Writing About Mental Illness

And how to do so with compassion

Content Warning: I mention some slurs often used to refer to people with mental health disorders. I don’t portray them in a good light, but I don’t want anyone surprised.

As someone who has multiple mental health diagnoses (ADHD, Autism, CPTSD) and as someone who is close with multiple people who have a variety of other diagnoses, I can say for certain many writers don’t handle mental health well. Media often portrays it badly, and many of these portrayals only increase stigma for people who experience these disorders.

Media has come a long way since the early days, and I’m not going to erase the hard work of many who have been pulling in that direction, but it’s still a struggle for many people. Particularly if you are writing about a mental illness you, yourself, do not have. With this being Mental Health Awareness month, I wanted to cover this topic because, frankly, I feel that it’s extremely important.

With all that said, I have some tips for people who want to write about mental health challenges from a place of compassion and authenticity. These tips are not one-size-fits-all, and the mental health community is not a monolith. Nor is any community, to be honest. These are, however, my opinions from my lived experience.

Mental Health and Characterization

Characters with mental health challenges may have a number of quirks or symptoms that will appear during the space of a story. These symptoms will, of course, be related to the condition(s) they have, but there are a few things you ought to know about these characterizations as a whole:

1. Remember that these are whole people.
   Individuals with mental health struggles are whole human beings. And if they’re adults, they are possessed of many (if not most) of the same mental capabilities as those without psychological conditions. Even if their intellectual capacity is diminished (based on certain disorders affecting that), they will have the full range of human emotion and will know far more than many people believe. As such, they should be given that space.

2. These communities have been devastated.
   Large scale closures of “insane asylums” only started in the 1980s. There were still open and functioning asylums up until 2015. People in these institutions were regularly subjected to incredibly horrible treatments and often both neglected and assaulted. It is only in very recent times that autistic people haven’t been sterilized and left in corners to rot in their own filth. I mention this because if it seems like there are “more mentally ill people lately” I think a large percentage of that is that we’re more visible because we aren’t being shoved away from society.

3. The media has often not portrayed us with compassion.
   If your understanding of mental illness comes from watching pieces like Split. Split demonizes DID something fierce, and most people with DID are no danger to anybody. Or movies like Fatal Attraction which portrays bipolar people as similarly dangerous. Which is hogwash.

4. People living with severe mental illness are more likely to be victims than aggressors.
   Statistically speaking, people with mental illness are more likely to be on the receiving end of violence than perpetrating it. Despite the fad of claiming that violence is the fault of mental health issues, the vast majority of people with serious mental illness are nothing like that. Risk factors for violence are dramatically more likely to come from a variety of social, contextual, and other factors.

5. The DSM-5 is out of date.
   In 2022, the APA published a revised version (The DSM-5-TR) which is more in date, but it is still well behind the science. For example, the autism section still focuses on the AMAB-centric presentation of autism and ignores the symptoms of AFAB people. It also doesn’t take into account autistic masking very well.

6. Medication plays an important role.
   Not all mental health conditions require medication, but those who do need medication don’t take it because it makes them high. If a non-ADHD person were to take my Vyvanse, they’d experience euphoria and a large burst of energy and motivation. However, for me, I just experience a calming of the mind and the ability to get my chores done at all. It doesn’t solve my ADHD issues, but it certainly helps. And it most definitely does not get me high. I don’t take it because it’s fun; I take it because it helps me function in a world where without it I am likely to forget to shower. Medication is an important element of my management system. And there’s nothing wrong with me needing it any more than it’s wrong for me to wear glasses because I have astigmatism.

Generated by Substack

How to Research Mental Health Conditions

For all I comment above that the DSM-5 is out of date, it is a good place to start when trying to understand the diagnostic criteria in effect today for people with various mental illnesses. But it is not where you should end your research. If possible, I strongly suggest talking to human beings who have the condition(s) you are trying to portray and asking them about their experiences.

I reiterate that people with psychological conditions are not a monolith. My experience with CPTSD is going to be different from someone else’s, even if we do share many of the same raw pieces of experience (flashbacks, nightmares, anxiety, etc.). If you don’t know anybody personally, you can probably find information from people in those communities online. TikTok, for example, has a number of communities surrounding mental health. As does Reddit. These are not clinical groups but more people talking about their lived experience.

What NOT to do

We are all humans who make mistakes, and that’s an understandable reality. I can, however, save you some trouble and help you identify a few things not to do when writing about mental health issues.

Please do not…

• …rely on stereotypes

• …make your villain a “psycho”

• …use the word “retard” or “retarded” to refer to a human being
  (The one and only exception to this would be in a period piece, but even then, realize it’s viewed as just as bad as racial slurs by the mental health community, so… use with caution.)

• …add to the stigma people with mental illness face if possible

• …make mental illness an excuse for violence

Those are a few of the major faux pas I can think of in regards to writing about characters with mental illness or writing about mental illness in general. Again, I am not a mental health professional, so I can only speak from my experience and point of view. But I hope this provides at least a spring board toward helping you discuss mental health issues in your own writing and treat people with more compassion.