Writing Mental Illness (general thread)

I have been seeing a few threads to this effect, but they're all unilateral. So, I have decided to begin a more inclusive version. Here, you can pose questions about the writing of any form of psychological, emotional, or neurological ailment.

I volunteer as tribute to answer questions about living with mixed-state bipolar disorder, since I really want to see that kind of thing written better than I have in most media.

Don't be afraid. I'm crazy, but I don't bite. Much.

Oh,perfect. Was in need of one of these.

Currently, I'm trying to write a character with severe, severe PTSD. I referred to a friend who knows someone with PTSD on the matter and he said the key factors were being really jumpy and occasionally going into periods of extreme lethargy.

I know there's a lot more than that, which is why I need this thread in the first place. Any pointers?

I know that they have flashbacks, frequent anxiety, and (sometimes) catatonia They also prefer to avoid triggering situations. That's about all that I know. I'm familiar with some PTSD tropers, though.

edited 30th Nov '14 11:42:14 AM by SpaceWolf

On PTSD, don't have it myself but I've done a decent amount of research (so I'd like to think).

One of the more common effects that I don't usually hear about is the "rift" that gets driven between them and the world. They can't go into a relaxed state as easily as we common folk can, and sometimes not at all. This makes it harder to maintain personal relationships as one could imagine, taking things "well" is very hard since they are usually deep down prepared for conflict and it can cause them to over-react. They can see this difference in themselves and will sometimes feel cut off from the rest of society and their friends or families.

In the military I've also heard of those who actually get annoyed when people try to connect to them empathically, "They have no idea what it's like." Or when they get the "Thank you for your service" treatment because they may have residual guilt about it and may see it as being undeserved, highly individual though and dependent on the experience, the individuals attitude towards the subject, and exact circumstances.

Now these observations were based on a few accounts and therefor are not descriptive of the condition as a whole, but when you said "severe, severe ptsd" this is what my mind immediately jumped to.

edited 30th Nov '14 1:12:50 PM by Slysheen

Insta-watchlisted. :D In the vein of Shadsie, I can offer feedback regarding ADD, depression, and anxiety (if anyone even needs help with those) and link to useful resources.

Re: PTSD - I don't know much that hasn't been mentioned, but for the sake of trying to be helpful... from what I understand, some of the symptoms will vary depending on what the source of trauma was. People will cope with surviving a military incident differently whether they were involved as a soldier (trained for the situation if not the psychological repercussions) or a civilian. Survivors of natural disasters or industrial accidents will react differently as well.

Does anyone have any experience with sensory integration disorder?

As someone stationed on a base with a lot of vets, PTSD, what I've seen and what I've been told:

• A lot of returning vets did present a "pleasant false front". This is both a coping mechanism and them trying to blend in. Happens a lot with depressed people, many will appear cheerful until you get to know them.

• Symptoms can appear long after the traumatic event (combat, accident, etc).

• Panic attacks can and will happen both with a trigger and without.

I have no experience with that one.

I appear to have accidentally written in a lot of things that give off PTSD. Good to know I don't have to do too much adjusting.

Another question, this time with high-functioning autism. I watched an anime about a character with this disease, called Sakurasou No Pet Na Kanojo (geez that's a mouthful), and the way that the condition was portrayed was actually really, really well done.

Any pointers? I know this might be a sore topic for some, but I'd like to know if this anime missed anything that might be important.

I'm just going to leave this here, because I've seen way too many people fuck this up and it makes my blood boil every time. It's very informative. Check it out.

But in particular, this:

Cannot stress this last one enough: Characters for whom being "insane" or "crazy" is pretty much all the character is about. People with mental illnesses are people with hopes, dreams, fears, ambitions, hobbies, passions, etc. Characters who are supposed to have severe mental issues need to be three-dimensional people as much as any other type of character does.

