This article discusses the structures and mechanisms of sanism, focusing on the impact on those labeled Mad or normal while looking for a way to overcome the sanist system. Sanist strategies like othering are analyzed and the intersections between sanism and racism, heterosexism, and classism are observed. In order to understand the effects of sanism the extent to which the sanist system produces fragile and vulnerable positions are discussed. The consequences of vulnerability for Mad people while demanding accountability from non-affected people are emphasized. Finally, the concepts of Radical Vulnerability and Critical Fragility are offered as ways to shift the negative paradigm of vulnerability in order to fight sanism in solidarity.