Annabelle suffers from post-traumatic stress disorder (PTSD) and anxiety after witnessing the shooting of her best friend and boyfriend almost a year earlier. The novel depicts Annabelle’s struggle to cope with and heal from this trauma, with the cross-country run signifying that healing can be much like a marathon—long and arduous, with setbacks as well as triumphs. Annabelle’s journey is both a test of personal strength and endurance as well as a testament to community and personal healing.

Even before beginning her run, Annabelle sees a therapist named Dr. Mann, who helps her cope with her PTSD. Gina is aware of Annabelle’s PTSD, and when Annabelle first describes her plan to run across the country, Gina states, “This is PTSD, Annabelle […] Don’t you remember what Dr. Mann said? This is hyperarousal, recklessness” (11), describing the traits of this condition. Dr. Mann offers many strategies to help Annabelle cope. One symptom Annabelle experiences is intrusive thoughts; memories of The Taker pop into her head unexpectedly, no matter how hard she tries to push them away. Annabelle describes this experience, thinking, “You wish you could annihilate some memories, too, but you can’t do that, either.