This study examines how dynamics surrounding biographical disruptions compare to more routine fluctuations in personal social networks. Using data from the Indianapolis Network Mental Health Study, the authors track changes in patients’ social networks over three years and compare them to a representative sample of persons with no self-reported mental illness. Overall, individuals at the onset of treatment report larger and more broadly functional social networks than individuals in the population at large. However, the number of network ties among the latter increases over time, whereas network size decreases slightly among people using mental health services. As individuals progress through treatment, less broadly supportive ties drop out of extended networks, but a core safety net remains relatively intact. The findings in this case provide evidence that social network dynamics reflect changing needs and resources: persons labeled with psychiatric disorders learn to manage illness, with functionality driving social interaction in times of biographical disruption.