Welcome!
Each year, I do something a little different on my Substack (my version of Taylor Swift’s eras).
In 2025, we re-imagine mental health (and the publishing industry) with the relaunch of my first memoir, Pathological: The True Story of Six Misdiagnoses.
Subscribe to be part of this bi-monthly endeavor to empower patients (and authors).
You also get access to:
The full anthology of my Substack writing, including
My second memoir, Cured—an account of my recovery of twenty-five years living with serious mental illness and history of the
Start with a Question, where we question what we believe to be true about being human in today’s fast-paced world
Less of More and More—for those who want a little less in a culture of too much
The 🎧 audiobook narration of Cured on the Substack app or Spotify
How to show your support:
Purchase or gift a copy of Pathological to empower patients with the information they need to receive the best mental health care available. Pathological was an Apple Best Books pick and hailed by The New York Times as a “fiery manifesto of a memoir…bristling with spikey intelligence.” It was featured on NPR, Oprah Daily, Salon, Forbes, The Los Angeles Times, and more.
If you don’t know me, I’m an award-winning author, educator, and activist. I’m an author at HarperCollins, on the creative writing faculty at Northwestern University, a freelance writer at The New York Times and elsewhere, a certified mental health peer recovery support specialist (PRSS), and a mental health keynote speaker who’s spoken to audiences across the country about recovery from mental illness. I’m also a Substack Growth Strategist and the founder and director of Substack Writers at Work.
I write for many publications, including The New York Times, The New Republic, The Los Angeles Times, The Atlantic, Time Magazine, and The Paris Review, where I was an advisory editor. As a writer, Sarah’s writing appears in many publications, including The New York Times, The Atlantic, Time, and The Paris Review, where she was an advisory editor. My essays have received Notable Mention in Best American Essays and Pushcart Prize nominations. I’m the recipient of the Hopwood Award for Literature and fellowships from Yaddo and the MacDowell Colony, among others.
I live in Chicago with my two beloved cats, Baby Theo and Sweets. They were instrumental in my recovery. More than anything, I want a t-shirt that says, Ask me about my cats.






Contact:
Publicity, Sarah Schoof, HarperCollins Publishers | Sarah.Schoof@harpercollins.com
Literary agent, Kim Witherspoon, Inkwell Management | Kimberly@inkwellmanagement.com
Speaking agent, Washington Speaker’s Bureau | (833.972.8255)
Direct, mssarahfay1516 [at] gmail.com
What people are saying about Pathological:
“Sarah Fay is a deeply compelling person and a fantastic writer. We were wowed by her talent for bolstering personal stories with takeaways backed up with careful research.” —Apple Best Books Pick, Pathological
“Sarah Fay’s artful work is pleasingly unclassifiable—masterfully written, distinctively researched, and deeply humane. I’ll just call it genius.” —Anthony Swofford, International and New York Times bestselling author of Jarhead
“Sarah Fay creates a work of art that entertains as much as it informs. The prose is so electric, incisive, witty, irreverent, devastating, sparkling! Fay has created a masterpiece that is a true original on every level.” —Porochista Khakpour, award-winning author of Sick
“We urgently need to think about our mental and emotional pain and distress in a more loving, nuanced, and intelligent way. Pathological is a crucial and 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
“Sarah Fay shows how our attempts to order the universe and our minds has caused at least as much harm as good.” —DT Max, staff writer at The New Yorker and author of The Family That Couldn’t Sleep
“We urgently need to think about our mental and emotional pain and distress in a more loving, nuanced, and intelligent way. Pathological is a crucial and 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
In this stunning debut—both a memoir and a work of investigative journalism—author and former advisory editor at The Paris Review Sarah Fay explores the ways we pathologize human experiences.
With exquisite detail and a precise presentation of fact, she digs up her own life at the root to finally ask, Is a diagnosis a lifeline or a self-fulfilling prophecy?
Powerful, mesmerizing, and unputdownable, Pathological sits alongside the other brave and inspiring classics of our time that explore a more intelligent, forgiving, and nuanced approach to human suffering.
Over thirty years, doctors diagnosed Sarah 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.
Pathological is the gripping story of what it was like to live with those diagnoses and the crippling impact each had on her life. It is also a rigorous investigation into the Diagnostic and Statistical Manual of Mental Disorders (DSM)—psychiatry’s “bible,” the manual from which all mental illness diagnoses come.
Yet as Fay found out, some of our most prominent psychiatrists have been trying to warn us that the DSM is fiction sold to the public as fact.
In Pathological, former advisory editor at The Paris Review and award-winning writer Fay calls for a new conversation about mental health diagnosis, one based on rigorous transparency.
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This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services.
