Writing a Mentally Ill Character

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On Writing Characters with Mental Disorders


A tutorial/guide/resource of sorts

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Contents:


 


(These are links to the posts)


 


 


Intro


 


Importance of Research


 


Basics of Research


 


Types of Disorders/


Brief Descriptions


 


Misc. Info


 


Note on Psychopathy


 


Links


 


Conclusion
 
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Intro

So, in the thread Types of Role Plays and Things Role Players do that Annyoy You, many people expressed their frustration of people rping mental disorders inaccurately and of romanticizing them.


To "romanticize" is described as "deal with or describe in an idealized or unrealistic fashion; make (something) seem better or more appealing than it really is" by the Oxford dictionary. While trying to de-stigmatize mental illness is great, it's not the same as romanticizing. Idolizing mental illness can encourage self-harm, self-medication, and ending it all to become something like a romantic tragic soul. It makes the attitude that the long, hard, unexciting work of therapy isn't worth it more prevalent. That embracing mental illness as a glorified tragedy and not seeking any kind of help is okay. [x] Obviously, it also spreads misconceptions and misinformation about mental illness. Healthy people may expect things that are completely unrealistic.


Portraying mental disorders inaccurately also spreads misinformation. This can fuel inaccurate stereotypes and myths, help stigma, cause confusion, and just be plain... incorrect. Which even if it wasn't harmful, it'd just be bad writing. Common stereotypes in the media are that mentally ill people are violent, unpredictable monsters, that there's no chance of getting better, that to get better all you need is to fall in love, that certain illnesses are only caused by chemical imbalances and with a pill are easily fixable and just go away, that young people with illnesses are "just going through a phase," that all mental health professionals are the same (either evil, foolish, or wonderful), or disorders are romanticized. [x]


The discussion of why it's bad can go a lot more in-depth.


Obviously the portrayal of people with mental disorders is important, and it's too often inaccurate. From the amount of posts in Types of Roleplays talking about it, it's easily seen that this is a large problem in roleplaying communities too.


So, I've decided to try to put this thread together to help out with writing characters. I myself am not a perfectly mentally healthy person, although I'm only certain about a few things I'm afflicted by. For personal reasons and situations, I'm not going to be going to a therapist any time soon, and as such don't have any diagnoses. And for personal reasons, I'm not going to discuss myself much in this thread or specific/detailed personal experiences.


While it is an interest of mine and the study of psychology is exciting to me I'm not a professional, and I'm not planning to go into this field, but since no one else is making a thread like this I figured better me than nobody.


This resource was made with healthy people in mind, because it seems they're the most likely to not realize the importance of correct portrayal or even that the misconceptions caused by the media even are misconceptions.





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Importance of Research

In the thread Types of Roleplays, I made this post suggesting that people don't do enough research, and that possibly some of the inaccurate portrayals and misconceptions could be corrected through doing research.


For writing a mentally ill character, research is one of the most important things. If you don't do any research and don't have the specific disorder, how are you supposed to have a good grasp of anything?


Even if you know someone with a disorder, you may not know a lot about it, or even as much as you think you know.


If you're going to be roleplaying or otherwise writing for a mentally ill character, research isn't optional- you have to do it. Sorry, but that's how it is. If you don't have any interest in taking time out of your life to do research, then just don't play a mentally ill character. You can make someone interesting, edgy, cool, unique, or what have you in an almost infinite amount of other ways. Otherwise you'll look bad, and actually mentally ill people or others who have done a bit of research will most certainly realize your inaccuracies and think you're an ass. You'll look ridiculous. There's really no nice way to put it, and it's the truth.


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Basics of Internet Research

This is going to focus on researching things on the internet, because I'm assuming that's how most people will go about it. I don't usually use books anyways, because I don't get to the library often. So I wouldn't have much advice on using libraries anyways.


It's important to remember what you learned in school about reliable resources. Try to use professional-looking websites. Fact-check by looking to see if the same information is in more than one place. If you can only find it on one article or on one website, it might not be true.


A great idea is also to look for information, stories, or experiences written by people with the illness your OC will have. Forums and threads where people with the same disorders come to talk, blogs, personal biographies, and etc. are all really good resources.


