Unhinged: A Memoir of Enduring, Surviving, and Overcoming Family Mental Illness

Unhinged by Anna Berry, is a unique and honest journey of the author’s self-struggle with mental illness, her process of achieving recovery, and finally moving on and attempting to help her family members who suffer from similar afflictions. From a physician’s perspective, this book is fascinating in that the reader is able to feel her emotions and despair as the black hole of her mental illness takes over her brain. The reader is pulled into the text, and it is difficult to put the book aside as you find yourself wanting to untangle the author from each difficult situation that she falls into. This book serves as an excellent platform from which to explore the trends in psychiatry, especially those relating to the advances from DSM I to DSM V. Berry points out that though the DSM is helpful in identifying mental illnesses in order to formulate treatment plans, if not used solely as a tool can result in patient’s being placed in specific boxes without room for variety in symptoms. The changes with each DSM can be difficult for the physician to remember and incorporate into their practice, but it can be more detrimental to the patient who continues to have a changing diagnosis. In reality, the dynamics of diagnosis and treatment are not as simple as just following the guidelines provided by the DSM manuals. In a Psychiatric Times article The Limitations of Our Diagnostic Classification: Beyond DSM’s Checklists Dr. Melvin Gray discusses the shortcomings of our current systems of psychiatric classification as it excludes the emotional aspect; the loss of this vital dimension of psychiatric disorders can lead to patients being placed into categories instead of a holistic approach to each patient as an individual. He emphasizes the need for psychiatrists who are experts at dealing with the depth of human emotions. Chapter one is an exploration of the reader’s struggles with attachment issues to different people who treat her poorly, including the mental health professionals who she is placed with. This is quite difficult for the reader who wants to reach through the pages and pull her out of these troubling situations. She has a fascinating description of all her different diagnoses and why she did not fit into those specific boxes that the professionals had placed her. It also helps the reader understand why the author has an inherent distrust of the mental health system in the United States. It is highly disturbing that the author and her family had the misfortune to deal with unethical practitioners, and you wonder if their illness course would have turned out differently if they had caring physicians. Throughout the book, the author recounts different stories regarding her family member’s struggles with mental illness. Although the stories themselves are fascinating with the grotesque destruction that the individuals place on themselves secondary to their mental illness, there is a recurring theme of the difficult concept of tough love. This is especially true in chapters 5-6 when she describes her different frustrating interactions with her mother and brother. The reader sees her futile attempts not as a lack of compassion, but more apparent is her underlying sense of frustration at being unable to help more, we often have no choice but to feel helpless. It is a bit disconcerting for the reader themselves to ponder the thought of helping a mentally ill family member who may also be quite manipulative. Berry ends the book with a recount of how her positive life changes have helped her overcome her mental illness, and also highlights her continued journey to help her family. Overall, this book gives an understanding of the patient’s experience and can be used to help take a more empathetic and attuned approach to mental illness. With the current situation in the US to push mental health treatment in a positive direction, this book serves as an additional resource to highlight the struggles that revolve around this issue. NAMI (National Alliance on Mental Illness), a patient advocacy group, discusses the process of recovery as a journey that is very different for every individual. They emphasize that it is a process and not a single event, and that recovery is possible. Unhinged provides hope that mental illness is not a death sentence, and rather just another illness that can be overcome.