Mental illness: writing the disease and writing the character

[Feo Takahari]

I'm considering writing a character with dissociative identity disorder and some comorbid issues. For narrative reasons, his background would be a bit unusual--I don't know of any real-world cases that precisely match what's going on in his head. I'm currently struggling with two competing arguments for how to approach this character:

#1: Write mental illness as part of writing the character's mind, or risk descending into stereotype. I knew from the start what sort of character I wanted, a rationalist atheist with a chip on his shoulder and a stubborn refusal to give up against overwhelming odds. Looked at with no concern for the diagnoses, his attitudes "make sense"--he's so logical because he was created as a way of bringing order and sense to a completely irrational home life, and he's so bitter because he wasn't able to save the innocent child personality he shared a head with. So what if he's incredibly unusual in regard to the real-world diagnosis? He's a person, not a DSM entry.

#2: Write mental illness as you would write physical illness, or you're not really writing illness at all, you're just making your character "cool." Albino readers complain all the time about albino snipers who have zero problems with sunburns and are basically just healthy folks with a coat of paint over them. And George R.R. Martin has expressed regret for having a character with achondroplasia perform impressive acrobatics, because that realistically wouldn't be possible with the condition. In the same vein, if I'm writing a character who supposedly has DID, but doesn't have borderline personality disorder, doesn't engage in self-harm, isn't prone to fantasy, and generally lacks most of the traits associated with DID, am I really writing about DID at all?

So what do you think? How much rope can I give myself before I'm just hanging myself with it?

P.S. I'm ignoring that whole "DID is a scam created by evil therapists!" conspiracy theory. I post on the same site as an alter who's a successful writer, and he doesn't take it well when people think he's a symptom of mental illness and want to speak to the "real person."

 

[Penpilot]

One of the things you could do first is to research how much latitude you really have. Some illnesses have a wide range of symptoms, and can manifest in different ways. Even if some symptoms are very-very-very rare, it's fair game and you can exploit that to your advantage. I had a medical condition that typically gave people a massive appetite, but on the rare occasion it did the opposite. Well, I got the zero appetite one and it sucked.

As for character or disorder, and which side to err on, it depends on the type of story you're telling. If you're trying to tell a completely sober story about someone with this disorder, then of course you'll want to keep things pretty tight. BUT if your story centers around something else then you'll have more latitude.

People will probably be willing to give a comedy more leeway than say a drama.

 

[Russ]

I think it really depends on the type of story you are writing. If it is fast paced and event driven, rather than heavily introspective, than I think you can play a little faster and looser with the known facts.

Also keep in mind that you are writing fiction not a medical text. Unless the character has been diagnosed in the narrative I don't see how anyone can argue with how your character acts as long as it is within the broad ranges of our understanding of behaviour. People could speculate what diagnosis might apply to your character but they might never know.

Think of it like a character in a medieval world who has a bad knee and limps. You don't have to specify that he had an ACL or MCL tear or chrondomalacia patallae or some such, rather you just write that his knee hurts and he limps.

If you are looking for a shorter answer, I suggest you go towards #1.

A little more info about the story and how the illness fits in it would help so we can give you more specific answers.

 

[ScipioSmith]

I'd go more for option 1. Like you said, you aren't writing a PSA, you're writing fiction, and the primary goal should be to tell a compelling story with an interesting character. Obviously you have to have some factual basis, otherwise you're no longer writing a character with DID, but you shouldn't let it hamper the storytelling unduly.

There's also the fact that, in many settings, the character's condition need not be accurately diagnosed, leaving you freedom to play a little fast and loose.

How advanced is the setting of your story?

 

[Feo Takahari]

How advanced is the setting of your story?

It's contemporary and takes place in our world. The MC has done research on his issues, and self-diagnosed with DID. He's never admitted his full story to a therapist, though, so he's not formally diagnosed.

 

[ascanius]

I don't really get what your asking with your questions so... How far down the rabit hole do you want to go? I don't know how much research you have done.

