Often with writing, we put our characters through hell. Some of the worst experiences are narrated in our stories leaving scars on our characters. These scars show up in the form of depression, anxiety, post-traumatic stress disorder, etc. in our characters, but unless one has first-hand experiencing these things, they can be hard to get write. And in a world where our readers actually have their own mental health struggles, it is important that we get it RIGHT.

As a registered nurse, I have a different view of mental health that shows up in my character development. I also experienced quite a bit of post-partum depression and anxiety which gave me an eye-opening view of mental health and how it is handled in the US. Long story short: I wasn’t impressed. For the next several blog posts, I’m going to be using my old nursing school textbooks and using that information to show how to write convincing characters that are suffering with mental health crisis.

This will not be a guide to be used to diagnose or treat mental illnesses. It is strictly a writer’s character development tool.

A mental disorder is “a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.” (Videbeck p. 3) So basically, if a person has a moment of anxiety, it does not mean that they have an ‘anxiety disorder.’ Everyone gets anxious now and again. An anxiety disorder would be someone who deals with anxiety often enough that it is hindering something in their life. For example, they can’t go to work because of the anxiety, or they develop an eating disorder, or they can’t leave the house. The anxiety is so bad that life—or areas of life—become impossible or very hard.

I got to this point dealing with my anxiety where life was nearly impossible. I couldn’t sleep, eat, work, write, or take care of my child. It was one of the lowest points of my life. This led to depression and thoughts of suicide. It was not that I wanted to die—I just couldn’t keep living with this constant sensation of wanting to rip my hair out.

It’s been 9 months since the worst of it, and I am still recovering while under the care of a therapist. The anxiety is still there—it probably always will be—but we’ve been working very hard on using coping mechanisms. I’ve come a long way and still have a long way to go. But now I have hope, which is something I didn’t have before.

But anyways. . .

There are several different types and classifications of mental/psychiatric disorders. Keep in mind that all of these can come about for different reasons. Some are related to genetics, others physical health issues, stress, and trauma. Each impact a person to different levels and treatments are not identical. Here is a basic list of them:

Anxiety: A vague feeling of dread or apprehension; it is a response to external or internal stimuli that can have behavioral, emotional, cognitive, and physical symptoms. A person with an anxiety disorder demonstrates unusual behaviors such as panic without reason, unwarranted fear of objects or life conditions, uncontrollable repetitive actions, reexperiencing traumatic events, or unexplainable or overwhelming worry. They experience significant distress over time, and the disorder significantly impairs daily routines, social lives, and occupational functioning. (Videbeck p. 227)

Schizophrenia: Causes distorted and bizarre thoughts, perceptions, emotions, movements, and behavior. It cannot be defined as a single illness; rather, schizophrenia is thought of as a syndrome or as disease process with many different varieties and symptoms, much like the varieties of cancer. A person with schizophrenia is characterized by some of the following: delusions, hallucinations, and grossly disorganized thinking, speech, and behavior, flat affect (or seemingly lack of expressions during social situations), lack of volition, and social withdrawal or discomfort. (Videbeck p. 252)

Mood Disorders: Also called affective disorders are pervasive alterations in emotions that are manifested by depression, mania, or both. These interfere with a person’s life, plaguing him or her with drastic and long-term sadness, agitation, or elation. Accompanying self-doubt, guilt, and anger alter life activities, especially those that involve self-esteem, occupation, and relationships. (Videbeck, p. 281)

Personality Disorders: Diagnosed when personality traits become inflexible and maladaptive and significantly interfere with how a person functions in society or cause the person emotional distress. (Videbeck p. 319)

Substance Abuse: A person using a drug in a way that is inconsistent with medical or social norms and despite negative consequences. (Videbeck p. 349)

Eating Disorders: Can be viewed on a continuum, with people with anorexia eating too little or starving themselves, to people with bulimia who eat chaotically, and people with obesity eating too much. (Videbeck p. 373)

Somatoform Disorders: The presence of physical symptoms that suggest a medical condition without a demonstrable organic basis to account fully for them. (Videbeck p. 393) For example: a person who has a limp but no underlying injury.

Cognitive Disorders: A disruption or impairment in the higher-level functions of the brain. They have devastating effects on the ability to function in daily life. They can cause people to forget the names of immediate family members, to be unable to perform daily household tasks, and to neglect personal hygiene. (Videbeck p. 440)

Keep in mind there can be quite a bit of overlap within each of these mental health categories. A person suffering anxiety can have a personality disorder. Or a person with depression can have a problem with substance abuse.

Obviously, this is just a very broad overview of mental/psychiatric health. The following posts are going to be breaking down each of these disorders on an understandable level and providing applications for writers on how to incorporate these things into your stories.

My last few blog posts were discussing what anxiety is from a clinical standpoint. Today, we’re going to bring all the pieces together and discuss how you can use this to form a character/story arc.

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If you have been exposed to any writing theory at all, then you are probably at least a little familiar with standard story structures. This is the form in which most stories go: First there’s an introduction followed by an inciting incident, then there’s the middle stuff as the character tries to manage the change in their world that was caused by the inciting incident. Everything comes to a head in the climax followed by the resolution. Now I’m going to describe this using what we’ve previously discussed in anxiety terms.  

