We Are All Crazy Now

3,144 words

Did you know that there are only two countries in the world where it’s legal to advertise pharmaceutical drugs on television? One is the U.S., of course, and the other is New Zealand ^[1]. I remember the early days of those ads, back in the 1990s. For example, there was the classic Zyrtec ad that showed someone climbing a mountain. You had to guess what the drug was for, because back then, they weren’t allowed to be more explicit. All the ad said was “ask your doctor.” My, how times have changed.

I am actually a connoisseur of these things. Soft focus, slow motion, plush New Age music, sunny days, happy seniors riding bikes, rambunctious golden retrievers, dandelion florets blowing in the wind, cardigan sweaters, smiles. And everybody’s got a black friend. Each of these ads is a tiny, polished gem; like a miniature Lifetime Channel movie. All the drugs have made-up, euphonious names: Cialis, Celebrex, Lyrica, Eliquis, Humira, Latuda, Chantix, Zoloft, Wellbutrin, and Xeljanz. They treat common conditions like depression, anxiety, erectile dysfunction, chronic pain, arthritis, and schizophrenia.

Wait. What? Schizophrenia?

Maybe I’m the last guy to find out, but tens of millions of dollars are being spent to advertise Fanapt (aka Iloperidone), a drug developed to manage symptoms of schizophrenia. I saw the latest ad ^[2] the other night on one of the cable channels, and at first, I thought it was a joke.

Let me set the scene. A series of weird, abruptly shifting angles introduce a middle-aged man sitting alone on a park bench. The scene is grey, dark, ominous. We hear a low murmur in the background, a cacophony of voices. The man seems agitated and clenches his fists. “I am a good parent!” he says emphatically, to no one in particular. Then we hear a voiceover, a woman with a British accent (suggesting — to Americans, at least — intelligence, authority). “Do you know how it feels to live with schizophrenia?” she asks.

Suddenly, an attractive young woman appears and approaches the man on the bench. She is about 30, with long dark hair. “Jared?” she says, with evident concern. At just this moment, the colors change and become warm. The sun seems to come out. Jared rises from the bench. “I’m hearing the most awful things. People shouting at me. . .” he explains. “It’s okay,” the unnamed woman says, as if she’s heard this a thousand times. She reassures him: “When you live with schizophrenia like us, it can feel like you’re living in a different world.”

Cue some light piano tinkling as underscore. “You should definitely talk to your doctor and ask about Fanapt.” The line has the feeling of inevitability. “Okay,” Jared says, and the two of them walk off together, moving at a rather brisk and self-assured pace. As the narrator tells us a little about how Fanapt faired against a placebo in clinical trials, the scene switches to a different area of the park. We are now introduced to “Cynthia,” a thirty-something blonde, who is also shot with a grey, “day for night” type effect. Cynthia looks worried. She watches as a mother unloads an SUV full of happy kids. Is the mother staring at her? When Cynthia realizes that the answer is probably no, the colors in the image become warm and sunny.

But Cynthia isn’t out of the woods just yet. Up on a hill (also shot in grey tones), some people pass by who also seem to be staring at her. And a man with a camera takes her picture. Or does he? In the blink of an eye, he is gone. Was he ever there? The dark-haired woman, still accompanied by Jared, shows up to save the day. “Cynthia, are you okay?” she asks. The colors once more become warm. “I feel like everyone’s out to get me,” Cynthia says. Cue the narrator with the inevitable information on Fanapt’s side effects. Jared, Cynthia, and the dark-haired woman now walk off together.

The chances of three friends encountering each other in a neighborhood park on a pleasant day are, I suppose, fairly high, especially if it’s a small town. But what are the chances they would all have schizophrenia?

Next, we see the trio seated at a table at an outdoor café. It’s a sunny day, naturally, and they are joined by a fourth person, who we only see from behind. He is young, dark-haired, and white, or possibly Asian. We never see his face, and he has no lines. We assume that he must be another schizophrenic. Did they meet this fourth person in the park, then decide to go and have coffee? Or is this scene set on a different day? Is this a regular coffee klatch for people who hear voices? Their table seats four only. Presumably, this means the Fanapt is working, or they would have needed a larger table to accommodate all their imaginary friends. The dark-haired woman seems to be the ringleader. “Remember, you’re not alone,” she says. “There is help.” The commercial ends with the narrator repeating that we should ask our doctors about Fanapt, or go to the website.

Another Fanapt commercial ^[3] seems to be set at a later date. The dark-haired woman is joined in the back seat of a black sedan by Cynthia. “It’s so good to see you.” “You, too.” The car drives away. Presumably, they are in an Uber. Cynthia quickly gets down to business: “So really, how are you?” Here the tables seem to have been turned; Cynthia is now the solicitous one. The dark-haired woman appears momentarily to struggle for words. Just then, the car passes a bus stop bearing an ad for Fanapt. “Oh, look,” she says with relief. “That’s what we’re both taking now. Fanapt. You know, it’s really been helping me manage my schizophrenia. I used to hear these terrible voices.”

