A collection of stories about people who have traversed the mental healthcare system with different diagnoses, different paths, and varying results. Interesting and thoughtful book.

If I could make this recommended reading, I would. This book is well written and balances the delicacies of mental health with empathy and care.

Strangers to Ourselves: Unsettled Minds and the Stories That Make Us by Rachel Aviv explores the different ways in which people try to make sense of mental illness, both on an individual and societal level. The book tells the story of six different people who experienced mental illness, including the sociocultural factors that shaped those experiences. One of these stories is of the author's own experience of being hospitalized at age six for anorexia nervosa.

The author is a writer for The New Yorker, and her journalistic background is very apparent in the stories she tells. Of the other five individuals whose stories were told in the book, two of them were still alive and directly interviewed by the author. One of these five was someone who had been a co-patient of the author’s during her childhood hospitalization.

The book opens with the author’s own story, then moves on to Ray Osheroff, who was a notable figure in the conflict between a psychoanalytical approach to psychiatry and an evidence-based approach. He had a lengthy stay for severe depression at an institution called Chestnut Lodge, where the treatment team insisted that psychoanalytic therapy was the only way he could get better. Although he was only getting worse, they refused to put him on medication. He later sued Chestnut Lodge for malpractice for not using evidence-based treatment, and the book explores the debate that this lawsuit sparked within the field of psychiatry.

Next up is Bapu, a deeply spiritual Indian woman who was diagnosed with schizophrenia. In telling her story, the author explores issues around spirituality and psychosis, culture, and the ways families respond to mental illness.

The story of Naomi Gaines, a Black woman who killed one of her children while psychotic, addresses how racism impacts how mental illness is framed and treated and how it impacts access to care. It also looks at the effects of deinstitutionalization, the large numbers of mentally ill people who end up in the criminal justice system, and the limitations of the M'Naghten Rule, which is the legal test that's commonly used in the US to establish an insanity defense. In Naomi's case, doctors didn't feel that she met the M'Naghten standard, and her public defender didn't think a jury would accept an insanity defense. The book also looks at the poor care that people with mental illness receive in prison. In Naomi's case, while in prison for second-degree murder, her antipsychotic was stopped due to cost. Unsurprisingly, her mental health deteriorated, and she was put in segregation for two months.

Next was the story of Laura Delano, a woman who'd been diagnosed with bipolar disorder and later borderline personality disorder. She took 19 different medications over the course of 14 years. The author observes, “While Black women tend to be undermedicated for depression, white women, especially ambitious ones, are often overmedicated, in order to ‘have it all’: a family and a thriving career.”

Laura ended up going off of medication because of emotional and sexual numbness, and she had significant difficulties with withdrawal, which led to her getting involved in online communities of others who'd also struggled with psychiatric medication withdrawal. The book explores the ways that people relate to the medications they are taking or have stopped taking and how this can shape identity and the stories people construct about their illnesses. The author also contrasts her own experience with Laura’s—while Laura’s doctors had pushed meds, the author had been taught to see her illness as “a kind of stress reaction… In a sense, Laura and I were mirrors on which different faces of psychiatry had been reflected.”

The author also shares her own experiences taking the antidepressant Lexapro as an adult. It sounds like it was prescribed not because of a psychiatric diagnosis, but rather to help with psychological rigidity around feelings of inadequacy. It was initially intended to be for short-term use, but she felt better on it and worse when she tried to come off of it. On a low dose, the author writes, “I was not depressed, but I was less social, flexible, and spontaneous. It seemed I had reached my baseline personality.” She ended up deciding to go back up to the full dose, and she's remained on the Lexapro for over a decade. She adds, “I also realize that I’ve endowed my pill of choice with mystical capacities—it contains the things I’m not but wish I was—and merely the idea of swallowing such a thing has healing power."

It was interesting to examine my own reactions to this. I’m very pro-medication as an option for treating mental illness, but I must admit, I judged the psychiatrist who started her on the Lexapro. Why? In part, it’s because I’m into evidence-based medicine, and prescribing medication for something it’s not indicated for seems like poor practice, but there’s also a more personal element to the reaction. I think that’s at least partly because I take meds to try to get back some of the self that my illness obscures, and taking meds to be a different person from the self feels… backward, maybe? Or maybe I’m just envious of the idea of taking meds as a self-enhancer rather than in an attempt to stay alive and maintain some degree of functioning.

The book has a lot of detail, drawing on interviews with many people associated with each story. It’s impressive in terms of journalistic quality, although my personal preference would have been to leave out some of the details that seemed less relevant. Then again, that’s at least partly because I wasn’t feeling well when I read it. I liked the author’s approach of looking at the bigger picture factors that came into play in each individual’s story and how this shaped the way these individuals and those around them understood the illness. Both the depth of investigation and the big-picture view make this a unique and fascinating book.


I received a reviewer copy from the publisher through Netgalley.

