As writers, I think we are drawn to mentally ill characters because they bring a depth and past to the page, unlike those ‘normal’ ones. However, we must be careful to portray those psychological ailments correctly and accurately if we want our readers to truly understand the full meaning of what our mentally ill character is actually going through which in turn brings, even more, caring from those readers. Personally, I love to write characters with mental flaws because I believe they bring to a story something other character flaws cannot and that is an internal struggle that is so universal that everyone can relate to at one point in their life.
Below are a few articles on how to plan, craft, and research mentally ill characters. With research being the most significant factor in your writing of the mentally ill. If you have personal experience with mental illness, be it from knowing someone or working with someone, rely on that experience to guide you through your understanding and writing. There is also a video on writing about mental health issues and some of the guidelines that go along with that. I hope you enjoy and use what you learn to write more😉
How to Treat Mentally Ill Characters When Writing a Novel
By: Sonja Yoerg.
The megalomaniacal CEO. The sociopathic killer. The suicidal teen. The anxious woman self-medicating with booze and pills while caring for her demented mother. As writers, we invite these characters into our stories because they are true-to-life and because their psychological problems invite curiosity and compassion.
Mental illness is common.
Another reason to include the mentally ill in your cast is that, unfortunately, few people’s lives are not touched by serious mental problems. In a given year, almost one in five Americans suffer from mental illness. This figure, while alarming, is likely an underestimate; the study didn’t include some prevalent disorders (ADHD and autism spectrum) and relevant groups, like people in prisons and mental institutions. Given the prevalence of mental illness, you might ask yourself if your characters aren’t a little too sane.
Mental illness is complex.
Handled with care, a character with mental illness can not only enliven a storyline but also open readers’ eyes to new experiences and perspectives. Sounds great, right? But psychology and psychiatry are complex and evolving disciplines, and a writer ushering a mentally ill character into his or her story has an obligation to avoid caricature and, most importantly, get the facts straight. Believability is the cornerstone to good storytelling, and facts are the mortar that keeps the cornerstone in place.
To avoid stereotyping and caricature—and to keep your story believable—try these five strategies and tips:
- Make the character relatable.
Although common, mental illness is not the norm, so characters with such disorders, especially psychoses, are imbued with “otherness.” The writer must provide a way for the reader to relate to the character despite the illness and because of it. In All the Best People, Carole LaPorte’s thoughts are disordered and she’s hearing voices—symptoms she strives to hide from her family. Her struggle to contain her illness, to be normal and whole for the sake of her loved ones, helps the reader identify with her. Barbara Claypole White’s The Perfect Son, featuring a teenager with Tourette syndrome, is an object lesson in how to develop a mentally disordered character. The boy is simply a boy, albeit a remarkable one.
- Keep the narrative front and center.
Stories work best when they are spun around a person and a set of relationships, not an illness. Even “issues books,” such as those written by Lisa Genova, are successful only when the story focuses on what happens to a particular cast of characters. For instance, Genova’s story about Alzheimers, Still Alice, would have been entirely different had the main character been a free-floating street artist rather than a cognitive scientist at Harvard. Mental illness can be debilitating and all-consuming, but it does not define a person. That job still rests with the writer.
- Balance internal and overt symptoms and behavior.
The internal world of a mentally ill person is fascinating but can readily overwhelm the reader. It doesn’t take pages of suicidal ideation, obsessive thoughts or internal word salad to deliver the message of an altered mental state. Go easy on the subjective craziness and opt instead to show how others are reacting (or not) to what is going on inside the ill person’s head. Also, not all mentally ill people have insight; they don’t necessarily know that their behavior and thoughts are abnormal. Obviously, if the person doesn’t realize they are ill, or if they become confused about it as my character did, then they might be an unreliable narrator. This can be a powerful tool but it is important to know upfront what relationship your character has with his or her illness, how that affects the interplay of external and internal worlds and the access others have to the character’s problems. It can be as complicated as you wish, don’t leave the reader behind.
- Specify the disorder, at least in your head.
Generalized “craziness” does not exist. A mental illness can elude diagnosis, or have a complicated diagnosis, but as a writer you should try to pinpoint the disorder, even if your character is never properly diagnosed. Why? Disorders are defined by specific behaviors and cognitive flaws, so the more you narrow down the diagnosis, the more you know about how your character might behave, feel and think. For example, mania is evidenced in several disorders, including bipolar disorder and drug-related disorders and some sub-types of schizophrenia. Knowing the underlying problem has ramifications for your character’s other behavior, their prognosis and treatment and whether the problem might have a genetic component.
- Get the details right.
I recently read a book in which someone treated with anti-depressants felt better within a few days. Nope. Relief via medication, if it comes, can begin after two weeks but the maximum effect can take eight weeks. Details like this matter not just because they satisfy knowledgeable readers but also because spreading misinformation about mental illness does everyone a disservice.
