Examining the Psychological Themes in the Movie Side Effects
The 2013 psychological thriller Side Effects directed by Steven Soderbergh explores complex mental health issues through the story of a woman named Emily Taylor. Her struggles with depression and anxiety after her husband's prison release lead to tragic consequences as she seeks treatment. Analyzing the movie from a psychological perspective provides insight into psychiatric disorders, the effects of medication, and moral themes surrounding mental healthcare.
Emily's Depression and Suicidal Thoughts
Early in the film, Emily clearly exhibits signs of major depressive disorder. She describes feeling numb, empty, and “floaty” – common symptoms of severe depression. Emily has lost interest in activities she used to enjoy and isolates herself from others. She also expresses suicidal thoughts to her psychiatrist, Dr. Banks.
Emily’s depression appears tied to situational circumstances – her husband Martin’s impending prison release after serving four years for insider trading. This reintroduction of stress and change into her stable life triggers depressive symptoms. However, she likely also has an underlying biological vulnerability to depression. Her father's suicide when she was young provides early childhood trauma that can increase lifelong depression risk.
Effects of Psychiatric Medications
A major theme of Side Effects centers around the powerful effects, side effects, interactions, and unintended consequences of psychiatric medications. Dr. Banks tries multiple antidepressants and anti-anxiety medications in treating Emily. Some provide benefits but also negative side effects like nausea and dissociative feelings.
When Dr. Banks prescribes Ablixa, it stabilizes Emily’s mood initially. However, she begins sleepwalking and experiences a traumatic episode where she drives her car while unconscious. This dangerous sleepwalking effect leads Dr. Banks to stop the Ablixa. Yet withdrawal from the drug triggers a return of suicide ideation in Emily.
The portrayal of medication trials in the film highlights the complexity of treating mental illness. Medication can be life-saving for some, but finding the right drug and dosage requires close monitoring by a doctor.
Emily's Manipulative, Criminal Behaviors
A major plot twist reveals that Emily actually has a borderline or antisocial personality disorder, not depression. Her manipulative behaviors include pretending to be mentally ill to avoid prison time and strategically lying to doctors about medication effects.
Emily shows a willingness to harm others, lack of empathy, and impulsivity when she stabs her previous partner to gain an alibi. Her charismatic charm masks underlying psychopathy and tendency for criminal behavior. This highlights how personality disorders can be difficult to detect and treat in a clinical setting.
Doctor-Patient Boundaries
The relationship between Dr. Banks and Emily demonstrates the ethical dilemmas doctors face regarding boundaries with patients. Dr. Banks meets with Emily after hours for therapy sessions at her apartment. He also initiates a sexual relationship with her, which is a major violation of ethical codes.
Doctors must maintain professional boundaries even with consent. The power dynamic makes it difficult for patients to reject a doctor’s advances. Dr. Banks' poor decisions stemmed from becoming personally invested in Emily’s well-being. His judgement became clouded, leading to the loss of his medical license.
Media Portrayals of Mental Illness
The film Side Effects provides interesting commentary on societal views towards mental illness in both positive and negative ways.
Illness Faking for Secondary Gain
Emily's falsification of depression symptoms to avoid criminal charges feeds into the misconception that many patients exaggerate or even fake mental illness. In reality, research shows that most people with psychiatric disorders are not malingering and deserve compassionate care.
While Emily represents an outlier case, her manipulation of doctors to avoid prison time unfortunately reinforces stigma. It perpetuates the harmful "faking it" stereotype among the public and even healthcare professionals themselves.
Medication Magic Bullets
The movie also conveys the myth that psychiatric medications are quick fixes or "magic bullets" that immediately resolve complex mental health disorders. Emily is essentially cured within days once she starts taking Ablixa. In truth, finding an effective medication for depression and anxiety can take weeks or months of trial and error.
Drug company advertisements also promote this myth of instant improvement to sell medications. More effective public education on how psychiatric meds work could help combat exaggerated expectations.
Positive Portrayals
However, the film also provides more compassionate, destigmatizing portrayals of mental illness. Emily's depression at the start of the film garners sympathy as a understandable reaction to difficult life circumstances. Her suicide attempt is depicted seriously rather than dramatized.
Additionally, the film highlights how medications affect individual patients differently. What works for one person may not work for the next. This underscores the complexity of psychiatry and discourages viewing medications as one-size-fits-all.
Key Psychological Diagnoses
Several psychiatric conditions and themes are represented in Side Effects. Examining the diagnostic criteria provides insight into the disorders affecting its characters.
Major Depressive Disorder
Major depression is characterized by loss of interest in normal activities, change in appetite, sleep disturbances, fatigue, cognitive impairments, and suicidal thoughts. Emily exhibits many of these symptoms initially when seeing Dr. Banks.
