PATHOLOGICAL

Fay's incisive, wide-ranging debut explores her decadeslong immersion in the mental health system.

Beginning when she was a teenager, Fay was diagnosed with six different mental illnesses, sometimes one by one, sometimes in combination, and often based on the skimpiest of evidence. Therapists and physicians concluded that she was suffering from anorexia, major depressive disorder, anxiety disorder, ADHD, OCD, and bipolar disorder. They prescribed medications accordingly, and Fay dutifully swallowed both the diagnoses and the pills—and then found it nearly impossible to extricate herself from either. The narrative, justifiably soaked with anger but also darkly funny at points, does not follow the course of the usual mental health memoir, in which the subject finally receives and responds to the “correct” analysis of her problems and lives happily-ever-after. Instead, Fay, still troubled, still medicated, stepped out of the loop of therapy and began to refute its basic tenets. The author boldly combines three strands: an account of her trip down the rabbit hole of the mental health system, where she tried valiantly to persuade herself to accept diagnoses that didn’t seem to correspond to her actual life; a dynamic critique of the various incarnations of the Diagnostic and Statistical Manual of Mental Disorders, which serves as a guidebook for many clinicians; and, unexpectedly but beguilingly, analyses of the ways punctuation can reveal and structure thought. While criticism of the DSM is not new, Fay's position as an insider suffering from the results of its application as a method of analysis gives her a unique perspective. Sharply personal and impeccably detailed, the book is bound to raise questions in the minds of readers diagnosed with any number of disorders about the validity of trying to cram individual experience into what Fay contends are essentially imaginary categories.

A provocative and original examination of the flaws in mental health treatment.