“Somebody Get Me Some Prozac!”: Trivializing Language and the Stigma of Drug Brand Names

Abstract

This study looks at a selection of newspaper content from 1995 to 2024 that mentions the names of SSRI drugs in passing as jokes, metaphors, or cultural references. These passing mentions of SSRIs are analyzed via qualitative textual analysis, considering stigma and trivialization. The results of the study suggest that stereotypes about SSRIs have been cemented via popular discourse and media coverage and persist today despite nearly 40 years of prescriptions. Mentions of the SSRI drugs in passing suggest the illusion of a post-Prozac society where mental illness has been “fixed” and therefore can be trivialized with little consequence. This work expands upon existing theoretical concepts to propose a new theoretical model—a continuum of trivialization and stigma which may aid researchers in parsing the ways that colloquialization, trivialization and stigma interact and overlap in media texts.

1. Introduction

Although controversy around the selective serotonin reuptake inhibitor (SSRI) class of antidepressants never officially died, Robert F. Kennedy’s recent inaccurate assertions that the drugs are addictive and dangerous raise questions regarding their public reputation (Kekatos, 2025). Some argue that SSRIs have saved lives, while others argue that they are over-prescribed and ineffective. The SSRIs Prozac, Zoloft, Paxil, Luvox, Celexa and Lexapro carry a great deal of cultural baggage. This study looks at the origins of some of that baggage by analyzing newspaper content from the years 1995–2024. The content sampled for the study is not about Prozac and the SSRIS, but mentions SSRIs in passing as metaphors, jokes, and knowing cultural references. This study uses qualitative textual analysis to look closely at these passing mentions, focusing on the way trivialization and stigma interact in language use as an indication of the overall feelings regarding the place of SSRIs in US society. Based on the work of previous scholars concerned with stigma and trivialization, the analysis led to the creation of a new theoretical model: the Trivialization Continuum of Potential Harm. The Trivialization Continuum contributes not only to a greater understanding of the continuing controversy around the SSRIs, but may provide future researchers with a means to conceptualize the way in which casual language use can lead to what Spencer and Carel (2021) call wrongful depathologization—a phenomenon that occurs when a mental disorder is simultaneously stigmatized and trivialized.

2. Literature Review

2.1. Background on SSRIs and Mental Illness in Media

Ever since Prozac (fluoxetine) was introduced to the United States, the SSRI class of antidepressants has had a profound impact on the US’s antidepressant market, public consciousness, and popular culture. Prozac and the other SSRIs “caused a cultural shift in this country more seismic than anything in psychiatry that had proceeded it” (Slater, 2018, p. 200). Valium, a tranquilizer, is perhaps the only drug that comes close to having the same reputation in popular culture as Prozac (Healy, 1997; Stossel, 2014). Prozac, the first SSRI, was introduced to the United States in 1988. By 1993, sales of the drug were already at 1.2 billion dollars (Freudenheim, 1994). SSRI prescriptions for cases of depression nearly doubled from 38% in 1992 to 60% by 1996 (Stafford et al., 2001).

To gain a greater understanding of the way Prozac was discussed in news coverage, Kuppin (2006) analyzed newspaper content between the years 1993 and 2003. The findings suggested that representations of Prozac were overwhelmingly negative, and that journalists needed to refocus on people experiencing mental illness who were discouraged from seeking treatment due to stigma (Kuppin, 2006). Additionally, representations of Prozac were frequently found to be trivializing, stigmatizing, or both (Kuppin, 2006).

Critics have argued for years that SSRIs are not the miracle workers described in much of the early media coverage, and that previously released antidepressants (such as MAOIs and tricyclics) may be just as effective, if not more so (Healy, 2003; Whitaker, 2010). Additionally, in the early days of SSRI promotion and prescription, fears grew about overprescription and the idea that everyone seemed to be on Prozac; a 2004 Washington Post column comments, “Do others besides me have the nagging sense that way too many people are consuming way too many pills these days?” (Tuller, 2004, p. 1).

Yet these fears about overprescription were not new. From the 1950s through the 1980s, many people feared the country was facing an epidemic of tranquilizer use (Speaker, 1992). These fears are reflected in the popular periodicals of the time. Some doctors raised legitimate concerns about addiction (Speaker, 1992), but many other articles took a tongue-in-cheek tone, glibly poking fun at “frenetic Americans,” who “gobbled [tranquilizers] like peanuts” (Newsweek Staff, 1956, p. 68). The popular culture of the 1960s and 1970s also helped to develop stereotypes of tranquilizer users (Sharpe, 2012). The lyrics to the 1966 Rolling Stones song “Mother’s Little Helper,” describe a harried housewife, who is “not really ill,” but takes “little yellow [pills]” to help her deal with the inconveniences of her life, and growing older. Both media coverage and popular culture created an assumption that drugs like Valium were used primarily by people who were too weak to handle daily life—not for people with diagnosable mental illnesses (Speaker, 1992).

Although the 1990s was deemed “the decade of the brain,” the decade also saw a great deal of anxiety around the proper use of antidepressants, and the true nature of depression and mental illness (Sharpe, 2012). Arguments abounded about whether Prozac prescriptions were legitimate medical interventions or merely attempts at “numbing psychic pain rather than confronting its real causes” (Sharpe, 2012, p. 93). Sharpe (2012) writes that the United States has always been deeply ambivalent about antidepressants, being “simultaneously attracted and repelled,” and that the attitudes formed about these drugs during their first decade are still going strong (Sharpe, 2012, p. 86).

