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.

Table of Contents

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 delusional belief means mental illness, psychosis, or insanity. In psychology, a delusional belief is a belief that the one holding it clings to regardless of facts shown to the contrary. Colloquially, a delusion is any false belief a person holds. While psychosis can create delusional beliefs, not all delusional 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.

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:

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?

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