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The Science and the Story of the Drugs that Changed Our Minds
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Although one in five Americans now takes at least one psychotropic drug, the fact remains that nearly seventy years after doctors first began prescribing them, not even their creators understand exactly how or why these drugs work — or don’t work — on what ails our brains.
Lauren Slater’s revelatory account charts psychiatry’s journey from its earliest drugs, Thorazine and lithium, up through Prozac and other major antidepressants of the present. Blue Dreams also chronicles experimental treatments involving Ecstasy, magic mushrooms, the most cutting-edge memory drugs, placebos, and even neural implants. In her thorough analysis of each treatment, Slater asks three fundamental questions: how was the drug born, how does it work (or fail to work), and what does it reveal about the ailments it is meant to treat?
Fearlessly weaving her own intimate experiences into comprehensive and wide-ranging research, Slater narrates a personal history of psychiatry itself. In the process, her powerful and groundbreaking exploration casts modern psychiatry’s ubiquitous wonder drugs in a new light, revealing their ability to heal us or hurt us, and proving an indispensable resource not only for those with a psychotropic prescription but for anyone who hopes to understand the limits of what we know about the human brain and the possibilities for future treatments.
Everything in this book is true. However, there are certain instances in which I have changed the names and identifying features of people I interviewed, at their request and to protect their privacy. There are other instances, however, in which names have not been changed. I allowed each subject to make that decision according to his or her comfort.
All autobiographical material emerged from my memory of events that sometimes happened as many as forty years ago or more. I composed my memories as they occurred to me and checked their accuracy by relying on family members who were with me at the time, when this was possible. I have made every effort to be accurate while also acknowledging that memories are friable, delicate webs held together by neuronal connections and chemicals we do not yet fully understand.
I wrote this book because I have been taking psychotropic drugs for thirty-five years, with different drugs or drug combinations during different decades of my life. Some of these drugs have been miraculously effective for a time, while others have done nothing but leave me with side effects—increased sweating, a rapid heartbeat, a mouth so dry my teeth began to rot in their sockets. Of every doctor who has ever prescribed me a psychotropic drug I have asked the same questions: How does it work? And, more existentially, how do you know I need it?
What did I mean by that second question? I meant that while I had symptoms galore, I had no physical proof that anything was wrong with me at all. Several times during my adult years, for instance, I’ve wound up in the emergency room for a bad case of strep throat, and each time the physician has instructed me to open my mouth and stick out my tongue while he peered into me with a flashlight and swirled a cotton swab around in the redness, after which he smeared my cells on a slide that would be tested to confirm the diagnosis and I would be prescribed the trusty cure, an antibiotic. Similarly, I keenly remember the morning of September 26, 1998, waking at dawn and popping my ovulation thermometer into my mouth, beep beep, my temperature still high, a sign I might be pregnant. The night before, in the bathroom, I had lined up the kits, not one but three, all with their little wells and the plastic cup to collect my urine. I got out of bed carefully, so as not to wake my husband. The bathroom was dark, the sun just hitting the horizon and extending a single ray into the sky. I peed into the collection cup and then, using the dropper, deposited my urine into the wells and watched, transfixed, as the test wands turned color, going from white to blue to red. A single line emerged, and then—was it? did I see it?—a second line began to form, faint but definite. The tests were telling me the most important piece of news I’d received so far in my life: I was gravid, with child, on the edge of my motherhood, a knowledge that filled me with fear and ecstasy. Because I’m compulsive by nature, I took a test every day for a week, watching the second line, the yes line, grow bolder and bolder, a sign that my HCG, a hormone secreted in early pregnancy, was rising.