Wikipedia is great but it shouldn't be your only resource. You shouldn't have only one resource, period. Even though Wikipedia can technically be edited by anyone, it can still be a good resource. However, it shouldn't be your only resource. Remember the fact-checking thing? Yeah. The things Wikipedia lists as references can be helpful too.


If you're not sure how to start, try googling (or using whatever search engine you like) the name of the disorder and descriptions or symptoms. Searching just the name of the disorder can bring up lots of results, and looking for symptoms generally can give you good descriptions. For first-hand accounts/details, try searching "First hand (name of disorder)."


When looking for firsthand accounts, make sure they're written by the person who has it, and not someone who "was affected." In my experience, accounts by people who knew someone with an illness generally end up being something about how much it hurt them to be around the ill person, and how terrible they are, or how hard dealing with them was, or how frustrated they got. Since those types of stories tend to be the most popular, unfortunately. These accounts paint the people suffering from the disorder in an often unfairly bad light, and they'll be biased and inaccurate. It's even worse for "scary" disorders like schizophrenia, antisocial-personality disorder, narcissistic personality disorder, and so on. Also, do not use guides on "how to tell if your ex was psychopathic/narcissitic/etc," or "how to deal with a loved one that has X disorder." They generally have the same problems. While some of the latter may be actually helpful, unless they're written by someone who has the disorder it's more common for them to not be.


If there's medication, therapy, or treatment available, research those things too. You can't just research a portion of an illness and leave out the rest. These things are about as important as the disorder themselves in accurate portrayal, since it affects the character too.


Spend lots of time making sure you know as much as possible and understand the disorder, how it's symptoms manifest, and how it would affect your character. Researching for five or even thirty minutes isn't going to be enough to have a good grasp of it, especially with all the misinformation and myths spread around.


Actually remember what you've learned. That's probably the most important thing. Take notes, write out a description of your character and how this affects them, or whatever. Just make sure you've actually learned about it before writing your character and keep these things in mind while you do.





Don't just look at the Types of Disorders/Brief Descriptions and Misc. sections and think that's enough. Do your research.


Lol.


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Types of Disorders/Brief Descriptions

Because there's so much misinformation I figure I'd give a list of the different categories of mental illnesses, list some common ones, and give a short description of those too.


To make things easier on myself I will be taking most of the descriptions from the psychology class I'm taking. I can't link to the class because it requires log-in info, but to give credit where it is due, the school is Connections Academy. It's a high-school class, but this is only meant to give a brief overview. I may add on some details not provided in my lessons.


Because my lessons do not include anything on mood disorders, learning disorders, or developmental disorders the descriptions will be taken from Wikipedia and be much shorter. Sorry about that.


To go more in-depth on any of these things, do your own research.





What makes something "not normal"- Maladaptive Behavior





Maladaptivity is the most common way that mental health professionals assess an individual's behavior. Unlike terms such as "normal" and "abnormal," which can have confining and/or negative connotations, considering maladaptive behavior allows psychologists and other health professionals to determine how behavior might cause an individual person distress. Generally, the two aspects of maladaptive behavior are the following:




  1. self maladaptivity, or the inability to reach personal goals/adapt to life's changes
  2. societal maladaptivity, or behavior that disrupts an individual's ability to function within a group


Contents:





Anxiety Disorders


Somatoform and Dissociative Disorders


Schizophrenia


Personality Disorders


Mood Disorders


Neurodevelopmental Disorders


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Anxiety Disorders-


Anxiety is a state of intense apprehension, uncertainty, and fear resulting from the anticipation of a threatening event or situation, often to a degree that normal physical and psychological functioning is disrupted. When anxiety is severe enough that it disrupts an individual's daily life, the person might be suffering from one of several anxiety disorders.


Many people feel intense anxiety in their lives, and, in fact, with over 19 million recognized sufferers in the United States alone, it is the most common mental disorder.


There is no conclusive research on what causes anxiety disorders, but there is evidence that suggests it runs in families.






  • Generalized Anxiety Disorder (GAD)

    is characterized by prolonged and excessive worry about situations even when there is no apparent cause for concern. People suffering from GAD may also experience physical symptoms like insomnia, headaches, and fatigue.