Mental health is a rapidly changing field, so ensure your information is correct for your time period. Terminology, diagnosis, treatment options and prognosis can be vastly different from one decade to the next. Fortunately, there are resources at your disposal:
- Consult the relevant version of the Diagnostic and Statistical Manual (DSM), the official guide to mental disorders. The American Psychological Association updates it periodically, so use the one corresponding to your setting. The National Alliance on Mental Illness (NAMI) is also an excellent resource;
- Seek out mental health professionals and those who have a first-hand experience with the disorder (patients and/or loved ones) to lend authentic details;
- Visit on-line forums, but be discreet, respectful, and appropriately cautious.
On Writing Mentally Ill & Insane Characters
You can’t go through an archive of fiction on the Internet or a collection of roleplaying profiles for long without finding a character who is supposed to be mentally ill, or “insane,” or something. However, many of these characters are based in huge misunderstandings and misconceptions about how such things work, and some of these misconceptions are harmful to real people with mental problems. So, here are some things to know and do when it comes to trying to write such a character yourself.
Know what it means to be psychotic, insane, and mentally ill.
First, the term “psychotic” refers to someone who has a severely warped perception of reality due to an underlying disorder. It is not to be confused with the term “psychopathic,” which means something else entirely. Someone who is psychotic may experience delusional beliefs (eg, that the government has bugged xir house, or that xe has a special mental connection to a celebrity, or that aliens are plotting to kidnap xir), or may experience hallucinations. Being psychotic does not necessarily mean a person will commit violent action – someone who is a pacifist, for example, isn’t likely to go shooting people just because a voice in xir head told xir to.
“Insane” is a legal term today. To quote Law.com, “insanity” is:
n. mental illness of such a severe nature that a person cannot distinguish fantasy from reality, cannot conduct her/his affairs due to psychosis, or is subject to uncontrollable impulsive behavior.
Let’s examine what it means to be “mentally ill,” or what it means to have a mental disorder. Different places give slightly different descriptions, but most agree that it has little to do with simply having some eccentric tastes or some unusual personal beliefs about the nature of reality. For a few examples, let’s take the Merriam-Webster definition, the Mayo Clinic definition, the National Alliance on Mental Illness’s definition, and the DSM5’s definition. To sum up the last one, a mental disorder typically causes disability or distress in one’s life, and cannot be accounted for as a normal reaction to a difficult event or as a behavior considered normal in the person’s culture. Furthermore, one is not mentally ill merely for having opinions or engaging in behavior that runs contrary to society’s expectations and values.
Now, society is full of people who will label people insane or crazy at the drop of a hat. Mutter under your breath to memorize something? SCHIZO! A little too energetic and enthusiastic? CRAY-CRAY! Rock yourself or twiddle your hands to calm yourself down? PSYCHO! A little too interested in a specific subject? NUTCASE! See the world in a somewhat different light from everyone else and have opinions that aren’t quite mainstream? INSANE!
Sure, these issues can potentially indicate an underlying illness, but are not proof in and of themselves. If people who exhibit them otherwise have no trouble getting along with their lives, let alone show any further symptoms that could indicate a genuine mental illness, then people are wrong (and cruel, if they use the terms in a derogatory or dismissive sense) in labeling them thus. If they don’t actually have any other issues, then they can probably be accurately described as quirky, eccentric, strange, offbeat, or odd. Insane, mad, crazy, and all those are would most likely be misnomers. And while we’re at it, characters who act “random” aren’t insane or “crazy,” either – being “random” is simply a form of goofing off.
As an example of a character who might be considered insane by the average but probably actually isn’t, let’s look at Dr. Finkelstein in The Nightmare Before Christmas. Fans occasionally refer to him as “the mad scientist.” However, there’s no in-universe justification to assume he is “mad.” He is narcissistic and controlling, yes. But given that he is respected by other members of his community – including the kind-hearted Jack Skellington – we can infer that Dr. Finkelstein doesn’t do anything too far out of his culture’s boundaries and norms. For all appearances, Dr. Finkelstein is not insane.
Some common myths and misconceptions addressed.
MOST MENTALLY ILL PEOPLE ARE NOT VIOLENT. The scant few who do harm others do not generally do so not because their mental illness magically erased their morals and ability to feel empathy, but because of a strong underlying delusion, compulsion, and/or lack of self-control. Potentially, a person who believed that xir child was possessed by demons due to psychosis might kill that child if xe believed it was the only way to get rid of the demons. But again, remember: most mentally ill people are no more violent than anyone else.
Also, a person does not simply snap and go into a state of permanent insanity or psychosis after a single traumatic event. Temporary bouts of psychosis are occasionally known to occur in otherwise mentally healthy people after traumatic or massively stressful events, but those who suffer them recover in under a month. Certain drugs and medications can also trigger psychotic episodes.
Trauma and stress can potentially worsen the symptoms of a pre-existing mental condition or trigger an episode associated with that condition, or make it harder for a person to cope with the symptoms of a mental condition. Long-term stress and abuse are associated with certain mental disorders. However, a person exposed to a single episode of stress or trauma isn’t going to develop that disorder out of the blue overnight.