There are no such surefire tests for determining depression. The truth is that while we have dozens and dozens of psychiatric drugs, while by conservative estimates one out of every five Americans is on a psychiatric drug, we still have no actual blood or urine or tissue test with which to determine the particular psychiatric illness a person suffers from. The body or brain of someone suffering from severe depression may very well be deeply different from the body or brain of someone of what we call normal mood, but if physical substrates of mental suffering do exist, psychiatry has so far been unsuccessful in definitively finding them. Therefore, when you take a psychiatric drug, you do so on faith. It is a great leap of faith, in fact, to take a drug when the doctor cannot actually find anything wrong with your body. Yes, you may be sleeping more or less than usual. Yes, you may be eating more or less. But these symptoms do not give rise to any particular chemical malfunction in your urine, your blood, or your skin.
All I know for sure is that in my case, when I took my first psychiatric drug—imipramine for depression—at nineteen years of age, my body seemed to be healthy, even if my heart hurt. Now, thirty-five years and twelve drugs later, my kidneys are failing, I have diabetes, I am overweight, and my memory is perforated. As the years close in on me, my lifetime now seems seriously foreshortened, not because of a psychiatric illness but because of the drugs I have taken to treat it—with diabetes and kidney trouble being just a couple of the well-documented side effects associated with the powerful antidepressant and antipsychotic Zyprexa, a drug I’ve relied on like some do a walker, propping me up so I can sail through my days, going as fast as I can in the hope I will get everything done before I die. It would not be an overstatement to say that on the one hand, psychiatric drugs have healed me, while on the other, they have taken my life and my health and ruined me, drawing death near. Because of the diabetes, I get sores on my feet, festering sores that ulcerate and ooze. At fifty-four years old, my body is in the shape of an octogenarian with issues.
But I am not angry at psychiatry for limiting my life the way it has, even as my decaying body scares me to my roots. Although the first psychotropic I took did me no good, the second one felt as if it had hurled me to heaven, where I lived a gilded life, rich and buttery, producing books and babies as fast as I could, because I knew the Prozac would wear off, and eventually it did. The next drug, the antidepressant Effexor, also eventually stopped working, and thus I became a consumer of polypsychopharmacy, sustained on a potentially lethal cocktail of drugs. My particular mix includes the risky Zyprexa, another antipsychotic called Abilify, Effexor, the anti-anxiety medication Klonopin, the stimulant Vyvanse, and probably one or two other pills I’m forgetting because there are so many. Because of these drugs, I am able to think, to compose, and to move productively through my life, although I do struggle with aphasia. What’s a little memory loss, though, in exchange for a robust ability to cope?
My marriage of two decades recently dissolved, and yet I get up each day and find joy in being alive. That’s what I call a robust ability to cope. That’s what I call proof that these drugs work, maybe too well. Shouldn’t I be shedding tears? I do, of course, but what I don’t do is get sucked into the quicksand of despair. I feed my chickens. I ride my ponies. I make my gardens, which are right now blooming in the spring’s first warmth, the salvia growing out of the ground in purple spires, the lupine sending up its colored cones, the false indigo blooming its excess of blues.
Thanks to psychiatry’s drugs, I have a mind that can appreciate the beauty around me, but then, thanks to psychiatry’s drugs, I am dying faster than you are, my body crumbling as side effect after side effect sets in, messing up my metabolism, wreaking havoc with my glucose, polluting my urine. Thus in my world I live according to Descartes’s central principle: my mind on the right, here and healthy, my body on the left, here and weak. Indeed his essential point, that there is a division between body and mind, proves to be terribly true in my case.
I wrote this book in part so I could examine some of the drugs I take, and others I never have. I wrote it in part hoping I would find, in my research, that there really are physical substrates to mental suffering. If psychiatrists could find them, it stands to reason there is a chance that drugs could be systematically made to correct the problem at its source, whereas now our psychiatric drugs are made too often in the dark, as serendipitous mistakes, with researchers trying a little of this and a little of that. The end result is that all of our drugs are in some sense dirty, casting their effects over the entire ball of the brain so that nothing is spared and the imbiber is left with the dreaded side effects. At the very least, finding the physical substrates to mental suffering would mean that one could be sure of a bona fide disease with a clear etiology and course.
