How do you write someone who's Clinically Insane?

Since my Google-fu is not what it should be, I can't really find all that much about someone who is clinically insane. Anything I should be aware of and things I should or should not try?

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"Insane" is a reality-tunnel that looks much like an alien planet to you. It is quite easy to imagine a very bizarre set of beliefs, and put these beliefs in a character — having him run through with it.

One note though — kindly don't write the straw-batshit stereotype, where the guy is drooling over and mumbling gibberish while waving his hands around like a lunatic.

edited 8th Feb '11 9:23:54 PM by QQQQQ

I think I can sorta help on this one, considering that one of the projects I have in mind has a clinically insane character in a major (anti-heroic) role.

Is your character supposed to be sympathetic? If so focus on any mental and emotional pain he must feel, but not so much that it becomes overbearing.

First and most important question... which sort of insanity?

What's precedent ever done for us?

Some of the most messed up people still manage to be very magnetic and charismatic, very good at getting people to love them not just in spite of but for their problems. I can see how one would have to learn how.

whoever wrote this shit needs to step on a rake in a comedic fashion

Look up the DSM-IV online and find the type of insanity that you want. It will tell you the behaviour that draws that diagnosis.

http://allpsych.com/disorders/disorders_alpha.html

So for Obsessive Compulsive Disorder (OCD) it says:

The key features of this disorder include obsessions (persistent, often irrational, and seemingly uncontrollable thoughts) and compulsions (actions which are used to neutralize the obsessions).  A good example of this would be an individual who has thoughts that he is dirty, infected, or otherwise unclean which are persistent and uncontrollable.  In order to feel better, he washes his hands numerous times throughout the day, gaining temporary relief from the thoughts each time.  For these behaviors to constitute OCD, it must be disruptive to everyday functioning (such as compulsive checking before leaving the house making you extremely late for all or most appointments, washing to the point of excessive irritation of your skin, or inability to perform everyday functions like work or school because of the obsessions or compulsions).

That would be how you write them.

Whether you think you can, or you think you can't, you are probably right.

What about something along the lines of Compulsive and Paranoid?

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I think having a look at the SNAFU Principle can help.

If you want compulsive and paranoid, try personality disorders. Specifically, Schizotypal, which can be comorbid with all manner of fun things.

I'll hide your name inside a word and paint your eyes with false perception.

If you want "clinically insane", I wouldn't go for OCD, myself. People with it may be suffering, but the nature of the disorder is that they tend to have a pretty good idea of what's going on with themselves. If you want realism, the term "clinically insane" isn't a great place to start, anyway. The term "insane" doesn't have any clinical meaning—legal at most.

whoever wrote this shit needs to step on a rake in a comedic fashion

Compulsive & Paranoid:

Well, it depends. Firstly, there are two kinds of paranoia - delusional and non-delusional. Basically, non-delusional means what they believe could be true, but they've leapt to the persecution explanation without sufficient evidence (wife acting odd automatically means she's cheating, or random people laughing are laughing at him, etc) while delusional means it's either impossible or extremely unlikely, and probably has clear evidence against it (aliens, CIA has a personal interest in them, etc). Non-delusional paranoia is the stuff of personality disorders, especially paranoid personality disorder. Delusional paranoia is seen in any of the delusional disorders (schizophrenia, delusional disorder, schizoaffective disorder, some severe cases of mood disorders, etc).

Compulsive could refer to several different things, too. Anxious compulsions, where not following through on the compulsion makes you extremely scared, are the hallmark of OCD and also characteristic of Obsessive-Compulsive Personality Disorder (which basically is perfectionism) and some forms of eating disorders (mainly anorexia). Addictions are another kind of compulsion, and there are plenty of diagnoses for various kinds of addictive behavior, such as substance abuse, certain eating disorders (mainly bulimia or anorexia/bulimia), kleptomania, etc. And lastly, there are compulsions done because they make the person feel happy, which seem to be mostly associated with the autism spectrum.

Both of those together would be either a person with multiple diagnoses, or OCD with poor insight (a subtype of OCD where they think their obsessive-compulsive behavior is perfectly reasonable and the imagined dire consequences really will happen).

If I'm asking for advice on a story idea, don't tell me it can't be done.

Err, I guess it depends — what are they diagnosed with? There are plenty of different brands of insanity out there.

For the run of the mill insanity, though, I guess you should try finding case studies of different types of schizophrenia or something. There where a few interesting ones via video on youtube last time I checked, though that was a really long time ago.

Also, this:

...Though I'm pretty sure its a bit of an exaggeration.

edited 9th Feb '11 7:28:02 PM by Dec

Nemo enim fere saltat sobrius, nisi forte insanit Deviantart.

^ Probably. I've seen similar stuff for autism, and it's usually exaggerated but mostly accurate.

If I'm asking for advice on a story idea, don't tell me it can't be done.