More recently, scholars have examined the way that mental illness and prescription medications are discussed on social media. Studies showed that SSRIs were the most talked about type of antidepressants on X and Reddit (An et al., 2025; Chart-Pascual et al., 2025), demonstrating their continued relevance not just in the United States, but worldwide. Trivialization and stigma are prominent on social media, (Robinson et al., 2019), as are negative attitudes toward antidepressants (An et al., 2025). While there is evidence that this might be starting to change (An et al., 2025), attitudes toward mental illness and antidepressants as measured by social media are generally ambivalent.

2.2. Stigma and Trivialization

Stigma is present when five interrelated components converge: distinguishing and labeling differences, associating differences with negative attributes, separating “us” from “them,” the loss of status, and discrimination (Link & Phelan, 2001). Stigma persists because it serves a purpose in society, and functions in three different ways: (1) exploitation/domination, or keeping people down, (2) the enforcement of social norms, or keeping people in, and (3) the avoidance of disease, or keeping people away (Phelan et al., 2008). Because stigma serves these specific purposes, there are strong underlying motivations in society to stigmatize (Phelan et al., 2008).

To define exploitation/domination, or keeping people down, Phelan et al. (2008) write that some groups have fewer resources so that more dominant groups can have more. The labor of non-dominant groups is often exploited, and ideologies develop to reinforce discrimination and perpetuate inequalities (Phelan et al., 2008). The researchers provide the example of racial discrimination in the United States; the belief that African Americans are inferior, less intelligent and dangerous made it possible for slavery to continue, and for a whole population to be “kept down” (Phelan et al., 2008).

Norm enforcement, or keeping people in, occurs when the dominant group defines what is socially unacceptable. Societies often attempt to “extract conformity” (Phelan et al., 2008, p. 362) from populations, and failure to comply with norms is often met with shaming. This type of stigma only applies to behaviors deemed to be voluntary because the expectation is that stigma and prejudice will somehow change these behaviors. Homosexuality, polygamy, extra-marital sex, criminal behavior, substance abuse, smoking, obesity and depression are all listed as examples of this form of stigma and prejudice (Phelan et al., 2008).

The avoidance of disease, or keeping people away, is rooted in the human evolutionary past, rather than social pressure in the present. Although modern humans may consciously know that they are unlikely to “catch” mental illness, physical disabilities, blindness, etc., they are programmed by evolution to avoid people that have markers identifying them as “diseased” (Phelan et al., 2008, p. 363). In this type of stigma, no one is attempting to control behavior, exploit or dominate “deviant” populations—instead, people avoid these populations (consciously or subconsciously) for fear of being “infected” (Phelan et al., 2008, p. 363).

Mental illness has long been stigmatized, and news media have been known to perpetuate this stigma by portraying people with mental illnesses as dangerous, violent, and to be avoided at all costs (Gwarjanski & Parrott, 2018; Stout et al., 2004). While it is true that people with mental illnesses are more likely to be victims of violent crime than the perpetrators, (NAMI, 2021), this association between crime and mental illness persists.

A related phenomenon to stigma is trivialization, especially as it pertains to mental illness. R. Pavelko and Myrick (2016) define trivialization as “the process of making a disease appear less complex, less severe, and deserving of mockery” (p. 42). Media representations have trivialized mental illness (R. Pavelko & Myrick, 2016), drug treatment for mental illness (Kuppin, 2006), and even stigma itself (Parrott & Eckhart, 2021).

Trivialization and stigmatization may be related concepts that are two sides of the same continuum (R. L. Pavelko & Myrick, 2020). Both are forms of “social bias,” that need to be further teased apart to understand their implications (R. L. Pavelko & Myrick, 2020, p. 583). OCD and ADHD are two disorders that have been frequently trivialized in media (R. L. Pavelko & Myrick, 2020; Spencer & Carel, 2021). Oversimplification, skepticism about its severity, and mockery are all ways a disease may be trivialized (R. Pavelko & Myrick, 2016). Even though trivialization is not the same thing as stigma, the outcomes for people with trivialized conditions may be just as detrimental (R. Pavelko & Myrick, 2016).

Spencer and Carel (2021) write that when a mental disorder is simultaneously stigmatized and trivialized, a phenomenon called wrongful depathologization occurs. In wrongful depathologization, symptoms are reduced to quirky personality traits, which denies people “a fully recognized psychiatric identity” (Spencer & Carel, 2021, p. 1). Wrongful depathologization creates a “twilight zone of mental disorder,” in which someone is deemed to be exaggerating their struggles, (trivialization), and also regarded as “epistemically suspect” due to their diagnosis (stigmatization) (Spencer & Carel, 2021, p. 1). The individual is stigmatized for belonging to a marginalized community, and their disorder itself is subject to trivialization, such as positive stereotyping (Spencer & Carel, 2021, p. 1).