I wrote this book hoping I would encounter ample research on the long-term side effects of, say, the SSRIs, the selective serotonin reuptake inhibitors, which have been around for thirty years now, long enough for some good longitudinal studies to have been done. But I found very little. When it comes to examining these blockbuster pills over the long haul, I met instead with an eerie silence, and almost no science at all. When it comes to studying side effects, virtually all we have are the original studies that Eli Lilly did to get Prozac approved in the first place, along with similar short-term studies by others in the years since, despite the fact that many patients, like me, have been sustained on a serotonin booster for decades. Why are so few really looking at the long-term effects? What is it we’re afraid we’ll find? I have grappled with this question and have tried to proffer some answers in this book.
I confess that I came to this book with a bias. I came as both a patient and a practitioner (I have a doctorate in psychology), and thus was hardly a blank slate when I began my research. My own experience has colored what I chose to focus on and therefore what I’ve found. Luckily for me, however, my bias was not so severe as to blind me to some very sweet surprises. My assumption, when I started this book, was that drug discovery in psychiatry was dead, that through the ascension of Big Pharma it had been reduced to a series of “me too” concoctions geared toward profiting from variations on already approved medications, with nothing original in the pipeline. What I discovered, however, was a group of researchers remaking the field by reviving psychedelics and employing them in novel ways for those suffering from psychic pain. This is the far frontier of psychiatry right now, and I believe it promises rich rewards. A handful of practitioners are reaching back into the past and, in doing so, changing the future of a field that is desperate for innovation. While some psychedelics are old, even ancient, drugs, they are in every instance being used in ways that are refreshingly unique and that offer relief to significant subsets of patients, many of whom would otherwise be out of options. MDMA (Ecstasy) shows potential in the treatment of social anxiety in autistic patients and for those suffering from posttraumatic stress disorder; psilocybin (the active agent in so-called magic mushrooms) can ease the anxiety that attends an end-stage cancer diagnosis and thereby remake the way we die.
The drugs I chose to write about in this book picked me more than I picked them. I was at no point aiming for something comprehensive but rather something riveting. I followed a linear timeline to some extent, but there is also a thematic thread that runs through these pages: these drugs tell the story of psychiatry’s trajectory over the centuries, like lenses held up to the field of study. Through them we can see what there is to see, and observe a biology-based profession fall prey to psychoanalysis and then seize science again in a move that made the profession at once narrower and wider. Yes, biology is crucial to psychiatric medicine. After all, a single cell contains a whirling world. But the biology-based psychiatry of our day and age misses the need we all have to make myth out of the fabric and cuttings of our lives. Patients rarely go into talk therapy anymore, in large part because health insurers refuse to cover it. This has made the field smaller than it once was, when Freudians and other theorists ruled the roost. I am not arguing for psychiatry to be led once more by the psychoanalysts, but the questions remain: Where do patients go to be heard in a profession increasingly adopting the language and structure of science? Where do they go to sculpt, to create and revise the plot of their tangled lives?
I wrote this book because I love stories, especially ones that have not been fully told. While it was easy to get the details of how the earliest antipsychotics were discovered, for instance, I’d yet to read a really good account of the magic dye methylene blue and all it led to—the blue dreams it cast. As with each of my books, my goals were strictly narrative. I wanted to bring the seminal drugs of this century and the previous century forward as stories that could be told and retold, read and reread. The science is accurate, but in every instance I have endeavored to embed it in the time-honored tradition of telling tales, with a beginning, a middle, and an end, with heroes and losers and plenty in between, struggling to make their way.
In a very real sense, my body holds a lot of the stories I’ve told here. It holds the history of psychopharmacology, with all the drugs I’ve taken having left their grooves in my flesh and in my brain, wherever they have worked or failed to work. Thus I wrote this book, in some inchoate sense, to discover my own body—its beginning, middle, and end.
