Writing about mental illness? This is what I want you to know

As a person who has grappled with her mental health through her life, I’ve experienced many facets of living with mental illness. At the same time I’ve had to see many portrayals of mental illness in fiction, and much of it doesn’t just annoy me as a “mentally ill person” but also as a writer. So what should you take into consideration when you’re writing about mental illness?

Before we begin, I want you to remember that I’m just one person. No matter what group of people someone belongs to, they can never speak for everyone in the group. Naturally there are people who disagree with me and there are experiences that I could never sufficiently write about because I don’t know anything about them.

That’s why you need to listen to multiple people and not just settle for a single blog post. I also want to point out that I’m a white person, and the treatment and diagnosis of mental illness has been and continues to be different for people of colour and other marginalized people.

Why should you care about ableism to begin with?

Ableism: discrimination of and social prejudice against people with disabilities based on the belief that typical abilities are superior.

When talking about being inclusive and about not using offensive words, some people always complain. Apparently “you’re not allowed to say anything anymore” and “people are too sensitive”. Sometimes they even say something about freedom of speech.

And you know what? You don’t have to care. You truly CAN write whatever you want. If you don’t care and you don’t want to care, this post isn’t here to convince you otherwise. This post was written for people who do care and who want to be considerate of other people, and anyone else is free to go watch Friends instead.

Just remember that the thing with “free speech” is that people are also allowed to express their opinions about your writing, including “Wow, the way you write this character was really problematic and you should step on a lego”.

Depression isn’t beautiful

I’m kinda hoping this trope is dying out but it’s been pretty pervasive in popular culture along with “suffering artist makes beautiful art only when depressed”.

Imagine this: The male protagonist falls in love with a beautiful woman, but she’s so sad. Oh no! Fortunately she’s still gorgeous and sexually available, and her depression just means she’ll be more likely to engage in philosophical conversations with our protagonist and she won’t bother him with annoying things like “talking about the future”. I’m sure you’ve seen a version of this somewhere.

The thing is, there is nothing pretty about depression. “Being sad” isn’t the only symptom, and sometimes there might be no sadness at all. That’s why some people don’t get diagnosed until they’re severely depressed because they didn’t understand their symptoms, woefully lacking of woe.

Here are some symptoms of depression that don’t often get talked about:

• Sleeping too much and still being tired
• Overeating, or eating just one thing because everything else requires thinking
• Neglecting personal hygiene
• Anger at things that seem trivial, short temper
• Crying in situations where it isn’t socially acceptable (for example in a grocery story, and not just at our male protagonist’s balcony while smoking a cigarrette in the middle of the night)
• Lack of sex drive

As you can see, these don’t really go with the sexy sad girl trope. If you’re writing about depression, please consider the different ways it can show up in your character’s life.

Stay away from harmful tropes when writing about mental illness

This would probably require its own post, but to be honest, I don’t have any of the usual mental illnesses that people see as “scary”, so I’m probably not the best person to write about them.

Before you start writing about mental illness, whether it’s a central part of your story or just something that happens to someone, please stop to consider if you might just be perpetuating harmful stereotypes.

“How are they harmful?” you might ask, “I’m just writing fiction?” Are you living in a vacuum?? If not, real people will see what you’ve written and your words can enforce their already harmful beliefs about mental illness. You might also be hurting real people living with the conditions. I’m fairly certain you don’t want that.

How to avoid harmful tropes when creating your character

When you’re trying to figure out if something is harmful, ask yourself these questions:

• Am I treating this character as a multi-dimensional human or am I reducing them to their symptoms?
• Am I only writing about how scary/dangerous/annoying their symptoms are to other people?
• Am I excusing bad treatment towards the character because of their mental illness? Do other characters get away with hurting them?
• Is my writing based on what I’ve seen in existing media or have I taken the time to learn from real people?
• Am a using a diagnosis as shorthand for “this person is bad”?

Some examples of harmful tropes include violent mentally ill people being scary to other people, portraying women with personality disorders as sexually promiscuous and therefore bad and therefore deserving whatever happens to them, and any trivialization of real symptons that can be really debilitating to actual people living with them (e.g. having to have things the certain way when someone has OCD).

This TV Tropes article includes some examples of bad mental illness tropes in media, though don’t get sucked into that site until you’ve finished reading this post! I don’t want you to get lost.

Seriously, we’re not scary

You might be protesting my claim of mentally ill people not being scary, because there are violent mentally ill people in the world and you are scared of them. Poor you! Just consider this: the symptoms that are scary for you are most likely more frightening for the people suffering from them.