Part of wrongful depathologization is willful hermeneutical ignorance, in which “hermeneutical resources developed by marginally situated knowers are willfully misunderstood by the dominantly situated knowers” (Spencer & Carel, 2021, p. 12). Diagnostic terms such as “OCD,” “bipolar,” “clinical depression,” and “ADHD” have been incorporated into everyday language, and so they are more likely to be used loosely and misinterpreted (p. 12). Linguistic resources that belong to psychiatric patients that help them understand their symptoms, such as the names of disorders, are repurposed by “dominant knowers,” and are thus “robbed of their hermeneutic power” (p. 12). Spencer and Carel (2021) go on to say that OCD in public discourse “has become a shorthand description of someone who dislikes mess” (p. 12). This use of the term has trivialized OCD as a psychiatric condition, and has led to the belief that it is benign, useful, or even positive.

Research shows that OCD and ADHD are far from the only disorders trivialized by media portrayals and coverage. Kuppin (2006) found that very little coverage of Prozac treated depression in a serious way. Instead, coverage often trivialized depression as something made-up, or at least self-indulgent: “Depression has shifted from something not talked about to something discussed (and joked about) so often that, although it receives attention, much of it is presented in such a way as to make it seem insignificant” (Kuppin, 2006, p. 124).

In this study, we explore the relationship between trivialization and stigma by looking closely at the way SSRIs are referenced in passing as metaphors and punchlines. Kuppin’s (2006) work demonstrated that references to Prozac are largely discussed with negative connotations by journalists, and that depression is often trivialized in the process. We build on Kuppin’s (2006) work by broadening the keyword search to the names of all the SSRIs, expanding the sample years, and looking at the connotations surrounding the discussions of SSRIs alongside relationships to stigma and trivialization.

• R1: Do the mentions of SSRIs in passing trivialize and/or stigmatize Prozac and other SSRIs?
• R2: How does this newspaper content construct a picture of the overall beliefs, assumptions or ideologies about SSRIs and antidepressant treatment in society?

3. Materials and Methods

Language helps to create social reality (Williams, 1977). According to Williams (1977), “no expression, that is to say, no account, description, depiction, portrait—is ‘natural’ or ‘straightforward’… [Language] is a socially shared and reciprocal activity” (p. 166). Textual analysis can be used to uncover dominant cultural ideologies embedded in language use (Brennen, 2025). Media artifacts, such as newspapers, can provide examples of the prevailing ideologies at a specific time and place (Brennen, 2025). Therefore, textually analyzing the language choices in newspaper content can provide a deeper understanding of the way ideologies around mental illness, health, and stigma function in society.

As Bødker (2015) writes, newspaper content cannot be understood in isolation from cultures of circulation. Newspaper content is one node in a larger network of media, and meanings are consistently shaped and reabsorbed by different media (Bødker, 2015). Similarly, the concept of a circuit of culture emphasizes the idea that meaning is created in multiple places and through multiple phases, including representation, identity, production, consumption and regulation (Du Gay et al., 1997). Therefore, the mentions of SSRIs in the content are both a reflection of cultural attitudes and meanings, and a reinforcement of cultural attitudes and meanings. As per Hall’s (1977/1993) perspective, Bødker (2015) writes, “…journalism—at every step of the process—is woven deeply into culture and time” (p. 108). The language represented by the mentions in the sample is impactful for its own sake, but also because of the connection to a wide circulation of both media and meanings.

In a similar vein, language used to describe mental illness and health has implications beyond that of a “semantic quibble” (McNally, 2011, p. 30). Language has the potential to further alienate or potentially destigmatize mental distress and mental illness; it also has real implications for policy making, securing resources, and accessing treatment (Goldman & Grob, 2006; McNally, 2011). With that in mind, in this critical–cultural analysis, we looked at what ideologies, assumptions and social beliefs may be implied in a newspaper content sample where Prozac and other SSRIs are referenced via metaphors, jokes, sarcastic comments, and passing remarks.

3.1. Sampling Strategy

We chose to limit our analysis to content from newspapers in order to observe continuity and change over a period of nearly 30 years (1995–2024). While much of the content from the 1990s and early 2000s originally appeared in print, and the later content appeared online, all content is derived from newspapers, and therefore a fair comparison can be conducted. We opted not to include social media content or online-only news media to keep our content consistent despite the massive changes in news consumption over the past 30 years. Additionally, while SSRIs have been internationally influential, we chose to focus on US newspapers to obtain a clearer picture of the way SSRIs are used as metaphors and jokes in US culture, and how this may contribute to trivialization and stigma.

The Nexis Uni database was used to search for newspaper content featuring the words “selective serotonin reuptake inhibitor,” the abbreviation SSRI, and the brand names of the six SSRIS: Prozac, Zoloft, Paxil, Luvox, Lexapro and Celexa. Over 100 local and national newspapers were searched. We chose 1995 as the start year for the sample and chose the end of 2024 as the cut-off point. Although Prozac was officially released in 1988, by 1996, SSRI prescriptions had nearly doubled, making 1995 a reasonable start date for the sample (Stafford et al., 2001). The initial search brought up over 10,000 results.

We used stratified sampling to portion out a manageable sample of content for this study. Stratified sampling separates a population into strata to obtain a greater degree of representativeness (Babbie, 2007). The newspaper content was organized into six five-year strata: 1995–1999, 2000–2004, 2005–2009, 2010–2014, 2015–2019, and 2020–2024. A random number generator was used to select 200 pieces of content as a sample from each strata, producing 1200 pieces in total. Within this larger sample, we examined each piece of content, using the “find all” function to identify the key word in each piece. Then, we determined if the content was primarily about SSRIs or just mentioned them in passing. For example, an article that discussed social concerns about children taking SSRIs was not included, but an op-ed that mentioned the need for “economic Prozac” was included (Trigaux, 2001, p. 1). The final sample contained columns (including editorials, opinion pieces and op-eds) (n = 70), reviews of movies, music, plays, etc., (n = 62), news stories (n = 57), event listings (n = 6), lifestyle pieces (n = 5), letters to the editor (n = 5), community forums (n = 4), and interviews (n = 2). These pieces of content, n = 211, were used for analysis.

