Pathological

USA TODAY NATIONAL BESTSELLER

AN APPLE BOOKS PICK OF THE MONTH

"Sharply personal and impeccably detailed."—Kirkus Reviews (starred review)

"[A] fiery manifesto of a memoir."—New York Times

“Masterfully written, distinctively researched, deeply humane … Genius.”—Anthony Swofford, international and New York Times bestselling author of Jarhead

“A major contribution … A necessary book.”—Johann Hari, author of Lost Connections

“This book is a triumph of the spirit and the flesh.”—Eliza Griswold, Pulitzer Prize–winning author of Amity and Prosperity

Is a psychiatric diagnosis a lifeline or a self-fulfilling prophecy?

In this stunning debut—both a memoir and work of investigative journalism—bestselling author and former advisory editor at The Paris Review Sarah Fay chronicles her harrowing journey through six psychiatric diagnoses that began when she was just twelve years old.

Diagnosed with anorexia, major depressive disorder, anxiety disorder, ADHD, OCD, and bipolar disorder over twenty-five years, Fay lived under the weight of each label—until finally, while in her forties and no longer able to live independently, she began to question the very system that defined her. With exquisite detail and wry honesty, she digs up her own life at the root to reveal the crippling impact of overidentification with psychiatric diagnoses, especially for young people.

Pathological is both a cautionary tale and a deeply researched exposé. Fay discovers that some of our most prominent psychiatrists have been warning us that psychiatry's diagnostic bible—the DSM—isn’t the scientific manual it’s touted to be.

Powerful, mesmerizing, and unputdownable, Pathological calls for a new conversation about mental health—one based on transparency and patient empowerment. It sits alongside the other brave and inspiring classics of our time that explore a more intelligent, forgiving, and nuanced approach to human suffering.

How can a system meant to heal cause so much harm?
Medical Memoir: Sarah Fay’s twenty-five-year journey through six different diagnoses—from anorexia to bipolar disorder—and the system that failed to see her clearly.Investigative Journalism: A deeply researched look into psychiatry’s diagnostic bible, the DSM, revealing why many prominent psychiatrists admit it isn’t the scientific manual it claims to be.DSM Criticism: An exposé on how unproven diagnoses are created and how overidentification with these labels can become a dangerous self-fulfilling prophecy.Patient Empowerment: A call for a new, transparent conversation about mental health that gives power back to patients and offers a more nuanced approach to human suffering.