According to horror movies, what is one of the scariest places to be in at night? An abandoned INSANE ASULYM, of course. The ghost of a deranged man will come and eat your liver! Watch out!! Do you know who’s more likely to experience traumatic and frightening things at a mental hospital, though? The patients. The history of treating mental illness is not full of kindness.

Here are some things that are actually scary:

• Unsympathetic bureaucracy. Rather not lose your house when you’re too ill to work? Too bad.
• Using politics as an excuse to kill innocent people, including children. This is called “war” and it happens all the time, usually by apparently mentally sound men who never actually have to fight in the wars they start.
• Shooting someone just because you could justify it in your non-mentally-ill brain.
• Being told you deserved to get hurt, because reasons.

These are all actually scary things that happen all the time, by people who are generally not considered as “crazy”. Kind of puts things in perspective when you’re scared of that man muttering to himself on the street.

Can you NOT use the word “demon” at all, please?!

Mentally ill people are not tormented by demons, real or imaginary. There ARE people who do hallucinate really scary stuff including demons, but again, it is more scary to themselves.

It is extremely disrespectful and ableist to use it as your horror story premise if it’s something you have no understanding of or you haven’t experienced it yourself. (When you ARE writing about your own experiences, though, you can do it the way that feels authentic to you, of course.) In the very least it’s just lazy and unimaginative writing. You’re not cool or edgy either.

I’m just really very tired of reading about people’s story ideas where mental illnes is caused by a curse, ghosts or demons. Why? Because it shows mentall ill people as “the other” and something scary, instead of boring-ass regular people that they generally are. It’s also nothing new or interesting, I’m sorry to tell you.

If you’ve already written something like this, there’s no need to feel bad about it or think that I’m attacking you. Now that you know better, you can do better. If your writing skills are any good, I have full confidence in you that you can come up with something far more fresh and interesting.

The purpose of therapy isn’t necessarily to “cure” mental illness

Let’s leave the world of demons and back to more mundane things: going to therapy. That’s what plenty of people do, if they’re fortunate enough to have access to it. But what is the purpose of going to therapy?

There are many different kinds of therapy and many reasons for going there. When you’ve had a traumatic event, like when you’ve been in a really bad car crash or when your best friend has died suddenly, going to therapy can seem like talking about the event and then “getting over it”.

Usually it’s not at all that simple, however, and it isn’t because therapy is ineffective. It’s simply because human mind doesn’t quite work that way. Most often the point of therapy is to give you the tools to deal with whatever is bothering you rather than fix it for you.

I don’t think I’ll ever become totally mentally healthy. I’m mostly fine with this. I’d be utterly wasting my energy if I was looking for a cure for depression, anxiety, panic disorder or OCD, and instead I’d just like to live my life and deal with any issues with the tools I have learned in therapy and outside of it.

Naturally, not everyone feels the same way as I do, and that’s okay. But when you’re writing about mental illness, I just want you to know that if your storyline revolves around someone going to therapy to get cured, and then living happily ever after as an officially mentally healthy person, your story might just be a touch unrealistic.

That said, WE WANT TO BE HAPPY AND FEEL GOOD. We really do. It’s just that we have to learn to do that regardless of what’s going on with our brain chemistry.

I’m personally not afraid of what would happen if I suddenly became 100% mental healthy (although it would take a lot of adjusting) because I’m an actual person with a personality and interests unrelated to my depression and other disorders, so please refrain from writing about characters who are afraid of losing their personality if they get better, unless it’s something you’ve experienced yourself. It’s just another harmful trope.

Sometimes we’re doing better, sometimes worse

Mental illness can have flare-ups just like an annoying rash. That’s why we can sometimes be doing just fine and then struggle to do even the bare minimum at other times. It’s normal.

Things that can worsen someone’s mental condition:

• Stressful situations like losing a job, noisy neighbours or, I don’t know, a pandemic.
• Getting triggered unexpectedly. (I had a very bad week a while ago after reading my old medical records where they referred to my mother’s abusive boyfriend as my “step-father”.)
• Not getting enough sleep
• Change of medication or forgetting to take meds even if it’s just once
• Change of seasons
• One thing went wrong and that was just too much

Including things like this will make your writing more realistic. It doesn’t have to take a huge disaster for your character to experience a bad mental health episode.

Many of us are kinda boring and you probably don’t know what’s “wrong” with us

You might think you can point out a mentally ill person in a crowd but you’d most likely be wrong unless you were guessing and you just got lucky. If you think you don’t know anyone who’s struggling or has struggled with mental illness, you probably haven’t asked or they’re afraid to tell you.