It is easy. I climb a crumbling low stone wall and push my hand through brambles to find an open window covered with torn strips of a metal screen, the trim rotten, the blistered white paint falling in jagged flakes as I part the remnants of the screen and, balancing carefully, thrust one leg through the old aperture. This very window was once barred, but now, lifetimes later, it yields with barely a nudge. It is as if this old building—heavy with history, loaded down with dreams and screams and maniacal memories—wants me to know all the horror it holds. As if it yields to me because I come as some sort of witness to days long gone, to a time when we treated the mentally ill in ways we might call mentally ill, plunging them into ice-cold baths, or nosing needles under their sunken skin to dose them with so much insulin that they hurtled into fathomless comas, lying on cots or in iron beds, their minds frozen until light finally made its way in and the patients reemerged. If insulin didn’t cure patients of their monsters and bi-headed beasts, we sometimes severed the fibers of their burning brains, leaving them docile as dolls.
Inside, this old asylum is mostly dark. Outside, it is a beautiful summer evening redolent of roses that grow along the low stone wall and pour across the upper fields overtaken with white-headed weeds and pink clover. Years and years ago, these same fields were closely mowed, as if by controlling the scalps of grass the staff could somehow also leash the brains of the madmen and women this institution contained. The grounds were quite lovely back then. The buzz-cut green and the exuberant roses and the stone walls lent a bucolic look that stood in stark contrast to the insides of the actual hospital building, where I stand in the late dusk of a June day, the sky outside the color of periwinkle. The outside smells of damp summer, the inside of mothballs and something stale but impossible to name.
By crawling through the window I have officially trespassed on state property, and yet I feel I must see these haunted halls. As my eyes adjust to the dimness of this dead place I can make out doors, dozens of them lining a corridor littered with medicine carts. The impression is of a place humming and hurried one moment and abandoned the next, as if an announcement came down from on high to jump ship and people left everything in mid-motion, the carts haphazardly strewn about, the prescriptions now faded and lying curled on the floor. I bend to right an overturned flask and then pick it up, holding it to the evening’s last light, against which is visible a faint golden glow from the liquid it once contained. I set the flask aside, then make my way forward through the murk and bump into a stack of books, toppling it to release a flutter of wings and the shrieking of birds—tiny birds with yellow vests who have built their nest amid the disintegrating tower of tomes.
Metal beds on wheels flank the long hallway, with its aged linoleum floor warped and bulging, broken in spots. The walls, painted a seasick green, are shedding, and there are closets stacked with rolled-up towels and rusty medicine cabinets. A while later, having ascended the stairs to the fifth-floor hall, I pass a canvas cot, and then, in a small room, a long bed over which are suspended the wires and suckers that were attached to shaved skulls for electroconvulsive treatment, current fed through the cranium that for some reason seemed to have some positive effect.
Crammed into a corner on the highest floor, the sixth, is a tiny square of space with a single caged bulb screwed into the buckling ceiling, the damp dirt floor beneath it clawed by who knows how many hands. This could well have been the “quiet room,” where patients were sent when their behaviors could no longer be controlled. Down below me, and beyond the fields that surround the structure, the city streets thrum. Through one of the dirt-speckled windows I can just make out a pair of women pushing strollers. A man walks by with a baguette tucked under his arm as vendors hawk their wares beneath bright umbrellas striped and swirled and dotted—a picture of perfection that serves only to deepen the gloom of this building soon to be razed, sent tumbling into a heap of broken brick by the crane’s wrecking ball.
Founded in 1833, this state hospital was once a bustling institution, forty miles west of Boston. In the 1920s, ’30s, and ’40s, this hospital, like a host of other mental hospitals (called then insane asylums) scattered around our country and abroad, was a place to send the crazed and “idiotic,” a place equipped with what today seem like terribly primitive tools to handle the screaming, sweaty bodies of men and women hounded by hallucinations in an era long before managed care and medication. A hundred years ago, even eighty years ago, very few people were confident that chemicals could mend the mind, which as recently as the nineteenth century was believed to dwell not in the brain but somewhere in a spirit or soul immune to chemical intervention. Those afflicted with serious mental illnesses—schizophrenia, bipolar disorder, severe depression, and autism—often lived out their lives between the walls of hospitals just like this one, undergoing questionable cures that, while never intended to harm, rarely worked.