I mean are you going to go with him walking up and going to work then finds himself at home making dinner at 7 pm after doing the shopping and buying things he hates eating, cleaning the house ect all the while the last thing he remembers is arriving at work.

or are you going to go with him knowing about his alts?

or is it going to be even less aparent?

If i'm understanding your questions I think it sould be a mix. I mean, having talked with people who have DID it is something that affects every day of their lives, mostly due to how those alts develop in the first place. It's hard to interact socially when there is the possiblitly of suddenly behaving like a 6 yr girl. I disagree with your aquantence though, DID is a symptom with very profound implications about their past or some event that has a great affect on them. They are all real, I just disagree with the symptom thing.

I take it something very taurmatic has happened during his childhood..... I toyed around with the idea of having one of my MCs having DID I decided against it after a while, it's too hard to show DID while at the same time not having her be completely crazy especially whe she is already kinda bonkers.

Good luck though. If you have any question I may be able to help a little.

 

[IrelandBeaver]

In answer to your first question, some of us in the mental health profession see diagnosis like a two-edged sword. On one hand, by giving someone a diagnosis, there's the risk of an individual believing that they must live up to that particular diagnosis, in a self-fulfilling prophecy sort of way. This could also cause others to see that individual as their diagnosis, and that any action/inaction is just part of their diagnosis. Essentially, they become their label. But on the other hand, without that diagnosis, it could be difficult to help someone. By giving someone a diagnosis, it becomes easier to determine a treatment plan and find the resources to help that individual.

As for your second question, giving someone a diagnosis does at times fall on the viewpoint of the individual making the diagnosis. Depending on an individual's degree, licensure, education, and time in practice, the same individual could be given different diagnosis depending on the professional. For example, you said your MC has done a self-diagnosis and come to the conclusion that he has DID. What's his training in mental health, and how did he come to that conclusion? What was it that caused him to think that he might have mental health issues? In some ways, self-diagnosing a mental disorder can be similar to how some people self-diagnose a physical illness by reading something online. That's not to say that only a mental health expert can diagnose someone. I still keep my DSM close by and look at it all the time. Still, there's a reason why most agencies, and states, require a certain degree/licensure to diagnose individuals. If he has not told his full story to a therapist, and if said therapist has no knowledge of past abuse, then perhaps they could be diagnosed as schizotypal and not DID, or perhaps he would be diagnosed with a Mood Disorder NOS (not otherwise specified).

PS: Although I cannot speak for all agencies, most require a diagnosis of some kind in order to begin treatment.

 

[Alile]

I guess with this sort of person, what you fail to mention is that you're not writing about a guy. There are at least two of them, two disctinct different personalities. You would need to know them both, but how much of this knowledge you use in the written story is of course up to you.

Mental illness is in your head. To me, you can't write it any other way than an illness showing itself in the mind. Yes, it might be because of chemical disturbances in your brain, but the result is shown in your mind. Have you ever thought about how you think? Well, now think about how you would think if your thoughts were sick.

What mis-judged thoughts would you have when the mind thinking them is ill, how would you feel - are you deluded by your thoughts when they are ill?
Can you trust your mind, your rational logic thinking self? Are your feelings real or are they sick too? Are they even your feelings now?

This is a very controversial topic... I'd be careful and thourogh. Do your readers the honor of being careful with this topic, do the people suffering from mental illnesses the honor of getting the necessary knowledge. An article in a magazine or a Wikipedia article just isn't good enough. Go to universities, read thesis papers and anything you can find; research and case studies. You might find a gem. If you do this wrong, a lot of people will be able to know. Today, what the health care system uses the most money on, is mental illnesses. (You might ask, what is wrong with our society when it spawns so many mental problems, but hey, that is another discussion.)

With a mental illness, and there are a lot to choose from, you might end up with a text-book description which will seem flat and impersonal because knowing about it and reading and learning about it in theory isn't the same as having expereience with it. Try to find the knowledge of it that comes from experience, having lived it; as opposed to a medical summary. Good ones are paranoia, anxiety, obsessive-compulsive behavior or personality disorder, eating disorders (men have them too, more and more) and that god-complex notion.

