0:09

Welcome to Nobody Told Me. I'm Laura

0:11

Owens. And I'm Jan Black. More than

0:13

47 million people

0:16

in the United States have been diagnosed

0:18

with a mental illness, and that means

0:20

that nationwide, almost one in five people

0:22

are living with a mental health condition.

0:25

Our guest on this episode, activist and

0:27

author Sarah Fay, is one of those

0:29

who've been diagnosed with a mental illness.

0:32

In fact, Sarah Fay has been diagnosed

0:34

or rather misdiagnosed with six mental illnesses

0:36

over the last 30 years. She writes

0:39

about her experience and raises important

0:41

mental health questions for all of

0:43

us in the new book Pathological,

0:45

the true story of six misdiagnoses.

0:48

Sarah, thank you so much for joining

0:51

us. Thank you both for

0:53

having me. It's great to be here. Tell

0:55

us why you decided to write this book,

0:57

why you felt it was really necessary. Well,

1:00

as you mentioned, I was diagnosed with six

1:03

different disorders, and it started when I was

1:05

12. So anorexia, generalized

1:07

anxiety disorder, major depressive

1:10

disorder, then ADHD, OCD,

1:12

and then bipolar disorder.

1:14

So I spent 25, 30 years

1:17

in total in the mental health

1:19

system, and I still

1:21

wasn't getting well. And I couldn't

1:23

understand why have I been given

1:26

six different diagnoses, and still I'm

1:28

not any better. And so when

1:30

I was in crisis,

1:32

actually, and I was

1:35

without a psychiatrist, and

1:38

I was suicidal at the time. And my

1:41

sister swept in. Anyone who's

1:43

been through this knows that the families are

1:45

the heroes of these stories. Certainly my family

1:47

is the hero of mine. They've been amazing,

1:49

but she swept in, she found me a

1:51

psychiatrist, and I went to see him. And

1:53

we had our 30 minute consultation. And at

1:55

the end, I waited for him to give

1:57

me a new diagnosis, a seventh one. I

2:00

was on my sixth or to

2:02

confirm the bipolar diagnosis. And

2:04

he looked at me and he said, I don't know what

2:06

you have. And my whole world shifted.

2:08

And I left his office. It was the

2:11

dead of winter in Chicago, a polar

2:13

vortex. And I just remember the

2:15

city looked so crisp, but

2:17

also harsher, but I felt

2:19

like no one knows what I have. Wait a second.

2:22

And I just realized I don't know anything about

2:24

the diagnoses I've been given. I know nothing. I

2:26

don't know where they come from. I don't know

2:29

what they really are. I don't know how

2:31

these doctors have determined that I have them.

2:33

And so because I have a doctorate and I spent six

2:35

years researching, I'm a bit of a research

2:38

dork. So what I did was I just

2:40

dove in and I started researching

2:43

mental health diagnoses. I said, I'm going to

2:45

learn everything about them. And I did. And

2:47

it was disturbing and a lot

2:49

of every day of nobody told

2:51

me, nobody told me, over and over again.

2:56

So you write in detail about what

2:58

you call the psychiatrist Bible,

3:00

which is how psychiatrists base

3:02

these diagnoses on. And

3:05

it's called the Diagnostic and Statistical

3:08

Manual of Mental Disorders and all of

3:10

the flaws that it has. So what

3:13

is the DSM and how is it

3:15

so detrimental? Yes, and

3:17

if your eyes just glazed over, listeners,

3:19

don't worry, mine did too. Like,

3:21

those words like diagnosed as well.

3:24

Like, diagnostic and statistical manual. But

3:27

what's interesting is the DSM, whether you know it

3:29

or not, that's what it's referred to as.

3:31

Also, as you said, psychiatry's Bible is

3:33

a huge part of our culture. So

3:35

you know it whether you know it

3:37

or not, meaning we have diagnoses, the

3:40

diagnoses that come from it. It's just

3:42

a book. I didn't know this. It's

3:44

a manual with pages and like

3:46

any other book. And so

3:49

All of our mental health diagnoses are in there.

