With stunning grace and precision, openness, and empathy, Sarah Fawn Montogomery talks about her outstanding memoir & her struggles with mental illness


By Leslie Lindsay 

Brilliant and incredible debut work of nonfiction, about the author’s life with myriad mental health diagnoses, QUITE MAD, should be required reading for all, but especially those who have been touched with mental illness, either in a personal or professional manner. 

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With searing intelligence, unflinching honesty, and a breadth of research, Sarah Fawn Montgomery has left me in complete awe. QUITE MAD (Mad Creek Books, 2018) is a gorgeous melding of literary journalism meets memoir and is focused mostly on women in the U.S. and their relationship with mental illness.

But.

Sarah Fawn Montgomery had a challenging family of origin, too. Much of this tumultuous upbringing is chronicled throughout the pages–delving into both of her parents’ backgrounds, their own anxiety, their desire to adopt a houseful of ‘special needs’ kids (abandoned at birth, drug-addicted babies, and those who otherwise weren’t cut out for foster care and their subsequent diagnoses). I read with interest, with disbelief, with shock.


“A wrenching account of a difficult upbringing and a chaotic brain that will leave readers marveling at the author’s endurance. . . . The author offers a gripping picture of the real pain and suffering of someone diagnosed with chronic mental illness.”

 Kirkus Reviews


The prose poetic, literary, thoughtful, raw, honest, and poignant. In QUITE MAD, Sarah takes the reader into a history of mental illness in the U.S. [of mostly women] marked with abuse, misunderstanding, social faux pas, medications, lack of healthcare, therapy, the paternalistic nature of psychiatry, and so much more. Much of this made me cringe, but it’s also, still reality. And things need to change.

We volley between this and Sarah’s personal story: her struggles with severe anxiety, her OCD, her disordered eating, and more. It’s all so well done and I couldn’t stop flagging pages.

Truly, an important, humane read that is very thought-provoking, while simultaneously evoking empathy.

I am so, so honored to welcome Sarah to the author interview series. Please join us.

Leslie Lindsay:

Sarah Fawn, I am in such awe of your debut non-fiction, QUITE MAD. It’s honest, authentic, kinetic. I was right there with you. I always, always want to know what was haunting a writer when they set out to write a particular title. With this, I think I know. Would you mind telling us, in your own words, what was driving you?

Sarah Fawn Montgomery:

I wrote the book that I needed as a patient. When I was first diagnosed with various mental illnesses, I desperately wanted information about my symptoms and treatments, and to counter the misinformation and medical sexism I faced. Being a mental health patient is isolating and frustrating, for your lived experiences are often invalidated by others who do not believe your symptoms and stories to be true. Doctor visits, often only a few minutes, focused on what was “wrong” with me and on medication, much of which proved ineffective and even dangerous for me, and I wanted to challenge this narrative. I also wanted to connect with other patients who felt the same. I wanted to explore a national history that has silenced and abused mental illness patients despite the American narrative that promises we’ve come a long way in our mental illness treatments even as mental illness rates in this country have steadily risen. This desire for research alongside patient perspective is why I wrote a hybrid text, part memoir, part journalism, a way to weave personal experience with medical authority.

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Leslie Lindsay:

The research! Oh, the research! I was enamored with the stats, the data, everything. Can you walk us through a brief timeline of your process—did you research as you went or all up front? How—when—does a writer say: ‘enough’ and get on with the writing?

Sarah Fawn Montgomery:

I’m so glad! I’m a bit of a research nerd—I love geeking out on topics, surprising myself, finding new directions. The majority of the research happened before the writing, because I researched as a patient before I researched as a writer. So many patients have to advocate for themselves because our current for-profit healthcare model simply does not provide patients the time they need to ask physicians extensive questions, to explore different options and opportunities, and to learn the histories behind their diagnoses. The stigma surrounding mental illness also means that many patients do not receive the support or seek out the community they deserve. Research becomes a way for patients to fill in the gaps left by our healthcare system, and to understand themselves within the larger history of patient experience.

My research process began with medical research on psychopharmacology and prescribing patterns, as I wanted to know about the various medications I encountered, many of which had detrimental side effects. But as I began to experience frustration with the medical care I received, I examined the history of mental illness treatment in the United States, focusing on the ways my frustrations echoed what patients experienced a hundred or more years ago. This is when I also began to write, because I wanted to use my personal experience to voice the historical narrative of being silenced, shamed, and erased. There definitely comes a point when the research has to stop—for me, the research stopped when I began to write, for I’d used it to figure out how I felt, to understand my experience more fully, and in many ways to anger me enough into tackle the telling.

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Leslie Lindsay:

Since a good chunk of QUITE MAD reads like history—a dark but fascinating—examination of mental illness in women. I wonder if you could give us a few highlights from the last three-hundred years or so? For example, uh…genital massage?

