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A crisis can lead to positive change without having been designed for it; the meaning comes afterward.

We construct meaning from mental illness with family who keep showing up and from clinicians who listen.

Redemption stories carry a survivorship bias, and many people with serious mental illness never get one.

Two years ago, I found myself locked in a county jail for four months because of threats I made while in a manic psychosis. I had spent almost a decade eluding treatment for my bipolar I disorder, and the consequences of that circumvention had caught up with me. Behind bars for the first time in my life, and surrounded by beige concrete, I took cold comfort in Nietzsche’s concept of amor fati, or love of one’s fate. Instead of accepting my fate, I thought of counterfactuals: What if I had accepted my diagnosis earlier? What if I had gone to the hospital instead of insisting I was fine?

Two years later, I find peace in a routine of stability and sobriety and writing and advocacy. I have a treatment plan that works for me, have rekindled a loving relationship with my mother after 10 years of estrangement, and have embarked on a career of mental health advocacy that grew out of the wreckage of a catastrophe.

Now, the impulse to tell a redemptive story is tempting. It would be easy, compelling, and even flattering to say that the illness was the price I had to pay for everything good that followed. A reckoning with the past invites the tantalizing questions: Can a mental health crisis be a gift? Who gets to decide?

In an essay from earlier this year, psychiatrist Awais Aftab narrates two recent accounts: although Tyler Alterman could not get out of bed for over a year, he now says that he is grateful for the depression that saved........

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