3:51

And Just to give you a visual of what

3:54

the book looks like, you have the diagnosis at

3:56

the top of the page. So Let's say Major

3:58

depressive Disorder. And Then there are. Them Less.

4:00

So you have to qualify for

4:02

the diagnosis by having five of

4:05

nine symptoms in the case of

4:07

major depressive disorder. And so it

4:09

it's It's very orderly, And

4:11

at face value. It looks okay.

4:13

I mean you wouldn't pick it up

4:15

and and question it. But what I

4:18

learned in my research is that really

4:20

the diagnoses are just series, so. I

4:22

pictured it like physical illnesses we discover

4:24

and illness and then we theorize about

4:26

at let's say so but we can

4:28

see it. We have an objective marker

4:30

avec meaning there's a blood test for.

4:33

Major The shows you have major depressive disorder Or let

4:35

me show you this brain scanner. Let me show you

4:37

this x ray. We don't have any of

4:39

that for. The diagnoses in that book

4:41

and the diagnoses that we receive And

4:44

then what I learned as well is

4:46

Robert Stitzer who is one of the

4:48

main architects of. Modern. Psychiatry and

4:50

the Dsm. He was asked, why do

4:53

you need five of nine symptoms. To

4:55

received a diagnosis of major depressive

4:57

disorder and me said. Mrs. Arbitrary

4:59

We went around the table unforeseen. like

5:01

to see you and sixteen. Make too many.

5:04

Ah, and I mean that

5:06

was how. That's. The same

5:09

criteria we use today. So

5:11

irrationally is different going to a medical doctor

5:14

for a broken bone and they can see

5:16

it on an x ray and say oh,

5:18

you have a broken bone or you have

5:20

a. Blood tests that tells them that

5:22

you have an infection and done

5:24

that just. Doesn't exist for

5:27

mental health issues. Exactly

5:29

an end to. you know, In some ways

5:31

when we think about it, there's nothing wrong

5:34

with that, diagnoses or what we have.

5:36

That's just what we as what we've been

5:38

dealt. Think about it. We've got a brain

5:40

and a mind. What is even a mind

5:43

that may resume Human is. So the

5:45

psychiatry up against a lot. We've gotta give

5:47

them a little gray. see it our read

5:49

in the sense of they're trying to do

5:51

something that essentially is almost impossible with

5:53

what we have now what we know. So

5:56

there's nothing wrong with the fact that Tsm

5:58

diagnoses and medical diagnoses. Or. really what's

6:01

called scientifically invalid, meaning you have no

6:03

biological marker, like you said, there's no

6:05

blood test for them. And

6:07

they're unreliable, which means the symptom lists

6:10

that we have don't always lead

6:12

to consistent diagnoses, but among clinicians,

6:14

but also for people, which is

6:16

why you can receive six in

6:18

your lifetime, perhaps. So

6:21

none of that, there's nothing wrong with that. We

6:23

have to use what we can. What I see

6:25

and why, going back to your question, why I

6:28

wrote the book was that I didn't know this.

6:31

And as a patient, I feel entitled

6:33

to that information. And I

6:35

started to see all these people

6:37

around me accepting mental health diagnoses

6:39

without knowing it too. And

6:41

that just seemed a real disservice to

6:44

the public. I was actually on NPR

6:46

recently with Paul Applebaum, who is chair

6:48

of the steering committee of the DSM, so like

6:50

the head of the DSM. And

6:52

I wrote a book critiquing it, I thought we

6:55

were gonna rumble or something, but

6:57

he was wonderful. And Tom Insel was

6:59

on there too, another really prominent figure

7:01

in psychiatry. And they both just agreed,

7:03

yes, the public needs deserves to know and

7:06

they deserve to know what psychiatry knows. And

7:08

so that's really the gap I'm trying to fill with

7:11

the book. So telling my story, which is

7:13

a page turner, I hope, and then

7:15

also giving people, I sprinkled in surreptitiously

7:17

all the information you need to know about

7:19

the DSM. Because a

7:22

lot of people just go from doctor

7:24

to doctor if they don't like the

7:26

diagnosis, right? I mean, is that a

7:28

bad thing to do? It seems like it would be,

7:30

but at the same time, if you're not fitting into

7:33

one of these categories and you're

7:35

not having any luck with psychiatric

7:37

drugs, that makes sense. Yes,

7:40

and I do know what that's

7:42

like. And that's why I don't want anyone

7:45

to think two things. One, I always wanna preface

7:47

mental illness is very, very real. And

7:50

I'm not at all questioning that category.