3.2. Data Analysis

The units of analysis were the sentences in the content that mentioned the keywords. Most of these mentions were only one or two sentences long, although the overall context of the piece was considered when deciding whether the mention was stigmatizing or trivializing. For example, it was important to know that the line, “bring Prozac,” was mentioned in a review of a film, so that we could understand the way trivialization and stigma might be at work.

For the textual analysis, we divided the 211 articles in half and coded them according to the following schema: the topic of content; the type of content; positive, negative or neutral connotations around use of the term “SSRI” or the name of an SSRI brand (Prozac, Zoloft, Paxil, Celexa, Luvox or Lexapro); the presence of trivializing language around mental illness, suffering, or other related issues; and the presence of stigmatizing language or connotations.

For trivializing language, we relied on R. Pavelko and Myrick’s (2016) definition of trivialization, “the process of making a disease appear less complex, less severe, and deserving of mockery,” (p. 42), to guide our analysis. We ascertained whether the use of the term undermined the seriousness or complexity of mental illness, used mockery, made it seem like mental illness was in some way advantageous to patients, or made mental illness seem ridiculous.

When we considered if a keyword mentioned was stigmatizing or not, we used Phelan et al.’s (2008) framework describing the functions of stigma: (1) exploitation/domination, or keeping people down, (2) the enforcement of social norms, or keeping people in, and (3) the avoidance of disease, or keeping people away.

For (1), exploitation/domination, or keeping people down, we examined how a passing mention of an SSRI might constitute exploitation or domination. We considered how ideologies might have developed that reinforce discrimination and perpetuate inequalities for people experiencing mental illness, or a mental health crisis. Comments that further enhance the vulnerability of this group were considered to be “keeping people down.” While these comments do not extract labor or resources per se from the vulnerable populations, they do use the population as a means for extracting humor. In other words, comments that are determined to be “punching down” at those diagnosed with mental illness could be considered exploitative.

For the enforcement of social norms, or keeping people in, we considered whether the language of the content expressed a desire to return to some standard of normalcy, or communicated the violation of a social norm. Any language that expressed the idea that people should be able to handle things on their own without medication was coded as norm enforcement/keeping people in.

For the avoidance of disease, or keeping people away, we considered whether the language made a judgment about people that take SSRIs, and whether those people were undesirable or to be avoided. We also put language in this category that told someone they needed Prozac or an SSRI, or language that warned people away from using SSRIS.

As we coded the data separately according to the predesignated categories, we also used reflective thinking and “in-process writing” to record questions, asides and commentary as they arose naturally (Lindlof & Taylor, 2011). We met to discuss preliminary findings and observations. While we were specifically looking for mentions in the sample (n = 211) that could be considered trivializing or stigmatizing, we found numerous mentions that did not fit into either category and some mentions that occupied several categories at the same time. This disjuncture in the codes we established, and the contents of the data led us to consider how we could best make sense of our findings. Lindlof and Taylor write that “disjunctures don’t necessarily signal a methodological failure; rather, they can help us move to a deeper level of theorizing” (Lindlof & Taylor, 2011, p. 275). Knowing this, we discussed the various shades of meaning between “not trivializing or stigmatizing” and “trivializing and stigmatizing.” We resolved the lack of nuance by devising a continuum of trivialization to fully encompass our findings. The “Trivialization Continuum of Potential Harm,” includes “Colloquialization” on the least harmful end, followed by “Colloquialization Leading to Trivialization,” then “Trivialization,” and lastly, “Trivialization and Stigma” on the most harmful end (see Figure 1).

4. Results

After developing the continuum and defining the categories of Colloquialization, Colloquialization Leading to Trivialization, Trivialization, and Trivialization and Stigma, we found exemplar content within our coded data that best illustrated these concepts. We identified 15–18 exemplars within the sample, and used these to help us to further define the categories. The results of the full data analysis, including the additional analysis of the exemplar articles, are reported below.

4.1. Colloquialization

At the far left of the Trivialization Continuum is “Colloquialization.” Colloquializations are mentions that use Prozac or the name of one of the SSRIs in a casual way, often as a kind of verbal shortcut, or a stand-in for something else. Colloquialization is an oversimplification, a shortcut for the purpose of conversational effect. For example, several pieces of content used the name of one of the SSRIs to denote a specific era in time: “Based on Susanna Kayson’s pre-Prozac memoir, this affecting if familiar fare chronicles the author’s two-year stay at Claymoore…” (Kempley, 2000, p. 1). Colloquializations are used with the assumption that the audience reading it has some knowledge of the cultural importance of the SSRIs. In a report about the economic outlook for prescription drug companies, the authors write, “there has been no new Prozac or angioplasty to drive up spending” (Sanger-Katz & Parlapiano, 2023, p. 1). We determined a mention to be strictly colloquial if there was oversimplification but no direct mockery.

