The Challenges (and Opportunities) That Come With Mental Health Diagnoses | Sarah Fay

Sarah Fay (0:00)

I live for 25 years. I mean, my mental state deteriorated for 25 years, and I have to be very respectful of that. It doesn't mean I have bipolar lurking in me, waiting to come out. It doesn't mean I have major depressive disorder. It means I've been through hell.

And it means that I have to take care of myself.

Michael Gervais (0:28)

Okay, welcome back, or welcome to the Finding Mastery podcast. I am your host, Dr. Michael Gervais, by trade in training a high-performance psychologist. And I'm excited to have a conversation with Sarah Fay. So Sarah is an award-winning author and mental health advocate, working to improve how we think and talk about our mental health.

She's currently on the faculty of the English departments at Northwestern University and DePaul University, and is the founder of Pathological, the movement. So that focus is on empowering people to make informed decisions about their mental health.

Now, her experience of being diagnosed with six different mental health disorders and finding no relief led her to write the best-selling journalistic memoir, Pathological, the true story of six misdiagnoses. Sarah, thank you so much for coming on and talking about a really challenging topic. So what I thought we'd do is we'd start with some context about why you decided to write your book. Can I read you a quote from the book?

Sarah Fay (1:32)

Yeah, please.

Michael Gervais (1:33)

Okay, so here's one that just grabbed us.

I wrote it to try to save people from going through what I went through. Pathological is dedicated to everyone who's been diagnosed and misdiagnosed and overdiagnosed. It's everything I wish I'd known about the mental health system.

Sarah Fay (1:51)

All right.

Michael Gervais (1:52)

So how do you respond to that?

Sarah Fay (1:56)

Well, I mentioned that I love that you chose this quotation. It's really the core of the book. It's really my motivation for writing it. And it's so important because when we start to criticize psychiatry or we start to criticize diagnoses or even put them under a microscope, people assume, oh, anti-psychiatry. And I'm not at all. And I wanted to be sure that quote really says it. I see a psychiatrist still.

He's wonderful. And he's very transparent with me about all these things. He's in the book, Dr. R. He's fine with being in the book, as far as I know. He hasn't objected. So I'm not at all anti-psychiatry. And what I wanted to do instead was bring to people, as I said, or as in the quote, everything I wish I'd known. And what's interesting is one Goodreads reviewer said my book is dangerous.

And I thought that was so fascinating. I shouldn't read those types of reviews, but I actually, at first it really disturbed me because I want to be a good person and I don't want to produce anything that's dangerous. But then I thought, why is it more dangerous to educate people before sending them or their children into the mental health system?

Like, how could that possibly be dangerous as opposed to sending them in unknowingly, not being able to really be empowered to make the decisions about their mental health that they need to make? And I think part of it is, and I know that this was where the reviewer was coming from is all this risks that maybe people won't ask for help. And I understand that, but just because we're criticizing, you know, the state of our, you know, sort of mental health system doesn't mean there aren't positives or that people can't use it. Like nowhere do I say it's unusable or be careful, never go into it.

Technically, I'm still in it, so yeah.

Michael Gervais (3:54)

Well, I like the fact that somebody picked up on that it is dangerous. And this might sound surprising to many folks in our community, but the DSM, we should talk about what the DSM is, but here's the provocative thought, is that I don't disagree with you, and I'm classically trained as a psychologist with a specialization in sport and high performance, and I use it as a framework, and rarely do I share kind of a diagnosis with an athlete or client, only if I have this thought that it's going to help them to know that there's a lot of other people that are struggling with some of the similar symptoms that they are. And so rarely do I share it with somebody, but for me, because I'm classically trained, it's kind of always working in the background, and that helps me to do two things.

It helps me to have, if I'm in a collaborative environment with other mental health or physical medical professionals, is to say, hey, listen, I'm seeing a cluster, and then there's a name for it that shorthands almost the cluster of symptoms that somebody's struggling with. And the other thing, which I'm not in the system at all, is for billing. Insurance companies use it to know, like, how do I pay?