7:52

I had one and I know it's

7:54

real. So that, I just

7:56

wanna be clear, questioning the DSM diagnoses are

7:58

really about questioning. the tools that

8:01

we're using to tell you what's wrong, or

8:04

by labeling people, this or that, that's

8:06

really what's being called into question, not

8:08

mental illness. So I always wanna just

8:10

be clear about that. But

8:12

what you bring up is the DSM, as I said, is such

8:15

a huge part of our culture, that

8:17

sometimes we're actually going and requesting

8:19

diagnoses. And that's something that never

8:22

happened before. We never had- And you

8:24

can look at these symptoms online and

8:26

say, oh, that's right, that's right, and

8:28

lead the doctor into that diagnosis. Yes,

8:30

exactly. And without anything to

8:32

prove or disprove it, then we're running

8:35

into trouble. And then I think the

8:37

other thing is doctors are as susceptible to

8:39

that, so they are looking for diagnoses too.

8:42

And this is my book, why I

8:44

think it's so important for people, is that

8:46

it represents what a lot

8:48

of people right now are going through,

8:50

and not the typical mental illness memoir

8:53

tends to be about psychiatry and anti-psychiatry,

8:55

and very much about

8:57

these extreme experiences. My

8:59

experience became extreme, but I really stumbled

9:01

into the mental health system in some ways.

9:04

And I think a lot of people do, looking

9:06

for an answer and looking for help. And

9:08

then the other part of my story that's more

9:11

like what a lot of people are going through is

9:13

that five of my six

9:15

diagnoses came from GPs, from general

9:17

practitioners, family doctors. So

9:20

I was not, I can't blame psychiatry for

9:22

what happened to me. And

9:24

so, and what I learned in

9:26

my research, which is shocking, is that actually

9:28

GPs are doing most of the diagnosing and

9:31

prescribing. They prescribe 80% of antidepressants.

9:35

And they prescribe- Wow, I have no idea. Yeah, I didn't

9:37

mean to- I never would have thought that they did really

9:39

any of them. I would think that would be a referral.

9:41

Yeah. I hate to say it,

9:43

but nobody told me. I mean, it's going over and

9:45

over again. But the, and

9:47

then they prescribe 50% of

9:49

anti-psychotics to children. So

9:52

you've got this, and then what gets more

9:54

disturbing, and again, I don't wanna, I

9:57

think that this is disturbing, but also a great

9:59

opportunity. is that in

10:02

a University of Michigan study from 2019, they

10:04

found that only 24%, so

10:07

less than a quarter of medical schools

10:09

offer GPs more than 12 hours

10:12

of psychiatric training. That's

10:14

all they have. That's it, I mean, like

10:16

let that sink in. That's a season of Grey's Anatomy.

