Sarah Fay, Author and Mental Health Advocate, Talks Navigating a Mental Health Diagnosis, Self-Stigma, and Mental Health in the Workplace

Nearly one in five people in the United States currently live with a mental health condition. About 46% of American adults and 20% of children and adolescents will have at least one mental health diagnosis in their lifetime.

Sarah Fay, Ph.D., MFA, is an award-winning author and mental health advocate on a mission to change the conversation about mental health. She is the former editor of The Paris reviewactivist and author PATHOLOGICAL: The true story of six misdiagnoses. She also created Pathological: The Movement, a public awareness campaign dedicated to empowering patients to take charge of their mental health treatment.

As she shares Pathological, over 30 years old, Fay was misdiagnosed with six different mental health conditions: anorexia, major depressive disorder, anxiety disorder, attention deficit hyperactivity disorder, obsessive compulsive disorder and bipolar disorder. In writing this book, she sought to learn as much as possible about the mental health diagnoses that so many people receive and discovered that while they can be helpful, overdiagnosis and misdiagnosis are pervasive. Here, she shares her perspective on understanding and navigating mental health diagnoses.

Where does a mental health diagnosis come from?

“The Diagnostic and Statistical Manual of Mental Disorders (DSM) looms large in our lives,” says Fay, because it’s the book from which mental health diagnoses originate. “We use the DSM for people to get educational services and apply for disability and for legal matters. It is also how mental health professionals are paid or reimbursed by insurance companies.

Fay was shocked to learn in her research that “criteria for diagnosing mental health conditions are based on theories and insights of mental health professionals – primarily white and cisgender heterosexual men from the American Psychiatric Association. They basically put together a list of disorders and symptoms that qualify someone for each disorder.

While the DSM is not inherently the problem, she explains, the discrepancy between what psychiatry knows (that these diagnoses are not the ultimate solution) and what the public knows is where the problem lies. For example, one thing she draws attention to in the book is that, despite the lack of evidence showing that all mental health diagnoses are chronic, they are often discussed as if they are, and many people are prescribed medications by their primary care physician (as opposed to a psychiatrist) without a clear plan for how long these medications will last.

Next steps if you are diagnosed with a mental health issue

While not everyone chooses to identify with their diagnosis, Fay explains, the stigma associated with certain conditions can have a significant impact on quality of life and self-esteem.

If you receive a mental health diagnosis, asking questions can help you plan ahead. “I’m not a doctor,” Fay says, “but what I bring to the conversation is 30 years in the medical system and having been diagnosed with six.” She shares that there are two stages she wishes she had known about sooner.

“The first step is to get treatment and commit to this treatment. You get a label when you receive a diagnosis in order to get treatment, but it’s not up to us to label ourselves. It is important to know the limits of a diagnosis instead of accepting it and identifying too much with it.

It also encourages the formulation of an “exit plan” with the help of your supplier. “One question I wish I had been able to ask is, ‘What will we do when or if I start to feel better?’

Another question would be about medication: “Are you going to take me off this medication eventually?” How are we going to do this? When are we going to consider doing this? What are the risks ? »

If you’re struggling with self-stigma, know that it’s completely normal. Fay encourages stepping back and acknowledging where it’s coming from rather than trying to completely cancel out those feelings. “Experiencing self-stigma means you are a product of a society that is not as good for people with mental health issues as it should be. This awareness can help reduce the intensity of these feelings.

Navigating a Workplace Mental Health Diagnosis

“In my experience, some workplaces are more open to certain diagnoses than others,” says Fay. Generally speaking, she added, “Some diagnoses are socially acceptable and some are not. So we’re very happy to talk about depression or anxiety or ADHD or OCD on social media or elsewhere, but schizoaffective disorder or depression with suicidality or schizophrenia is another story.

Whether or not to disclose your diagnosis is an individual decision. Fay points out that disclosing does not necessarily mean revealing your exact diagnosis. “You can be transparent about your mental health by sharing that you are having emotional difficulties without sharing the diagnosis.”

With a current employer, she says, “One thing that can be helpful is asking your mental health provider or psychiatrist for advice on how to start that conversation or having them write a letter for your employer. .”

For team leaders, it also encourages being a vulnerable leader and speaking to those around you in terms that speak to your team. “If I was talking to my team, I might say, ‘I’m also suffering from anxiety because of this project’ instead of saying, ‘I have an anxiety disorder.’ »

While many don’t feel comfortable disclosing mental health issues to clients, Fay again emphasizes that it’s an individual choice and you can share as much or as little as you feel comfortable with.