Analysis & Comment

Opinion | Interrogating the Stories We Tell About Our Minds

The journalist Rachel Aviv complicates narratives surrounding mental illness.

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Produced by ‘The Ezra Klein Show’

The National Institute of Mental Health estimates that nearly one in five adults in America lives with a mental illness. And we have plenty of evidence — from suicide rates to the percentage of Americans on psychopharmaceuticals — that our collective mental health is getting worse. But beyond mental health diagnoses lies a whole, complicated landscape of difficult, often painful, mental states that all of us experience at some point in our lives.

Rachel Aviv is a longtime staff writer at The New Yorker and the author of the new book “Strangers to Ourselves: Unsettled Minds and the Stories That Make Us.” Aviv has done some of the best reporting toward answering questions like: How do people cope with their changing — and sometimes truly disturbing — mental states? What can diagnosis capture, and what does it leave out? Why do treatments succeed or fail for different people? And how do all of us tell stories about ourselves — and our minds — that can either trap us in excruciating thought patterns or liberate us?

[You can listen to this episode of “The Ezra Klein Show” on Apple, Spotify, Amazon Music, Google or wherever you get your podcasts.]

We discuss why children seeking asylum in Sweden suddenly dropped out mentally and physically from their lives, how mental states like depression and anxiety can be socially contagious, how mental illnesses differ from physical ailments like diabetes and high blood pressure, what Aviv’s own experience with childhood anorexia taught her about psychology and diagnosis, how having too much “insight” into our mental states can sometimes hurt us, how social forces like racism and classism can activate psychological distress, the complicated decisions people make around taking medication or refusing it, how hallucinations can be confused with — or might even count as — a form of spiritual connection, what “depressive realism” says about the state of our society, how we can care for one another both within and beyond the medical establishment, and more.

This episode contains a brief mention of suicidal ideation. If you are having thoughts of suicide, text 988 to reach the Suicide & Crisis Lifeline. A list of additional resources is available at

You can listen to our whole conversation by following “The Ezra Klein Show” on Apple, Spotify, Google or wherever you get your podcasts. View a list of book recommendations from our guests here.

(A full transcript of the episode will be available midday on the Times website.)

“The Ezra Klein Show” is produced by Annie Galvin and Rogé Karma. Fact-checking by Michelle Harris, Mary Marge Locker and Kate Sinclair. Original music by Isaac Jones. Mixing by Sonia Herrero, Isaac Jones and Carole Sabouraud. Audience strategy by Shannon Busta. Special thanks to Kristin Lin and Kristina Samulewski.

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