How Big Pharma Turned Women’s Strength Into Sickness: A Deep Dive Into The Pathologization Of Female Emotion

Antidepressant use has nearly doubled among women in the United States since the turn of the century. In 2018, 18.6% of adult women were taking antidepressants, compared to 10% in 1999. But is this rise due to increasing depression, or is it the result of a carefully crafted campaign that sold the promise of a miracle pill? In reality, Big Pharma has made billions by turning women’s emotional reactions into a disease that needs treatment, insisting that antidepressants are the go-to, quick-fix solution.

Women’s Emotional Sensitivity: An Adaptive Trait

Women are biologically wired to be more sensitive to negative stimuli, a trait often referred to as neuroticism. This heightened emotionality has been extremely important in protecting women and their offspring. Since women are innately the primary caretakers, their natural ability to read nonverbal clues aids them in understanding the emotional needs of their families and newborns. Women's sensitivity also helps them recognize dangers and act swiftly to protect the lives of those they love.

Historically, this emotional sensitivity was an essential survival tool, especially in navigating complex social situations and protecting families. But in recent decades, the pharmaceutical industry has pathologized this natural response, turning a vital trait into something to medicate.

There’s a distinction between healthy and unhealthy neuroticism. Healthy neuroticism, the instinctive awareness of danger or environmental shifts manifested in a negative emotional reaction, helps women make decisions and care for those around them. It’s that gut feeling you get when something feels off or the ability to sense a loved one’s distress before they even speak.

On the other hand, unhealthy neuroticism is when negative emotions become overwhelming and difficult to manage. Rather than providing solutions, it might exacerbate issues and affect those closest to us. But even in these cases, medication isn’t necessarily the solution. Deeper issues like trauma or unmet emotional needs are often at play. Pain and struggle are part of the human condition, and emotional difficulties are a natural response to life’s adversity.

Negative emotions are indications; they tell us when something in our lives needs to change.

Unfortunately, modern psychiatry often treats neuroticism broadly with medication, failing to distinguish between healthy emotional reactions and unhealthy ones. Yet, negative emotions are indications: They tell us when something in our lives needs to change, whether it’s our behavior, attitude, or environment. Instead of medicating these feelings away, we should see them as signs guiding us toward action. This misunderstanding of women's emotions stems from a long history that originates from the archaic notion of hysteria and involves pathologizing women's emotional responses.

The History of Hysteria

Treating women’s emotions as a disease dates back thousands of years to Ancient Egypt, in 1900 BC, where it was believed that a wandering womb caused erratic behavior. This theory was later adopted by the Greeks, with Hippocrates coining the term “hysteria” and suggesting the uterus could move around a woman’s body, resulting in physical and emotional symptoms. Treatments included sexual intercourse and smelling concoctions to appease the wandering womb.

This belief persisted into the 17th century when women who weren’t in physically fulfilling marriages or hadn’t borne children were thought to be more prone to hysteria because their uterus hadn’t fulfilled its purpose. By the 19th century, women were still carrying smelling salts in their purses to treat their “symptoms” and soothe their agitated womb. Medical opinions shifted in the late 1800s when French neurologist Jean-Martin Charcot linked hysteria more to the nervous system than the uterus.

In the early 20th century, Freud took it further by defining hysteria as a psychological condition rooted in repressed emotions. By 1980, hysteria was removed from the Diagnostic and Statistical Manual of Mental Disorders Third Edition (DSM-III).

Though hysteria is no longer a diagnosis, the medicalization of women’s emotions persists today. Behaviors that were formerly classified under hysteria were rearranged to fit more contemporary diagnoses, of which many are treated with antidepressants, like selective serotonin reuptake inhibitors (SSRIs).

The History of Antidepressants

Before the release of the DSM-III, depression was seen as a psychosocial issue, typically treated with therapy. It was considered normal to experience bouts of depression in response to life’s challenges. However, the introduction of Major Depressive Disorder (MDD) in the DSM-III in 1980 shifted this view. Depression was now defined by specific symptoms, like sadness, loss of interest, and worthlessness, leading to a biomedical understanding of the condition. This redefinition downplayed the impact of life’s stressors and framed depression as a disorder of the brain, paving the way for antidepressants to become the primary treatment.

In 1988, Eli Lilly introduced Prozac, the first FDA-approved SSRI, as an effective treatment for clinical depression, deemed significantly successful in addressing the DSM-III’s newly defined symptoms of MDD. Prozac quickly gained popularity as it was marketed as a miracle drug with fewer side effects than earlier medications. Eli Lilly and other pharmaceutical companies worked closely with the American Psychiatric Association (APA) and other professional organizations to promote the use of SSRIs for depression. For example, the APA's 1994 Annual Meeting featured a symposium titled "The Use of Selective Serotonin Reuptake Inhibitors in Depression: Clinical Efficacy and Pharmacoeconomics" which was sponsored by Eli Lilly and featured speakers who were paid consultants for the company.