  • Obsessive-Compulsive Disorder (OCD)

    is characterized by obsessive, irrational thoughts (of germs, for example) that increase/intensify feelings of anxiety. In an effort to reduce that anxiety, people with OCD often engage in compulsive, repetitious behavior (such as hand-washing to eliminate germs). Even if individuals suffering from OCD realize that their thoughts are irrational, they are unable to control anxious thoughts or their consequent compulsive behaviors.


    There are four kinds of OCD as far as awareness goes.


    Basically, there are those who are fully aware, those that are aware that they have something wrong but don't know what, those who only know that others view their feelings as incorrect, and those who fully believe the reasonings they have for the repetitive behavior. Generally the more aware they are of the inappropriateness of their thoughts/actions, the more likely they are to have been or be in therapy. (Information provided by

    https://www.rpnation.com/profile/7290-saphiretsuki/@SaphireTsuki

    https://www.rpnation.com/profile/7290-saphiretsuki/)



  • Panic Disorder

    is characterized by panic attacks. During panic attacks the feeling of being in danger overwhelms individuals, and they may experience physical symptoms such as sweating, chest pain, nausea, dizziness, chills, or hot flashes. Additionally, they may also feel disconnected from reality, like they will lose control, "go crazy," or feel like they are dying.



  • Post-Traumatic Stress Disorder (PTSD)

    occurs in individuals who have gone through a traumatic event. These events are varied and can include any number of things, such as: war, sexual abuse, witnessing the death of a loved one, or natural disaster. PTSD is characterized by three main symptoms: 1) reliving the trauma through flashbacks or nightmares; 2) avoiding places that trigger memories of the trauma; and 3) emotional detachment.



  • Social Anxiety Disorder (also called Social Phobia)

    occurs in individuals who experience anxiety over judgments others may make of them in social situations or fear of public embarrassment. Individuals suffering from social anxiety disorder tend to avoid social situations.



  • Specific Phobias

    are characterized by an exaggerated and irrational fear of objects or situations that are generally not harmful. Like individuals suffering from OCD, these people realize that their anxiety is unwarranted, yet can't get past it. Some examples of specific phobias include fears of heights, dogs, bugs, or snakes.


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Somatoform and Dissociative Disorders-


There are certain times when the need for escape severely disrupts not only daily routines/responsibilities, but also a personal sense of well-being. Two primary instances of disruptive escape are somatoform and dissociative disorders.

Somatoform Disorders-



  • Conversion Disorder

    , also known as hysteria, is marked by a significant change in, or absence of, physical functions in the body. These changes are usually the mind's attempt to escape from overly stressful situations. Individuals with conversion disorder are generally characterized as being extremely indifferent, although conversion disorder can be subdivided into three sets of more specific symptoms:




  • Sensory symptoms — Individuals either feel too sensitive to stimulation (hyperanesthesia) or numb to pain (analgesia).



  • Motor symptoms — An individual's motor skills may be disrupted (paralysis) or distorted (ticks, twitches).



  • Visceral symptoms — Individuals experience the visceral (instinctive) in the extreme (burping, vomiting, coughing).







  • Hypochondriasis

    is marked by an obsession with normal bodily functions. Unlike individuals suffering from conversion disorder, hypochondriacs maintain normal bodily function. These individuals are plagued with the constant fear that some unknown or undiagnosed disease is overtaking their bodies.




The more common signs of hypochondriasis include:






  • Preoccupation with minor physical complaints



  • Overly concerned with deadly diseases, like AIDS



  • Requesting repeated physical examinations



  • Visiting several different doctors with the same complaints ("doctor shopping")



  • Complaining of incompetent medical care



  • Repeatedly performing physical exams on their own body







  • Somatization Disorder

    is characterized by individuals, usually under thirty years of age, who have a pattern of unexplained physical complaints. In order to be diagnosed with a somatization disorder a patient must have:




  • at least four separate physical complaints of pain (e.g., chest, neck, painful urination)



  • two gastrointestinal symptoms (e.g., vomiting, bloating)



  • one sexual/reproduction complaint not related to pain



  • one pseudoneurological complaint (e.g., paralysis, loss of balance)






Victims of

Somatoform Pain Disorder

experience chronic pain, debilitating pain (socially, physically, psychologically) that has no diagnosed physiological basis.






