Friday, October 18, 2019

How to Properly Portray Mental Health Issues in Fiction

Ah, mental health. Awareness has been rising of late, yet fiction still tends to portray mental health issues in hurtful and uneducated ways. How do we go about fixing this problem?

Well, we can start out by listening to what E.B. Dawson and S.M. Holland have to say on the topic. They are both incredible authors who are also mental health advocates, and they have kindly agreed to share their wealth of knowledge with us. Do you feel lucky? I know I do.

Get your note-taking tools out and prepare to learn:

How to Properly Portray Mental Health Issues in Fiction: A guest post by E.B. Dawson and S.M. Holland

E.B. Dawson


1. Don’t glorify mental health issues. You may think this is an obvious one, but I see it all the time. The most common manifestation of this I see is to take one aspect of a mental illness, magnify it, and give it to a main character without the connecting symptoms/struggles/consequences. Example: A genius character, a specialty in his field, struggles with OCD and blows up when his new assistant moves something on his desk half an inch. “It’s funny,” you say. “It’s their flaw,” you say. “It humanizes them.” The problem is that true OCD is a very serious, often debilitating condition. That little outburst is probably the symptom of a deep rooted issue that has caused this man and his friends and family a lot of pain. If he does not get help, it is going to manifest in other heartbreaking ways in his life. If your character truly has a mental illness and you only insert it into the story when it is convenient, then you are glossing over the issue and communicating that mental illness is just something to make your character more interesting. Yes, mental illness IS interesting, there’s no doubt about that. But it needs to be respected and depicted accurately.

2. Don’t demonize mental health issues. Instead of giving mental health issues to their protagonists to make them more interesting or romantic, some people will be tempted to give them to their antagonists in order to make them more scary, disturbing, or complex. I don’t think I need to explain why this is super sensitive territory. It is true that mental illness can distort people’s perceptions of reality or morality. It is true that some people with mental illness struggle with societal norms or societal rules. You don’t want to fall into the trap of having your story accidentally imply that people with certain mental illnesses are freaks or criminals. I’m not saying that your antagonist/villain can never have mental health issues. What I am saying is that if they do, you had better do your research. Real people who struggle with these issues or have friends and family members who do, will not be super pleased if you use it to make your story more sensational.

3. Behavior stemming from mental health issues has consequences. What does this mean? Well, this is related to my other two points. It’s also a tip on how to avoid the pitfalls of points one and two. I see this in movies and books ALL. THE. TIME and it makes me frustrated. A lot of stories will throw in erratic behavior/emotional dysfunction for the purpose of plot, humor, or tension without truly understanding where these behaviors stem from. As soon as the scene is over, the story and characters move forward as if all is well.

Here is the problem: these behaviors are like symptoms. They only exist because there is a deeper problem that needs to be addressed. Even if it is not the focus of the story, there needs to be an acknowledgement of consequences. Everyone knows that if a character breaks his leg in scene one, he cannot be running around in scene two unless appropriate time has passed in between. Most authors will take the time to be consistent with physical consequences, but there are way too many who disregard emotional/psychological consequences. The sad result is the same as it would be if writers disregarded physical consequences. If the majority of writers portrayed characters able to walk two weeks after breaking their leg, people would start forgetting that it actually takes months to recover from such an injury. Example: the full blown temper tantrum is a good example and it’s super popular in media right now. Let me tell you a secret: if an adult throws a full blown temper tantrum (I’m not talking about just snapping at someone or something like that), there are some issues there that need to be worked out. Too often the plot moves on without anyone acknowledging serious concern or changing their opinion of the character. And surprise, surprise, that character never struggles with anger again. Not realistic. Physical manifestations of anger are scary to witness and often break trust. They aren’t funny or romantic nor are they usually isolated events.

Find E.B. Dawson here: 



S.M. Holland 


1. Proper research is important. One of the biggest mistakes I have observed when it comes to writing about characters with mental illness is the lack of research. A lot of people will rely on what they have seen or observed through social media or Hollywood films. A lot of the time, they get it wrong or just scratch the surface. Hollywood and the media tend to either glorify or demonize mental illness. I think it is important to understand, to the best of your ability the clinical understanding and definitions of the mental illness you are trying to work with. The DSM (Diagnostic and Statistical Manual of Mental Disorders) is a great place to start when it comes to trying to understand on a clinical level. Once you understand the basic workings of a mental illness, you can build up from there. Google and youtube can both be good places to search for articles or clinicians talking about how to work with and treat a mental illness. For example, there are several different types of schizoaffective disorder. A lot of symptoms overlap, but there are certain symptoms that are specific to each vein of schizoaffective disorder. If you wrote a book based solely on someone seeing things, you would miss the mark and create a cliche character. Doing thorough research and not relying on what you have already seen in other novels or movies will take you far.

