Friday, 26 July 2013

Side Effects: The debates this film raises on mental health issues.

This review contains spoilers

I was curious about the release of Stephen Sodebergh’s new film, Side Effects (2013), especially when I heard that there was a discussion of mental illness within the film. The cast put me off at first as Jude Law, Rooney Mara and Channing Tatum are certainly not my favourite actors, but I was willing to give this film a go as I expected it would soon be getting a lot of positive attention from the critics (much like Soderberg’s other films such as Magic Mike). The film is a very tight dynamic thriller for most of the duration, except the final act that is a little chaotic. The film is quite successful at provoking debates on issues of mental illness and medication and I will be discussing these for this blog.  

The film follows a young woman, Emily (Rooney Mara), as her husband Martin (Channing Tatum) is being released from jail. Emily is seen struggling with symptoms of Depression and eventually drives her own car into a brick wall, in a suspected suicide attempt. At the hospital she meets the English Dr Jonathan Banks (Jude Law). Jonathan is introduced to the film as he is brought into to talk to a man who has been brought to him by the police. The policeman thinks this man is insane, but Jonathan soon finds out that he speaks French much better than English, and whilst conversing with him in French he also finds out that his father recently died and he saw his ghost. Jonathan explains that this man is just grieving and it is perfectly normal for a Haitian to see the ghost of their dead just after they have passed away. I enjoyed this short scene as it showed that people, who appear crazy to others, are in fact just in pain. With some patience you can understand where the person is coming from and there is an ability to move forward rather than the situation be aggravated by ignorance.

When Jonathan meets Emily, he is unsure whether or not to hospitalize her, but decides to let her remain as an out patient with her agreeing to come for therapy and to start taking an SSRI, Zoloft. She is seen suffering from side effects such as sickness, which is often seen with people who take Zoloft. Her boss, who is shown to be sympathetic to her Depression, tells her that she had similar reaction to Zoloft and she had more luck with another type of anti – depressant. Jonathan finds out that Emily had seen another psychiatrist Dr. Victoria Siebert (Catherine Zeta – Jones) before him, who prescribed her Prozac. This discussion of anti – depressants here does give quite an accurate representation of what it is like for a person with Depression. It is quite frustrating as it can take a while to get the right fit in terms of medication, so they have to try several, with differing side effects, but those with these problems should have faith as there are many different types of medication out there so they will find the right fit for them eventually.

Victoria says to Jonathan that she recently started one of her patients on a new drug, Ablixa. She says that she does this because the patients see the adverts on the TV for the new drug and they believe in it as they see people getting better. I remember when I went to New York with a friend and one night we turned on the TV, I was so surprised that they advertised for medication. It unsettled me a bit, as if medication was just another product. This film seems to be critiquing this idea and the film could be onto something here, is there an unhealthy relationship between Americans and medication?

Despite my agreement in the critique of advertising for medication however, when it comes to mental illness my opinions differ here. As the mental illness being discussed throughout the majority of the film is Depression, I will focus with my issues in relation to that. Depression makes you feel ashamed and like you are not worthy of recovery. So the idea the idea of advertising making you believe in something when you are dealing with the debilitating illness that takes away all hope is quite insulting. For people who suffer with Depression, it is important that think they will not be viewed as someone who saw an advert on TV and want all their problems to be washed away by a miracle drug, but instead be safe with their emotions taken seriously and given full support. There are far too many people who are silent in their Depression due to many fears, one of them being that they will not be taken seriously. Even though I disagree with adverts for medication, as it could lead to people taking medication needlessly, I think that when it comes to criticizing these adverts, one needs to be careful that your argument does also contain respect for the sufferers of the illness. Instead of suggesting that the brainless masses will watch these adverts for anti – depressants and rush out to get their hands on some, maybe instead the strongest argument against adverts for medication is that they are trivializing anti – depressants, also suggesting that Depression is a trivial illness, making it in line with cough medicine or headache relief. It could be what is so disturbing about these adverts is a combination of the idea of a medication reliant country and the trivialisation of serious illnesses. It also touches on the idea of a country obsessed with side effects.

One of the things I found amusing about the adverts for medication was that most of the advert is spent listing possible side effects of the medication. This obsession with side effects is usually to prevent court cases, and is an obsession that the film is trying to tap into. The film uses the fact that there is a lot of anxiety around the side effects of medication, hence the title of the film, and taps into this to make an unnerving thriller for anyone caught up in this anxiety. 

Emily starts taking Ablixa, and starts feeling very good. The only side effect seems to be that she sleepwalks. Her husband is quite disturbed by her sleepwalking and this side effect worsens. Martin comes in one night and calls out to Emily. She does not reply, and he whispers under his breathe “Damn pills”. She is in the kitchen, cutting vegetables, but looks like a zombie. She then stabs him to death. Here is where the film starts to tap into the insecurities of many people watching. The film uses the fear of medication. Many fear medication for mental illness in particular. They fear it will mess with your mind and leave you far worse than you were before. This could well be seen as a fair point of discussion and a great way to start a debate about these issues. However, there is a worry that someone who already holds a strong view against medication could see this film, and despite the plot twist at the end, be much firmer in their beliefs in trying stopping someone with mental health issues from taking their medication. 