The monoamine hypothesis largely drove the rise of SSRIs in the 1980s. This hypothesis argues that depression occurs because there’s a deficiency in key brain neurotransmitters like serotonin and dopamine. This theory first came about in the 1950s when doctors saw something intriguing: patients receiving the medication reserpine for high blood pressure began exhibiting depressive symptoms. Reserpine had an effect on serotonin levels. Around the same time, another medication, imipramine, which was being tested as an antidepressant, was also found to increase levels of serotonin and norepinephrine in the brain. These early findings gave the pharmaceutical industry a reason to push the idea that depression was simply about chemical imbalances, even though the science behind it was still (and remains) far from complete.

Researchers and psychiatrists to this day admit to not knowing why or how these neurotransmitters affect depression. In fact, a large-scale systematic review published in 2022 found no evidence of serotonin deficiency causing depression and no correlation between serotonin insufficiency and depressed patients.

Selling Antidepressants to Women

SSRIs are part of a long history of miracle pill sales targeting women, each promising relief from emotional distress and the burdens of daily life. Every decade since the 1950s has introduced a new pharmaceutical solution aimed at easing women’s anxieties. Miltown, the first popular psychotropic drug in the U.S., led the charge in 1955. Initially marketed for both men and women, Miltown’s focus shifted to women when it was found to inhibit men’s productivity.

In 1958, Wallace Laboratories even commissioned Salvador Dali to create artwork symbolizing Miltown’s tranquilizing effects for the American Medical Association convention. His artwork portrays a transformation into a joyful, untroubled woman, embodying the calming impact of the drug. Medical journal advertisements reinforced this notion by showcasing women and presenting Miltown as a remedy for their anxiety.

Marketing emphasized how Miltown could make pregnancy more enjoyable, ease menopause, and relieve premenstrual tension. By 1960, three-quarters of American doctors were prescribing Miltown, and 500 million prescriptions had been issued by 1965. But as concerns over side effects and dependency grew, the search for the next wonder drug began.

Librium, introduced in 1960, followed by Valium in 1963, became the new favorites and were promoted as having fewer unwanted secondary effects. Valium became the go-to drug for doctors to prescribe to homemakers, so much so that this became a part of popular culture, inspiring the Rolling Stones song “Mother’s Little Helper.” By 1972, Valium was the most prescribed drug in the U.S., with 20% of women and 8% of men taking it. You cannot help but notice the similarity of these statistics to the percentage of women taking antidepressants today. 

As Benzodiazepines (Benzos) fell out of favor, SSRIs took over in the 1980s. Eli Lilly’s marketing strategy for Prozac reflected those of earlier decades, with sayings like “Sue’s playing with her kids again…just like normal,” targeting mothers like Wallace Laboratories’ Miltown in 1960. Antidepressant brands like Effexor XR and Zoloft also targeted women in their advertising, with phrases like “I got my mommy back” and images of happy mothers interacting with their children. This plethora of advertisements positioned SSRIs as the solution to women’s emotional struggles.

Notably, by the 1990s, direct-to-consumer advertising had been legalized, and antidepressants were advertised directly to women through TV, magazines, and other media. Ads like “I couldn’t even bring myself to do the dishes” and “Pot Roast Burnt? Husband Home With The Flu? You're Having One Of Those Prozac Days” played on women’s fears of failing as wives and mothers, convincing them that antidepressants were the answer. These campaigns effectively played into the anxieties of women about not meeting certain expectations, bolstering the rise of antidepressant use.

The use of tranquilizers and drugs to manage women's emotions has been normalized and encouraged by doctors and pharmaceutical companies, leading to the culture of pharmaceuticalization of women’s misery that persists today. Miltown was replaced by Valium, and Benzodiazepines have now been replaced by SSRIs, which has propelled the continuation of overmedicating women with new antidepressants, or should I say, the wonder drugs of the 21st century.

What You Should Know About Antidepressant Side Effects 

Antidepressants, particularly SSRIs, are often the first-line treatment for women with DSM-5-TR depressive symptoms (the latest DSM). But using SSRIs for an extended period of time might lead to unsettling side effects. Research shows that prolonged use of SSRIs can lower serotonin levels and profoundly alter brain chemistry. A study, investigating 222,121 people, has linked SSRI intake (for more than 10 years) to an increased risk of developing cerebrovascular and cardiovascular disease, as well as higher mortality rates.

Sexual dysfunction is another common side effect, as explored in depth by another Evie article, with some women reporting an inability to orgasm or a lack of interest in intimacy even after stopping the medication. These long-term consequences cast doubt on the effectiveness and safety of the widespread use of antidepressants.

Trust Your Body’s Signals

Women’s emotional sensitivity, anxiety, and feelings of depression are usually accurate responses to life’s challenges. When you feel a certain way, this is your body trying to tell you that something is important. Instead of numbing these feelings with medications that do not tackle the root cause, trust that your emotions are not a sickness, but a strength guiding you to act.

Like many women, I too fell for the “quick-fix” solution of antidepressants as a teenager. I’m grateful that I stopped taking them quickly enough to avoid long-term effects. If you’ve been prescribed antidepressants and feel misled, know that you aren’t alone. The goal of this article isn’t to undermine what women go through, but to empower women with knowledge that’s often left out of the conversation. Understanding how antidepressants have been sold and marketed to women is key to making informed decisions about your health. Because, at the end of the day, your health is the foundation of how you show up for yourself and your loved ones, and it deserves the utmost care.