10:18

You know, what are we, you know,

10:21

and then what's also even

10:23

more disturbing is they ask

10:25

those same doctors, do you feel

10:27

comfortable diagnosing patients with psychiatric disorders,

10:29

and the majority of them said,

10:32

very comfortable. So there's

10:34

a real problem there, which I think is

10:36

very fixable, which is nice in the sense

10:38

of, and I'm being blithe about this. I

10:41

teach at a University, so I know how hard it

10:43

is to change curriculum, but change

10:45

the curriculum, train our GPs. I mean,

10:47

they're there for a reason, and they're given

10:49

that privilege of diagnosing for a reason, which is

10:51

that a lot of us don't have access to

10:53

psychiatrists. And so it's about

10:56

access to care, so it comes from a good

10:58

place, but we really

11:00

need to change that and make

11:02

sure that they're being trained, or that the other

11:04

thing I really recommend for people is, if

11:07

you are diagnosed by a GP, see

11:11

a psychiatrist if you can. Again, I know

11:13

that's a luxury, but the other thing is

11:15

ask your psychiatrist to confirm the diagnosis,

11:17

I mean your GP to confirm

11:19

the diagnosis with a psychiatrist. That

11:23

can happen. Now, what

11:25

happened in your story after you

11:27

had these six misdiagnoses and

11:29

you went to the seventh

11:33

doctor who said, I don't know what you

11:35

have, then what happened in your story? Well,

11:38

then it's kind of fascinating. So he

11:40

never told me what I had, and

11:43

I never asked again.

11:46

He did tell me that he's changed it two more times.

11:49

I don't know what number we're on,

11:52

but I've never asked, so I still

11:54

have a diagnosis, I am still on

11:56

medication, I still see him, he's still

11:58

my psychiatrist. He's very open with... me about

12:00

the flaws in mental health diagnoses.

12:02

We talk about it. He knows he's in the book. He's

12:04

okay with being in the book. I don't know if he's

12:06

going to read the book. I don't know. But I

12:09

think he comes off looking pretty good. So I told

12:11

him that. But he, you know, so I

12:13

have never asked for it because what happened to

12:16

me and not everyone does this, but I

12:18

think quite I've heard from a lot of

12:20

readers who have, which is that I

12:22

over identified with my diagnosis, I

12:25

really became it each one. So

12:27

I really could see myself in the diagnosis.

12:29

And there's a good reason for that. Our

12:32

diagnoses are mental health diagnoses, the

12:34

symptoms of them are all things

12:36

that are a part of daily life,

12:38

depression, anxiety, you know, so they're just

12:40

part of being alive with the notion

12:42

of maybe psychosis, and a couple of

12:44

other things. But so it's

12:46

very easy to see yourself in any

12:49

diagnosis, not everybody, but if you're

12:51

slightly, you know, hardwired, like I am

12:53

a sensitive creature, you know, which is

12:55

how I see myself. But

12:57

so that you know, you're going to see

12:59

yourself in the diagnosis, and I certainly did.

13:01

And that also came from a place it's

13:04

not faking it. I mean, I want

13:06

to be very clear, I was never faking.

13:08

But when you do over identify what happened

13:10

is it became my whole life. And

13:13

every emotion, every thought, every

13:15

behavior I attributed to my

13:17

diagnosis. So if I was

13:19

sad, unexplainably sad, one

13:21

day, it was my depression. That was

13:24

my depression, like I owned it. And

13:26

now that I don't have a diagnosis, when I

13:28

wake up sad, which happens, unexplainably, I don't

13:30

even nothing's wrong, but I'm terribly

13:32

sad, I have to wrestle

13:34

with that now. And I can't just say it's

13:37

my depression. And I,

13:39

it kind of forces me to really

13:41

feel my emotions and and, and allow

13:44

them to be in my life and to

13:46

look at my thoughts, but also to look

13:48

at my circumstances and say, Okay, am

13:50

I working too much? Is there something that might

13:52

be pushing me to feel this way? Am I

13:54

not listening to myself or, you know, something along

13:57

those lines. So it's been very beneficial for

13:59

me. not to have a diagnosis.