All too often I see people treat mentally ill characters as, if not one of the above things, like a list of symptoms for them to check off.

edited 10th Dec '14 9:22:30 PM by GameSpazzer

Thank you, Spazzer. I fully agree with you. This is very important.

Another crucial note: Psychosis is not psychopathy.

Gameknight: You would need to talk to someone who knows more about HFA. I know several people with AS, but few with HFA. It's worth noting that they're distinct disorders.

edited 10th Dec '14 9:37:12 PM by SpaceWolf

Thanks for this post, it is very good.

This is probably the most common mistake I see regarding that list, particularly in genre works where the villain is 'insane' because his worldview or values are different to the heroes'.

edited 10th Dec '14 10:52:46 PM by editerguy

Forgot the awareness level or awareness reaction when writing characters with mental illness.

When somebody learns what's wrong with them, it can also change their behavior.

So, I want to write a villain with autism, but need a list of things to avoid. I asked some autistic people I knew in real life for some information to help me, but what they provided to me was already covered on the above list...and they weren't comfortable with talking anyway.

@Spaz Great advice. Sorry for the late reply, my watchlist is busted.

@Space Wolf I would like a more in-depth explanation on that. As deep as possible. The character in Sakurasou, Mashiro, seemed to be fundamentally disconnected from reality. She did not know why it was embarrassing to be naked in front of a boy she didn't know, or why it was inappropriate to go out in public wearing only panties and a cat suit. Tropes seems to agree that this is almost textbook high-functioning autism.

I planned to play this from a much more disturbing angle, having my character not understand why it's inappropriate to burn entire cities to ashes or why people would be afraid of her fire. But you saying "Psychosis is not psychopathy." is giving me pause here.

So psychosis (psychotic) has the delusions, while psychopathy (psychopathic) does not?

I want to take a little moment to rant:

One thing I see in media a lot is "mentally ill = hallucinations." Take a fairly recent episode of The Simpsons, for example, in which a one-shot character is shown having a "crazy spell" where they imagine things warping and turning into weird things and on their desk is a bottle of pills "for bipolar disorder."

As someone who has the actual illness, I'VE NEVER HALLUCINATED IN MY LIFE. (Well, unless you count dreams, and no one does, because everyone has them). While I have read that some bipolar people hallucinate when in a very out of control state of mania, it doesn't happen to all of us and has never happened to me. For me (and most people) being bipolar is an "emotions are set on extra strong and somewhat unstable" thing. Most of us can be highly functional, some of us can even hide it. (I'm not very good at hiding my emotions, which is why I can't work, but that's not typical of most, and even I can function in non-stressful situations).

I thought of something to share, too, that might be of help for people writing the depression-side of said disorder or just depression in general: It's how the weirdest little things can "snap out out of" a low-mode where you're prone to bad decisions. Example: Last week, I was out for a walk and I needed to cross a busy street to get home. I'd gauged a space between traffic to make a dash across the highway when a car came barreling at me. I backed up as the person in the car suddenly had an epiphany that there was a human in front of them and squirrelled back the way I came. I thought "It looks like I'm not depressed enough today to let it hit me," which I had given brief thought to. The stupid little thing that was on my mind that kind of "made me care" was how my guy was going to bring home some good Chinese food for dinner on his way home from work. I was looking forward to having duck, which I don't get to have that often - and that's the thing that kept my will to live up for that day. It really was the stupidest little thing to snap me out of a general apathy that might have otherwise had me not getting out of the road so quickly.

I don't know insightful that is, but I thought it might be inspiration for a good story.

It seems like things like that happen to me all the time. Sometimes, it's even a kind word on the Internet from someone on a forum. (Which is why the Anxiety/Depression thread over in Yack Fest needs full support and people who aren't feeling down to hang out in it for the sake of those who are).

