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Thursday, January 28, 2010

Self Parody and Prescription Drug Commercials

Imagine you're watching a car commercial and you hear the following: “While this vehicle has been shown to be a safe under most circumstances, occasionally there are problems that you should be aware of. Every once in a while the driver's side air bag deploys unexpectedly. This is not particularly problematic if the car is still in park, but more so if you’re moving. In addition, the heating system occasionally malfunctions resulting in a bit of smoke floating through the interior of the car. It’s nothing to be concerned about. Within ten minutes the smoke should dissipate, allowing you to see the road clearly again. There have also been instances when the vehicle’s locking mechanism gets stuck making it difficult for passengers to exit the vehicle. If this happens and you can’t open the car doors, call 911. Afterwards, be sure to contact your car dealer.“

Other than SNL or the Daily Show, it’s unlikely we’re ever going to hear anything remotely like this. Yet, the above car parody is not much different from the prescription drug commercials which, at times, border on self parody. The poster child for this self parody genre is the ad for the psychiatric drug, Abilify.

The theme of the commercial is this: If you’re currently taking a commonly prescribed antidepressant drug like Prozac or Zoloft and feel that it’s not quite working as well as you had hoped, then Abilify is for you. The combination will bring a smile to your face as you are now able to function unencumbered by life’s burdens.

I’ve watched this commercial a number of times and it never ceases to amaze me. After the initial pitch, the attention shifts to the side effects of the drug which, by law, the drug companies have to make you aware of. What’s unusual about this drug is both the number of serious side effects and the length of time it takes to recite them. The following is some of what you hear:

“If you suddenly have suicidal ideation or unusual thoughts, feel dizzy or start to vomit, experience involuntary repetitive movements of the limbs, develop symptoms of diabetes or have trouble breathing, be sure to contact your doctor.”

The third time I watched the ad, I decided to time it. It takes forty-seconds to list just the major side effects of Abilify. I don’t know about you, but if it takes a full forty-seconds to list what terrible things could possibly happen when I’m taking a drug, I'll pass. Given all the other ways that are available to help lift your mood and augment the medication you are currently on — lifestyle management changes like getting some additional sleep and exercise come immediately to mind — it would seem that taking a drug like Abilify should be the choice of last resort.

Oh, and by the way, one of the side effects that’s not mentioned in the commercial, but is likely to happen in a significant number of people, is weight gain. That’s conveniently left out. It was probably just an oversight, since a drug company would never purposely mislead the public.

I think I rather take my chances with the car whose airbags deploy unexpectedly.

Sunday, January 17, 2010

Newtonian physics and the Obama Presidency

Anyone who every took a course in physics remembers Newton’s third law of motion: for every action there is an equal and opposite reaction. It appears that our brain understands this quite well, which is why there is a psychological analogue of this principle that every one of us has experienced. The higher up you go – the more intense the experience of joy/happiness/elation - the further down you fall as the intensity of the experience quickly metabolizes through your nervous system. And nobody understands this more clearly at this moment in time than our President as he struggles to be a great leader.

Barack Obama came into office riding the historic wave of being the first Afro-American President, with CHANGE as his battle cry. He was confident, charismatic, intelligent and articulate. He was following a President who had none of these qualities and whose Presidency had failed miserably. From the outset it appeared as if his success would be both immediate and inevitable. Yet, one year later, 54% of the electorate disapproves of his performance. What happened and why?

We can spend a lot of time talking about issues and policy, the difficult Presidential learning curve and the continuing criticism of the conservative right, but more than anything else, the primary reason he’s struggling is that he started out way to high. When he took the oath of office it felt more like a coronation than an inauguration. The excitement and elation over his election created impossible expectations. He was anointed a savior before having done a single thing. And when he was given the Nobel Peace Prize – something he clearly didn’t deserve – that pretty much sealed the deal for his current predicament. All the substantive issues-the wars in Iraq and Afghanistan, the economic woes and his policy initiatives-are secondary to the “physics” of his Presidency. The higher up you start, the further down you fall.

So what are we to make of all this? Does this mean Barack Obama was not meant to be a competent President nor a great leader? Does this mean the events of his first year in office presage the rest of his Presidency? Or, does it simply mean that his initial frustrations and failures had to happen in order for him to experience the reality of what the Presidency was all about. Success is only fully appreciated when you’ve earned it. Obama hadn’t failed before and truly believed everything that had carried him to victory during the election would continue unencumbered as President. He was wrong. But sometimes being wrong is a really good thing.

Now we’ll find out whether he can do this job well. Now we’ll see whether the skills he displayed as a candidate can merge with the skills he is first developing as a leader so that the President this country needs will slowly emerge over the next two years. For there will inevitably be a moment in time – some extraordinarily difficult crisis that every President eventually faces – which will force him into psychological places he has never experienced and stretch him to his limits. Then, and only then, will we know whether Barack Obama is bound for greatness.