42.

Smardon

(2007). 'I’d rather not take Prozac’: Stigma and commodification in antidepressant consumer narratives. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 12(1), 67–86. https://doi.org/10.1177/1363459307083698

43.

Stallybrass, P. & White, A. (1986). The politics and poetics of transgression. Methuen.

44.

Steiner

(2016). “Wrestling with the Angels”: Stuart Hall’s theory and method. Howard Journal of Communications, 27(2), 102–111. https://doi.org/10.1080/10646175.2016.1148649

45.

Stepnisky

J. N.

(2007). Narrative magic and the construction of selfhood in antidepressant advertising. Bulletin of Science, Technology & Society, 27(1), 24–36. https://doi.org/10.1177/0270467606295973

46.

Stout, P. A., Villegas, J., & Jennings, N. A. (2004). Images of mental illness in the media: Identifying gaps in the research. Schizophrenia Bulletin, 30(3), 543–561. https://doi.org/10.1093/oxfordjournals.schbul.a007099

47.

Sullivan

H. W.

Campbell

(2015). Do prescription drug ads tell consumers enough about benefits and side effects? Results from the health information national trends survey, fourth administration. Journal of Health Communication, 0730(February 2016), 1–6. https://doi.org/10.1080/10810730.2015.1018635

48.

Thoits

(2011). Resisting the stigma of mental illness. Social Psychology Quarterly, 74(1), 6–28. https://doi.org/10.1177/0190272511398019

49.

Ussher

(2011). The madness of women: Myth and experience. Routledge.

50.

Ventola

C. L.

(2011). Direct-to-consumer pharmaceutical advertising therapeutic or toxic? P&T, 36(10), 669–684. PMID: 22346300.

51.

Walker

(2020). Ask Your Doctor About Chemical Imbalances: Mass-Communicating the Biomedical Model of Mental Illness Through the Selective Serotonin Reuptake Inhibitors, University of Colorado at Boulder.

52.

Wahl, O. F. (1995). Media madness: Public images of mental illness. Rutgers University Press.

53.

Walker

(2021). Resisting stigma and evaluating realism in a direct-to-consumer advertisement for psychiatric drugs. International Journal of Pharmaceutical and Healthcare Marketing, 15(4), 550–571. https://doi.org/10.1108/IJPHM-10-2019-0069

54.

Wilkes

M. S.

Bell

R. A.

Kravitz

R. L.

(2000). Direct-to-consumer prescription drug advertising: Trends, impact, and implications. Health Affairs, 19(2), 110–128. https://doi.org/10.1377/hlthaff.19.2.110

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.06 MB

0.19 MB