In 1991, more than 150 years after it first opened, this hospital at last closed its doors, meeting the same fate that had already befallen many other such mental hospitals in the decades following the deinstitutionalization movement that gathered momentum in the 1960s, when President Kennedy, whose sister Rosemary had been the victim of an early and failed prefrontal lobotomy, provided funding for community mental health centers, a move that was further encouraged by the passage of President Johnson’s Medicaid and Medicare bills. In 1955, at their peak, American mental hospitals held 560,000 patients nationwide, double the number at the turn of the twentieth century. By 1988, three decades later, that figure had fallen to 120,000.
One of the phenomena that truly made this sea change viable—allowing patients to be treated in the least restrictive setting possible, whether that was in a community health center or at home with their families—was the discovery, in the early 1950s, of a blockbuster drug called chlorpromazine. When branded and marketed as Thorazine in this country and Largactil in Europe, this new drug stabilized untold thousands of schizophrenic, psychotic, and otherwise mentally ill patients and eventually brought about a sustained exodus from mental hospitals in the United States and abroad.
Great and Desperate Cures
One way of grasping the meaning of Thorazine is to know the types of treatments that preceded it, treatments which the former University of Michigan psychologist Elliot Valenstein has called “great and desperate cures.” There was, for instance, insulin coma therapy, first used by Austrian psychiatrist Manfred Sakel in 1927, in an attempt to treat opiate addicts in withdrawal with small doses of insulin. Some of these patients, however, slipped into hypoglycemic comas, and when they awoke, following an emergency administration of glucose, their personalities seemed altered. Addicts who had been defensive, angry, difficult were now “tranquil and more responsive.” This led Sakel to wonder whether deliberately inducing comas in schizophrenic patients might produce a similar recovery. He set about trying this and claimed miraculous results after inducing comas, sometimes as many as sixty times in a two-month period, in his schizophrenic patients. Perhaps unsurprisingly, patients emerging from these comas did appear more docile, but the treatment carried severe risk—including death and irreversible coma.
Convulsive therapies were also popular during the first half of the last century. Before electroconvulsive treatment (ECT) was developed, convulsions were brought on by injecting patients with drugs. Ladislas Meduna, a psychiatrist working in Budapest, noted that epileptics who also had schizophrenia appeared to have fewer seizures and that, conversely, schizophrenics who suffered from epilepsy would often have spontaneous remissions of their psychoses after a seizure. Meduna chose first camphor and then metrazol, a white crystalline drug employed as a respiratory or circulatory stimulant, to induce seizures in schizophrenic patients. Afterward, his first test subjects rose from their beds and asked, in perfectly lucid ways, when they could go home. “I felt elated and I knew I had discovered a new treatment,” Meduna said. “I felt happy beyond words.”
What was the operating theory behind metrazol therapy? Some claimed that it gave the mentally ill a near-death experience that set them straight once the seizures were over. Instead of scaring schizophrenics to death, the thinking went, it scared them back to life. Patients coming out of metrazol shock often called for their mothers, or begged the nurses to hold them, childlike behavior which their physicians considered proof that the seizure had altered their personalities for the better. No longer raucous or caught up in the clutch of hallucinations, metrazol patients were frequently friendly and cooperative, and this led doctors to believe that with enough treatments, the positive behavior would become habitual.
Metrazol therapy, however, had a host of thorny problems. When asylum physicians beyond Meduna tried it on their patients, the seizures the drug caused were horrific. The treatments filled their patients with dread, and they begged to be spared the injections, which caused their whole bodies to writhe and spasm in convulsions of such ferocity that they frequently suffered fractures: dislocated shoulders, broken femurs, clavicles, scapulae. One patient compared it to being “roasted alive in a white-hot furnace.” And yet it was not uncommon for patients to have as many as forty metrazol injections.