4.2. Colloquialization Leading to Trivialization

There were also mentions in the sample that started to veer into the territory of trivialization through undermining the seriousness of mental illness. For example, “I thought I was low enough when I was lumped into the “bucket of deplorables” but now I find I’ve sunk even lower. Wow, where’s my Prozac?” (Richmond Newspapers Inc., 2018, p. 2). While this mention does not mock mental illness or those who take SSRIs directly, it does suggest that it does not take much to send someone running for Prozac, and that Prozac may not be necessary for any kind of serious ailment.

4.3. Trivialization

The mentions that were deemed truly trivializing included a lack of seriousness and direct mockery. In a film review, the writer comments, “It also takes a while to adjust to Prozac-ed presentation of Springsteen songs…turned into up-tempo dance numbers…” (Thompson, 2019, p. 1). By turning Prozac into a process that sugarcoats songs, it suggests that Prozac itself is a trivial substance that shouldn’t be taken seriously and deserves mockery. Numerous reviews in the sample used similar statements to suggest that a film, album, play, etc., was only tolerable if an SSRI (usually Prozac or Zoloft) accompanied it. Again, this kind of mention is trivializing because it suggests that Prozac is not a drug necessary for any kind of serious issue, but rather something to be used as a crutch to get through minor setbacks.

4.4. Trivialization and Stigma

A mention was determined to be both trivializing and stigmatizing when there was a lack of seriousness and direct mockery combined with perpetuated ideas of us vs. them, status loss and discrimination. Once we determined that a mention was both stigmatizing and trivializing, we examined how stigma functioned by determining whether the language sought to keep people in, down, or away. As shown in Figure 1, wrongful depathologization (Spencer & Carel, 2021) comes into the picture when trivialization meets stigma.

Some of the mentions were both trivializing and stigmatizing and fit the category of “keeping people down,” or exploitation/domination. These were mentions that made jokes at the expense of people who experience mental illnesses like depression and anxiety. For example, “Prozac appreciation day: The first 5000 people crazy enough to attend receive a free psychiatric evaluation and a prescription refillable after every loss” (Kelly, 2007, p. 1). This mention associates the stigmatizing word “crazy,” with Prozac directly, inferring that “crazy people” are the butt of the joke. In this case, people who take Prozac are not only trivialized by the association with college football, but they are also stigmatized through exploitation—or humor at their expense.

Other mentions in the sample fit the category of “keeping people in,” or the enforcement of social norms. Some content suggested that some people need Prozac or an SSRI to get back to normal. Other content suggested that taking SSRIs is for serious problems, and that you should resist taking SSRIs because doing so might classify you as “crazy.” Still other pieces suggested that the only way to return to normalcy is to get rid of the drugs all together. The author of a column about parenting writes, “I assure you, though, this is normal, so relax and don’t grab the Prozac unless you’re going to share with the rest of us” (Fisher, 2010, p. 1). This mention enforces norms by saying “don’t grab the Prozac,” but it also trivializes by suggesting Prozac is a kind of recreational drug that would be fun to use in a group setting.

Most frequently, we found trivializing and stigmatizing mentions that sought to keep people away through disease avoidance. While this could be difficult to determine, it usually showed up in a statement about somebody needing to be medicated, somebody who had been turned into a “zombie” via medication, or statements about “those people” who take SSRIs. For example, a 2004 review of the film Little Black Book states, “Murphy works so hard to—oof!—act, you want to slip her a spare Prozac from the stash you brought to get you through the movie” (Hunter, 2004, p. 1). This mention is both trivializing and stigmatizing because it undermines the seriousness of mental illness (by suggesting an actress needs an antidepressant to act, and a viewer needs it to get through a film), uses direct mockery (in this case, of the actress Brittany Murphy,) and perpetuates ideas of “us” vs. “them” (people who need SSRIs vs. those who take them to survive a movie), and serves a purpose in society by keeping people away—namely those same individuals who need SSRIs.

Many of the mentions in the sample covered multiple categories of stigma. The example mentioned earlier, “Prozac appreciation day,” could also be categorized as keeping people away, since it expresses a clear negative sentiment about “crazy people” (Kelly, 2007, p. 1).

5. Discussion

In response to RQ1, we found that most of the mentions of SSRIs in passing trivialized, or trivialized and stigmatized mental illness, suffering, or the use of SSRIs. Indeed, we did not find a single mention in the sample that stigmatized without also trivializing, although we identified several mentions of SSRIs that trivialized, but did not rise to the level of stigma. This reaffirms the statement that trivialization and stigmatization are closely related concepts that are two sides of the same continuum (R. L. Pavelko & Myrick, 2020).

Importantly, we found that mentions of SSRIs in passing cannot always be categorized as trivialization or stigma. The defining feature of the mentions that we call “Colloquialization” is oversimplification without trivialization. They demonstrate little knowledge of the reality of taking an SSRI, or the way SSRIs work. Instead, these mentions assume an over-simplified reality that goes no further than equating Prozac with something that makes you feel better. Colloquializations fit the first part of R. Pavelko and Myrick’s (2016) definition of trivialization, “making a disease appear less complex” and “less severe.” However, they do not venture into the territory of “deserving mockery” (p. 42), and therefore they cannot be classified as true trivialization. Yet colloquialization can easily give way to trivialization. The continuum suggests that when people casually use the terms “Prozac,” “Zoloft,” etc., it is possible to do so without trivializing or stigmatizing, but the threat is always present.