  • Body Dysmorphic Disorder

    is sometimes referred to as somatoform pain disorder, but more and more it is being distinguished as separate and distinct. Those suffering with BDD are overly preoccupied with what they believe is a physical defect, often surrounding areas of the face, and they spend at least one hour per day thinking about their appearance. Constantly glancing into reflective surfaces and/or avoiding mirrors altogether are two common symptoms of BDD. Although the DSM-IV lists BDD under somatoform disorders, many clinicians treat this disorder as a form of OCD because of the ritual grooming and/or camouflaging techniques that these patients can develop.




Dissociative Disorders


A group of mental disorders characterized by a sudden temporary alteration in consciousness, identity, or motor behavior. In other words, the mind disassociates, or escapes, from the body because it is too difficult to integrate a particular experience into the conscious self.



  • Dissociative amnesia

    , also called psychogenic amnesia, occurs when a person blocks out personal information about himself or herself. This type of amnesia has several manifestations: localized (memory loss about specific, usually traumatic, events); selective (memory loss about portions of events); generalized (memory loss about an individual's entire life); systematized (memory loss about specific categories, i.e., certain people, places, or things).




  • Dissociative fugue

    , also called psychogenic fugue, occurs when a person unexpectedly leaves the environment to go on a journey. These journeys can be very brief or extend over long periods of time (because these individuals are confused about their identities, some have been known to take on new ones). This is a very rare condition.




  • Dissociative Identity Disorder (DID)

    occurs when someone develops more than one distinct identity. These identities may have different memories and personalities.


    Ghost's Notes, courtesy of

    http://psychcentral.com/lib/dispelling-myths-about-dissociative-identity-disorder/[X]

    http://psychcentral.com/lib/dispelling-myths-about-dissociative-identity-disorder/:


    It was previously known as Multiple Personality Disorder, but the name was changed over 20 years ago. Using it's "new" name is correct- MPD is not.


    This is one of the media's favorites, but it's also misrepresented a

    lot.


    The first common misconception relates to memory loss. Some people may think that individuals with DID may

    completely

    forget trauma, and in the media examples I can think of off the top of my head it's common there too. Individuals may forget episodes or aspects of it, but it's rare to forget 100% of it and then suddenly recover memories.


    The second is that many people think of DID as "different people in one person's body." More accurately though, it's characterized by different identities or "self-states" and an inability to remember things beyond normal forgetfulness that's attributed to switching self-states.


    The third is that it's really rare. Actually, it occurs in about 1% of the population, which is as common as bipolar disorder and schizophrenia.


    Although it's not that rare, it's also often falsified either purposefully or accidentally by the individual, and there's some controversy over it. Cases where memory is completely absent between alters is considered most believable, and cases where each alter can remember what the other does is not, and likely something else.


    Next is how obvious it is. People who have it usually don't know they have it until they seek treatment for symptoms or co-morbid disorders, and the people around them most likely won't know either. DID is more subtle than the media likes to think it is.


    People afflicted with DID don't really have distinct personalities, but as said before, different self-states which is like having different ways of being themselves, which we all do to some extent, but people with DID cannot always recall what they do or say while in their different states.They may act very differently and they may not. The media likes to portray people's alters as being violent or sadistic, but it's not always the case and is simply a stereotype.


    The last thing I can think of that I don't immediately have a source for (but I'm lazy) is that DID people, unless they have a comorbid disorder, are not delusional. They don't have hallucinations of their alters, as much as I love

    Fight Club.




  • Depersonalization disorder

    occurs when individuals feel chronically detached from themselves. Many have described this feeling as similar to the "spaced out" feeling of intoxication. However, individuals with depersonalization disorder might experience this feeling so often that it may eventually impair their ability to distinguish reality.


    Ghost's Notes (No source because this is strictly from knowledge already in my head from sites, forums, and my experiences):


    Individuals with depersonalization disorder do not actually break from reality, however, and they recognize that it is only a feeling.