Other treatments, some of which caused patients degrees of discomfort we can only imagine, since seemingly they left behind no record of their experiences, involved the injection of animal blood and castor oil and massive doses of caffeine. For quite some time, sleep therapy became a popular intervention in the treatment of schizophrenia—a kinder although no less dangerous undertaking. Patients were fed a cocktail of tranquilizing tonics and drugs meant to send them into slumbers that, in some cases, lasted as long as two or three weeks. The rationale: in states of deep rest the nervous system might find its precarious balance again. It’s true that some schizophrenics were actually helped by sleep therapy, but there were a number of fatalities as well. Patients’ lungs filled with fluid, pneumonias developed, or vomit was aspirated—all in a time before penicillin.
In 1938, Italian psychiatrist Lucio Bini discovered that he could cause convulsions in mental patients using electricity instead of drugs. Bini tried his new therapy on catatonic patients, some of whom were helped by this charge to their systems, as they emerged from their catatonia and began conversing with those around them. Others, however, as they lay on the table, seized to no effect at all, the voltage so high they flopped like fish, again and again, as the body was charged and changed, in a mode of treatment that seems barbaric to the modern mentality. (Electroconvulsive therapy, which actually can be extremely effective in severe depression that has failed to respond to antidepressant medications, is still used today, the theory being that the electrical current “resets” the brain. But the voltage is much lower, the treatment is typically used on only one hemisphere, and patients are given muscle relaxants so they do not have violent seizures.) Other hospital-based therapies of the time included ice wraps, freezing baths, or just plain old restraints, with the patient simply tied to a chair while his dreams and demons wafted.
Were the lengths to which these psychiatrists went to calm the mad mind heroic, or simply cruel? Canadian doctor Heinz Lehmann, for instance, noting that the psyches of his schizophrenic patients seemed much clearer when they were felled by high fevers, sought out ways of inducing in his patients the most extreme temperatures he could, going so far as to inject turpentine into the abdominal wall of one female patient in the hope that the infected abscess formed in the wake of such a procedure would cause a fever high enough to quell her hallucinations. Some have criticized Lehmann for what they consider cruelty, but it’s more likely that this doctor, who would later become one of the first North American prescribers of Thorazine, had the best of intentions, so driven was he to find ways of suppressing psychosis.
- "In her informative and detailed new book, Blue Dreams, Lauren Slater traces the meandering, mercurial history of psychiatric drug discovery...She is at her most prescient when discussing Prozac, from its initial promise to its saturation of American culture...Slater also helps to further debunk the 'chemical imbalance' myth of mental illness, citing 'the paucity of evidence' supporting the role of neurotransmitters in depression...The most moving and ultimately most compelling parts of Blue Dreams are those where Slater recounts her harrowing history of drug treatment for bipolar illness. Here she illuminates the long-term physical effects of these medications, a subject rarely addressed in the psychiatrist's office...Slater wisely points out that anyone who ingests a pill for the treatment of, say, depression or anxiety or psychosis is essentially introducing a foreign substance into the brain. And yet, she goes on to say, what would you have people with a serious mental illness do? There are surely untold numbers of those who, without the benefit of a drug for their mental illness, would be dead. Slater considers herself one of them. In details both lyrical and crushingly painful, Slater describes her lifelong struggle with what Winston Churchill called the 'black dog' of depression. There is the nightmarish daydream of a sun that burns day and night, that never sets, leaving her 'trapped in a white hysterical light.'...Blue Dreams is a raw and honest memoir, and frankly one of the few that show the truly dark side of medication--even as that medication saves lives."—Amy Ellis Nutt, Washington Post
