Short abstract
Directed by Zach Braff On general release in the United States UK release date: 26 November www2.foxsearchlight.com/gardenstate
Rating: ★
It has been more than 40 years since Ken Kesey, in One Flew Over the Cuckoo's Nest, described electroconvulsive therapy (ECT) as a trip to “that filthy brain-murdering room that the black boys call the `Shock Shop,'” and almost 30 since Milos Forman's film adaptation of Kesey's novel swept the American Academy Awards. Yet despite decades of evidence that ECT is both safe and effective, its public image has never fully recovered.
And now, with the treatment of depression under renewed scrutiny, we have Garden State—an independent film from first time director Zach Braff that dramatises the dangers of prescribing antidepressant drugs to children. Perhaps profiting from the ongoing debate over this issue in the US government, the film had, at the time the BMJ went to press, accrued more than $21m (£11.6m; €17.1m) at the box office in limited release. Reviews have been uniformly positive, likening it to The Graduate in its quirkiness and generational tone.
The movie begins in a state of emotional paralysis. Andrew Largeman (played by the director, Zach Braff, who also wrote the script) has not been able to cry since he was a child—a condition, it turns out, that does not preclude a modestly successful career as a Hollywood actor. When he learns that his mother in New Jersey has just drowned, Andrew responds by clambering out of bed, staring dumbly at himself in the bathroom mirror, and opening the medicine cabinet. Inside we see hundreds of prescription drug bottles arranged in neat rows: sertraline, citalopram, Percoced (acetaminophen and oxycodone), hydrocodone...
Figure 1.
Zach Braff: is he doing for antidepressants what Ken Kesey did for ECT?
It turns out that Andrew's psychiatrist is also his dad—an unrepentant ogre played by Ian Holm who has been prescribing his son lithium since the boy was 10. The movie follows Andrew as he quits his medications and returns home to attend his mother's funeral. Meanwhile, he reconnects with old friends, falls in love with someone new, and confronts his overbearing father.
When a doctor and family friend advises Andrew to find a new psychiatrist, he seems disinclined to resume conventional treatment. Instead, a succession of contrived errands takes him out of town and scooting around New Jersey on a vintage motorcycle. Somewhere along the line, Andrew is motivated not only to cry, but also to scream.
“I'm not taking those fucking drugs anymore,” he finally tells his father when he gets back to the house. “I've felt so fucking numb to everything I've experienced in my life, and for that I'm here to forgive you.”
But his father holds fast: “You're going against your doctor's recommendation; that's a pretty weighty experiment to take on.”
“For the first time let's just allow ourselves to be whatever it is that we are,” Andrew concludes, “and that will be better.”
It's a message that's picked up on Zach Braff's Garden State blog (www2.foxsearchlight.com/gardenstate/blog/index.html), where countless adoring adolescents have posted their own struggles with antidepressants. But a recent entry from Braff addresses an issue he deems “VERY important. Garden State is not a movie that condemns taking medication for psychiatric reasons... [it] focuses on a character that was incorrectly prescribed some very serious medications at a young age.”
Even though Braff claims to “completely support medicine when it's needed,” responses on the website suggest that a different message has come across. “I don't need predictability like I thought I did when the medicine spoke for me,” writes a young fan. “All I need is to be me.” “I dutifully took [paroxetine],” writes another, “and somehow morphed into an android.”
Garden State has come along at a time of fierce debate on the use of antidepressants in children. Without clear scientific consensus on their safety and efficacy, stories like these may have the final word.