Long before the Internet and direct-to-consumer advertising, the medical profession tried to reassure people about their health concerns. Remember “take two aspirins and call me in the morning?”

Flash forward to today’s online “symptom checkers.” They are quizzes to see if someone has a certain disease and exhortations to see their doctor even if they feel fine. Once drug makers discovered that health fears and even hypochondria sell drugs, there seems to be no end to the new diseases, symptoms and risks people need to worry about.

In fact, since drug ads began on TV, Americans take so many drugs it inspires satirical T-shirts like the one that says:

“I take aspirin for the headache caused by the Zyrtec I take for the hay fever I got from Relenza for the uneasy stomach from the Ritalin I take for the short attention span caused by the Scopoderm I take for the motion sickness I got from the Lomotil I take for the diarrhea caused by the Xenical for the uncontrolled weight gain from the Paxil I take for the anxiety from Zocor I take for my high cholesterol because exercise, a good diet and regular chiropractic care are just too much trouble.”

Here are some of the ways ads use fear to keep the public buying drugs.

1. Fear of aging and losing sex appeal. Hormone replacement therapy which millions of women took until 15 years ago was officially marketed to stop hot flashes and keep bones strong. But unofficially, it was marketed as a way of staying young and sexy as marketed by glamorous models and actresses. Early HRT ads told women they had “outlived their ovaries” and not kept up with their husbands who wanted younger looking women. More recently, “low-T” drug advertising tells men the same thing. According to drug marketers, people don’t have lower hormone levels because they age, they age because they have lower hormone levels.

2. Fear of everyday symptoms. Once upon a time, people with heartburn took Tums, Alka-Seltzer or Maalox and vowed not to eat so much. They did not worry they had gastroesophageal reflux disease (GERD), were on their way to cancer of the esophagus and take proton pump inhibitors like Nexium for the rest of their lives. Similarly, having the blues over problems with marriage, family, jobs or finances was not termed “depression.” Nor were energetic little boys immediately said to be suffering from ADHD.

3. Fear of new diseases. From the aggressive marketing of “shift-work sleep disorder” and “non-24-hour sleep-wake disorder” to exocrine pancreatic insufficiency (EPI) drug makers raise fears about obscure diseases that are so rare they would never be advertised unless “demand” was being created. Humira-maker AbbVie, in addition to raising “awareness” about EPI, warns people their back pain could be ankylosing spondylitis.

4. Fear that your child is not normal. ADHD is not the only way drug marketers have medicalized and monetized childhood. Temper tantrums are now called “disruptive mood dysregulation disorder.” Thanks to “pediatric psychopharmacology” children are increasingly diagnosed with oppositional defiant disorders, mixed manias, social phobias, bipolar disorders, conduct disorders, depression and “spectrum” disorders. Children are compliant patients who have no choice but to do what they parents, teachers and doctors tell them. Worse, they stay on the drugs for decades with no way of knowing if they need they them now — or ever needed them.

5. Fear that your drug isn’t working. Adding a second drug to a first one maximizes revenue. But is it ethical? If a first drug is not working why take it? Maybe you never needed it. In past years, campaigns told people to add Abilify or Seroquel to their antidepressant to make it work better. Industry-funded doctors simultaneously reclassified depression as a life-long and even progressive condition — though it was considered neither before expensive drugs to treat it emerged. Having a progressive condition that is not being treated increases the “fear” sell of course.

6. Fear of silent diseases. According to drug ads, just because you have no symptoms doesn’t mean you aren’t suffering from silent conditions. You might be “at risk “ of bone loss said ads for anti-osteoporosis drugs like Fosamax, Boniva and Prolia (once the money in hormone replacement ran out). No pill in the history of the world has been as successful as the statin Lipitor with its “Know Your Numbers” TV ad campaign. Yet dietary cholesterol as a strong risk factor in heart disease has recently been questioned. And the ads don’t mention diet and exercise.

Such fear tactics to sell drugs are everywhere and why it is said that the healthiest people are those who do not watch TV drug ads.

Martha Rosenberg is an investigative reporter whose work has appeared in the British Medical Journal (BMJ), Consumer Reports, Public Citizen, the Center for Health Journalism at USC Annenberg, the Nieman Foundation for Journalism at Harvard University, and other outlets. She studied at Rush Medical School and writes on health care, food, medicine, and public policy.

Rosenberg’s reporting has been cited by Memorial Sloan Kettering Cancer Center, Mayo Clinic Proceedings, Public Library of Science Biology, ScienceDirect, the Journal of Pain & Palliative Care Pharmacotherapy, the Journal of Trauma & Dissociation, Britannica, National Geographic, Hastings Law Journal, and Wikipedia. She is the author of several books, including Multidisciplinary Management of Chronic Pain: A Practical Guide for Clinicians, Born With a Junk Food Deficiency, Big Food, Big Pharma, Big Lies, and Food, Clothes, Men, Gas and Other Problems. She publishes on Substack, OpEdNews, and her Amazon author page.

Image credit: Shutterstock.com