- "Striking . . . Slater, a writer and psychologist, takes a skeptical yet compassionate approach to the history of psychopharmacology, one shaped by her own experience as a patient . . . Blue Dreams is a vivid and thought-provoking synthesis."—Lidija Haas, Harper's
- "Poignant and lyrical...Slater's experience makes her a convincing travel guide into the history, creation and future of psychotropics."—Maggie Jones, New York Times Book Review
- "In this gonzo examination of the messy history and brave future of psychotropic drugs, writer and psychologist Slater sifts through the remedies one in five Americans relies on but knows little about--even breaking into an abandoned asylum in her quest."—Natalie Beach, O Magazine
- "Ambitious...Slater understands neuroscience in far greater detail than the average patient. This allows her to bounce between first-person narrative and historical survey... Her depictions of madness are terrifying and fascinating--she vividly details her own mental breakdown with bracing candor--and she brings something new to a well-worn genre...Blue Dreams provides a useful entry point for patients with mental illness and their families, and fills in many of the gaps that doctors fail to address in the course of a routine consultation--and does so with uncommon honesty."—Matt McCarthy, USA Today
- "Slater has taken many psychiatric drugs over thirty-five years, and in this engagingly personal book, she explores the success and the side effects they engender."—Tom Beer, Newsday
- "Slater suggests that it's tempting--but wrong--to think of modern medicine as a system of elegant cures that have replaced the crude treatments of the past. In psychiatry, she says, the latest techniques aren't necessarily better than the older ones."—JM Olejarz, Harvard Business Review
- "With the experience of a patient, the heart of a storyteller, and the lens of a scientist, Lauren Slater chronicles the evolving, perplexing relationship between the physical and the mental."—David Eagleman , New York Times bestselling author of Incognito: The Secret Lives of theBrain and host of PBS's The Brain
- "A profound and essential look at a phenomenon of our times. Meticulously researched, Blue Dreams is also a deeply moving personal investigation into the drugs so many of us rely upon for our survival. Lauren Slater is much more than a trusted guide: she's a brave and eloquent companion who doesn't shy away from controversy. You'll be talking and thinking about Blue Dreams long after you've read it."—Terri Cheney, New York Times bestselling author of Manic
- "Thought-provoking...Enlightening...In this ambitious undertaking, Slater applies vigorous research and intimate reflection to the issues involved with treating mental suffering...Ultimately, the author finds great hope...A highly compelling assessment of the role of psychotropic drugs in the treatment of mental-health issues."—Kirkus Reviews
- "Weaving together the history of psychopharmacology and her personal experience as a patient, Slater offers readers a candid and compelling glimpse at life on psychiatric drugs and the science behind them . . . Intriguing and instructive."—Tony Miksanek, Booklist
- "Slater offers many insights here, and her moving personal story truly illuminates the triumphs and shortcomings of psychotropic drugs."—Publishers Weekly
- "Mixing memoir, history, and medical reporting, she brings a deep appreciation of all the hope that has gone into these drugs, both among those who make them and those who take them."—Ben Kafka, Bookforum
Praise for Lauren Slater"An enormously poetic and ebullient writer." —Elle
- "Slater is more poet than narrator, more philosopher than psychologist, more artist than doctor . . . Every page brims with beautifully rendered images of thoughts, feelings, emotional states."—SanFrancisco Chronicle
- "Brutally honest and brave . . . Slater reminds us that a writer's true gift--and power--lies in the ability to generously turn what seems like a specific experience into a universal one."—EntertainmentWeekly
- "The closest thing we have to a doyenne of psychiatric disorder."—Village Voice
"The beauty of Lauren Slater's prose is shocking . . . Slater's vision is, ultimately, one of unity and possibility."—ClaireMessud, Newsday
- "Smart, charming, iconoclastic, and inquisitive."—Peter Kramer, author of Listening to Prozac
- "Engaging, provocative, and even fun."—NewEngland Journal of Medicine
- On Sale
- Feb 5, 2019
- Page Count
- 416 pages
- Back Bay Books