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In her book Pathological: The True Story of Six Misdiagnoses award-winning author and mental health advocate Sarah Fay (Ph.D., MFA) shares her journey through the country’s mental health system. Over 30 years, doctors diagnosed Fay with six different mental illnesses—anorexia, major depressive disorder (MDD), anxiety disorder, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and bipolar disorder. Her book details what it was like to live with those diagnoses, and the crippling impact each had on her life.

In this week’s episode of Watching America, Fay talks with host Dr. Alan Campbell about her book and how her experiences have given her a new mission in life.

Described as part memoir and part investigative journalism, Fay’s book also explores the Diagnostic and Statistical Manual of Mental Disorders (DSM) — psychiatry’s standard manual on which all mental illness diagnoses are based. She hopes her experiences will help move the conversation around mental illness away from simplistic diagnoses and toward a deeper understanding of our mental and emotional lives.

Fay’s journey through mental illness began when she was diagnosed with anorexia at age 12, even though she had none of the classic body dysmorphia symptoms. She says she quickly found a new identity within the diagnosis. It was just the start of a succession of varying diagnoses that she would receive, usually from her general practitioner during an annual visit.

“I'm getting diagnoses from men in white coats with stethoscopes around their necks,” she explains. “Often their offices were in hospitals. Why would I ever question the scientific validity or reliability of the diagnosis that I was receiving? And only later did I learn that the diagnoses we give are really kind of best guesses.”

Unlike a diagnosis of cancer or a broken bone, there is no x-ray or blood test to indicate a mental illness.

“There is no objective marker for any DSM diagnosis, aside from dementia and rare chromosomal disorders,“ Fay explains, ”and that I did not learn until way too late.“

Though a diagnosis can certainly play a role in the treatment of mental illness, Fay says she hopes to equip readers with information about the limitations of diagnoses and provide them with questions to ask clinicians to help clarify issues and form a viable treatment plan. To aid her in this mission she has created Pathological: The Movement.

Hear more about her journey in the full interview.

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