14:02

And I said to my family for, you

14:05

know, I've been saying this for a couple of years. I

14:07

said, I think I'm well, I mean, I

14:10

don't think well, I mean, I think I'm

14:12

cured. And my family said, Yeah, I

14:14

know, I think you are too. So because there's

14:17

this, I mean, I live in a different

14:19

mind right now. And so I'm

14:21

writing the sequel to pathological, which is about

14:23

how I healed, and how,

14:26

you know, that recovery from mental illness, and I don't

14:28

like that word, but people have

14:30

been hesitant to say, you know, that you

14:32

can be cured. There isn't a cure

14:35

being meaning the noun, there isn't a

14:37

pill we can take, there isn't one

14:39

practice of meditation that we can do,

14:41

that will cure mental illness. But I

14:43

believe that going through certain processes and

14:45

doing certain things, and maybe not necessarily

14:47

the way I did, it might be

14:49

individual for each person, I

14:51

am cured. And then I

14:53

didn't feel comfortable saying that. And certainly not writing

14:55

it in a book, but Thomas Insel, who was

14:57

former head of the NIMH, he just came out

14:59

with a book, a wonderful book called Healing

15:01

our Path from Mental Illness

15:04

to Mental Health. And he has said,

15:06

mental illness is not chronic, we need

15:08

to start giving people hope and letting them know

15:11

that they can heal. So now

15:13

I'm always Tom. We

15:18

love having you as part of our

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nobody. I

17:27

think as a society, we're not

17:30

really doing a service

17:35

by whether or not we're trying to do

17:37

it by saying like with a celebrity, I

17:40

don't know Pete Davidson, for example, okay, he's

17:43

depressed. And so whenever I think

17:45

about him, it's absolutely no judgment,

17:48

but it's just something that I think

17:50

about. And I know even, you know,

17:52

when my mom and I are having

17:54

conversations, it's like, Oh, yeah, he's depressed

17:56

or something. So do you think that

17:58

that's not a good thing? and

18:00

that's making it so that people are

18:02

kind of afraid of, you know, coming

18:04

out and telling the world what they

18:06

have because they don't want to be like

18:09

Pete Davidson or any celebrity. He

18:11

may not be depressed nowadays. That's

18:14

true. He may be

18:16

cured now. Yeah, I don't maybe

18:18

it's Kim Kardashian is the cure. But

18:22

yeah, it's I mean, it's, it's

18:24

interesting that you bring that up. I'm

18:26

actually finishing up an op-ed and opinion

18:28

essay on this and how mental health

18:30

awareness has backfired. It

18:32

comes from a great place. I mean, it meant,

18:35

you know, Mental Health Awareness Month, which is May,

18:37

you know, that started in 1949. It's

18:40

been around and the point of it

18:42

is wonderful to educate people about mental

18:44

health and diagnoses and mental illness and

18:47

to eliminate stigma. There's nothing wrong with

18:49

that. But what's happened is

18:51

the focus of all of our discussions

18:53

about mental health have become centered on

18:56

diagnoses, like that's the starting point in

18:58

the end point, and there's nothing else

19:00

there. Even when we

19:02

talk about other aspects of mental health, it's

19:04

in terms of diagnoses. And it's gotten

19:06

to the point where we've, we've, we've confused

19:09

depression, the emotion with depression,

19:11

the disorder and anxiety, the emotion

19:14

with anxiety, the disorder. And

19:16

we use the terms interchangeably. So

19:19

I think that that and then you've got they're all

19:21

over social media. They're, you

19:23

know, they're people are self-diagnosing on social

19:25

media. We have TikTok therapists. And then

19:27

as you said, celebrities come out. And

19:31

one scholar wrote about essentially

19:33

how young people will look at a

19:35

celebrity, you know, who's talking about a

19:38

mental health diagnosis and say, Oh, if they

19:40

have it, maybe I have it too, in

19:42

this kind of idolizing way. So

19:44

there's there's there can be backfired

19:46

there as well. It's tricky. We

19:49

can talk about is awareness of a

19:51

diagnosis a good thing or is it

19:54

actually making us identify with them?

19:57

And then, you know, it has been reported that people

19:59

are asking for. diagnoses and that never

20:01

happened. But what's interesting is I

20:03

was in the 19th century, people

20:05

didn't know their diagnoses. And

20:08

this was true actually pre 1960s. So

20:11

it was just for doctors. Actually the DSM

20:13

was simply for doctors to communicate with each

20:15

other. It was never meant. These diagnoses were

20:17

never meant for us, ever. And

20:21

so for us to be identifying with them,

20:24

that's not what they were for. So

20:27

my doctor has my diagnosis and he can

20:29

communicate with anyone. And so I'm just living

20:31

in the 19th century and everyone else can

20:34

live here. I

20:36

don't know. Yeah, and

20:38

don't you also think that

20:40

maybe the prospect of getting

20:42

a diagnosis and a label

20:45

may prevent some people from

20:47

actually seeking help because they don't

20:49

wanna be called of

20:52

whatever it might be that they

20:54

have a negative association with. That's

20:57

such a good point. And what's interesting about

20:59

that is I read, part of

21:01

my research was that you would think

21:03

the biological explanation for mental health diagnoses,

21:05

which by the way, I didn't know.

