Fredrik deBoer was 20 in 2002 when his mind turned on him. He grew paranoid. His thoughts tangled. His energy swung wild, and he was deeply lonely. It took a strict medication routine to get his life back, by his mid-30s. Now he's written a book about a culture that, he says, treats an illness like his as an identity to claim.
The book is All in Your Head (Simon & Schuster, 336 pages, $30). Sally Satel reviewed it for the Journal. She's a psychiatrist and teaches at Yale's medical school. Her verdict is warm. She calls it "a poignant and powerful call to sanity." Mr. deBoer has written on education and social trends before. His 2025 novel, The Mind Reels, follows a college student with an illness like his own.
He starts with history. Early in the last century, psychiatry tried lobotomies and insulin comas. In the 1950s and '60s, new drugs like Thorazine replaced them, and news stories exposed the state asylums. Patients left those hospitals in waves. By the 1990s most of the old institutions were closed. The money for steady care in the community never showed up. Many of the sickest people were left on their own.
The revolving door
Mr. deBoer's sharpest point is about one word, anosognosia. It means a sick person can't see that they're sick. It's common in schizophrenia and in bipolar psychosis. That's why the usual system fails them, he argues. His example runs one week. A person in psychosis spends two days in an emergency room. They leave with a printout and a bottle of sedatives. Within days they're psychotic again. He wants laws that require follow-up care after a serious episode. He also argues for easier involuntary treatment, a position plenty of people reject. "The grand experiment in maximum autonomy has failed," he writes. He has a second target, too. Young people online who claim a diagnosis as an identity. He says that pulls attention and money away from the people who are truly ill.
Our read
Our domain is Health Costs, with a Consumer Protection point (M11). Set the politics aside and one fact stands. A two-day ER stay is not a care plan. Families with a seriously ill adult child, sibling or parent learn this the hard way. The hospital stabilizes and discharges. What happens next is on you. And the person you're helping may not believe they need help. That's the illness talking.
If you support someone like this, the thing in your plan this story touches is the paperwork that lets you act. Two pages. A signed release so the hospital can call you and talk to you. And a first-week plan on file for after discharge, with the follow-up appointment already booked, the pharmacy named, and a number to call. Get both done this week, while things are calm. One more check from the review. Mr. deBoer notes that wellness coaches and trauma guides aren't regulated. Before anyone bills you for therapy, look up their license on your state board's website. If this kind of care sits in your budget, bring it to your next review. It changes a plan more than people expect.