Also, contrary to what some people think, not all unprovable or outlandish beliefs mean mental illness, psychosis, or insanity, and neither will a competent psychotherapist immediately assume they do. In psychology, a delusional belief is a belief that one clings to regardless of facts shown to the contrary, and cannot be explained through things that this person has learned. Colloquially, a delusion is any false belief a person holds. While psychosis can create delusional beliefs, not all false or outlandish beliefs come from psychosis.
If John taught from birth that the world was a giant cabbage, that humanity was descended from aphids, and that anyone who said otherwise was part of an evil conspiracy to lead people away from the truth, he could hardly be considered psychotic for believing thus. People in general are often reluctant and find it difficult to let go of beliefs that they find soothing, or that give them a sense of place in the world, or have held for a long time, or have deep personal investments in; if they resist convincing otherwise due to this, they cannot be described as psychotic, insane, or mentally ill for it.
Things that need to be avoided.
The pretty little “mad” waif. You know, the characters who sit around in pretty frilly dresses, sip tea (or blood), and make pretty little babble at people (or stuffed animals). These characters inevitably make mental illness look pretty and romantic.
The “mad” prophet/prophetess. The characters who through nigh-incomprehensible babble deliver prophecies and wisdom. This perpetuates the myth that there is something magical or mystical about mental illness.
The perfect innocent who snaps, goes “insane,” and goes on a murder rampage. For reasons mentioned earlier, this is bollocks. Plus, it reinforces the misconception that mental illness or insanity automatically means violent behavior.
Characters who do bad things simply because they’re mentally ill. Mental illness isn’t a magic switch that flips a person’s morality topsy-turvy or turns it off entirely. While mental illness can in some cases contribute to a person’s harmful or destructive behaviors, there is still always an underlying motivation behind the person’s actions.
Characters whose coolness, awesomeness, or badassery is supposed to derive from their “insanity” or “madness.” This is a form of romanticizing mental illness, so please avoid doing this. It’s fine if your character’s awesomeness or coolness comes from being an offbeat eccentric, but to link it to actual insanity or mental illness is not okay.
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.
Using “insanity” or “craziness” as an excuse for a character behaving in an incoherent, inconsistent way. Mentally ill people who do strange-seeming things usually have an actual rationale for it that just isn’t obvious or intuitive to the average person. Let’s say we have a psychotic individual who puts a radio into a freezer. This person isn’t doing it because mentally ill people are just so lolrandom, but is more likely doing it out of a genuine belief that the radio ought to be put there for some reason – perhaps this individual believes that putting the radio in the freezer will destroy the government spying devices in it, or stop it from emitting harmful radiation.
Mentally ill adults who act or speak in a childish manner due to their mental illness. For example, by being strangely naive about things most people know (“why do you make so much noise when I poke you with this knife?”), talking in a “childish” manner (“you’ve been naughty, and now you must be punished!”), or by depicting caring for them as being much like caring for a sick or injured child. Mental illness typically doesn’t make people act or talk like children, and even when they do need care they absolutely should not be treated like children by their caretakers. This is an irresponsible trope to use as it helps perpetuate the harmful myth that mentally ill people all have childish mentalities and need to be treated like children.
Anything that implies that being “insane” is something that people do simply to be irritating, difficult, different, or rebellious. Because it’s not. It’s the result of a mental illness. It’s not something that one can simply up and decide to be or not to be.
Anything that implies that anyone with with strange or unconventional ideas, opinions, or habits must be “insane.” As explored above, a person can believe or do things that would be considered pretty strange by the majority of the populace without actually being mentally ill.
(Note that for the last two, it’s one thing if characters in the story believe thus. But if the rest of the story agrees with these characters and shows their views to be absolutely true… then you’ve got an issue.)
Research, research, RESEARCH!
What you see in TV and books is often wrong, and what the population at large believes is often wrong. For example, many people think of schizophrenia as a mental illness that causes multiple personalities, when in fact it causes psychosis and can dampen a person’s ability to feel emotion. Bipolar disorder doesn’t cause an instant shift in mood, but rather its effects happen over a period of time.
Likewise, the terminology to refer to the mentally ill has changed over the years – while using “mad” or “crazy” would have been considered perfectly professional in times past, today the terms are considered by many to be insensitive and hurtful due to their long history of being used in derogatory and dismissive fashions. So it’s important that you know which terms would be appropriate to use in your work depending on the time period and setting you’re writing.
Whatever mental condition you’re planning to write, do the research. Read books, medical websites, blogs, etc. – anything you can find. But remember – the map is not the territory. If you go to a website that lists symptoms and behavioral criteria and base a character’s condition solely on that, you will get it wrong. Make sure you look into sources where people who have the condition are writing. Don’t limit yourself to one source, either – read as much as you can.
You might also be interested in:
A Few Things Writers Need To Know About Psychology & Psychotherapists
Basic Tips To Write Better Abuse Victims & Abuse Situations
Basic Tips To Create Better Characters With Tragic & Traumatic Backstories
On Writing Misfits, Loners, & Malcontents
External References & Resources
Medical definition of psychosis
Brief psychotic disorder – Definition
What Really is a “Psychotic Break with Reality”?
What Makes Serial Killers Tick: Are They Insane?
Why religious belief isn’t a delusion – in psychological terms, at least