🎧 The Story About Recovery You're Not Supposed to Hear | Prologue

🎧 Listen to Sarah read the prologue here or on Spotify:

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I have only a vague sense of when I recovered.

But I do remember the moment I realized that after twenty-five years of serious mental illness, I’d been recovered for some time.

Winter in Chicago. I was walking my sister’s sheepadoodle puppy, Augie (full name—Lady Augustine Fluffington), in Lincoln Park. As Augie leaped and dove into the snowbanks, jutting her nose in and out of the fresh powder in delight, my mind became still. No racing thoughts. No harrowing voice. My body felt easy. No pulsing anxiety in my chest, no sodden pit in my stomach, no revved-upness, no wave of depression crashing against me. I was just there, in the world—a person having a life holding a leash with a puppy on the other end of it losing its little puppy mind over the snow.

My anxiety returned after about a minute, but by then I understood how the mind works: it was just my brain warning me of danger when there wasn’t any. By then, evolutionary psychiatry had offered me an understanding of my human experience that years of therapy and medication and meditation and breathing and diagnoses didn’t, specifically the fact that our brains are designed to keep us alive and that’s it. It’s locked in a dark skull trying to protect us from danger based on internal and external sensory information in a world practically seething with overstimulation. Most of the time, the brain is going to misfire.

That night, at two or three in the morning, my thoughts came in tormenting bursts. After twenty-five years of trying to shut them down and run from them and, for a time, drink them away—all of which only intensified them—I’d finally started to let them be. The next day, anxiety pulsed in my chest, but I let that be there too, reminding myself that anxiety is part of the human experience; there’s no escaping it.

The stillness and easiness didn’t rid me of negative emotions or create some sort of Instagram ideal of a life. With them came not a feeling of happiness or anything close to bliss but a mild okay-ness, enough-ness, and sometimes, on my best days, contentment—which, I now believe, is all we really need.

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Most people don’t know that recovery from mental illness is possible. I didn’t, which meant my mental illness had a distinct advantage over me.

Then I heard about a woman diagnosed with schizoaffective disorder who’d become so well that she ended up an executive at Google (Google-executive well, which seemed to me the pinnacle of mental wellness), so I decided to try (even though I had a different diagnosis—bipolar disorder), and it worked (though not having a mental illness anymore didn’t look how I thought it would).

Then I read the statistics:

• Over half of all adults recover from major depressive disorder—58 percent never experience another episode.

• Over 50 percent of adults diagnosed with major depressive disorder recover spontaneously, their only treatment being the passage of time.

• Among adolescents, more than half never experience another major depressive episode again.

• A 2020 study showed that anxiety disorders have a complete recovery rate of 40 to 72 percent.

• In eating disorders like anorexia and bulimia, full recovery is 62 percent and 68 percent, respectively.

• One study showed that 65 percent of adolescents diagnosed with ADHD no longer meet the criteria ten years later.

• Studies show that OCD is curable in children, who often grow out of it without treatment.

• Bipolar rarely gets talked about in terms of recovery though that’s starting to change.

• Even full recovery from schizophrenia is possible with a 2018 study finding that nearly half of those with schizophrenia reached recovery. A more conservative 2020 study showed a rate of 29 percent, which is also high given that schizophrenia is often treated as if it’s inevitably deteriorating. Other recovery rates from schizophrenia are more hopeful. In the 1970s, researchers John Strauss and William Carpenter conducted an extensive, multi-year study finding that 67 percent of people diagnosed significantly improved, and many fully recovered.

• One meta-analysis of data collected between 1969 and 1999 found similar recovery rates across cultures, countries, and healthcare systems. Researchers concluded that 45 to 65 percent of people with serious mental illnesses will recover with or without treatment over time.

Then I met other people who’d become well. Some of them knew the exact dates they’d recovered—July 16 or April 12—and celebrate it every year. I loved that. I pictured cakes, candles, streamers. Happy Recovery Day cards.

But people don’t like to talk about mental health recovery because, well, it’s hard enough to talk about mental health in any way that’s sane (pun intended).

We’re swept up in pathologies and social media mental health influencers.

And publishers are wary of people talking about mental illness if they aren’t medically certified to do so.

Which is why this story is the story about mental health recovery you aren’t supposed to read.

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» Continue to Chapter 1.

» Or return to the table of contents.

Buy my Pathological: The True Story of Six Misdiagnoses as part of my relaunch 2025 to improve our mental health system by empowering patients with the information they need to get the best available treatment.

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