Steven Soderbergh, who has tackled such hot-button topics as environmental pollution (Erin Brockovich), the war on drugs (Traffic) and epidemiological preparedness (Contagion) in the course of his multi-faceted career, takes on the pharmaceutical industry and the pills it promotes to treat depression in his newest film, Side Effects, which premiered Thursday night in New York at the AMC Lincoln Square.
A thriller, Side Effects takes a closer look at antidepressant drugs -- and the writers and producers behind the film were not shy about their desire to explore the often-taboo topic.
"There are a lot of people who suffer from depression, and a lot of those people are certainly helped by medication,” the film’s screenwriter, Scott Z. Burns, said. "And then there are a lot of people who are sad, who are not depressed, who see ads on TV and feel these medications might be a shortcut to the place they want to go. And that’s a concern. I think that when psychiatry is, like any branch of medicine, when it’s practiced responsibly, that’s a great thing."
The film stars Rooney Mara as Emily, a depressed woman whose husband (Channing Tatum) is unshackled after four years in prison for insider trading. When he emerges from the clink, she falls back into a clinical depression that first enveloped her when his prison sentence started.
Soon after the sorrow returns, Emily crashes her car into a wall in a seeming suicide attempt that lands her under the care of a psychiatrist (Jude Law), who begins a mix-and-match attempt to find the SSRI that will best lift her from depression. Everywhere she turns, there is someone in her life offering advice on which pill is best, relaying their own experiences with various antidepressants; paired with segments that feature physicians name-checking drugs from Celexa to Zoloft, the first third of the film points out the ubiquity of the medicines in today’s society.
Burns worked closely on the script, which he was once supposed to direct, with Dr. Sasha Bardey, a psychiatrist and instructor at New York University who works on mental illness cases in the criminal justice system and served as one of the film's producers. Bardey elaborated on Burns’ distinction between the depressed and sad, offering a more clinical split.
"The line is where it impacts on your functioning," he explained. “You should be sad if you lose a loved one, you lose a job, you get divorced, you should be sad. But if you’re getting up, you’re putting your clothes on, you go to work, you do what you need to do, you’re just sad. But if your functioning is impaired, then you’re depressed, and then sometimes you need either medication or psychotherapy, or really, both."
Bardey added that many people are medicated unnecessarily, while many who do need it go without treatment. Indeed, a 2011 study found that 11 percent of Americans over the age of 12 take antidepressants, but only a third of those that suffer from severe depression take medication for that affliction. That serves as something of an indictment of pharmaceutical companies and their heavy advocacy, both in advertising -- which is mocked in the movie and on a website created for the fictional drug it features -- and interaction with doctors.
In one of the movie’s most pointed scenes, Law and the partners in his psychiatric practice have a lunch meeting with a representative from one such drugmaker; they munch on filet mignons as they discuss the sizable ancillary benefits of working together, from World Series tickets to free Hawaiian golf vacations. The rep is hoping to tempt the doctors into participating in a study of a new drug by dangling a cool $50,000 as a reward for tracking data and keeping notes on the patients that volunteer to try the untested drug (which the subjects are given for free, no insurance company involvement required).
"I think ultimately that I really want to fight against the stigma that holds psychiatry down and mental illness down," Bardey said. “But I think the only way to do it is be honest about it. Full disclosure. If big pharma is involved, people have got to know. If medications have side effects, people should know this. People should be informed of what’s going on."
In Side Effects, characters discuss some of the negative reactions that they’ve had to various medications, emphasizing that no one drug works for everyone, and even when one does help depression, it can cause other, unwanted problems. Those conversations are reminiscent of the first scene between Bradley Cooper and Jennifer Lawrence in Silver Linings Playbook, in which they trade effusive stories about the zombification they felt under the influence of their bipolar meds. Of Trazodone, a tranquilizer, Cooper says, "It flattens you out. I mean, you are done. It takes the light right out of your eyes." Cooper's character refuses to take medicine, exiting a psychiatric ward after eight months and then working to overcome his illness with a combination of exercise, positive thinking and dance.
While Side Effects also joins that debate, Thursday night its actors, though acknowledging the potential for controversy, also emphasized the film's entertainment factor.
“I think that the movie does have a commentary on society and the pharmaceutical industry and pills, and hopefully it will spark conversation,” Mara said, “but I think it’s more fun and more of a smart thriller than anything."
Catherine Zeta-Jones, who plays another psychiatrist in the movie, offered a similar response.
"The movie has that underlying theme, but this is certainly not a movie about that. It is a wonderful backdrop in which to base a fantastical psychological thriller, the edge of your seat. With the prescription, it’s about how one pill can change everything -- for the good, which a lot of pills do -- and then for the bad."
With so many in America on the medications, and some in Hollywood having previously found themselves in hot water after voicing opinions about antidepressants (see: Tom Cruise and Jim Carrey), those involved with Side Effects appear to be treading lightly, careful not to offer any mass diagnosis or condemnation. At best, as Mara said, the movie can make a suggestion, and perhaps, let the discussion take on a life of its own.
"In my opinion, mental illness is no different than physical illness, it’s no different than diabetes or high blood pressure. It’s an illness that needs to be cured," Bardey said. "We should take away the mysticism, peel away the layers. Let’s be clear and transparent about it. And I think this movie tries to do that a little bit. And if it’s a little critical and it makes people think and it makes my profession react, so much the better."
Email: Jordan.Zakarin@THR.com; Twitter: @JordanZakarin