Mental Health Disorders In Fiction


Article written by E. Prybylski

Hello! Lovely to meet you all as I guest blog this week. My usual blog focuses on the craft of writing,

so I thought I would combine Chrystele’s focus on mental health with my own purview and discuss

the way writers often handle mental health in writing. As someone who suffers from CPTSD

(Complex Post-Traumatic Stress Disorder), ADHD, anxiety, and depression, I have been in therapy

for many years. During this time, I have, as you may expect, done a lot of reading and watching

movies. And much of the time fiction gets mental health wrong.

The first thing I advocate for any writer is that they research the thing they are writing

about if it isn’t something they are experienced with already. It’s okay not to know things, but

“write what you know” comes with an unspoken second half: Research what you don’t. This is just

as true with mental health as it is with anything else.

In addition to mental health disorders, neurodivergence (autism/ADHD) is also frequently

misrepresented. So frequently, we see people leaning into tropes about folks with these conditions

to the point where the characters become caricatures rather than human beings. I ascribe part of

this to the fact that mental health and things like neurodiversity are uncomfortable subjects for a lot

of people.

It's my opinion that people are uncomfortable with mental health issues for similar reasons

to why they are uncomfortable with physical disability: it can happen to anyone. We like to feel

invincible and as though that couldn’t possibly happen to us, but the reality is that a moment in

time can change anybody’s life. Whether it’s being hit by a car, struck by lightning, or being mugged

at gunpoint (or worse), a single moment can change a life forever. Nobody wants to think about that

because it’s anxiety-inducing to do so. So we push it to the back of our heads and tell ourselves we

are too strong to be subject to that. Other lies include that PTSD is only for veterans, depression is

only a person not trying hard enough, and ADHD isn’t a “real” disorder but is just someone not

being motivated enough.

If you see a common thread of blaming the sufferer through what I just said, you’re right;

that is exactly the common response. In fiction, it’s often no different. While certain people are

treated with empathy a lot of the time (veterans with PTSD come to mind, and they deserve the

empathy) other folks are not. While this trend has begun to change there are still many places and

works where it’s clear to me that the writer just doesn’t “get” mental illness.

It's also important to note that people with mental health problems are not a monolith any

more than autistic people are or people with disabilities. My opinions on this matter come from

well over a decade of therapy, intense study, and personal experience. I am not a psychologist.

However, other people in the mental health community may feel differently than I do, which I

accept. My opinions are my own.

As an example, I’d like to delve a little into Iron Man 3. While my commentary should

contain no real spoilers, if you haven’t seen the movie by now, I’m not sure you plan to. In the

movie, Tony Stark is wrestling with severe PTSD from the events of “The Avengers.” In “The

Avengers,” New York City is under attack from alien beings, and Tony Stark pulls a heroic self-

sacrifice to try and close the portal through which the aliens are coming. While in space, he

experiences a moment of extreme helplessness fraught with the knowledge that he is going to die.


The fight itself is traumatic, and many people perish, but the moment that keeps resonating in

Tony’s mind is the feeling of helplessness because during the rest of the battle he was able to act,

and being helpless is not something his mind knows how to parse.

Iron Man 3 shows Tony wrestling with nightmares, acting with more aggression than he

should, displaying borderline manic periods, and having severe responses to PTSD triggers. He has

flashbacks, sure, but not every flashback is shown as images or sounds, which is an apt description.

Speaking from personal experience, flashbacks can be emotional flashbacks (reacting emotionally

as though it is still happening), auditory, or visual. They aren’t all times where the sufferer literally

believes they are back in that moment of trauma, either, which is one of the big things I see fiction

(and particularly television) get wrong. That can happen, it’s not, by far, the most common

manifestation of a flashback.

While there may certainly be other television shows and movies that got it right before Iron

Man 3 hit the screen, it was the first movie I’d ever seen where I recognized every single one of the

character’s symptoms, and it felt real, raw, and genuine. It wasn’t just the same old, same old. Since

then, other media has done more to further the cause of depicting mental illness in a more real

manner, though some illnesses are treated better than others. A woman with anxiety is still likely to

be portrayed as a shrinking violet who is “hysterical.”

This mirrors the way real life people with mental illness are treated, too. I spent years

attempting to get on Disability for a myriad of health problems combined with my mental health

struggles and was told by a judge that I can’t possibly have social anxiety based on the fact that I

attend a church once a week. Nevermind that my church is all of about fifteen people the majority of

whom I have known since I was born. It’s like visiting family every weekend, but no, clearly because

I can attend a safe event for an hour or so a week, I cannot have social anxiety that makes average

interactions extremely difficult for me. I must be lying.

If you are going to write about mental illness in a story, it would behoove you to consider

that these people ought to be whole people, not just collections of disabilities. So frequently I see

characters portrayed that way, and it will never fail to make me twitch. The autistic character is, of

course, going to be a math savant but be incapable of doing literally anything else. The individual

with PTSD is going to be a veteran every time and have full sensory flashbacks and never know

where they are. The woman with anxiety is going to be a jittery disaster who lives her life on

medication and is portrayed in a slightly ridiculous manner.

No. We are real people.

Write us as such.

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