For example, at first glance, the difference between saying, “I decided to make Prozac’s acquaintance and get on with it,” (Hanes, 2010, p. 1), and “it is my Prozac, my relaxer,” (Weston, 2018, p. 1), may appear very slight. Yet the first mention, while using the word casually by stating that the speaker “[made] Prozac’s acquaintance,” does not suggest that the drug is worthy of mockery, or suggest misunderstanding about the use of the drug. The second mention states that something is the speaker’s “relaxer,” thereby implying more casual use. Other similar statements, such as “And movies I go to whenever I have a minute. I use them like Prozac,” (Gates, 1995, p. 1), suggest that Prozac is something one can use whenever one feels like a pick-me-up. In this way, it links to the early stereotypes of housewives popping Valium. The difference is subtle, but it is enough to notice a progression from a lack of judgment to a more direct comment on the value of psychotropic drugs in society. “I decided to make Prozac’s acquaintance,” is an example of Colloquialization. “It’s my Prozac, my relaxer,” moves into the Colloquialization Leading to Trivialization category.

Mentions make their way from Colloquialization Leading to Trivialization to the Trivialization category when they not only undermine seriousness but move into full mockery. The title of a 2002 review of a Pearl Jam album, “Somebody get me some Prozac! Despite a start, Pearl Jam’s “Riot Act” is ultimately a downer” (Peterson, 2002, p. 1), undermines the seriousness of mental illness by assuming that a depressing album might be enough to necessitate psychotropic drug use. However, “so drop two Zoloft and hum along to the Muzak,” (Rowe, 1999, p. 1) is a thoroughly trivializing statement: it uses the term “drop,” (as if Zoloft is akin to LSD,) and suggests that Zoloft is such a heavy drug that it might cause someone to actually enjoy Muzak.

In fact, mentions in the sample frequently suggest that SSRIs can be used in ways similar not only to tranquilizers, but to recreational drugs. According to trivializing mentions in the sample, SSRIs can not only be “dropped” (Rowe, 1999, p. 1), but “mainlined” (Brantley, 2004, p. 1), “snorted” (Hanauer, 2024, p. 1), “popped” (Pakulski, 2010, p. 1), or “gulped” (Harris et al., 2021, p. 5). You can be “pumped up on” an SSRI (Wilkes-Barre Times Leader, 2002, p. 1), it can be “spoon-fed” to you (Trigaux, 2002, p. 1), you can “take it by the fistful” (Plotnikoff, 1998, p. 1), or you can install “Prozac licks” (Bay Area News Group, 2009, p. 1).

SSRIs are also discussed sometimes as part of “cocktails” you can take to feel better. They further the idea that SSRIs are substances you can take as a quick pick-me-up. In a column about turning 30, the writer states, “everyone expects I’ll be stuck in bed with a cocktail of Prozac and Chunky Monkey ice cream” (Friedman, 2006, p. 1). Similarly, writers talk about “washing down 100 mg of Zoloft with boxed wine” (University Wire, 2018, p. 2), and “dos[ing] myself afterward with a cocktail of Zoloft and Mucinex” (Green, 2018, p. 1).

According to Speaker (1992), this is not unlike the language around tranquilizers in the 1960s: “Gobbling tranquilizers like peanuts” is not a far cry from claims that “our generation gulps Prozac” (Harris et al., 2021, p. 5). In these mentions, the way the drug is taken is important. “Taking Prozac” is not a trivializing statement, but gulping, popping, dropping, etc., can be considered not only trivializing, but stigmatizing too.

Some of the mentions perpetuate the idea that SSRIs can transform people into frightening versions of themselves, i.e., “walking around like zombies pumped up on Prozac” (Wilkes-Barre Times Leader, 2002, p. 1). Calling someone a “Prozac Queen” (San Diego Union Tribune, 1997, p. 1), is an insult meant to categorize them as a kind of freak. Similarly, in an article about Mike Tyson, his speech is described as “alternately ranting, blistering, Zoloft-muddled” (Jenkins, 2002, p. 1). The phrase “wandering off into Prozac-induced forgetfulness” (Murphy, 2024, p. 2) also suggests that someone may be turned into a lesser version of themselves via SSRI consumption. In these mentions, SSRIs are both the cause of the monster status, and the description of the monster status itself, such as the description of “six young kids” being turned into “melancholic, Prozac-popping adults” (Pakulski, 2010, p. 1).

While these mentions imply that the SSRIs can turn you into a kind of monster, they also warn readers that you do not even want to be a “candidate” for an SSRI: “Investing should not be about turning you into a candidate for Prozac” (Rudd, 2000, p. 1). At the same time, not taking your SSRI also has the potential to turn you into a kind of monster. A 1999 column remarks that road rage “used to be all verbal, but it is now getting more physical, particularly among people who forgot to take their Prozac” (Buchwald, 1999, p. 1). In a news article about Trump’s 2020 impeachment trial, Sen. John Kennedy mentions, “I think everybody ought to pop a Zoloft, take their meds, and let’s wait and finish up” (Tribune-Review Publishing Company, 2020, p. 2). This mention suggests that Zoloft is a tool for quickly returning to normalcy or banishing a kind of insanity.