Sarah Fawn Montgomery:

Goodness, there is so much! Past treatments, particularly for women, were barbaric. The Rest Cure, for example, where women who were too loud, too excited, too adventurous, etc., were expected to go to bed for months at a time, unable to read, write, receive visitors, even bathe or feed themselves. Men, however, were treated with The West Cure, which focused on grand adventure and rugged horseback riding and hunting. Lobotomy was performed primarily on women who had not given content, but whose fathers and husbands were concerned by behavior they did not feel was ladylike. The results, of course, were that patients became docile and agreeable, easily controlled. And as you mention, genital massage was considered treatment, though the results were labeled medical rather than sexual, as women at the time were not seen as capable of desire or orgasm. Medical sexism continues today, women diagnosed and treated at much higher rates than men, prescribed psychopharmaceuticals—the first of which was described as “a chemical lobotomy”—at much higher rates, though rarely do we consider or discuss the ways violence and abuse of women, imposed silence and resulting anger, might contribute to mental illness.

Leslie Lindsay:

And your family. Tumultuous. Saintly. Dysfunctional. Healing. How might you describe them—and to what extent do you feel your struggles were a product of nature versus nurture?

Sarah Fawn Montgomery:

My family is a complex intersection of experiences—I am one of eight siblings ranging in age from nearly fifty to fifteen. Five of my siblings are adopted from various racial and economic backgrounds, but no matter our family of origin, each of us has struggled with severe abuse and mental health challenges. While the intention behind this blended family was good, to bring us together in love and support, growing up in this dynamic was difficult, in part because stability was rare and because so many people needed physical and mental health care. The origins of mental illness are complex—part genetics, part circumstance—but to bring so many hurting people together often amplified tensions and pain, and our working-class background meant that we didn’t always have access to the care we needed or the knowledge about mental illness that it takes to properly attend to needs.

Leslie Lindsay:

But you broke free. You left for college and graduate school and a relationship of your own. You’re successful and happy. Can you talk about that? Did the distance strengthen you?

Sarah Fawn Montgomery:

Making the decision to distance myself from my family both emotionally and physically—they all live in California while I live just outside Boston in Massachusetts—was a difficult choice, but one ultimately aimed at protection, preservation a kindness, for us all. As I mentioned before, my family narrative is one that centers on seeking out trauma and trying to force recovery, even when it is not possible. Ours is a story of desperate hope and the pain that comes when recovery cannot be fulfilled. The patterns established in each of us through nurture and nature, as well as the unique ecosystem we created when we come together is one that simply could not sustain me. So I chose the distance, the solitude that works best for me, choosing care rather than chaos. It was and still is to a certain extent, painful and lonely, but my mental health improved tremendously, while my siblings and parents continue to struggle in their patterns.

The distance has strengthened me individually but it has actually been the publication of this book that has strengthened my relationship with my parents. I was incredibly worried about how they would react to a memoir that exposes our family’s vulnerabilities, our members’ many flaws, and their own insecurities as parents, but I found that the process of writing about their choices allowed me to understand them a bit more, and I have grown fiercely protective of them through the process of speaking about them in interviews and book tour events.

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Leslie Lindsay:

Yet at the heart of your struggle, anxiety prevails. What was it like writing about it? Did it heighten your anxiety?

Sarah Fawn Montgomery:

Writing nonfiction, no matter the topic, always requires vulnerability, but I definitely felt an increased pressure with QUITE MAD, in part because I write very closely about what happened to my brain and body, but also because prior to the book’s publication, I’d spoken very little about my experiences with mental illness. Part of what I want to do with the book is destigmatize mental illness—according to the National Institute of Mental Health, one in five adults in the United States lives with a mental illness—by speaking openly about my struggles, even if this meant exposing myself and risking anxiety. While there were certainly challenges in describing and to a certain extent “proving” my experience to a public that often doubts or suspects those with mental illness, my main anxiety came from whether or not I accurately represented the mental illness community. I was less interested in convincing those who are quick to judge than I was about getting it right for those of us who have faced this ableism.

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Leslie Lindsay:

There’s so, so much in QUITE MAD, I could ask questions all day. What is it you hope others take away?

Sarah Fawn Montgomery:

My main hope is that those who live with mental illness will find a sense of comfort in community. Mental illness is incredibly lonely and it is difficult to advocate for yourself when the world doesn’t believe you, reacts instead with doubt and suspicion. But there is great comfort in finding others with similar lived experiences, whose stories remind you that you are not alone or strange or broken, but instead part of a larger community that supports and sustains.

Leslie Lindsay:

Sarah Fawn, it’s been such a pleasure. Thank you.

Sarah Fawn Montgomery:

Thank you! I’m so honored you spent time with my words and story!

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For more information, to connect with the author via social media, or to purchase a copy of QUITE MAD, please see: 

Order links: 

Sarah_Fawn_Montgomery_QUITE_MAD_author_photo.jpgABOUT THE AUTHOR: Sarah Fawn Montgomery is the author of Quite Mad: An American Pharma Memoir (The Ohio State University Press, 2018), and the poetry chapbooks Regenerate: Poems of Mad WomenLeaving Tracks: A Prairie Guide, and The Astronaut Checks His Watch. Her work has been listed as notable several times in Best American Essays, and her poetry and prose have appeared in various magazines including Crab Orchard ReviewDIAGRAM, Electric Literature, LitHub, The Normal School, Passages North, The Rumpus, Southeast Review, Terrain, and others. She is an Assistant Professor at Bridgewater State University.

You can connect with me, Leslie Lindsay, via these websites: 

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#mentalillness #mentalhealth #amreading #memoir #OCD #family #estrangement #stigma #historyofmentalillness

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[Cover and author images courtesy of author and used with permission.]

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