Gallery: Op-Ed: Why YouTube Matters to the Science of Depression
01zoloft
As an anthropologist of science, I am fascinated with how people create their own meaning from scientific content, which in turn shapes public understanding of science and, ultimately, scientific agendas themselves. [__From the Fields__](http://stag-komodo.wired.com/wiredscience/tag/from-the-fields/) is a periodic Wired Science op-ed series presenting leading scientists' reflections on their work, society and culture. [](http://stag-komodo.wired.com/images_blogs/wiredscience/2012/02/nate_greenslit.jpg) *[Nate Greenslit](http://www.metasymptom.com) has a Ph.D. from MIT in the History and Social Study of Science & Technology. He was a postdoctoral scholar at the Media Lab, where he innovated on techniques in ethnography and experimental psychology to study the placebo effect. He currently teaches at Harvard and is a visiting scholar at MIT, where he launched a new ethnographic project on how relationships between musicians and fans are evolving through social media. Nate is also a prolific Boston-based musician and occasional comedy writer.* YouTube has become a lively repository for this kind of meaning-making. A great example is advertising for antidepressants: User-generated parody videos have given neuroscientific claims about depression a new cultural life. So-called “direct-to-consumer” television and print advertising of antidepressants has been a controversial practice since its introduction in 1997, prohibited in all countries except for the U.S. and New Zealand. This sometimes-political lightning rod of the pharmaceutical industry has also been the *de facto* promulgator of putative neuroscientific theories of depression and anxiety disorders. But since YouTube was launched in 2005, a formerly passive television audience has become a collective of active media participants. Rather than a handful of corporate pharmaceutical behemoths controlling the simple narrative that depression is a “chemical imbalance,” YouTube has become the center of a much more complex mediascape in which everyday individuals get to tell their own stories about depression and drugs, which often challenge drug companies’ own dominant brain-based explanations. Viewers who dislike these ubiquitous pharmaceutical ads do not simply ignore them; they circulate them, comment on them, and rescript them as their own parodies. Along the way, people on YouTube don’t just create their own remixes of "Charlie Bit My Finger," but of scientific theories of mental illness. One of the best and most pervasive examples of this is Pfizer’s advertising campaign for the antidepressant Zoloft. Parody videos of the original Zoloft TV commercial (above) rejigger the images to comment on the validity of the science of mental illness, and on the corporate motives of pharmaceutical companies. Video parodies such as those on the following pages can be analyzed to better understand the new cultural life of neuroscientific claims. *Video: [SuperBowlSammy](http://www.youtube.com/watch?v=twhvtzd6gXA)/YouTube*
02zolift
Simple Brains ------------- One of the most recognizable images from antidepressant advertising comes from ads for Zoloft (sertraline) that ran in magazines and on television between 2001 and 2006 (when Pfizer’s patent ended) depicting a “chemical imbalance” as the cause of depression. Although the campaign ended, the original ad still lives on YouTube, and the notion of the chemical imbalance has taken on a cultural life of its own as viewers have posted their own parodies of the ads. [](http://stag-komodo.wired.com/images_blogs/wiredscience/2012/02/original_440.jpg)The ad spoof above for “Zolift” mocks the simplicity of Pfizer’s original cartoon (right) of neurochemical transmission, implying that it is an insulting non-explanation. “This is a diagram of cells bouncing off of brain nerves. Your brain is very complicated, so we won’t try to explain anything here,” the voice-over says. The parody may be an amateurish send-up, but it articulates and participates in a serious historical debate among neuroscientists, psychiatrists, patients and policymakers over what exactly depression is, and how it should be treated. The Zoloft ads were particularly contentious for their tenuous scientific claims. Pfizer was accused of making fraudulent claims about the links between so-called “chemical imbalances” and depression. The company defended the ad campaign by appealing to the “general medical understanding” about the connection between serotonin and depression. Despite the controversy, the Zoloft ads stayed on the air and, eventually, through the YouTube parodies and other new trans-media conversations, the cartoon image of the chemical imbalance became a widely circulated and transformed cultural object. *Video: [superturbosonic](http://www.youtube.com/watch?v=ggszayGpu-g)/YouTube*
