By Rupal Patel
Content Warning: This book includes detailed first-hand accounts of self-harm and suicide. If you are suffering from depression or mental illness, feeling triggered, or ruminating about self-harm, please call Fordham’s Counseling and Psychological Services at: 212-636-6225 (Lincoln Center) or 718-817-3725 (Rose Hill/Westchester). If you are in immediate danger of harming yourself or someone else, please call 911 or take yourself to the nearest emergency room.
Summary from Goodreads
Despite her success as a journalist, Anna Mehler Paperny was plagued with feelings of failure and profound despair. Her first suicide attempt in her early 20s landed her in the ICU, followed by weeks of forced inpatient treatment where her experiences ranged from disturbing to utterly hilarious. This was Anna’s introduction into Canada’s psychiatric care system. After being discharged and dealing with the inter and intrapersonal consequences, Anna found herself struggling with the typical challenges facing most mental health patients – a string of bad therapists, ineffective medication, and staying both insured and employed. Using her journalism background to her advantage, Anna sets out to interview the leading experts in mental health care in the Canada and US going to psychiatrists and neurological experts, brain-mapping pioneers to newer experimental treatments. Candid about her experiences with the pharmacological pitfalls and side effects of long-term treatment, offering various case studies beyond that of the typical white patient, Anna shows readers the successes and failures in how we treat the disease that affects and kills millions worldwide.
Book Review
Anna Paperny's account of the anguish of suicidal ideation, the havoc it creates on one's life, and the consequences of an attempt on one's life - making one's loved ones aware, the guilt felt about doing them harm, and the potential for employment problems after a long-term medical leave - is one of the most brutal and honest narratives found in self-help literature and layperson psychology today. As well as providing candid details about her experiences with treatment-resistant depression and multiple suicide attempts, she also provides accurate and well-researched information regarding the social, political, and economic aspects of mental illness. Most self-help books do not cover the raw details of suicide, however Paperny uses her personal experiences to enrich the interviews she conducted, giving them real-life context as opposed to the usual overly clinical and/or patronizing language found in most such books.
The author elaborates on the realities of mental health treatment for marginalized populations, explaining that such treatment is often only accessible to the wealthy due to the availability of medications, better health insurance, and the ability to pay for therapy out-of-pocket. As she explains, patient-therapist relationships do not follow a one-size-fits-all model; patients often work with multiple therapists before identifying an individual whose modality, schedule, and even personality are the most compatible with their expectations and needs. Those with low-income simply cannot afford this luxury of trial and error. Paperny also points out the barriers experienced by other marginalized populations, including BIPOC, AAPI, immigrants, and women. These populations are often ignored in mental health and self-help related books.
While some may find her use of problematic terms like “crazies,” “nutbar,” etc. stigmatizing, it was admittedly an effective method of introducing those with no experience of depression and suicidal ideation to what life in an inpatient psychiatric with vivid self-harming fantasies is like. The terms show that Paperny, like others with debilitating mental illness, holds the same internalized stigma and shame. By combining the personal aspects of a memoir with the data-driven investigation of an exposé, she hopes to not only help readers see beyond these labels, but also free herself from them.
A few interesting (and maddening) tidbits from the book:
In the late 1980s, Prozac was introduced to the market as the first SSRI. Due to its effectiveness in treating depression, there has been little research into developing other pharmacological treatments.
Women are more likely to suffer from depression than men. However, anti-depressant medications have been clinically tested disproportionately on men compared to women.
Neurologists, clinicians, and researchers do not know what causes depression, what creates it, or how the drugs used to treat it actually work.
Trials for mental health treatments typically exclude patients based on the risk of suicide, despite the patients' dire need for treatment and the public health risks associated with suicide.
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