It is a bit of a dangerous topic, because a lot of people suffer from mental illnesses, and as a writer you need to understand just how difficult this is in our world. It's perfectly okay to be sick from work because you broke a leg. But tell your boss you are home because you are depressed and would rather kill yourself than go through another minute of life... Well, that's not so okay. The social stigma is strong. People can understand you can't walk out the door because your leg is broken, they sort of accept and understand that pain, but they can't accept that you can't walk out your door because of agoraphobia, where you are afraid for no logical reason, where fear controlles your life.

 

[SeverinR]

I try to include real symptoms for the problem the character has.
Most of my battle hardened characters have some level of PTSD. People handle and have symptoms that vary in severity and how noticeable it is on the outside.
I try to look at people with PTSD. I also look at the clinical definitions and descriptions to include what applies to my characters.

You can simply have people with "generic" mental problems. If a person has many problems, they can show various problems that aren't all related to one "diagnosis". But if you want it to be a pivotal plot point or character flaw, then study up on the illness and drop the subtle clues in the story.

I thought it was funny when after the third movie of the HUnger games, people came out and said Katniss exhibited signs of Post traumatic stress. Why would Katniss have PTSD? Seeing children her age dying horrifically and people enjoying it.

 

[spectre]

The symptoms of DID are so explicit that taking on variances in writing separate aspects of your character is completely within the rules. I think you'd have luck using clearly distinct language, the rationalist, the optimist, the pessimist. Very clearly drawn lines, the fact is you can tie the rope to hang yourself but when your character "splits" he's going to use another kind of knot. DID is like a world with well defined geographic areas.

Insofar as writing from mind or physical aspects those lines should cross. Neither is strictly associative to one character even if it is particular. Make sure to take them both on. Writing from a mind perspective will help you delineate a specific frame of mind, rationalist or logical or whatever, but if you plan to write your story strictly from this vantage outside of some defect most conditions and reactions are still describable with the exception of changes in viewpoint. You'll find your not really writing from the mind unless your characters are also isolated from their environment somehow which mental illness does but DID might break that trend.

Memento is an example of screenplay writing written in the style you're talking about but doing so as a rule means there is an imposing cause which DID doesn't satisfy but something like omniscience will govern. By that I mean you have to break the trend unless you have one character with DID or not.

Anime does a lot of what you suggest mind and physical because it deals with the superhuman or supernatural vs. the human condition all in the same story. A lot of anime relies on the fact that most emotions are commonly experienced and expressed in a lot of situations.

Your question is really hard, hope this made sense. The Giver is a balanced example.

 

[Gaskoin]

Mental problems always last a long time, I know that myself.

 

[Gaskoin]

I remember being diagnosed with impulsive-compulsive disorder. It was very confusing and scary for me. It's a good thing that I was able to at least find information about it here OCD Therapy: Signs, Diagnosis, and Effective Treatment , it's as clear and understandable as possible. So at least I calmed down and figured out how to move forward. Fortunately I was cured of this problem, but if you are also faced with such a problem I recommend to study these materials.

 

[Gaskoin]

I remember being diagnosed with impulsive-compulsive disorder. It was very confusing and scary for me. It's a good thing that I was able to at least find information about it here , it's as clear and understandable as possible. So at least I calmed down and figured out how to move forward. Fortunately I was cured of this problem, but if you are also faced with such a problem I recommend to study these materials.

 

[Gaskoin]

Really cool

 

[Bloodywake]

I actually have the exact same thing going on with my main character except the cause is completely different than what you would think. (The second identity was actually forced in to his mind by omnipotent power.)
I have it actually take a third course I don't know if you want to take. My main character is normally not effected by the second presence until certain things occur. However the two of them can converse with each other more often than not however they're mentally at each others throats. And even hurt each other physically at times.

 

[Finchbearer]

Lots of old threads being resurrected - be mindful of dates! This one is from 2015…