03hamloft
Neurotic Neuroscience --------------------- Zoloft parodies on YouTube such as this one reinvigorate historical tensions between brain-based and psychological explanations of depression. By the 1970’s the theory had taken hold in psychiatry that some mental illnesses such as schizophrenia were caused by child-parent relationships gone awry. In 1979, an advocacy group known as the National Alliance on Mental Illness was formed by mothers of schizophrenic patients in response and began pushing brain-centric research on mental illness. The pharmaceutical industry quickly became NAMI’s biggest financial backer. Subsequent massive media campaigns touting neuroscience as a marriage of scientific objectivity and social destigmatization caused family-centric explanations of mental illness to lose ground. But these psychological explanations of mental distress have not gone away, as demonstrated by a spoof that imagines [the Zoloft campaign was targeted at Shakespeare’s Hamlet](http://www.youtube.com/watch?v=YLEAv_0wzDc) (still above). “While the cause is unknown, depression may be due to a backstabbing family member,” the tagline reads. *Image: [DEPINTO](http://www.youtube.com/watch?v=YLEAv_0wzDc)/YouTube*
04ecstasy
Normal, Happy, or High? ----------------------- To date, pharmaceutical advertising has never shown the bodily consumption of pills. From a marketing standpoint, it is crucial that antidepressants not be perceived as “happy pills” that enhance or change experience, but rather as medical technologies that restore a normative state of health. Drug companies don’t want their products to end up as controlled substances as benzodiazepines such as Valium did. These drugs were introduced in the mid-1960s as “minor tranquilizers” to treat depression and anxiety. By the 1970s benzodiazepines had become the most prescribed class of drugs in the world. They were also the first psychiatric drugs in the U.S. to be consumed recreationally, and by the 1980s the U.S. Drug Enforcement Agency reclassified the drugs to restrict access to them. The pharmaceutical industry has since been deeply invested in the legal distinction between licit and illicit drugs and the difference between illness healing and pleasure seeking. For instance, one of the first direct-to-consumer pamphlets for Prozac claimed that, “Prozac doesn’t artificially alter your mood and it is not addictive. It can only make you feel more like yourself by treating the imbalance that causes depression.” In the wake of the advertising campaign for Zoloft, a number of parodies cropped up that play around with the ethics of prescription drug taking. The example above was first featured on the comedy show *MadTV* in 2003 and has been kept alive on YouTube with over two million views. This parody transfers the logic of the Zoloft ad to the logic of how Ecstasy works. “Ecstasy works by releasing a series of chemicals into your system—endorphins and serotonin,” the voice-over begins. The anthropomorphized neurotransmitter in the foreground then says, “Heehee – party, dude! I can feel my skin, I think it’s moving!” [](http://stag-komodo.wired.com/images_blogs/wiredscience/2012/02/madtv.jpg) *Video: [gika119](http://www.youtube.com/watch?v=QHG8cjI5B-w)/YouTube*
05placebo
Advertising (and) the Placebo Effect ------------------------------------ Not only do neuroscientists debate the most basic of biological mechanisms that may be involved in depression, but if and how antidepressants work is completely up for grabs. [](http://stag-komodo.wired.com/images_blogs/wiredscience/2012/02/placebo.jpg)In recent years, analyses of clinical trial data made available through the Freedom of Information Act argue that, overall, the class of antidepressants that Zoloft belongs to [do not work much better than placebos](http://stag-komodo.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect). But we now live in a world in which specious biological theories about depression are being used by advertisers to boost the placebo effect of drugs whose antidepressant properties and biological actions are uncertain in the first place. The idea that advertising itself can help determine our relationship with our antidepressants is being taken quite seriously by drug marketers. They have defended consumer-directed advertising as a way to actually enhance the placebo effect, supposedly resulting in better drug compliance. Consider this Zoloft parody, a music video for a song called “Just Use Drugs,” which depicts not the consumption of the medication, but the consumption of the Zoloft commercial itself, in order to persuade one to self-medicate. *Video: [manorengineer](http://www.youtube.com/watch?v=5Drh2tBD8kQ)/YouTube*