    Related to depersonalization and often accompanying it is derealization, which is a similar but distinct feeling of being detached from reality, or that the outside world is unreal. Like depersonalization, the individual is aware that it is only a feeling.


    Both in depersonalization and derealization the individual may also experience hyper-awareness, which can either be a pleasant or unpleasant experience. Usually it's the latter.


    Both can be chronic and/or episodic.


    If afflicted individuals are not aware of these disorders they may worry that they're going insane.


    They are both categorized as anxiety and dissociative disorders. Anxiety often accompanies them. The states can be brought on by anxiety, or the states themselves can bring anxiety. However, it's not required that there is any anxiety.

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Schizophrenia-





Schizophrenia refers to a group of psychotic disorders where a person displays some or all of the following symptoms: delusions, hallucinations, illogical thoughts, and a general break with reality. The different forms of schizophrenia have nuanced, but distinct, patterns of those symptoms.


The symptoms of schizophrenia can be organized into three categories.




  • Positive: This category refers to behaviors that should not be present in an individual, but are. These symptoms include delusions and hallucinations. For example, individuals with schizophrenia might hear voices that no one else can hear; they might see things that are not there; they might believe that someone is reading their mind, or trying to harm them in some way.


  • Negative: This category refers to behaviors that should be present in an individual, like sociability and emotion, but are not. Instead, this type of schizophrenia is marked by social avoidance and emotional withdrawal.


  • Disorganized: This category refers to the confused thinking and speech (to the point of incomprehensibility) that many schizophrenics experience.



The types of schizophrenia are-




  • Paranoid: Paranoid schizophrenics are very suspicious of others and often feel that they are at the core of an elaborate persecution.


  • Disorganized: This type is also known as Hebephrenic. These patients are incoherent, and have both positive and negative symptoms.


  • Catatonic: These individuals are extremely withdrawn, negative, and isolated. Additionally, they may exhibit somatoform-like disruptions in their motor skills.


  • Residual: These people have previously been diagnosed with or have suffered from delusions/hallucinations, but are not currently experiencing them. These individuals lack motivation for day-to-day life.


  • Schizoaffective: These patients suffer from schizophrenia as well as some other mood disorder such as major depression or bipolar disorder.


  • Undifferentiated: These individuals suffer many of the symptoms of schizophrenia, but they do not conform to any of the previous categories.


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Personality Disorders





A personality disorder is any of a group of disorders in which patterns of perceiving, relating to, and thinking about oneself and one's environment interfere with the long-term functioning of an individual, often manifested in deviant behavior and lifestyle. In other words, individuals with personality disorders often have difficulty relating to other people in particular, and society in general, because of their often inflexible thoughts and behavior.


They can be suffering from other mental disorders, lack a sense of personal responsibility, or have a distorted vision of self and others.


Currently, the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) has identified 10 distinct disorders in three different categories.


Diagnostic criteria requires people to be 18 or older to be diagnosed with a personality disorder. Individuals under the age of 18 cannot be diagnosed with a personality disorder.





Cluster A (Odd Disorders)-


Cluster A PD's are considered a part of the schizophrenia spectrum, although they should not be confused with schizophrenia as they are separate disorders.

  • Paranoid personality: These individuals have difficulty trusting others, and they often believe, without reason, that others are out to wrong them in some way.


  • Schizoid personality: Characterized by emotional withdrawal and a lack of desire for close relationships, even with family. Schizoids are often seen as loners. They may be emotionally cold and detached.


  • Schizotypical personality: Eccentric. Displaying odd behavior, dress, social interaction, and even thought.


Cluster B (dramatic, emotional, or erratic disorders)-

  • Antisocial personality: Lack of regard for moral or legal standards. These individuals also may have a difficult time in interpersonal relationships. Additionally, individuals with this disorder are sometimes referred to as sociopaths or psychopaths.


  • Borderline personality: These individuals have rapid mood swings, impulsive behavior, volatile relationships, and tend to lack personal identity.


  • Histrionic personality: These individuals exhibit exaggerated, inappropriate, and rapidly shifting emotional reactions to everyday situations. They tend to be overly dramatic, self-focused, and attention-seeking.