There are those who have been affected from their plans to see the doctor or take their medication by those around them who think that taking medication or getting help for mental illness will only result in them turning into a vegetable, addicted to “happy pills” or in a mental hospital. The term “happy pills” could not be more offensive, but it is surprising how much it is used. The medication used does not warp your mind; it helps the unbalance of chemicals that causes Depression. You will not end up in a mental hospital unless you are a serious threat to yourself and others. On top of this, medication is never the sole treatment available. It is advised that you also get therapy and come off the medication when the time is right, with supervision from a doctor. None of these reassuring factors are featured in the film, probably because they want to create suspense and reassurance will not fit in well to the film. 

Is the film brave then in touching on these issues? On the one hand the film is brave in touching a subject that can lead to strong reactions. On the other, the film does seem to be stating that this is for entertainment (to create suspense), lessening the edge of the points they are making. They touch on the subject enough so that the issues are raised, but not so much that they can get into trouble for doing so. This is probably due to Sodebergh, whose previous films have also debated controversial topics including one of his earliest films Sex, Lies and Videotape (1989). So by now, Sodobergh knows how to raise debates on a subject without a huge scandal. 

After Emily has killed her husband, there is a question of whether she is responsible or if it is the medication. Jonathan is then called into questioning from the police. He is asked as to why he came to the USA to practice, instead of staying in the UK. He replies that he came from Durham and says: “Where I come from, if you’re seeing a therapist the assumption is that you’re sick. Here the assumption is you’re getting better.” As he delivers this line Jonathan looks quite smug, with the police also seeming happy at his response. What exactly is he implying here? That the UK is backwards compared to the USA in terms of therapy and dealing with mental illness? Although therapy is very popular in the USA,the UK are so backwards in their relationship to therapy. I think it was the idea of smug Americans nodding their head to that as if Durham was some backwards English village that annoyed me. In fact Durham is a city home to one of the world’s top 100 universities. Therapy is becoming more and more acceptable here in the UK, and accepted that when you go to a therapist, you are most likely to have an illness, but want to get better. Going to a therapist is therefore a step in the right direction, which takes strength and a desire to move forwards. Hopefully, this will be the view held by the majority of people in the near future.

Jonathan tells Emily that she is not at fault for what she is going through and that she is just “a victim of circumstance and biology”. Emily herself describes what she is going through similar to a “poisonous fog”. Both of these descriptions of Depression are accurate and yet they somehow seem to underestimate the pain a person with Depression must go through and the strength it takes to try and overcome it. For instance one cannot imagine a doctor stating such a brash statement to a patient, that they are just “a victim of circumstance and biology”, to a diabetic for instance. It is far more complex than that. However, it was a statement that he made to ease the guilt of his patient, which is a valid point as it is not the person’s fault that they are now suffering a period of Depression, despite blaming themselves being one of the symptoms of this illness. On top of this, the analogy to fog is one I hear often, but do not think this is sufficient as implies no strength from the patient as when the fog eventually lifts, it is by miracle rather than by hard work from therapies such as CBT.

There is another interesting debate raised, which is how much is Jonathan to blame? Another psychiatrist that Jonathan asks for advice poses the question “Would you have treated her any differently had she been a man?” Suggesting that because she was an attractive young woman, Jonathan indulged her in her fantasies a bit too much. He did after all prescribe her a drug, for which he did not even know the possible side effects. Despite the film portraying him to show that he was doing his best for her at the time, and after when he tries to find out what really happened, it is interesting to question the level of authority he is given with his patient and whether or not this is right to leave one psychiatrist with so much power and overall judgement over their patients. Despite this, his crazed obsession in finding out the truth does prove to be worthwhile of his time, so he is not crazy but right. So the authority of the psychiatrist is not questioned to a very large extent.

The question he is so intent on proving is whether or not Emily is guilty of the murder of her husband. Was it the drug or was it in fact her all along? If you do not wish to know the answer of this question, skip the next paragraph.

When the question is answered, Emily turns out to be quite deceptive; it seems that Emily has had a different mental health issue all along. This twist unsettled me a bit. The difference between her being a person with Depression and being Schizophrenic in the film’s eyes is somewhat distorted. With Depression, she was at risk of killing herself. With Schizophrenia she was in danger of killing others. Not only this but to use her being schizophrenic as a final development of the film is sort of abusing her mental health problems for the benefit of a final dynamic twist. Is it ethical to use mental health problems in this way? In my opinion, no. Yet psychological thrillers have used mental illness for a long time in order to make their thriller seemingly more complex and stimulating. Is this then a kind of mental health exploitation? Where mental illness is being used purely for suspenseful edgy entertainment, this could most likely be the case. However, this film is not purely exploitative as it expects an intellectual and active viewer, to engage with the films debates and not to simply take it at face value. 

Overall, the film is gripping and well made. There are some good performances, from Jude Law, Catherine Zeta Jones and Rooney Mara. The cinematography is finely executed so that the film looks great as well. The debates raised in the film are not delivered with clear cut answers, which could be a way of avoiding controversy, but also gives the viewers a chance to engage in the debates raised and make up their own minds. Despite not being a fan of the way the film used mental illness in the final chapter of the film, in which it seemed that it could be just another edgy twist to the film and almost mental health exploitation, I did enjoy engaging in the debates the film raised. I would recommend watching it to make up your own mind as this is an intellectually made film that will have very differing opinions from viewers.

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