Wow, that Uber driver sure is getting an earful!

Cue another surreal, grey-hued reenactment in which the dark-haired woman, apparently back in her college days, is hearing a sinister murmur of threatening voices. Cynthia commiserates, saying, “I used to feel like everyone was staring at me.” Her flashback, also grey-toned and set to ominous music, involves an older Asian woman and an older black man (a couple??) glaring at Cynthia as she shuts the trunk of her car. A bicyclist and a driver (both white) then show up and, in rapid succession, stare at her. Then the camera shoots her from above, making her seem small and vulnerable, as if she is being targeted by the Almighty.

The commercial ends with Cynthia and the dark-haired woman entering a gallery filled with entartete Kunst. Probably not a good place to go if you are teetering on the brink of madness. As the narrator again tells us about Fanapt’s clinical trials and its possible side effects, an Asian woman greets them, presumably the owner or manager. At the finale, the dark-haired woman turns to Cynthia and says, “The good thing to know, is we’re not alone.”

No, you’re certainly not. It would seem there are a whole lot more of you than I had realized.

You see, my first reaction to these commercials was to wonder just how many people there are in the US suffering from schizophrenia. Are there so many that it’s worth it to Vanda Pharmaceuticals (of whom I had never heard) to spend millions of dollars advertising this drug? Apparently so. In a recent year, Bristol-Myers Squibb and Otsuka together spent $107.9 million advertising Abilify, their schizophrenia and bipolar disorder drug. It accounted for 12.6% and 40% of Bristol-Myers Squibb’s and Otsuka’s sales, respectively. According to the sources I consulted, close to 1% of people in the US have been diagnosed with schizophrenia. That may seem small, but it’s actually more than three million people. With governments and insurance companies paying exorbitant prices for prescription drugs, the treatment of schizophrenia is actually big business. Who knew?

Certainly not me, though perhaps (as is often the case) I am just the last to know. So what’s the takeaway here? Just a couple of creepy and unintentionally amusing TV commercials?

Something about the whole thing seemed awfully sinister to me. Though perhaps I’m just being paranoid and need to take my Fanapt. I began to get curious about how candidates for Fanapt and other anti-psychotic drugs are screened. Surely there must be some kind of online symptom checklist or questionnaire. The Fanapt website doesn’t feature one, but a Google search for “schizophrenia test” directed me to mind-diagnostics.org ^[5].

This site offers a number of assessment tests for such maladies as depression, anxiety, PTSD, borderline personality disorder, and, indeed, schizophrenia. The site promises that once you’ve been assessed, “Mind Diagnostics” can hook you up with a therapist, ready to dispense medication and send the bill to your insurance company. I decided to take the schizophrenia test. It consisted of seventeen statements to which I was supposed to respond, “strongly agree,” “agree,” “neutral,” etc.

To statements such as “I hear conversations between people that others cannot hear” and “I can hear other people talking or whispering about me so quietly that others don’t notice” I was able to confidently answer “disagree.” Some of my other answers might, however, raise eyebrows. To “Sometimes I feel that others may intend to harm me or are planning to harm me,” I clicked “agree.” The reason is that I am a dissident, and if my real identity were known, plenty of Leftists would want to harm me. They’d at least try to get me fired from my job. They might even try to kill me. No paranoia here; just honest risk assessment.

In response to “Sometimes I believe that another person or thing can take charge of my mind or body,” I answered “agree.” Many times in my life I have looked back on things that I have done and been shocked. Who was that? At times I have been “possessed,” for lack of a better word, by moods or obsessions. Anyone who is hypoglycemic can attest to the fact that another “thing” can take charge of their mind and body. I also agreed with “I can tell what is going to happen before it happens,” because I am fairly good at prognosticating. For example, I can often tell when drivers in front of me are going to change lanes, even when they don’t signal. I’m not sure how I do this. Now, I realize that the writers of this quiz had other things in mind when they framed these statements and that they expected only really crazy people to agree with them. But this just means they should have worded the thing more carefully.

My results? I scored 28 points out of a possible 156. And now we come to the interesting part. How is this score interpreted? According to the site (and you can see this in the screenshot I’ve posted below), if you score 1-11 points you are in the clear. However, if you score 12 or more you are “at high risk for schizophrenia.” Yes, you read this correctly. There are only two categories: no risk, and risk. And scoring anywhere from 12 to 156 points means that you’re a candidate for the bughouse. I think we can safely conclude that this test is not a scientific instrument.

So what’s the purpose of it? Well, the payoff comes when you scroll down the page and get to my “Recommended Treatment.” “We recommend online counseling which can be very effective at treating Schizophrenia,” says “Mind Diagnostics.” Wait just a minute: schizophrenia is a serious mental illness that requires a careful screening process involving, at least to some extent, observation of behavior. This would seem to require that the patient actually be sitting in front of a psychiatrist. But, apparently, we’re beyond that now. “Online counseling allows you to receive care from a therapist via phone, video chat, or instant messaging.” Instant messaging? Seriously? “It can help address self-destructive behaviors, limiting beliefs, painful feelings, relationship issues, and more.” Actually, no, I don’t think online counseling can do any of that. What it is great for, however, is hooking people up with prescriptions.

