Why Are So Many Girls On SSRIs?

Sometimes "mental health awareness" feels like a marketing strategy.

By Freya India4 min read
Pexels/cottonbro studio

Throughout this past May, I was inundated with what felt like an endless stream of emails and ads and messages for Mental Health Awareness Month. TikTok started a new mental health hashtag to help me put my well-being first. Maybelline paid TikTok influencers to promote their make-up and pretend it was about “ending the stigma around anxiety.” Even the skincare brand Bioré pitched their pore-strip products as a means to “strip away the stigma of anxiety” (yes, including that influencer who used a school shooting as her sales strategy). But one campaign that stuck with me came from Minded, the women’s medication company, which created a hashtag to help “normalize psychiatric medicine” and “end the stigma” around drugs like SSRIs.

That last one stuck with me because, really, I struggle to see the stigma. Prescriptions for antidepressants, particularly for girls, have soared in recent years. In the U.S., antidepressant usage has surged by nearly 65% in the past 15 years, with women twice as likely to take them as men. In the UK, antidepressant prescriptions for children age five to 12 increased by more than 40% between 2015 and 2021. In the UK, one in three teenagers has been prescribed them.

And all over the internet, girls are so casual and blasé about these pills, even glamorizing and fetishizing them. We have antidepressant TikTok filters and SSRI phone cases. We have Prozac-shaped pillowsHot Girls Take Lexapro sweatshirts, and Stay Sexy, Take Sertraline artwork. Under hashtags like #mentalhealth on TikTok, which has nearly 88 billion views, girls describe SSRIs as silly little pills, call brain zaps from Zoloft withdrawal “the zappies” and put their medication in Disney-themed sweets dispensers. And these girls are absolutely convinced that they have a chemical imbalance in their brain, lamenting that they are “wired this way for life" and “won’t ever get better."

Where’s the stigma? If anything, the fact that all this persists despite ongoing debates about SSRIs’ effectiveness and safety is pretty remarkable. As far as I know, the chemical imbalance theory of mental health has never been proven. Drug trials show that antidepressants are barely any different from placebos when it comes to treating depression. And these pills come with serious risks: SSRIs like Lexapro and Zoloft carry a “black box” warning for an increase risk of suicide among adolescents. Other side effects range from constant nausea to seizures to complete sexual dysfunction. So why – when we can’t definitively conclude that they work or are even that safe – are so many girls on SSRIs? And why are we still convinced they are so stigmatized?

Conspiratorial as it sounds, this cultural emphasis on stigma is very convenient for the pharmaceutical industry. Stigma certainly exists in areas of psychiatry and undeniably did so in the past. But some of these campaigns today seem less about fighting stigma and more about pushing a specific narrative. They encourage us to see our emotions through a medical lens and to take pills for our problems. They expand the meaning of mental illness to encapsulate more and more of the human experience, calling it de-stigmatization and normalization while conveniently expanding their customer base. In other words, some of these mental health awareness campaigns feel more like marketing campaigns.

Take the American telehealth company Hers, for example. Hers is a direct-to-consumer brand that sells “self-care” products for women and girls like hair gummies, skincare creams, and psychiatric medication. Heal on your schedule, they promise, with medication shipped straight to your door! According to Hers, their site is apparently “so chill” that it’s like “shopping for leggings, not prescription meds.”

For Hersmental health awareness becomes a useful marketing strategy. “Mental health without the stigma and judgment – that's what Hers does,” they proclaim, with links to their products. They are just so passionate about normalizing all this stuff for us, kindly offering to “break down your barriers”, remove “the huge roadblock of stigma,” and “get you facing the tough stuff faster.”

But in normalizing these conversations, Hers also medicalizes some very common behaviors. There’s Paxil for social awkwardness. There’s Lexapro for generalized anxiety. There’s Zoloft for Premenstrual Dysphoric Disorder (which some medical professionals claim doesn’t actually exist, and was created by pharmaceutical companies). “Nervous about your big date?” asked one ad for Hers. Well, the cardiovascular medication propranolol “can help stop your shaky voice, sweating and racing heartbeat. No in-person doctor visits, just an online consultation and delivery can be right to the door!” In another ad, a woman vaguely describes her depression – waking up late, not eating enough, eating too much, “whatever it…manifests into” – before medication is described as her “little extra help.”

And Hers isn’t the only one. Other direct-to-door medication companies are all about raising awareness and combating stigma. DoneADHD wants drugs like Adderall to be “judgement-free.” Minded is starting a movement to “de-stigmatize mental health medication.” Cerebral (who is facing a lawsuit for over-prescribing ADHD meds) reminds us that it’s okay to medicate (“share or like this once to fight the stigma!”). Plus, each of these companies pays influencers on TikTok – most users of which are young girls – to distill all kinds of behaviors into diagnosable symptoms, from being distracted as a sign of ADHD to being forgetful as a symptom of an anxiety disorder.

To be clear: I think the mental health crisis is real. Which is to say, young girls are cutting themselves, starving themselves, and committing suicide at record rates. Pretty much every person I talk to about my writing tells me a tragic story about a teenage or pre-teen girl they know who is just falling apart. And there are, of course, times when these girls are suffering so much that serious intervention is necessary, and maybe that involves medication.

But I believe both. I believe that girls are genuinely suffering in the modern world and also that a major part of it is the marketization and medicalization of their normal distress. There are girls who are severely mentally ill. But there are also girls who have learned to see their behavior in ways that conveniently serve industries like the medical drug sector and better categorize them for online advertisers. And I think we are kidding ourselves if we pretend that condensing every emotion into something diagnosable and solvable with consumption isn’t doing profound psychological damage to Gen Z.

I don't believe compassion is expanding the pharmaceutical market to include any girl who experiences negative emotions.

We shouldn’t stigmatize those who are suffering. But we should think carefully about our compassion, where we direct it, and how it can be co-opted. Because I don’t believe for a second that compassion is making serious medication as accessible and convenient as possible to the point it resembles Deliveroo. I don't believe compassion is expanding the pharmaceutical market to include any girl who experiences negative emotions. And nor is it normalizing and normalizing and normalizing diagnoses and drugs until we start to stigmatize how it feels to be human.

The truth is that we are a generation of girls and young women with more drugs available to us than ever before. For every surge of anxiety, sadness, panic, period pain or social awkwardness, there’s Prozac, Paxil, Celexa, Effexor, Zoloft. Diagnosed in five minutes. Prescribed in 10. It’s futuristic. It’s revolutionary. It doesn’t really work. Because the easier they make it to sign prescriptions and swallow pills, and the more Mental Health Awareness months and weeks and campaigns flood our inboxes and app stores and algorithms, the worse we seem to feel.

So that’s my fear. My fear is that, of those millions of girls taking SSRIs and other serious medications, many aren’t doing so because of a very successful mental health awareness campaign, but a very successful marketing campaign. And that isn’t something we should ignore. In fact, that is something we really should be raising awareness about.

This article was originally published on Substack.

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