Pathological: The True Story of Six Misdiagnoses by Sarah Fay

For decades Sarah Fay tried to understand her mental illness through the lens of the six diagnoses she’d been given by various providers: anorexia, major depressive disorder, anxiety disorder, attention deficit hyperactivity disorder, obsessive-compulsive disorder, and bipolar disorder. But when embracing these diagnoses yielded only more confusion and trauma—“pathologizing her thoughts and behaviors and behaviors,” each diagnosis “a self-fulfilling prophecy”—Fay began to interrogate their source: the Diagnostic and Statistical Manual of Mental Disorders (DSM), the iconic psychiatric handbook for identifying mental illness. The result is Pathological: The True Story of Six Misdiagnoses (HarperCollins, March 2022), a book that blends memoir and investigative journalism to radically reexamine the way the psychiatry field makes its diagnoses, in search of more meaningful support for those who live with mental illness. 

In “The Fully Fact-Checked Memoir: Backing Up Facts, Standing Behind Truth” in the March/April 2022 issue of Poets & Writers Magazine, Fay describes the rigorous process of fact-checking the book. Fay understood the supreme importance of an immaculately-constructed argument: “The issue lay with the claims I was making,” she writes. “Was I backing them up enough to take on the mental health industrial complex and change the minds and lives of 150 million Americans?” But instead of feeding her anxieties, the fact-checking process only steeled Fay’s confidence in her argument. 

In this audio recording, Fays read from the prologue of Pathological, a book that Anthony Swofford says “joins our finest literature on medicine and psychiatry and the eternal riddle we call our minds.”