The case studies of people from different races, cultures, class and religion, and the impact those factors
had on their mental illnesses. Treatments did not take that into account which impacted treatments received along with what insurance is willing to cover along with medications. Insightful and eye-opening.
#NetGalley #Farrah, Straus & Giroux

Ah I'm so bummed! I thought this was going to be on Kindle. Like others have mentioned, I'm not able to open it :( I was super excited about this one too. Hoping to nab it once it's out!

An interesting study of mental illness through case studies of several people who have received diagnoses like anorexia, depression, schizophrenia, etc.
Especially interesting to me was the history and use of treatment drugs in the last few decades.

Thanks to NetGalley and Farrah, Straus, & Giroux for the ARC to read and review.

I recommend this one to everyone. It was a fascinating read on mental illness. I'm going to purchase a couple of copies for the library because I think this is going to be a popular one.

Rachel Aviv writes an informative and enlightening book about the history and treatment of mental illness. Strangers to Ourselves explores mental illness in different cultures and times. The language and diagnosis of mental illness varies from one person to another across cultural, gender, and personal norms. It seems that even the medical community uses different diagnosis and treatment options. I found it difficult to be engaged in the first part of the book. But as I read more, I found the book difficult to put down. Once you read this compelling series of individual cases of people with diagnosed mental illness, you will never look at mental illness in the same way. I highly recommend this book to anyone who is interested in learning more about the treatment of mental illness in our society and it’s profound effect on the people diagnosed.

Thank you to NetGalley and FSG for the e-book! Strangers To Ourselves is a comprehensive account of the lives of six mentally ill people including the author’s own perspective. These six people face different illnesses between depression, schizophrenia and eating disorders and detail the backgrounds of each patient as they vary from each other. Out of the six, I found Bapu and Naomi’s stories to be the most eye opening based on their influence of class, race, culture and religion. With brilliant attention to detail, Rachel Aviv brings light to these realities with the themes of advancements in treatment with the changing of time, contrasting personal backgrounds and conversations with doctors and loved ones of these people. Very interesting read! I highly recommend for those interested in nonfiction, psychology and mental illness.

I so wanted to read this book but the format it arrived in made it very hard--really wish it had been a kindle or easier to read. At any rate I look forward to reading it when it is published.

Rachel Aviv is an author I whose articles I’ve read in the New Yorker.This book is an intimate informative look at peoples struggles with their mental health problems such as anorexia and more.The author brings us personal stories from people she interviewed sharing her own mental health issues.This is a fascinating informative read highly recommend.#netgalley #fsg

This was such an eye opening book and I loved that the stories told were from diverse backgrounds and countries. I appreciate the boldness of those allowing their stories to be shared because it will help remove the stigma that people with mental health issues face. It has made me evaluate the opinions I form of those that are maybe having a difficult mental journey.

Thanks to Netgalley and FSG for the ebook. When the author, one of my favorite writers at the New Yorker, was six, she was briefly hospitalized for anorexia. Today in her magazine, and again in her first book, the author examines mental illness in its many forms. This book tells the story of four people, including a man who was hospitalized in a facility that wouldn’t give him antidepressants and he later sued the institution, which has far reaching results. She becomes interested in a charity in India but the woman who runs the charity asks her to write about her mother, a woman who constantly tried to turn her back on the world to follow her religious zeal, who was diagnosed with schizophrenia, but many thought her a saint. There is also a mother who serves time for a deadly act that she spends the rest of her life seeking redemption and a seemingly perfect young woman who is prescribed one pill on top of the other and who is trying to see if there is a livable life beyond pills. The reporting in all these stories is nuanced and, at times, quite personal. An amazing book.

I am sure that this book will speak to engage many. It did not do that for me. I do not say that as criticism of the work but simply in the spirit of being honest

I am unable to read this on the NetGalley app and this one is (unusually for this publisher?) unavailable in a kindle compatible format.

Unable to open this book in my e-reader so I can not review this book. I'm not sure what happened but I cannot open it at all in NetGalley.

Can't access this on an e-reader as other reviewer mentioned. The protected PDF format didn't even work. Won't be reviewing this.

I'm always fascinated by writing about mental illness and although I wasn't familiar with Rachel Aviv's work for "The New Yorker," I've quickly become a fan of hers. This book followed several different individuals who have struggled with mental illness and various diagnoses (including anorexia, bipolar, major depression, etc.) and their experiences trying to get help and trying to heal. Aviv did an insane amount of research that made this a deeply detailed and moving testament to the strength of these people who have suffered so much. Aviv including her own personal story also made this a book go above and beyond what a typical journalist would include along with facts and data. This was a cohesive, well-structured book that I feel grateful to have read. Getting insight into someone's raw, honest struggle is always a privilege.

ARC cannot be read on an eReader, thus no review - please provide more visible information regarding the available formats, so reviewers do not ask for ARCs they can't read. Thank you!!.