2. Real life feedback is imperative. Unfortunately, even a professional can get it wrong. Years of studying and working in the field with mentally ill patients does not trump real life experience. I highly recommend finding sensitivity readers who live with or have experienced the mental illness you are trying to portray. Whether it be someone you know personally, or someone you find through an online forum, I feel this is an important step in order to help your character’s authenticity. It is good to remember that everyone who struggles with mental illness, like bipolar or depression, etc, experience it differently. However the basic workings are similar. A sensitivity reader can help you work through your manuscript and help point out when your character's struggles are being exaggerated to glorification. They can also help you with proper language usage so you are not demonizing people who struggle as Dawson mentioned above. If finding someone who struggles with the mental illness you are trying to portray is difficult, someone who works in the field with people who struggle or a family member of someone who struggles is a good alternative.

3. Mental Illness does not only affect the person/character. When writing about characters who struggle with mental illness, it is also important to remember that they are not the only one affected. We have to remember that there are different levels when it comes to mental illness. In the center is the sufferer, the first ripple is family, or a spouse, who they live with. These are the people who see the struggle everyday. They may have to help more, like either helping their spouse shower, or taking their kid to the hospital. They hear and see the tears, and that takes a toll on them. Maybe it will cause them to have their own spiral of depression. The next ripple out will be friends, teachers or co-workers. They are aware that the person is missing more work, or falling behind on school work, slowly becoming more distant, and so on. As far as your characters reach is, that’s as far as the ripples should go. Mental illness isn’t a single depressive episode in a story, and then they move on. It is an all life consuming disease. In a lot of novels I have read dealing with mental illness, the illness stays in the characters head, and nobody around them knows. Rarely this is true (of course there is always the exception). At the very least, the first ripple, family, spouse, roommate, etc, would be aware that something was off. As the struggle gets worse, you can expand those ripples.

4. Mental illness isn’t a quirky character flaw or a plot vice. Please, if you are writing about mental illness and it is not helping grow people’s understanding of the struggle, just drop it. Your manuscript does not need it. Remember to always be respectful when researching or talking to other people about their struggles.

Find S.M. Holland here: 


I don't know about you, but I think these tips are awesome. If every book followed these guidelines, I would be far less inclined to chuck a book or my Kindle across the room in frustration. 

Do you portray mental health issues in your writing? How do you go about doing it in a healthy manner? I'd love to hear about your endeavors! 

Related articles: 
Writing Characters with Depression: What You're Doing Wrong
9 Tips for Maintaining Mental Health as a Writer

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6 comments:

  1. This is awesome! As a reader and one with a mental illness, I love and agree with most of these points.

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  2. Thank you both for this. It definitely bugs me when people just use mental illness as a side act. No. It is definitely deeper than that and it does affect other people around you. For instance, my sister struggled with deep depression for years. I'm an empath so it affected me a lot, so much that after trying help her, I would spiral downward into my own depression. We don't live in bubbles. Actions, thoughts, emotions,...they all have consequences.

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  3. These are such helpful tips! I think it's definitely important to remember the reader when it comes to writing 'issues' into books. If it's not helpful or honest, what's the point of putting it in?

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  4. Thank you so much,EB Dawson and SM Holland. That is such thorough and helpful advice, and turns our attention from just our stories to respect for real live people dealing with their own and others' mental illness. In my Young Adult novel the foreign correspondent father's PTSD as a result of covering wars and natural disasters has a profound effect on his family. I hope he is also a sympathetic character, even as his sons struggle with his over-protectiveness which threatens to ground them when they want adventure. I have done my research, as far as I am able, and I hope I respect those who have suffered much and been damaged by what they have seen and done. That includes our veterans and first responders in civilian life. Thank you again, and thank you Hannah.

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  5. Mental health is really important and it is needs extra care as like physical health.
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