Mental Health and Writing

I’m a firm believer that at some point in all of our lives that we each deal with some level of mental health issues. From anxiety to schizophrenia or depression to bipolar, to some degree we all have something to deal with internally. And even if we can’t or won’t see the issues within ourselves, which is common, we’ve all known someone that had some issues. Maybe they struggled with OCD, ADD, ADHD, paranoia, or some other issue.

Regardless of what we, or they, may have struggled with, it creates experiences and memories that as a writer can influence our character building. People who suffer from delusional paranoia are likely to behave a certain way and have a particular perspective on the world around them that may offer a stark difference to that of their contemporaries. Likewise, someone with schizophrenia may have very strong beliefs about what their experiences were only to have those experiences be entirely fictional.

To better illustrate the different ways mental health can be demonstrated in our writing, let’s explore the phrase “I have been excluded from family gatherings.”

On the face of the statement, it would seem this person is expressing a belief that family members have conspired to keep them away from family events. But let’s explore the subtleties of mental health possibilities that might create a greater narrative for this character.

First up, anxiety. Social anxiety is a bitch. I struggle in large crowds of strangers where I’m expected to speak to the group as a whole or mingle excessively. I struggle with small talk and reading social cues of those around me. As a result, I tend to shy away from such events or to sit in the back to avoid others when I have no choice. Often times when my family or friends want to go to concerts, bars, or to things like karaoke, I don’t get an invite these days. In days past, I would get frequent invites to do things that I would generally decline because I didn’t feel comfortable or enjoy being in that environment.

Well, guess what. After a while I stopped getting invited. At some point, my friends and family figured out that some of the things they did were not my bag and figured it easier to not invite me than to get another decline. But if I didn’t decline, if I wasn’t having fun or was viewed as a “party pooper” for not participating, at some point the collective group might feel as if they would have more fun without me since what they were doing was their thing but not mine.

And this is where the mental health aspect AND the self-awareness aspect come into play. If I have no awareness of my anxiety issues or have refused to deal with my anxiety issues, I might be angry that my friends and family are having fun without me. I might feel offended that I wasn’t invited, not realizing that either through my actions or inactions that I had created a divide between me and them that signaled to the others that I did not want to be there. I might accuse them of excluding me out of spite instead of understanding that my unrecognized and untreated mental health issue pushed them away.

Where on the contrary, if I understand my issues and how those issues influenced my personality and actions, I might be disappointed to see my friends and family having fun and I’m not there but would also have the self-awareness to know that if I had been there that I would not have had the same level of fun. There’s something very powerful in knowing about your issues and understanding how to effectively cope with them.

Imagine the differences between two characters that suffer from anxiety where one understands how to cope with it and the other constantly puts themselves in situations that exacerbate their situation without understanding how it affects them or those around them. 

Next, let’s take a look at paranoia. Paranoia is defined as “an unrealistic distrust of others or a feeling of being persecuted.” So in the context of our sample phrase, “I have been excluded from family gatherings,” paranoia could be something as simple as seeing family members living in two different houses together without you. Paranoia can also be represented by thinking others are talking about you, even if they’re not. It can leave you feeling excluded because you are reading into the actions of others far beyond what might be happening. A simple dinner or conversation among friends or family in which you were not included does not mean that they are discussing your or leaving you out for malicious purposes. Instead, that’s the distrust of the mental health issue causing you to think and feel things without adequate reason.

And paranoia is a tricky issue because it can stack. Once there is a matter of distrust, any action might inspire more distrust. It creates a downward spiral at that point. You think people are conspiring against you so you become suspect of even the minute and insignificant activities of others. Eventually, if left unchecked, paranoia can drive someone to take extreme measures where none are warranted. For example, if unchecked paranoia has led you to believe that family members are conspiring against you, you might lash out at those family members. Angry phone calls, text messages, or outbursts.

And what’s really sad, such aggressive responses towards others because of your own paranoia can create something of a catch-22 in this scenario. If your paranoia has led you to angrily accuse others of malicious actions against you unjustly then you might have just become a self-fulfilling prophecy. If you are going to accuse, berate, attack, and potentially assault others for your misconceived affronts, you will soon likely find yourself being excluded because you are viewed as unstable or a threat to those around you. People will actively avoid you because now they have reason to.

Here again, those who recognize and have sought treatment for their issue might be able to successfully reflect on their past experiences to help others around them understand the paranoia of another or perhaps they suffer some type of relapse. Imagine in your writing that you have a character suffering from extreme paranoia while another has dealt with their issue and works to assist their fellow companion. That could make for some interesting and immersive bonding between those characters.

And finally, we will look at schizophrenia. Schizophrenia is defined as “a disorder that affects a person’s ability to think, feel, and behave clearly.” Common symptoms for those suffering from schizophrenia are hallucinations, delusions, or confused thinking and behavior.

