ATLANTA— Celebrity endorsements have been around nearly as long as advertising itself. Movie stars, musicians, and famous athletes bring immediate name recognition to any product that’s for sale—from cosmetics to wine, from appliances to automobiles. In recent years, the power of celebrity has ventured into new advertising territory, that of the mental health field. More and more celebrities have spoken publicly about having depression, and drug manufacturers have employed a number of them to advocate the seeking of treatment as well as the benefits of their particular brand of antidepressant. Such an alliance may be the result of a reduced stigma attached to depression, and/or it may be helping to reduce that stigma. Either way, there’s a good chance that a celebrity-endorsed antidepression campaign is coming to a media outlet near you.

One current celebrity-based marketing campaign for depression treatment features actress Lorraine Bracco, who plays psychiatrist Jennifer Melfi on HBO’s “The Sopranos.” Ms. Bracco has teamed up with Pfizer in the company’s “Why Live With Depression?” campaign. Ms. Bracco spoke about the importance of the doctor–patient relationship in overcoming the misconceptions and stigmas associated with depression at the 2005 Annual Meeting of the American Psychiatric Association (APA).

TV PSYCHIATRIST TALKS PSYCHIATRY

“The irony hasn’t escaped any of us,” said Ms. Bracco. “I play the psychiatrist on ‘The Sopranos’ who treats Tony Soprano for his depression. Meanwhile, in real life, I’m actually someone who has suffered from depression and had to seek the help of a psychiatrist…. Having firsthand experience working with my doctors to help me overcome my depression has helped me create a pretty great character…. As a patient, I know that there is much that we experience but have difficulty verbalizing, especially at the beginning of treatment. When I was living with depression, I was in a hole, and I couldn’t climb my way out. I found it isolating and lonely. It was something that took me a really long time to realize that I couldn’t beat on my own.”

Ms. Bracco said that her depression resulted from a number of events in the 1990s, including a divorce, a subsequent failed relationship, a custody battle, a sick child, and a significant amount of debt. However, just when she thought she was getting her life back together, she began to feel worse. “In spite of my efforts to work through it, I kept sinking lower and lower into my depression,” she said. “I kept telling myself, ‘You’re a strong-willed person, why can’t you get over this?’ At this point, seeing a psychiatrist or taking medication was not even an option in my mind. I had so many fears and misconceptions about depression and getting treatment for depression…. My life was happening around me. It was like I was dead inside, and finally I realized that it hadn’t been just days, weeks, or months, but an entire year had passed. I had no joy or pleasure.”

It was at this point that Ms. Bracco called a doctor and admitted to herself that she was depressed. “It was probably the biggest realization that I had and the most courageous,” she said. “In understanding the fact that it wasn’t a sign of weakness and that it was a real medical condition that requires real medical attention made me realize right there and then that I needed this help and I was accepting it and my life was going to get better.”

Eventually, Ms. Bracco’s physician helped convince her that it was okay to treat her depression with medication and that being on an antidepressant “doesn’t mean that I was weak.” She continued to see her doctor for talk therapy for two and half years and took medication for about 15 months. Within a few weeks of taking the medication, she said that she began to see a change in her mood. “I realized this not because it was changing who I was, but because I was feeling like myself again,” she said.

“It was an amazing feeling to come out from under that huge weight that I had been lugging around. Today, I am no longer on medication, and I’m happy being me again…. After recovering from depression, and hindsight is always 20/20, I realized how stigma was my greatest enemy…. I began to realize the impact that I could have on people’s lives. I really wanted to help lift the stigma associated with depression and make mental health a productive public topic of conversation.”

DIVING FOR GOLD

Former US Olympic gold medal winning diver Greg Louganis has been part of GlaxoSmithKline’s celebrity antidepressant marketing campaign to gay consumers, along with actor Chad Allen (“Dr. Quinn, Medicine Woman,” “St. Elsewhere”). Mr. Louganis spoke at the APA’s “Conversations” segment (whose previous speakers were Tipper Gore, Carrie Fisher, and George Stephanopolous), which was sponsored by AstraZeneca, in what was billed as a talk on depression, substance abuse, and having an HIV-positive diagnosis.

“I was training for the 1988 Olympic games and I got the [HIV-positive] diagnosis,” said Mr. Louganis. “My thought prior to making any type of decision at all was that if I was HIV-positive, I was going to pack my bags, because I was training in Florida, go back to southern California and lock myself in my house and wait to die. That was the mentality at that time.”

He was eventually convinced to stay in Florida and continue to train, while taking all the medication that was available at the time. Throughout his training, Mr. Louganis said that he did a lot of freeform writing in his spare time. “It was always really depressing,” he said. “It was really sad stuff. But it was something that I needed to get out. When I was growing up, I could understand how somebody could die of sadness. They didn’t kill themselves; they just died of sadness. So those were the feelings that I was dealing with. Fortunately, I had my diving, gymnastics, and physical activity. As long as the calendar was full and I had places to go, I was fine. There were a few suicide attempts. Chances are, I had too much time on my hands.”

