Or, maybe you recognize her from her appearances on just about every comedy show that mattered in the last two decades, from "Saturday Night Live" and "The Larry Sanders Show" to "Jimmy Kimmel Live," "Mr. Show with Bob and David" and "Chapelle's Show." She even had her own Comedy Central show, "The Sarah Silverman Program" from 2007 to 2010, which received a Primetime Emmy nomination.
She's learned a thing or two from all that living, and she's been dispensing wisdom in recent media appearances to promote her film. Here's a smattering of what she has to say about depression, body image and the "vagina tax" women pay in comedy and other realms of society.
Look in the mirror less
Sure, it's necessary to check yourself before leaving the house, and many people can't avoid paying attention to their appearance for their jobs. That doesn't change the fact that looking in the mirror can provoke anxiety for many.
Silverman projects this anxiety in a scene in "I Smile Back" in which she gazes in the mirror and lifts her arms to see how her breasts would look at a higher position.
Repeated references in news articles to her "coltish" beauty and slender figure notwithstanding, Silverman told NPR's Terry Gross
that she still experiences insecurity over her body. To keep it at bay she follows this brilliant piece of advice from her therapist: Look in the mirror less.
"It really blew my mind in the greatest way," she said. "And I just thought, 'oh, right.'
"I always look at myself knowing that I will have a certain degree of cognitive distortion ... so I put it on a bell curve. I kind of adjust what I'm seeing and know that it's better than what I'm seeing, whether that's true or not."
Talk about taboo topics
Comedians often crack jokes that make people uncomfortable and stir controversy, as Silverman knows well. (See her her 2001 appearance on "Late Night with Conan O'Brien
There have been other times when Silverman used comedy to address social injustices and instances of inequality. In a 2014 viral video, she parodied the wage gap
between men and women in the United States, calling it a "vagina tax."
"Comedy has always played a big part in pop culture and the way we see history. It's more of a mirror to society and more of an honest reflection of history than history, sometimes," Silverman told CNN's Christiane Amanpour.
For example, there was a time when the transgender community was rarely acknowledged, she said. What's changed over time is people started talking about the community and its experiences, she said.
"If you look at all things that were at one time taboo and aren't anymore, the change is that it became a topic of discussion," she said.
"If you look at the trans community, these people always existed; they just were living in personal hells where they couldn't expose themselves," she said. "What it took was -- and it continues to take -- is that it just becomes part of a conversation and then it's not so crazy anymore."
... And depression is one of those topics
When it comes to dealing with depression and anxiety, Silverman is fond of quoting Mister Rogers, who once said
, "Whatever is mentionable can be more manageable."
It's something she learned over time coping with depression, starting when she was a teenager in New Hampshire. She has several ways of describing depression and how it's different from grief or sadness. To her, it's an instant "chemical change," like a "cloud covering the sun" or a sudden onset of the flu.
"My perspective of the world changed about three degrees, and everything I saw was different," she told NPR's "Fresh Air." "I had been an extremely social person with best friends and the class clown. And all of that meant nothing, suddenly. I didn't see any reason -- being with friends felt like a burden."
She was initially prescribed four Xanax four times a day. She said she found a new psychologist and eventually stabilized after tapering off her medication. She channeled those experiences into playing her character, Laney, in "I Smile Back."
"She really lives entirely in anxiety, in that state we all get in occasionally of 'what if?'" she told Amanpour. "We tell ourselves horror stories and that's anxiety... and there's no space for anything else."
But treatment is a lifelong process -- a commitment, even -- of adjusting medication if need be and finding the right person to talk to.
"We drive every kind of car before we pick a car. Plan on seeing 12 different therapists before you find one. It's important," she told James Lipton
, host of "Inside the Actor's Studio."
"People say I can't afford therapy. Get a shittier car -- it's important."
You can't have the highs without the lows
Even if you take your medication and regularly visit a therapist, the mood swings never go away, Silverman said. But you learn how to manage them.
Silverman started experiencing panic attacks as an adult after she started working as a writer at "Saturday Night Live."
"I remember thinking I want to move home to New Hampshire. ... You just want to go home, and you don't want to do anything scary. And then I found a woman who put me on a pill called Klonopin that all it does is block panic attacks. And that really saved my life in that I was able to go to work at 'Saturday Night Live' and exist through each day while I was figuring this out," she told NPR.
Silverman said she has been on a low dose of Zoloft since 1994, what she calls a "godsend." It doesn't make her numb but it helps keep panic at bay.
"It was the perfect fit for me, and I feel like I can live life," she told NPR. "It wasn't something where, like, now I'm happy. I'm very lucky in that I still experience highs and lows. And I think those lows are important. But I am not totally paralyzed, and, you know, it keeps me from just complete staid paralysis."
It's OK to tell girl jokes
When Silverman started in comedy the men around her held up Paula Poundstone as the exemplar female comedian because any man could take her material and be just as funny, she told NPR.
"She's not talking about tampons and stuff," she said. "And I really took that as truth. I just accepted it as the way things were and that that was cool."
Over time, she came to see the value in sharing her experiences. And she found an audience for them. "Comedy is talking about my own experience, and I'm a woman. And that's my experience. And just because it isn't yours doesn't invalidate it."
Embrace the quiet moments
From comedian Gary Shandling, who gave Silverman a shot on his popular HBO 1990s comedy, "The Larry Sanders Show," Silverman learned not to fear the quiet moment.
The context for Silverman was onstage, but it's a skill that could apply in everyday life.
"He really taught me to find comfort in the quiet moments," she told "Inside the Actor's Studio." "The moments between the jokes, the setup, the punchline ... can be just as powerful and say just as much as words."