When you’re writing about mental illness, there’s no reason for your characters to be extra special just because of it. Of course your character with depression can be really funny or quirky, but it isn’t direct result of the mental illness, and most people with mental health issues are just regular people going about their lives.

Steer away from these words when writing about being mentally ill

If you want to write about mental illness respectfully, there are some words you might not want to use. For example, when you’re describing your character, you might not want to call them deranged or insane. Sure, other people might call them that, but it should be obvious that these words are hurtful.

In recent years there has been a lot of talk about whether you can use the word “crazy” or not. I know it’s common to use that word in regular speech, but if you’re not sure when it’s okay to use it, then refrain from using it when describing someone in a negative way. For example, “This chocolate cake is crazy good!” is fine, while “You must be crazy if you’re an antivaxxer” is not. You can’t just call someone crazy just because they’re uninformed or mean-spirited.

You should also have a think about what words you use about when talking about mental hospitals. You know what’s really easy to write? “Mental hospital”. That’s it. Maybe even “psychiatric hospital” if you’re feeling fancy. No need to call it a looney bin or a lunatic asulym, unless you’re writing historical fiction and that’s what people commonly called them. And as usual, what your characters say in dialogue is a different thing altogether, but you as a writer should be aware of what words are hurtful and what aren’t.

I’m also aware that some people don’t want to call themselves mentally ill, and that’s understandable. You probably can’t find terms that EVERYONE is okay with, but just try to be mindful and definitely don’t call someone “chicken-throwing crazy”. (No, I don’t know what that means either, but it’s a direct quote from an Instagram post I read a while ago.)

Try not to use outdated terminology when writing about mental illness

If your story takes place in modern times, you should check if you’re using the correct terminology. There are many terms that people use that aren’t actually correct anymore, and if you’re going to use them in your writing, you should be aware of what’s outdated and what isn’t. A quick Wikipedia check should tell you what is the current, correct terminology.

For example, “multiple personality disorder” is an outdated term, as well as “manic depression”, and nowadays they’re called “dissociative identity disorder” and “bipolar disorder”. Outdated terms aren’t necessarily offensive, just something you should be aware of as a writer. You do want to use your words intentionally, don’t you?

Don’t demonize medication

People have all kinds of silly beliefs about medicating mental health in real life, but that doesn’t mean you need to perpetuate them in your writing unless you’re trying to make a point about what an ass-hat someone is.

If you yourself have negative experiences with being medicated, you’re totally allowed to write about that. I hope that by now it’s obvious that I’m not trying to dictate how people should write about their own experiences. But in most cases using medication like antidepressants is no bigger deal than popping thyroxine into your mouth each morning.

We’re more than just mental illness

The fact that I get OCD flare-ups during stressful times in my life is probably the least interesting thing about me. If I was writing about my own life, my suicide attempts would be just one chapter, and even that wouldn’t be very interesting. You know what’s more interesting about me? I love dad jokes. I’m a published author. I have trouble distinguishing things that come in pairs. I’m scared of trucks.

When you’re writing characters with mental illness, make sure their symptoms or their diagnosis aren’t the only interesting or the most interesting thing about them. If you want to write well, it means writing characters that are more than just one thing, just like real people. Mental illness can’t be your shortcut to how to make a character unique.

Do point out ableism in your story world

Yes, ableism towards mentally ill people exists in real life. I’m aware, thanks. It might also exist in your story world, but if you want to take the stance that ableism is bad, then this should somehow become evident in your story.

You don’t have to have a narrator in your story saying “being mean to mentally ill people is bad, guys!” I’m sure your storytelling skills are above that. Just remember that your characters don’t exist in a vacuum and all actions should have some kind of consequences, and your characters should always be reacting to whatever is happening in your story. You’re always saying something when you write fiction, and it’s your job to try and say the thing you actually mean to say.

Use sensitivity readers

You don’t need to be perfect, you just need to strive to do your best.

If you’re not quite sure if what you’ve written is okay, you can use sensitivity readers to make sure you’ve approached the subject respectfully. If you’re wondering what the heck that is anyway, it’s essentially someone who will read your manuscript to point out any instances of ignorance towards a group of people that you’re not a member of. If you’re wondering why you should bother with sensitivity readers, let me quote this article:

While some may consider their role “fraught and subjective,” I think we can all agree that multidimensional characters, fresh perspectives, and detailed, believable world-building all make for better books. 

And isn’t that all we want to do, to write better books?

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Protagonist Crafts is a blog about writing fiction, written by a published author and creative writing teacher. You can find more writing tips and inspiration in the blog and you can get the best author tools at Writer Lifestyle on Etsy.