The association between SSRIs and monsters runs both ways: people who do not take their Prozac can be monstrous, but so can people who do take their Prozac. The link between them is that both types of people are supposed to be taking an SSRI, and this fact alone is enough to put them in the same category. It does not necessarily matter whether the person has forgotten to take their SSRI, or if they are “pumped up” on an SSRI; either way, they are associated with SSRIs and therefore are stigmatized by association.

These mentions could be categorized as all three types of stigma use in society: “keeping people down,” “keeping people in,” and “keeping people away.” The mentions work to keep people down by making jokes at the expense of people who take SSRIs and have not been turned into frightening monsters. By building up the idea that SSRIs violently transform people, it belittles the people who are helped by them, and it may also deter people from seeking help for fear of being turned into similar monsters. The mentions work to keep people in by suggesting the undesirability of being one of these monsters. In the same way, the categorization of SSRI takers as monsters keeps them away from more “normal” people. Furthermore, these mentions perpetuate the association between mental illness and crime that has long plagued the news media (Ma, 2017). News media frequently portrays people with mental illnesses as dangerous, violent, and to be avoided at all costs (Gwarjanski & Parrott, 2018; Stout et al., 2004).

RQ2 asked how the content constructs a picture of the overall beliefs, assumptions, and ideologies surrounding SSRIs and antidepressant treatment in American society. Our Trivialization Continuum of Potential Harm (see Figure 1) shows the spectrum of ways that casual language around SSRIs could potentially shape the way the drugs are seen in American society. Importantly, even though Prozac was only released in 1988, by 1995 newspaper content was rife with jokes, metaphors and knowing cultural references, revealing the impact that the drugs had on public discourse. The newspaper content also illustrates the way that media circulates ideas, both reflecting and creating meanings. Overall, the mentions in the sample point to oversimplification and a lack of seriousness around SSRIs and the disorders they treat. All the mentions in our 30-year sample at the very least colloquialize, but many of them also trivialize and stigmatize.

Colloquializations like “Hello, darkness, my old friend. Got Lexapro?” (Koslow, 2017, p. 2) are a form of oversimplification that suggest that SSRIs are a normal part of mainstream American life—they are banal in their popularity and reach. These kinds of mentions are on the low harm end of the Trivialization Continuum, because while they are not serious, they are not necessarily disrespectful either.

While this kind of overfamiliarity and banality persists through all levels of the Trivialization Continuum, the Colloquialization leading to Trivialization, Trivialization, and Trivialization and Stigma categories point to pervasive stereotypes about the kinds of people that take SSRIs. Frequently, a connection is often made between the types of people that take tranquilizers and the types of people who take Prozac. Most of these mentions have a tongue-in-cheek approach to discussing “those people” who rely on psychotropic drugs. For example, the female writer who says people expect she will be “stuck in bed with a cocktail of Prozac and Chunky Monkey ice cream,” (Friedman, 2006, p. 1) comments on the stereotype that women use psychotropic drugs as a crutch to deal with life. While the writer expresses her beliefs that turning 30 is not all that bad, use of the phrase “cocktail of Prozac and Chunky Monkey,” still works to reinforce the “mother’s little helper” stereotype that was first created in the 1960s.

Not only do the mentions that closely associate the SSRIs with Valium and other tranquilizers reinforce negative stereotypes, but they also create confusion around the way that SSRIs work. If one can “drop” (Rowe, 1999, p. 1), “mainline” (Brantley, 2004, p. 1), “snort” (Hanauer, 2024, p. 1), “pop” (Pakulski, 2010, p. 1), or “gulp” (Harris et al., 2021, p. 5) an SSRI, it implies that SSRIs work immediately and may even be addictive. Other mentions that directly compare SSRIs to tranquilizers include a column bemoaning the state of the Minnesota Vikings, “reading this far in this column entitles you to a tranquilizer gun filled with Prozac” (Souhan, 2023, p. 1), and a review of the movie Signs, stating, “M. Night Shyamalan directs as if he gives the camera Prozac every day” (Elliott, 2002, p. 1). Again, these imply that the results of Prozac are instant and tranquilizing. These mentions work to keep people in by norm enforcement, suggesting that SSRIs are for people looking for a quick fix.

The frequent mentions of people “popping” and “dropping” SSRIs is not only trivializing and stigmatizing, it also paints a picture of social decay. Similarly, people “walking around like zombies pumped up on Prozac” (Wilkes-Barre Times Leader, 2002, p. 1) reads like a kind or warning. In the introduction to a column about looking for hope, the writer sets up the status of society as being less than hopeful: “Gas prices jumping and airlines bumping. Blackouts looming and Prozac booming” (Dolbee, 2001, p. 1). In a community venting forum of the Atlanta Journal-Constitution, a participant suggests the state of the country is quite dire: “the best thing that could happen around here is if the county would start putting Prozac in our water supply” (The Atlanta Journal-Constitution (AJC), 2007, p. 1). These mentions are another indication of an attempt to both reinforce norms (keep people in) and a type of disease avoidance—a warning about what can happen if certain kinds of people and behaviors are not kept away.

While it is beyond the scope of this research to link the number of mentions in each decade to the degree of trivialization or stigma, the same kinds of jokes appear in the content from the mid-1990s and the content from the mid-2020s. For example, “so drop two Zoloft and hum along to the Muzak” (Rowe, 1999, p. 1) is from 1999, and “snorting Zoloft in the bathroom at intermission” (Hanauer, 2024, p. 1) is from 2024, but both mentions rely on the same joke about taking Zoloft the way people take recreational drugs.