Generalized Anxiety Disorder
Generalized anxiety involves persistent, excessive worry about everyday issues. Physical anxiety symptoms include restlessness, fatigue, muscle tension, sleep problems, and concentration issues. Emily displays some anxiety along with her depression.
Post-Traumatic Stress Disorder
PTSD causes flashbacks, nightmares, and mental distress related to a past trauma. Emily seems to have some mild PTSD symptoms triggered by her husband Martin’s infidelity and insider trading scandal while they were married.
Borderline Personality Disorder
Borderline personality is marked by instability in mood, relationships, self-image, and impulsive risky behaviors. Emily ultimately meets criteria for this disorder based on her deception, lack of empathy, and willingness to harm others for personal gain.
Antisocial Personality Disorder
Antisocial personality involves a pattern of disregarding others, lying, aggressiveness, recklessness, and lack of remorse. Emily exhibits many of these traits in how she carefully manipulates those around her.
Key Ethical Issues Presented
Analyzing Side Effects also highlights important professional ethics issues for psychiatrists and mental health professionals.
Informed Consent
Doctors must obtain informed consent from patients before prescribing medications, clearly explaining risks and benefits. Dr. Banks should have provided more detailed information to Emily about potential Ablixa side effects like sleepwalking and vivid dreams.
Boundaries with Patients
Psychiatrists and therapists must avoid any sexual relationships with current or recent former patients. Boundary crossings, like meeting in non-office settings, should also be approached with great caution.
Do No Harm
The principle of “do no harm” obligates doctors to act in patients’ best interests regarding treatment recommendations and management decisions. Prescribing Emily a new, relatively untested drug like Ablixa could be seen as violating this core tenet.
Confidentiality
Patient confidentiality must be maintained except in cases where there is an imminent threat of harm to the patient or others. Dr. Banks breaches Emily’s confidentiality when reporting her crimes to the authorities.
Competence
Psychiatrists must remain within their scope of training and experience in treating patients. Dr. Banks’ errors call his competence into question regarding side effect management and monitoring.
Key Lessons for Mental Health Professionals
The film Side Effects offers several cautionary tales and learning experiences for psychiatrists, psychologists, therapists and other mental health professionals.
Avoid Overprescribing
Doctors should exercise restraint in prescribing new psychiatric medications, especially for off-label uses. A more gradual approach titrating dosages can help identify side effects before they become dangerous.
Monitor New Medications Closely
Frequent follow-up and contact is crucial when starting patients on new psychiatric drugs to assess response and side effects. This vigilance was lacking with Dr. Banks’ laissez-faire approach to Emily’s care.
Remember Patients' Capacity for Deception
While most patients are honest, some personality-disordered individuals are capable of remarkably deceptive manipulation. Maintaining professional objectivity is key to detecting malingering.
Avoid Dual Relationships
Boundary crossings seem harmless initially but often lead down a slippery slope to violations of ethics and harmful patient outcomes. Dual financial, social, or romantic relationships must be avoided.
Consider Co-Occurring Disorders
Patients frequently suffer from multiple psychiatric conditions, including personality disorders and substance abuse alongside anxiety and depression. Thorough assessment helps identify all issues needing treatment.
Separate Professional Worth from Outcomes
A psychiatrist's self-worth should not be overly tied to positive patient outcomes. Some people, like Emily, are determined to deceive and defy treatment – that is not the doctor's fault.
Conclusion
In summary, the film Side Effects raises thought-provoking questions surrounding psychiatric disorders, the complexity of medication management, ethical boundaries, and societal attitudes toward mental illness.
While some elements perpetuate stigma, the film also humanizes depression and demonstrates compassion. It serves as a valuable case study for mental health professionals on the unpredictability of treatment, importance of lifestyle context, and potential for patient deception.
Above all, Side Effects highlights how doctors must balance efficacy with safety when prescribing, carefully track medication effects, and provide empathy to patients who are suffering.
FAQs
What mental health issues are represented in the movie Side Effects?
The film explores depression, anxiety, suicidal thoughts, personality disorders, and the side effects of psychiatric medications.
How does the movie perpetuate stigma around mental illness?
The main character faking illness reinforces myths that people exaggerate symptoms for secondary gain. It also conveys medications as quick fixes.
What ethical issues related to psychiatry are raised in the film?
Issues like poor informed consent, boundary violations between doctor and patient, overprescribing medications, and confidentiality breaches are depicted.
What positive portrayals of mental illness does the movie provide?
The film humanizes depression, takes suicidal thoughts seriously, and highlights the trial-and-error process of finding effective medications.
What lessons can mental health professionals take away from the film?
Lessons include avoiding overprescribing, monitoring new medications vigilantly, maintaining boundaries with patients, and separating self-worth from patient outcomes.