On the "mad prophets/seers/etc," what if you're writing from the view of a culture (or the fantasy equivalent of it) where that's a genuine viewpoint? A crapton of indigenous religions believe that epilepsy/narcolepsy or similar-appearing illnesses were signs of spiritual power, to the point where "the falling/sleeping sickness" is pretty much shorthand for one of those two illnesses. Just because modern society knows what's actually happening when you have a seizure or pass out doesn't make the cultural views any less valid.

Or is it just the generically "crazy" type of prophet who isn't particularly culture-specific that's advised against?

I mean, I roleplay as a pan-cultural Fox Spirit who's a Mad Oracle transgender shapeshifter as a result of the Crazy Like A Fox AND Cunning Like a Fox coming together oddly, and that's hardly the kind of "crazy person spouts conveniently coherent prophecies/advice" that the link seems to be talking about.

edited 13th Dec '14 8:26:24 PM by Sharysa

The problem is the Viewers Are Morons trope comes into play:

• Most writers assume that the viewer/reader/listener need to see/hear the character going "batsh_t" otherwise they won't get the idea that the character is mentally ill.

• A lot of people forget the Values Dissonance, sadly before mid-90's the mentally ill were Acceptable Targets. Many writers seem to not get a clue that this has changed.
  • Hence Cloudcuckoolander + "mentally ill" = "funny" or "villain"

From Imgur.com:

Game Spazzer: HELL YES. Thank you for posting that.

• The culture may believe that, but that doesn't mean it's true; and even if it's true in your setting for some reason, there will always be people who don't benefit from it. How does society treat people who have seizures but don't get the expected spiritual wisdom and power? What can those characters choose to do? What about the people with illnesses that don't produce seizures at all - learning disorders, for instance?
• Having spiritual or social power doesn't negate the detrimental symptoms - or if it does, the character doesn't really have a disability. A character who sees visions but can distinguish them from reality is no more schizophrenic than a character with super leg prosthetics is lame.
• Mental illness pervades every aspect of a person's life, but also does not define them. A list of neuroses is not a character, no matter how long it is. (This ties into Taira's comment about Viewers Are Morons.)

...to be honest, I may simply have gotten the wrong impression from your summary, but your RO character doesn't sound mentally ill in the slightest. "Crazy like a fox" is not insane, and simply calling them a Mad Oracle doesn't indicate anything on its own either. :/

If it's crazy and it works, it's not crazy.

...I'm sure there was more I was thinking about, but I've sat on this draft for so long I've forgotten what else there was. >_<

Why not just invent fictional diseases? People can't be offended if the victim is suffering from Nimipolar or something.

That can work in the right story, but you shouldn't look at it as a way to avoid doing research... You might be surprised how hard it is to genuinely make something up. :)

Something I'd like to see more of are protagonists who are medicated and this is acknowledged as an okay thing. Over in the Hero Critique Thread I once posted a write-up on a character I've got in mind who is exactly that—an ex-FBI agent turned small town cop who had an extreme breakdown but is now medicated and trying to put her life back together. I wrote her at least partially with the intent of making the point that being medicated is not a sign of weakness, it is a sign of taking responsibility for your own mental well-being.

@Asepai

Someone who is psychotic has a disconnect from reality. Someone who is psychopathic has an extreme Lack of Empathy and (usually) malignant antisocial tendencies. They're not connected at all.

Out of curiosity, why do you want to write an autistic villain? As somebody on the spectrum I'm curious about that choice, because as a general rule I'd say autistics/Aspies would make fairly poor villains. Speaking very generally, we're badly coordinated and nonathletic, unlikely to be experts at manipulating people due to social confusion, and saddled with a fairly obsessive regard for "The Rules". I'm not denying that there are some fairly scary people out there who are on the spectrum (I knew one guy who veered into MRA/stalker territory) but I'm not sure we're great villain material for a story.

edited 25th Jan '15 8:01:06 PM by AmbarSonofDeshar

Though we also have a tendency to be obsessive. Which is a pretty easy trait to incorporate into a villain.