Mr. Louganis said that he sought psychotherapy in the 1990s, as well as beginning antidepressant medication. “That helped me kind of Band-Aid it over,” he said. “I probably had a little more energy to go forward.” It was later, after the publication of his book, that he began to work with a psychologist and learned how to talk publicly and openly about issues such as depression, dyslexia, and being HIV-positive.

ANTIDEPRESSANTS AND ADVERTISING

Not all celebrity-endorsed antidepression campaigns are created equal. Many, like Ms. Bracco’s, are unbranded, in that the featured celebrity and campaign do not mention an antidepressant by name. However, some celebrities actively promote a specific antidepressant drug. Others speak to raise awareness for a disorder, some of whom have been criticized for not publicly revealing the fact that they have been paid by a drug manufacturer. Still others may simply crave the attention and spotlight—and money—that comes from endorsements, regardless of the product, and its potential side effects, that they are promoting, and thus providing ammunition for critics of the use of celebrities who endorse antidepressants.

Other celebrity-endorsed campaigns for depression have included Emmy-award winning actress Delta Burke (“Designing Women”), who fronted Wyeth’s “GOAL! Campaign to Help People With Depression ‘Go On And Live.’” The campaign was created to help illustrate “what it means to achieve virtual elimination of depression symptoms (remission) and once again fully enjoy the areas of life, like volunteering, that make people who they are,” according to Wyeth’s Web site marking the launch of the campaign.

In addition, Grammy award-winning singer/ songwriter Shawn Colvin and former Pittsburgh Steelers quarterback Terry Bradshaw have publicly discussed mental health issues as part of marketing campaigns by GlaxoSmithKline, which makes Paxil^® and Wellbutrin^®.

According to An Phan, a spokesperson at Pfizer, such campaigns can have a big impact on reducing the stigma associated with depression. “The ‘Why Live With Depression?’ campaign with Lorraine Bracco is an unbranded campaign and is based on consumer insight that helps remove some of the barriers that keep people from seeking treatment for depression,” Ms. Phan told Neuropsychiatry Reviews. “Depression is a serious medical condition that often goes underdiagnosed and untreated. Lorraine Bracco, like many other people, was helped by depression medicine. Patients should understand that depression is not a character flaw or a sign of personal weakness, but a serious medical condition that requires appropriate treatment. We felt it was important to encourage people with depression to speak to their doctor and not fear the stigma associated with taking prescription medication for depression.... Part of our mission is to educate people to help them better understand depression and the importance of treatment.”

Celebrities have raised awareness for other mental health disorders as well, including Pfizer’s “Moving Past Trauma” campaign with Noah Wylie (“ER”) and Naomi Judd (from country and western group The Judds). “Moving Past Trauma” was aimed at frontline health care providers who work with patients who had posttraumatic stress disorder and was widely used after 9/11. In addition, former Miami Dolphins running back Ricky Williams has extolled the virtues of Paxil, which he had used to overcome shyness and social anxiety disorder.

Celebrities—especially those in the arts—may seem like naturals for speaking about depression, as it has been well documented that a large number of musicians, writers, poets, and actors have reportedly had depression and/or bipolar disorder. That long list includes composers and musicians Ludwig van Beethoven, Samuel Barber, Frederic Chopin, Eric Clapton, Dolly Parton, Sting, Sheryl Crow, and Brian Wilson of the Beach Boys; writers Ernest Hemingway, Jack London, Truman Capote, Virginia Woolf, Mary Shelley, Leo Tolstoy, and F. Scott Fitzgerald; poets Emily Dickinson, Dylan Thomas, Edgar Allan Poe, Sylvia Plath, and Walt Whitman; and actors Marlon Brando, Jim Carrey, Marilyn Monroe, Jessica Lange, and Linda Hamilton.

Because of well-documented associations like this, the age-old debate about whether depression can actually inspire creativity persists. Kay Jamison, PhD, Professor of Psychiatry at Johns Hopkins University in Baltimore, wrote in her book, Touched With Fire: Manic Depressive Illness and the Artistic Temperament, “Poetic or artistic genius, when infused with … fitful and inconstant moods, can become a powerful crucible for imagination and experience. That impassioned moods, shattered reason and the artistic temperament can be welded into a ‘fine madness’ remains a fiercely controversial belief.”

Many have argued against suggestions that depression influences creativity and are concerned that individuals with a creative spark and its frequently accompanying passion can be wrongly diagnosed as having manic depression. Peter D. Kramer, Clinical Professor Psychiatry at Brown University in Providence, Rhode Island, and author of Listening to Prozac, recently questioned in a New York Times Magazine article as to why people believe that depression and artistic and literary greatness go hand in hand. “Depression is not a perspective,” wrote Dr. Kramer. “It is a disease.... We should have no trouble admiring what we do admire—depth, complexity, aesthetic brilliance—and standing foursquare against depression.”

—Colby Stong

Suggested Reading
Jamison KR. Touched With Fire: Manic Depressive Illness and the Artistic Temperament. New York: Free Press, 1996.
Kramer PD. There’s nothing deep about depression. New York Times Magazine. April 17, 2005:50-53.
Famous People Who Have Suffered From Depression or Manic Depression. www.geocities.com/coverbridge2k/artsci/famous_people_depression.html.

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