The mentions in the sample suggest that Americans are intimately familiar with stereotypes, assumptions and jokes about the SSRIs. Intense media coverage, the rise in direct-to-consumer advertising for pharmaceuticals and booming sales created an over-familiarity with SSRIs which was reified through cultures of circulation (Bødker, 2015). The recirculation of these ideas through media including television, advertising and newspapers transformed antidepressant use from a shadowy, seldom-mentioned topic into dinner table conversation (Kuppin, 2006). Indeed, scholars suggest that taking an antidepressant before the age of Prozac was a far more stigmatizing experience (Shorter, 1997; Smardon, 2007), yet the media spotlight on and intense popularity of the SSRIs may have created a new kind of stigma bred by overfamiliarity and commercialization. In some ways, the popularity of SSRIs brought antidepressants out of the shadows, but onto a battlefield where drugs before them, like Valium, became casualties of mental illness stigma via trivialization.

Our continuum suggests that trivialization can not only lead to stigma, but can coexist with it. Indeed, trivialization can even mask stigma, by making it appear amusing or lighthearted. This aligns with Spencer and Carel’s (2021) concept of wrongful depathologization, where psychiatric symptoms are reduced to quirky characteristics, and people with mental illness are denied a recognizable psychiatric identity which can lead to treatment. Linguistic resources and terminology can help people understand their disorder, but when terminology is willfully misunderstood, it robs people of this psychiatric identity (Spencer & Carel, 2021). Spencer and Carel (2021) write about this phenomenon with OCD and ADHD, but our research shows that something similar has happened with the names of the SSRIs, which have come to imply numerous harmful stereotypes.

Overfamiliarity with tropes and stereotypes around the SSRIs leads to the illusion of a post-Prozac society. Similar to post-feminism, where it is believed that feminism is no longer needed, or the idea of a post-racial society, where racism is considered extinct, a post-Prozac society is one where it is assumed that mental illness has been officially “fixed,” or at the very least destigmatized by drugs. In a post-Prozac society, both SSRIs and the people who take them can be trivialized or made fun of because the consequences are low: if all you need to do is “pop a pill” to cure depression or anxiety, why would anyone need to take these issues seriously?

Yet while the illusion of a post-Prozac society runs rampant through the newspaper content sample, the reality of SSRI treatment is much messier and more complicated. People frequently try numerous antidepressants before they find one that works for them, and some people find that SSRIs do not work for them at all. But the stereotype that SSRIs are fast-acting, tranquilizing, and akin to recreational drugs persists. The attitudes formed about the SSRI drugs during their first decade are still going strong (Sharpe, 2012). Current knowledge and more recent controversies seem to have little effect on the cemented mythology around the SSRIs.

6. Conclusions

As means of communication multiply, the circulation of news widens (Park, 1940, p. 684). The means of communication have broadened considerably since 1995, the starting year for the sample. Language not only circulates in newspapers, advertisements and entertainment media, but in numerous digital contexts including social media and in recent years, generative AI. Scholars have mentioned that stigma and trivialization are not uncommon in social media posts (Robinson et al., 2019), and it is likely that as the means of communication multiply so too will the opportunities for colloquializing, trivializing, and stigmatizing. This makes it imperative that scholars continue to examine the way that casual language circulates through news media, and creates the illusion of a post-Prozac society.

This illusion can be harmful because it exists independently from either scientific knowledge or lived experience. Instead, a post-Prozac society is a conjured, non-existent world where mental illness is solved, or was never a big deal in the first place. More critical, careful use of the names of SSRIs and the disorders they treat would help to dismantle this illusion. Not all mentions of SSRIs have to be serious to be non-trivializing or non-stigmatizing, but all mentions of SSRIs should be conscious of the lived experiences of the people who take them. In the interest of creating a society free from wrongful depathologization, jokes about SSRIs should never “punch down” at vulnerable populations. Instead, if an SSRI or mental illness is mentioned in a lighthearted way, it should be in the interest of dismantling the prominent stereotypes and assumptions that have permeated media discourse for decades.

7. Limitations and Future Research

This research contributes to understanding of trivialization and stigmatization of mental illness by looking at the way the SSRI drugs are mentioned briefly and casually in newspapers. It contributes a theoretical model for understanding the way that colloquialization, trivialization and stigma function in language about drug treatment and mental health. However, our insights are not generalizable. Quantitative researchers may want to explore the frequency of trivializing mentions of SSRIs and the rates of SSRI prescriptions to see if there is any causal link between the two. Additionally, causal links could be explored between the co-occurrence of trivialization and stigmatization in newspaper content, or in other forms of media such as broadcast news or social media posts.

Further, the Trivialization Continuum could be applied to social media content about mental health and illness. This application could illustrate if and how digital media furthers the spread of trivializing and stigmatizing talk about drug treatment for mental health issues.

This research is also limited to US newspapers. Future researchers may want to examine the Trivialization Continuum as it pertains to newspaper content about SSRIs on an international basis. This kind of research may uncover whether this kind of colloquializing, trivializing, and stigmatizing is a US phenomenon, or an international one.

Lastly, the Trivialization Continuum could be applied to other stigmatized and trivialized diseases, and the way these diseases are represented in both print and online media.