21:08

No one told me that that's never

21:10

been proven. There is no

21:12

such thing as a chemical imbalance. That

21:14

was debunked 20 years ago. Wow. I

21:16

had no idea. I mean, I

21:18

had. Nobody, what are you talking about? Yeah.

21:21

So those aspects of this that are not being talked about

21:27

but what they found as well is

21:29

that they thought, oh, the biological explanation

21:31

is good. It may not be proven

21:33

yet, but it's going to be is what

21:35

they promised for 20 years, but it hasn't been.

21:39

But the biological

21:41

explanation prevents people from

21:44

self-stigmatizing, right? That's the idea. Because

21:46

if you think, well, it's not a character flaw.

21:48

It's not something wrong with me. But

21:50

what they found is actually it leads to more self

21:52

stigma because then it's in

21:54

you. It's you. It's like

21:56

your biology instead of something you

21:58

could possibly turn into. transcend or heal

22:00

from or move past. What

22:04

advice do you have for somebody who

22:06

has recently been diagnosed with

22:09

a mental health disorder and feels

22:11

really shattered and a sense of

22:13

shame because of it? I

22:17

understand that. I think the most

22:19

shame I felt was with bipolar

22:21

disorder, certainly. So I understand that.

22:23

And I was shocked to get

22:25

that diagnosis. I didn't think, I mean, it

22:27

shouldn't have come as a shock because I

22:29

received it while I was in crisis, but

22:32

it really did. And I didn't want it.

22:35

But then what happened to me was I clung

22:37

to it. So it was almost

22:39

like, oh, this has to be the answer.

22:41

This has to be where I'm gonna find

22:43

the key to my mental health. So

22:46

I would just say to be, it

22:48

can be great to identify with a

22:50

diagnosis. So a good example of this

22:52

is autism. That community,

22:54

I mean, they just rally. They rally

22:57

around each other. They get services for

22:59

themselves. They get funding. I mean, they're

23:01

amazing. That's a very positive diagnosis and

23:03

where I see diagnosis working really well.

23:05

I mean, there are some issues with

23:08

it, but for the most part, it's

23:10

a good example of that. The issue

23:12

with me was identified with all the negatives.

23:15

So I was really holding myself back. And

23:17

that's what I encourage people not to do.

