The Latest Mania: Selling Bipolar Disorder

O ne of the most famous direct-to-consumer television adverts for a drug begins with a vibrant woman dancing late into the night. A background voice says, " Your doctor probably never sees you when you feel like this. " The advert cuts to a shrunken and glum fi gure, and the voiceover now says, " This is who your doctor usually sees. " Cutting again to the woman, in active shopping mode, clutching bags with the latest brand names, we hear: " That's why so many people with bipolar disorder are being treated for depression and not getting any better—because depression is only half the story. " We see the woman again depressed, looking at bills that have arrived in the post before switching to seeing her again energetically painting her apartment. " That fast-talking, energetic, quick tempered, overdoing it, up-all-night you, " says the voiceover, " probably never shows up at the doctor's offi ce, right? " No drugs are mentioned. But viewers are encouraged to log onto www.bipolarawareness.com, which takes them to a Web site called " Bipolar Help Center, " sponsored by Lilly Pharmaceuticals, the makers of olanzapine (Zyprexa). The Web site contains a " mood disorder questionnaire " (http:⁄⁄www. bipolarhelpcenter.com/resources/ mdq.jsp). In the television advert, we see our heroine logging onto www. bipolarawareness.com and fi nding this questionnaire. The voice encourages the viewer to follow her example: " Take the test you can take to your doctor, it can change your life….getting a correct diagnosis is the fi rst step in treating bipolar disorder. Help your doctor to help you. " This advert markets bipolar disorder. The advert can be read as a genuine attempt to alert people who may be suffering from one of the most debilitating and serious psychiatric diseases—manic-depressive illness. Alternatively, the advert can be read as an example of what has been termed disease mongering [1]. Whichever it is, it will reach beyond those suffering from a mood disorder to others who will as a consequence be more likely to see aspects of their personal experiences in a new way that will lead to medical consultations and in a way that will shape the outcome of those consultations. Adverts that encourage " mood watching " risk transforming variations from an emotional even keel into potential indicators of latent or actual bipolar disorder. This advert appeared in 2002 shortly after Lilly's antipsychotic olanzapine …