Let me paint you a real-world example of someone having a delusional schizophrenic episode. A young girl had suffered a traumatic event in her life. This triggered an episode where she believed that everyone, including her closest family members, were trying to poison and kill her. For several days she wouldn’t eat or drink out of fear that others were conspiring against her. Of course, nothing of the sort was going on and nobody was doing anything other than trying to help her but her mind had convinced her that these people, people who she had known her whole life, were out to get her. And no amount of reassurance or statements to the contrary of her delusional beliefs were accepted by her.

Now, that example might sound extreme but schizophrenics commonly think that they are the targets of some malicious attacks or they have an irrational fear that someone or a specific group of people are a physical threat to their well being. But not all schizophrenic episodes go that far. Some might just believe that events happened that were negative to them that never really happened. Some schizophrenics might have been at a table with others having a conversation but due to their schizophrenia may have a warped perspective of what that conversation entailed. And even if others all agree that the conversation was not what you believe, your mental health might make it difficult, even impossible, to accept the reality versus their strong delusional belief. Schizophrenia can be so powerful that a sufferer cannot see the truth even when confronted with it openly and clearly.

A character with schizophrenia could be a misunderstood villain. They’re not evil, only in need of help. They think people are out to get them so instead of waiting to die they go on the offensive, only the people they fight against aren’t the enemy. And sticking with our sample phrase, “I have been excluded from family gatherings,” might be nothing more than a twisted perception of one’s mind suffering from an undiagnosed and untreated mental health issue.

In a nutshell, mental health can create conflict, resolve conflict, build character depth, connect with readers who associate with those characters, and more. But this also shows the depth and damage that unrealized mental health issues can have on relationships. Sufferers can feel excluded because their actions have caused them to be excluded. Ostracizing someone who had regularly acted irrationally, rudely, or unpredictable is to be expected, especially if everyone else sees the mental health issues on display but the sufferer refuses to accept the truth and/or get help. At some point, the perceived exclusions might be very real because the fictional exclusions caused them to treat those around them poorly, so much so that others no longer want to be around them.

Perhaps you’re outsider joining a family but your own paranoia keeps you from letting yourself accept the family so you project your own insecurities and trust issues on them until you’ve alienated them too much. Perhaps your anxiety has left you sitting on the sideline too many times that you’re no longer invited to the game even though you want to be. The flip side to that is also, your anxiety keeps you from initiating anything so others view the relationship as one-sided and tired of being the only ones to make the effort. Perhaps your schizophrenia has you believing things that aren’t real and any exclusions you think happened never happened. Add to that, your schizophrenia has caused you believe others have done you wrong so you treat them poorly for no reason which only causes them to exclude you for real because why would someone include you after you act so terrible to them over fictional events!

This all can create complex stories, complex relationships, complex subplots, and more. And mental health isn’t confined to a particular genre or time period of writing. Mental health is an issue for everyone, regardless of race, sex, religion, time of existence, or even place in the universe. But at the same time, by writing about these things, we can better understand them and maybe even perhaps help our readers become more knowledgeable and understanding of metal health issues. And who knows, maybe in our writing we can help others realize their own issues that they then seek help for.

At the end of the day, each and everyone of us can have a unique perspective on the same event. The same thing seen from multiple viewpoints can create multiple interpretations of what happened. And when mental health is added to those perceptions, the reality of what transpired can become distorted, or even fabricated, to varying degrees by each witness depending on their own issues and the severity of them. This means you can take a simple phrase like, “I have been excluded from family gatherings,” and make it so much more. Is there truth to the statement or a delusional perception? Is this a self-fulfilling prophecy after years of unsubstantiated claims and outbursts against those who did nothing wrong?

There's an old adage of "there's this person's story, the other person's story, and somewhere in the middle lies the truth." And while this typically applies to people arguing and crafting arguments to their benefit while selectively leaving things out or phrasing things to elevate or minimize importance, it can also apply to how those suffering from varying mental health issues see things. I can wave at someone but someone with anxiety might see that action as unnerving because they don't want to talk to me. Someone with paranoia might suspect that my simple polite wave was either some secret code that I shared with the other person that somehow alienated the observer or that it represented a closer relationship with the other person that the observer resented. Someone with schizophrenia might view that simple wave as me and the other person executed a coordinated attack against them that was kicked off by the hand signal.

In each of those examples, there's my story that I gave a simple wave to an acquaintance that I saw at a distance and wanted to be friendly. There's the story of the acquaintance of simply walking down the street, I waved at them, and then the observer may have reacted to that gesture. Then there's the story of the observer as detailed above. The truth is that I waved at another person and the observer's mental health issues led them to misinterpret my action into something else. And depending on the observer's exact diagnosis, the severity of that diagnosis, and other factors of triggers, current emotional states, etc., the observer's reaction(s) might be from the mild to the extreme, each with their own repercussions socially, physically, emotionally, financially, and even legally. This opens a lot of doors for character and world building to weave complex narratives, relationships, motives, and so much more.