Insights in “Side Effects”

Clip: Dr. Banks (Jude Law) discusses Emily with another psychiatrist (Catherine Zeta-Jones).

I just watched Side Effects, and it kind of made my brain explode. To be exact: it gave me too much to think about. I can’t remember the last time I watched something that offers so much fertile (if imperfect) commentary on the relationship between mental health and culture — a relationship medical science navigates largely through drug development. For mental health problems that are treated as medical disorders, like depression, researchers seek physiological causes and try to make effective pills. This system creates a complex world, one Side Effects draws us into.

As a film, Side Effects occupies its own artistically murky world. Movies that use vaguely science-based plot points often warn audiences that they’re entering a fantasy. Some are clearly set in a distant future or a re-imagining of the past. And many such films announce themselves as science fiction by, say, depicting monsters or fancy robots.

But in Side Effects, director Steven Soderbergh doesn’t mark anything as belonging to science fiction and/or a distant future. The plot is pretty grounded in the real world: A young woman named Emily faces her husband’s return from jail, where he served four years for insider trading. To cope with her anxiety and depression, Emily starts seeing a psychiatrist and goes on antidepressants. Then, as the film’s title implies, the medication causes troubling side effects.

Besides the “Ablixa” pill Emily ends up on, all the antidepressants mentioned in the film exist. So if any big claims were made about these drugs’ safety or efficacy, they would need to be checked against real life. But Side Effects (or at least its first three-quarters — I’ll bite my tongue about the ending) focuses little on how specific pills work. It drums up some fear about antidepressants causing violence. Overall, though, the film captures the real-life status of that issue: the jury’s still out. While some psychiatric drugs have violence as a rare but serious side effect, many researchers caution against generalizing based on those results.

Beyond antidepressant use, what Side Effects really speaks to is social issues in the medical treatment of mental health. Within its first 90 minutes, the film turns a critical eye upon ad campaigns for antidepressants, the way the legal system handles mental illness, the ethics of clinical trials sponsored by pharmaceutical companies, and the delicate balance of trust and responsibility in patient-doctor relationships.

I know — phew. But there’s more! Another theme is the way cultures affect perceptions of mental illness. We meet Emily’s psychiatrist, Dr. Banks, encountering a patient being restrained by a cop. Dr. Banks realizes that the patient wants to speak French. So he switches to French and finds out that the man saw his dead father driving a cab. Hearing this, the cop dismisses the guy as nuts. Not so, responds Dr. Banks — the patient is Haitian. And Haitian culture is more open (than American medical culture) to the idea of encountering the dead. So if you understand that, you realize the man is grieving, not insane. But that realization only comes about with context.

Cultural context is also crucial in Emily’s life, based in ever-anxious New York. Among her well-groomed colleagues in advertising, and her husband’s colleagues in finance (or at least their wives), it seems standard to have tried antidepressants at least once. So here Side Effects offers social criticism: it suggests that glossy professional cultures normalize stress and depression, as unavoidable costs of having such busy lives.

That critique gives me two minds. On one hand, I’m all for questioning workaholic culture and its high-stakes mentality — the voluntary sacrifice of sleep, relationships, peace of mind and other (arguably basic) needs for a job. On the other hand, I’m wary of characterizing depression as a “rich person’s problem.” That’s inaccurate, and it also undermines the importance of expanding mental health resources for low-resource populations, like individuals in prison.

But it’s fitting for me to feel torn, because provoking appropriate confusion is what Side Effects does best. Despite unfolding as a contrived thriller, it at least hints at the complexity of real-life issues. Those issues underlie every incident of violence committed by someone who may have mental illness. And they raise questions about the medical, legal and social systems we develop to address mental health. Thanks, Steven Soderbergh — this film taught me almost as much as I learned from Magic Mike





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