Blue Dreams arrives in the thick of a debate about the pharmaceutical approach to mental health, and synthesizes forceful critiques from Gary Greenberg, Irving Kirsch and Robert Whitaker, among others. Slater is pithy, readable and generally fair, although I wish she had engaged more thoroughly with the defense of antidepressants ... The real strength of this book comes from Slater’s very particular position. She is patient and psychologist, part of the first wave of people who were prescribed Prozac in the 1980s. She describes how, in the years since, her mind has been saved and her body destroyed ... Blue Dreams, like all good histories of medicine, reveals healing to be art as much as science. Slater doesn’t demonize the imperfect remedies of the past or present — even as she describes their costs with blunt severity. And, improbably perhaps, she ends on a note of hope, calling these early efforts to address mental illness 'the first golden era.'
The story of Slater’s attempts to get and stay well weaves throughout Blue Dreams: The Science and the Story of the Drugs That Changed Our Minds and provides some of the book’s most poignant and lyrical writing. Just as important, her experience makes her a convincing travel guide into the history, creation and future of psychotropics. She is, understandably, not an uncritical cheerleader. But she resists the facile role of hard-charging prosecutor. And no wonder, really, given that the drugs have allowed her to have two children, write nine books, marry (and divorce) and hold dear friendships ... the journey begins to feel too wide-ranging and, occasionally, too thin on details about what we’re passing along the way. Still, several of the up-and-coming treatments — many of them not new at all — shift our focus from unmediated pill popping. Among them are placebos, which don’t work for all patients and have no effect on those with Alzheimer’s. But, as Slater rightly notes, numerous studies show their amazing potency, which remains too untapped by a psychiatry field still enthralled with drugs.
Various facts and stories in Blue Dreams feel familiar — the hit-and-miss development of antipsychotics, MAOIs, and SSRIs; the cynical machinations of drug companies and the routine compromises of psychiatrists — yet the result is a vivid and thought-provoking synthesis. Some of the book’s most striking insights come when Slater, rejecting mainstream psychiatry’s Whiggish claims about increasingly precise diagnoses and constant drug innovation, inverts them to reveal a different form of optimism: older treatments that have fallen out of fashion, often because they’re harder to patent or to make a profit from, still offer promising avenues for exploration ... If Slater has any discernible bias, it’s in favor of human connection, of relationship, despite the messy and unpleasant side effects — the dangerous power imbalances — that this, too, can bring.