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Title: Melancholy and the infinite treatments : an investigative study into the marketing of antidepressants
Author: Williams, Rachel
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2018
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In the 1990s the estimated prevalence of depression was two thousand times higher than in the 1960s (Leader 2008a; 2013). This astronomical rise in depression corresponded with the launch of blockbuster antidepressants released in the late 1980s: selective serotonin reuptake inhibitors (SSRIs). Perhaps the most well-known of these drugs is Prozac, which, as evidenced by the book and subsequent film Prozac Nation, became a pop culture phenomenon (Wurtzel 1994; Skjoldbjærg 2001). This thesis argues that the increase in depression diagnoses after Prozac hit the market is reflective of a broader narrative within the treatment area. Historically, what constitutes a pathological low mood has invariably been defined by those purporting to have a treatment. Indeed, the marketing of treatments routinely corresponds with diagnostic marketing. In contemporary societies, treatment is primarily defined and controlled by mammoth commercial entities: multinational corporations. The proposed solution is invariably pharmacological in the form of drugs such as Prozac. Adopting an investigative methodology inspired by traditional social scientists, such as Derek Layder (1993), and investigative journalist Mark Lee Hunter (2011), this thesis examines the marketing activities of antidepressant manufacturers. The long shadow cast by Prozac over the depression treatment market is unavoidable and integral to understanding contemporary issues in this area. With this in mind, it is essential to use an approach which embraces and foregrounds the historical context. Furthermore, as Layder (1993) argues, history envelops every aspect of the research process, and, as such, history should be prioritised and treated as a method in and of itself. This research identifies evidence which suggests that the increase in depression diagnoses and antidepressant prescriptions is due, in part, to unethical marketing techniques, or, more specifically, covert marketing that targeted medics and charities. For example, doctors were flown to exotic islands by pharmaceutical companies, a charity was paid to covertly promote marketing messages, not to mention that I could handwrite this thesis a thousand times over with pens sporting antidepressant brand names. These activities are indicative of a pharmaceutical industry driven by medicalisation, or pharmaceuticalisation. However, in light of public criticism over such practices companies have subsequently endeavoured to ensure that the promotion of antidepressants follows ethical guidelines. Today, there are more rigorous regulations pertaining to gift giving and hospitality, and, indeed, this research verifies this shift towards greater transparency in these practices. However, such improvements are mitigated by what Abraham (2008) designates as 'neo-liberal corporate bias.' Hence, as pharmaceutical companies self-regulate their marketing activities, this regulation is often refracted through self-interest and the profit motive. Overall, this investigation demonstrates that depression continues to be defined by the Big Pharma companies that promote drug treatments, which leaves the door open for future research when the depression treatment du jour inevitably changes.
Supervisor: Not available Sponsor: Economic and Social Research Council
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available