INTRODUCTION: FROM ANXIETY TO DEPRESSION AND BACK

As portrayed in pharmaceutical company advertisements, the typical nervous problems seen in both psychiatry and general practice from the 1960s through to the early 1990s took the form of an anxious woman in her twenties or early middle years. The exhortation was to treat her with benzodiazepines (such as Valium), marketed as tranquillisers. In contrast, during this period, advertisements for antidepressants typically featured much older women. However, in the 1990s young or middle-aged women with nervous problems were portrayed in the advertisements as depressed, with the exhortation to treat these problems with selective serotonin reuptake inhibiting (SSRI) antidepressants such as Prozac. By the end of the 1990s anxiety seemed all but forgotten by the advertisers. But, post 11 September 2001, the ‘typical’ woman is once again likely to be viewed as anxious, with exhortations to treat her with SSRI drugs, which seem now to have become anxiolytics. What is happening here? Are the biological bases of nervous problems really changing so quickly, or is this a matter of marketing of available new drugs, along with changes in nomenclature and fashion? There is arguably more to this than just a matter of changing fashions in the labels we put on nervous problems. In the past decade or so, pharmaceutical companies have developed abilities to change the very language we use to describe our most intimate experiences.