Character is living life in a relatively normal way whether they be a young teen or an expert secret agent. Then a stressor occurs: teen is in a major car accident and loses her leg; secret agent is betrayed and watches helplessly as his entire team is killed. This stressor will cause a psychological and physiological response in the character (see post: Anxiety for Writer’s Summarized). Depending upon what type of story you are writing, you may want to linger here for a bit. If your character is a teen suffering from loss of limb, a good portion of the story might be spent on failing to accept herself, falling into a depression, and journeying out. (Keeping in mind that these mental health conditions are linked and anxiety often leads to depression. For more information on types of anxiety disorders, what they look like, and why they might manifest, see post: Writers Guide to Mental Health: Anxiety Disorders)

At some point in the story, a decision by your character, conscious or otherwise, needs to be made. Are they going to live in a continual state of anxiety? Or are they going to move forward and out of that state?

Your character may not come out of it. They may fall into a depression and that’s how the story ends. Keep in mind that is an option. A tragic option, but an option nonetheless.

If your character does seek help and healing, they will probably go through some sort of a process where they face their fears and become more courageous. This can be through self-initiative or with the formal help of a therapist. How this happens will be determined by a lot of factors including your story type, setting, and character’s personalities. For information on how anxiety is treated in a clinical setting, check out my post: Writers Guide for the Treatment of Anxiety Disorders.

Probably the best, well-known story to use as an example in bringing all this together is Batman. Bruce Wayne is afraid of bats. They cause an anxiety related response, so he exposes himself to these bats until he is braver. Then he channels the bat in order to defeat the underworld.

Of course, this is just a superficial representation of what is taking place in the broader story as a whole. Bruce Wayne experienced a trauma when his parents were murdered by members of the criminal underworld. For years, he struggled with the grief and fear of this event. Then he channeled his fears, became a criminal vigilante, and confronted them and defeated the criminal underworld.

*Trigger warning* Details regarding the execution of Jews during the Nazi regime.

One of the biggest shames in writing history is the mischaracterization of the mentally ill. I could go into a long rant about this point alone citing all the scenarios and atrocities. I believe there is a central misunderstanding within the population or writers that leads to these mischaracterizations—the myth that one must be mentally ill in order to be evil. Why would someone murder a child? Because they were a sociopath. Why would someone cut up their parents into tiny pieces? Because the voice in their head told them to. This waving of the hand over atrocities and claiming they had to be insane is appalling. Of course, the more uncomfortable fact is most people who commit evil are sane, rational people.

This fact should chill us to the bone. Because that means that ‘normal’ people are capable of horrible atrocities. We are capable of incomprehensible evil.

I’ve heard it said that one should read history from the eyes of the perpetrator, not the victim to prevent themselves from going down the same road. This is good advice.

One of the books that inspired my story Surviving Midas was Ordinary Men: Reserve Police Battalion 101 and the Final Solution by Christopher Browning. It’s a harrowing read and one I had to take breaks from in order to finish. There is very little in terms of records regarding the mental state of the Nazis who executed the Jewish people during the holocaust. During the investigations that followed the war, very few former Nazis would admit to having taken part in any executions. For whatever reason, the men of the Reserve Police Battalion did share their stories.

So what sort of men was it that executed millions of Jewish people?

For the most part, ordinary men as the title of the book implies. These were farmers, craftsmen, factory workers, with families and children of their own. The Reserve Battalion 101 was given orders to arrive in a town called Jozefow at the break of dawn, haul the Jewish people from their homes, load the men up into trucks for a workcamp, and shoot the women and children. According to certain accounts, these men were shocked and horrified by the orders they were given. Even their commander spent most of the day wringing his hands and muttering about what terrible business they had been wrapped up in.

Group after group after group of women and children were taken out to the woods, forced to lay down on their stomachs, and shot in the back of the neck. Many of the officers did not make it through the first couple of executions before asking to be removed from the task. Their requests were granted.

They could have gotten out of it from the start, and some of them did. Upon arrival to the Jozefow, their commander informed them any could step out of line and go back to the barracks. Only a couple took him up on that offer. Others would later say they were too stunned in the moment to react with a clear mind, but that wasn’t the only opportunity to bow out. One officer states he stayed up by the trucks for the rest of the day loading the men and being sure to look busy any time a new group of executioners was being rounded up.

So, why did they do it?

Per their statements, they feared being considered ‘too weak’ or ‘cowardly.’ They did not want to ‘lose face’ before the other policemen. As one officer stated: “I must answer that no one wants to be thought a coward.” It was one thing to refuse at the beginning, he added, and quite another to try to shoot but not be able to continue. Another stated his reason to not refuse was simply because, “I was a coward.”

One policemen, who killed as many as twenty before quitting stated: “I thought that I could master the situation, that without me the Jews were not going to escape anyway . . . Truthfully I must say that at the time we didn’t reflect about it at all. Only years later did any of us become truly conscious of what had happened then . . . Only later did it first occur to me that (it) had not been right.”

Others rationalized their actions by believing they were not going to alter the fate of the Jews by saying no anyways. In one bizarre statement, an officer stated he killed only children while his neighbor shot the mothers. His belief was by shooting the mother, the children were dead anyways.

I write about this from perspective of an author because I think it’s important for us to be aware of this. Part of the job of an author is to show the truth through lies, and it’s not the truth that most heinous crimes are committed by the insane. It’s misguided, rational people who do the most damage. People who are afraid—in fear for their life, in fear of their livelihood, or just in fear for their reputation—are the most dangerous of us all. Let us strive to know truth and goodness and not be afraid.

And let’s tell the truth with our lies (stories) so that others can see it too.