side effects

Well, folks, this week’s post is not quite what I intended it to be! I watched Side Effects, a 2013 film directed by Steven Soderbergh that I was pretty sure addressed the topic of mental health. After all, the synopsis I read for it was: “A woman turns to prescription medication as a way of handling her anxiety concerning her husband’s upcoming release from prison.” What a great movie to cover for this blog!

About twenty minutes into the film, I remembered I had also seen a review comparing it to Gone Girl. (If you haven’t seen Gone Girl yet, please stop reading this post right now and go watch it. If you have seen Gone Girl, then you have a general idea of where this movie goes.)

Side Effects does address some fairly large areas of interest to me: mental health, Big Pharma, the role of psychiatrists, and the control that the medical field can hold over its consumers. Rooney Mara and Jude Law are Emily Taylor and Dr. Jonathan Banks, respectively. Without giving too much away, a movie that starts as a case study of one woman’s journey through psychotropic medications morphs into a mystery/thriller, with Law’s Dr. Banks acting as both psychiatrist and detective.

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Emily Taylor, played by Rooney Mara (via DVD Talk)

As a moviegoer, I really enjoy films that defy my expectations, which this movie does well. The opening scene shows a hallway covered in blood, a crystal clear indication that someone has attempted (or completed) suicide. However, once the plot of the film picks up, you realize that’s not the case at all.

As an advocate for positive and accurate depictions of mental health in film, I think this film falls short in a number of ways. Though I initially thought this movie was commenting on the debilitating side effects that many psychiatric medications can have, and the common practice of prescribing more medications to mitigate side effects, I realized quickly this wasn’t the case. Instead, it uses this premise to set up a very different type of story that ends up highlighting but not criticizing some of the worst practices in modern psychiatry.

For example, there is literally a scene where Dr. Banks threatens to use ECT (electroconvulsive therapy) on Emily as a punishment (this makes more sense within the context of the movie, I swear). ECT — still known as “shock therapy” colloquially — is a highly effective treatment for persistent and severe depression. It is a safe procedure done in an outpatient setting, in very rare cases when other forms of treatment have failed. The last thing ECT needs is a fictionalized depiction of it use as torture when so many people already think it’s used regularly in inpatient psychiatric settings.

Interestingly, one of the co-producers for the film was Dr. Sasha Bardey, a forensic psychiatrist, who said this in an interview after the release of the film (emphasis mine):

But, very specific to me, it’s important that psychiatry, psychiatrists, mental illness and patients be depicted in a realistic way, because my field suffers a great deal from a stigma around it. And the only way I think to get rid of that stigma is to be realistic about those issues. And not just the good parts. I’m not talking about painting a beautiful lily-white picture of what mental illness or its treatment is. But to look at it realistically—the good and the bad—and have people accepting it for what it truly is.

I tend to disagree with Dr. Bardey on this. Yes, stigma against mental illness is incredibly prevalent, and it’s the reason that I started this blog. Yes, there need to be more realistic portrayals of what life with a mental illness is like. But in my mind, the “lily-white” depictions of mental illness and treatment in media are few and far between.

Not that Google searches are scientific in any way, but here are the first results I got when I searched for “movies with mentally ill characters:”

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I would argue that none of these movies portray a wholly good side of mental illness or treatment, and only a few of them cover the complexities of life with mental illness. In fact, NAMI released a list in December 2015 of the seven best portrayals of mental illness in film, and of these ten movies, only Rain Man, A Beautiful Mind, and Silver Linings Playbook made the cut.

And no, Side Effects does not showcase the good along with the bad. Dr. Bardey notes that the characters in this film were taken from a number of real-life cases and combined into a few characters. Somehow, even with this attempt to keep the movie grounded in reality, it still manages to follow a truckload of other problematic tropes that, for me, diminishes the power of having a “realistic” portrayal. Also interesting how “realistic” almost always translates into “terrible,” as I struggle to find any positive depictions of mental illness in this film.

If you plan to watch this movie, you might want to stop reading here! I will try my best not to spoil the details of the plot, but it is the plot twist that I find the most troubling.

The “good” aspects of mental illness that I noted in this movie are rare. And most of them are before the revelation halfway through the movie that, SPOILER ALERT, Emily did not have a mental illness, and was instead participating in insider trading with her lover/therapist who also happens to be a woman (yes, it sounds ridiculous to boil down the movie to this sentence, but I’m not kidding). So, all of a sudden, this woman who was built up to be a sympathetic character with a mental illness is now the manipulative villain (who ALSO happens to have a female love interest, causing her to fall into the “Depraved Homosexual” trope that exists in far too many movies).

Upsettingly, the film ends with Dr. Banks wielding his very legal power to force medications and hospitalization on Emily, while her cries of foul play are dismissed because she is “crazy.” This feels like a good time to point out that people with severe mental illness are 10 times more likely than the general public to be the victims of violence, rather than perpetuating violence.

The movie is obviously well-researched, as it includes helpful information about the difference between grief and mental illness, accurate portrayals of psychoanalytic theory, and detailed depictions of the side effects of various SSRIs (a class of drug used to treat depression). But that’s where I find the positive aspects end.

I understand that there are both good and bad people out there who happen to have mental illness. The problem is that they are, vastly more often than not, the villain when their stories are told through film. I won’t mind portrayals of the “bad” side of mental illness and treatment once there are an equal amount showing the good side.

And I’ll get off my soapbox now! If you made it through this whole post, I’m proud of you. I have even more things to say about this movie, but I will save everyone the extra paragraphs! Please, if you’ve seen this movie, let me know what your thoughts are in the comments.

Side Effects (2013): ★★★½


Now that it’s October, I want to shift my focus to the horror genre and its interesting handling of many issues related to mental illness — stay tuned!