This whole racket (which is exactly what it is) reminds me of the TRT (testosterone replacement therapy) racket I ran across a couple of years ago. Same deal: take this online quiz. Results: you are an excellent candidate for TRT! Click here to chat online with a doctor who can prescribe you TRT. Then you’re just set up with some pickup location in your area where you go to collect the ampoules and syringes. “Mind Diagnostics” offers a similar arrangement: “Tap here now to chat online with a Licensed Counselor who can treat Schizophrenia.”

What are the chances you don’t really need TRT? What are the chances you don’t really have schizophrenia? But surely pharmaceutical companies and, especially, M.D.s wouldn’t push schizophrenia drugs onto people who don’t need them. Right?

Right??

Years ago, I went to a party and met an advertising executive who told me how he had masterminded the “restless leg syndrome” campaign. Do you remember that? It was yet another dubious “disorder” for which a drug had actually been developed. The guy frankly admitted to me that his ad campaign was not primarily designed to appeal to people who had already heard of restless leg syndrome and were convinced they had it. Instead, it worked by the power of suggestion. The mild symptoms the ads described have actually been experienced by a majority of people at one time or another (mild twitching in the lower legs and an urge to move them). The ads were designed to plant the idea in those people’s minds that they have a “disorder” and need treatment. In other words, they were designed to create a market that didn’t exist prior to the advertising.

Could something similar be going on with Fanapt? It’s such a sinister prospect I am hesitant to write this — to share this suggestion with anyone, for fear my own sanity will be questioned. The dark-haired woman might show up and ask if I am “all right.” “Yes! I am all right ^[7],” I will cry, and she will suggest I ask my doctor about Fanapt.

It is interesting to contrast Fanapt’s commercials with ads from several years ago selling Abilify. As noted earlier, this is a popular anti-psychotic drug. However, it has been marketed primarily as a treatment for depression, and the ads are cheery and upbeat. Some feature cloying cartoons. No disembodied voices, dark greys, or strangers’ dirty looks. The reason for the difference seems obvious to me: Fanapt is an anti-psychotic for the age of COVID and cancel culture. Jared and the dark-haired woman’s auditory hallucinations are, admittedly, on the wilder side. But is Cynthia’s experience very much different from what the majority of Americans are now living, each day?

Leaving the house feels weird now. You can’t forget your mask. You can’t get too close to anyone. You’ll be walking down the sidewalk with no one near you and your mask around your neck. You can finally breathe. But then you notice some masked person walking in the opposite direction, on the other side of the street. Did they just glare at you? You’d better pull up that mask. Inside the grocery store, you sneeze and have to lift your mask to wipe. All eyes are upon you. Or are they? You want to shop and get out as quickly as you can.

A black coworker brings BLM buttons to your office. She leaves them in a pile by the coffee maker. Everybody goes and gets one. Except you. You can’t live with lies like that. Self-respect is too important. Did anyone notice? Not everyone actually put the buttons on, so maybe you’re in the clear. But what if tomorrow they’re all wearing them? Did the black coworker look at you a little funny just now? Have they finally put two and two together? Are they on to you?

Gosh. You seem a little paranoid. But remember, you’re not alone. There is help. . .

A recent article in Forbes magazine ^[8] is titled “Researchers Doubt that Some Mental Disorders are Disorders at All.” I can give you the short version: suppose that in some contexts depression, anxiety, and PTSD are normal, healthy responses to circumstances and not “illnesses.” Wow. What’ll they think of next? It’s amazing, isn’t it, how stupid so many smart people are? The very idea that these things have to be “illnesses” just because they feel bad is beyond dumb. But it’s a willful stupidity, and a profitable one. Tell everyone who is depressed or anxious that something is “wrong” with them and then sell them a drug.

The article is mildly interesting but ultimately shallow. It fails to make the obvious point that anxiety, depression, and, yes, paranoia, are actually healthy responses to a society that has become almost completely dysfunctional.

All the traditional sources that have given meaning to life are dead, gone. Diversity has destroyed social trust. No media or government sources can be trusted because they lie all the time. Those of different political persuasions really do seem to live in alternate realities. If the looters come, you can’t count on the police showing up to save you. If you’re white you’re guilty, just by being born. You will never be able to expunge your terrible guilt, no matter what you do. You must police everything you say and do (especially online) because one little slip, one ideological deviation, could destroy your life forever. But take heart because, in fact, no lives matter: we are all disposable commodities now. Even the medical industry no longer cares about what happens to us: we are simply customers whose maladies (real or imagined) make certain people very rich.

It’s a heartless, sick, empty world teetering on the brink of the abyss and the only way to deal with it is to at least try to understand it (which is what websites like this one are for). But that’s quite beyond the capacities of most people. Under the circumstances, madness actually seems like a healthy response to this world.  But that can never be admitted, because then fundamental questions would have to be asked. Much easier just to reach for the soma.

We are all crazy now.

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