23:20

If it offers some sort of relief

23:22

to diagnosis, that's great. That's wonderful. And

23:25

I have very close friends for whom

23:27

that's true. And I support them 100%. Definitely

23:30

don't wanna take anyone's diagnosis away. I'm

23:33

not medically trained to do that for one

23:35

thing, but. So yeah,

23:37

to just not necessary, not to

23:39

take on all the negatives as

23:42

being a part of you. I

23:44

mean, there are other things that worked well for me,

23:46

but that's not really advice that I could give anyone

23:48

else. But the one thing of course is if

23:50

you get a diagnosis from a GP,

23:53

please ask for a second opinion. What

23:56

are some of the concerns that you have

23:58

in terms of people? and

24:00

the pandemic and the mental health issues

24:03

that they may be feeling as a result

24:05

of the pandemic that may not

24:07

be a specific mental illness. Yeah,

24:11

I mean, where I see that, and this

24:14

is all over the media, and I'm sure you've seen

24:16

it too, is mental health crisis

24:18

among teens. And I think

24:20

that what's being a little bit left

24:22

out, first of all, what people are doing is trying to

24:24

find the reason, and I feel like we were

24:26

in a global pandemic and they were in their

24:28

rooms for two years. There

24:31

you go. I hope

24:33

they, I mean, if they were feeling anxiety

24:35

and depression, we'd worry about that. We'd call

24:37

them sociopaths. So

24:39

it's kind of, I mean, I think

24:41

that that, it's not to say that there isn't

24:44

something wrong. Like just like with me, there

24:46

was something wrong. What I worry about is

24:48

someone who is in a similar position to

24:50

what I was in. When you receive a diagnosis

24:52

at 12 and you

24:54

identify with that diagnosis and you start to

24:56

see, I mean, what happened to me was, I

24:59

was, as I said, 12 and my parents were

25:01

divorcing and I was going to a new high

25:03

school. I was terribly sad and

25:05

I was terrified. And I had a stomach

25:07

ache and I wasn't eating. And it was

25:10

extreme, I was not eating, but I wasn't

25:12

counting calories and I wasn't weighing myself and

25:14

I didn't think I was fat, which are

25:17

kind of the cornerstones of the

25:19

anorexia diagnosis. But we went to

25:22

my pediatrician and he said,

25:25

you have anorexia. And so

25:27

I from then on associated stomach

25:29

ache, sadness, terror with a

25:31

diagnosis. So I started to

25:33

associate my emotions and my thoughts and

25:36

my behaviors with a diagnosis instead of

25:39

just letting them be there as

25:41

part of my life and as

25:43

everything in my life. So I

25:45

worry about during the pandemic, so

25:48

many young people receiving diagnoses

25:51

without being told that these

25:54

diagnoses are approximations and

25:56

may or may not be

25:59

totally. what we think they are. And

26:02

since the medical field has such

26:04

focus on these diagnoses, it

26:06

makes me nervous that you might have

26:08

people kind of doing the opposite of

26:10

saying they have the symptoms that make

26:14

up the disorder that they think they

26:16

have. And they may just say, Oh my

26:18

God, I don't want to be bipolar. I don't

26:20

want to be psychotic or

26:22

something like that. And maybe

26:25

don't say

26:27

what they're actually feeling because they don't

26:29

want to have that disorder. And they

26:31

know the questions that the doctors would

26:33

ask to test that. What

26:36

gets where this gets also really confusing

26:38

is there are now

26:41

acceptable diagnoses and unacceptable ones,

26:44

even cool diagnoses and

26:46

uncool. So the accepted

26:48

ones are ADHD and depression and

26:50

anxiety and phobias. Those

26:52

are okay. But a polar, no.

26:54

Borderline personality disorder, no. And schizophrenia,

26:57

no. So you've got this kind

27:00

of subculture of diagnosis where what

27:03

if you had a child who's suffering

27:05

from schizophrenia, but that's not a cool

27:07

diagnosis. I mean, it's really kind

27:10

of getting into a place where, yeah, it's

27:13

confusing. What are some of

27:15

the things that worked for you, some of the

27:17

things that you were able to do on

27:20

your own without medication that

27:23

that helps you feel better mentally?

27:26

There are a lot of the things I'm about to

27:28

say are going to feel like, really, that's kind

27:30

of dorky. And it is they are. I

27:33

just want to preface that. One

27:35

thing that I do is every morning, and

27:38

this was something I started once

27:40

I stopped identifying with the diagnosis

27:42

is I just write

27:44

down all my thoughts. So

27:47

just one after another in a list, just

27:49

one after another. They are

27:51

incredibly negative. I'm soundingly negative.

27:53

My favorite one is everything's

27:55

wrong. Like, what is that? I don't know how

27:57

to deal with that. I got to confront it.

28:00

But after a while, and I started reading

28:02

a lot about evolutionary psychiatry,

28:04

and I came to understand that our brains

28:06

are designed to keep us alive. That's it.

28:08

Not to make us happy, not to make

28:11

us calm. They are just there to keep

28:13

us alive. And the way they do that

28:15

often is to alert us of danger everywhere

28:17

all the time. And I think people

28:19

like me, I mean, my, I still have,

28:21

you know, deep ways of depression

28:23

and crippling anxiety. So it's not

28:25

as if things have changed that

28:27

that much. In the

28:30

sense of I mean, it has changed. But those

28:33

emotions are still there. Those experiences are

28:35

still there. But knowing that

28:38

my brain is really negative because

28:40

it's trying to protect me has really

28:42

changed everything. I hope that doesn't sound

28:44

too meta or like weird. No, no,

28:46

no, no, no, but these negative thoughts

28:48

that I have, I get them out, I put them on

28:50

a piece of paper, and I throw them away.

28:53

Like that's just okay, we're done with them. And

28:55

now we're gonna go about our day. And

28:57

so I don't even look back at them. It's just a

28:59

way to get it out. And this will sound,

29:02

you know, a little bit woo woo or spooky, but

29:04

I feel like, okay, my brain needs to be heard.

29:06

I'm alerting you to all the danger. I'm letting

29:09

it be heard. And now we're moving on. So

29:11

that's been I mean, it sounds and I'll do it. So I'll

29:13

do it in the middle of the day too, if I if

29:15

I noticed that my anxiety is at a pitch or

29:17

something like that. So that's been incredibly helpful.

29:19

And then a weird thing,

29:21

I never thought of the physical aspects

29:23

of mental health in the sense of

29:26

when I am struggling. So let's say

29:29

I'm suddenly feeling overcome with sadness, drink

29:31

a glass of water or 60% water like

29:34

that's contributing. That's like taking one for the

29:36

you know, like giving back to the team

29:38

guy. And so I

29:40

just drink a glass of water

29:42

and sometimes it helps amazingly well. I

29:45

mean, it doesn't solve any problems,

29:47

but it's weird how those two things

29:49

are have become a kind of

29:51

cornerstone of my life. I think those

29:53

are really great pieces of advice.

29:55

I think that yeah, anybody could try and

29:57

use those and those aren't really talked about.

30:00

but they make so much fun. And

30:02

they're very inexpensive. Yeah. Very. They're free.

30:04

And we both offer them the water.

30:06

Yeah, I love that. At

30:09

the end of each show, we always ask

30:11

our guests, what is your Nobody Told Me

30:14

lesson? So what do you wish that someone

30:16

had told you prior to embarking on

30:18

your own mental health journey that

30:21

you had to learn the hard way? And

30:23

you'd like to pass on to someone else

30:25

who's maybe about to

30:27

start seeking help for their own

30:29

mental health? The

30:32

one thing that I would wish

30:34

I'd known and that I would love to give to

30:36

everyone as a gift is that recovery

30:38

is possible. And mental illness has

30:40

not been proven to be chronic. That

30:44

would have changed a lot for me is to know.

30:46

I mean, I was told all of my diagnoses were

30:48

chronic. I was told I'd have them for the rest

30:50

of my life. And I

30:52

just wish someone had said, no, you could

30:55

recover from this. And here's what we're going to do

30:57

and maybe take you off medication or maybe

30:59

not or whatever it is. And I

31:01

just wish I'd had that option and

31:03

that in mind. And

31:05

Sarah, how can people connect with you on

31:08

social media and on the internet and learn

31:10

more about your work? So

31:13

I'm at serafay.org,

31:15

s-a-r-a-h-f-a-y.org. And

31:17

I'm serafay author, all

31:19

one word, S-A-R-A-H-F-A-Y author

31:22

at serafay author on

31:24

all socials. Great, great. Well,

31:27

Sarah, this has been just so eye

31:29

opening and fun, too, to talk with

31:31

you. I mean, you're so open and

31:33

honest. You never think with mental health

31:35

that that would be a positive

31:38

show. But my god, I feel really

31:40

hopeful. I was going to say, I

31:42

feel better. I

31:45

feel better for the world. Good,

31:47

because I do, too. I mean, I can't tell

31:49

you how hopeful. I'm writing

31:51

a sequel to Pathological. And I just

31:54

feel so hopeful, especially about that, and

31:56

giving that to people. We

31:58

were all in this together. just are.

32:01

Right. Yeah. Well

32:05

again our thanks to Sarah Faye whose

32:07

new book is called Pathological, the true

32:10

story of six misdiagnoses. And again her

32:12

website is sarahfaye.org. I'm

32:14

Jan Black. And I'm Laura Owen. You're

32:16

listening to Nobody Told Me. Thank you so

32:18

much for joining us.