  • Narcissistic personality: Overly involved with the self. These individuals need to be admired by those around them and they are very sensitive to criticism. This is because they obtain their self-worth from interactions with others. They also find it hard to empathize with others. Narcissistic personality disorder is named for Narcissus, a fictional Greek hero who was obsessed with his own image. (Additional information provided by @SaphireTsuki)


Cluster C (anxious or fearful disorders)-

  • Avoidant personality: Very self-conscious in social settings, these individuals generally have feelings of inadequacy.


  • Dependent personality: These individuals need to have others around to feel complete and secure. They often are unable to make decisions alone and live in fear of separation from their loved ones.


  • Obsessive-compulsive personality: This disorder overlaps with anxiety disorders. These individuals are dogged by inflexible, often repetitive, and uncontrollable patterns of behavior.


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Mood Disorders





Not mentioned in my lessons, so the description covers less disorders, and information is taken from Wikipedia. Sorry.


Mood disorder is a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature. The classification is known as mood (or affective) disorders in International Classification of Diseases (ICD).


Mood disorders fall into the basic groups of elevated mood (such as mania), depressed mood, and moods which cycle between mania and depression known as bipolar disorder. There are several sub-types of depressive disorders or psychiatric syndromes featuring less severe symptoms. Mood disorders may also be substance-induced or occur in response to a medical condition. [X]


Since the two most common ones are depression and bipolar disorder, I figured I'd also get a description from their wikipedia pages.

  • Major depressive disorder (MDD) (also known as clinical depression, major depression, unipolar depression, or unipolar disorder; or as recurrent depression in the case of repeated episodes) is a mental disorder characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities. Major depressive disorder is a disabling condition that adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, around 3.4% of people with major depression commit suicide, and up to 60% of people who commit suicide had depression or another mood disorder. [X]


  • Bipolar disorder, also known as bipolar affective disorder (and originally called manic-depressive illness), is a mental disorder characterized by periods of elevated mood and periods of depression. The elevated mood is significant and is known as mania or hypomania, the difference being the severity or whether it is accompanied by psychosis. During mania an individual feels or acts abnormally happy, energetic, or irritable. They often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced. During periods of depression there may be crying, poor eye contact with others, and a negative outlook on life.The risk of suicide among those with the disorder is high at greater than 6% over 20 years, while self harm occurs in 30–40%. Other mental health issues such as anxiety disorder and substance use disorder are commonly associated. [X]

    It is likely for those who suffer from it to refuse to take medication. This is because in their manic or hypomanic stages they feel so good that they do not think that they need to take the medication. Ironically, it is one of few diseases that     absolutely cannot be effectively treated without medication. (Information provided by @SaphireTsuki)


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Neurodevelopmental Disorders


Not mentioned in my lessons, so the description is much shorter and taken from Wikipedia. Sorry.


Neurodevelopmental disorders are impairments of the growth and development of the brain or central nervous system. A narrower use of the term refers to a disorder of brain function that affects emotion, learning ability, self-control and memory and that unfolds as the individual grows. The term is sometimes erroneously used as an exclusive synonym for autism and autism spectrum disorders.


Disorders considered neurodevelopmental in origin, or that have neurodevelopmental consequences when they occur in infancy and childhood, include:




  • Autism and autism spectrum disorders such as Asperger syndrome
  • Fetal alcohol spectrum disorder
  • Motor disorders including developmental coordination disorder, stereotypic movement disorder and the tic disorders including Tourette syndrome.
  • Traumatic brain injury (including congenital injuries such as those that cause cerebral palsy)
  • Communication, speech and language disorders
  • Genetic disorders, such as fragile-X syndrome
  • Down syndrome
  • Attention deficit hyperactivity disorder
  • Mendelsohnn's Syndrome
  • Schizophrenia


Neurodevelopmental disorders are associated with widely varying degrees of difficulty which may have significant mental, emotional, physical, and economic consequences for individuals, and in turn their families and society in general. [X]


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Misc. Info

Info that I didn't think fit anywhere else, but still thought I'd mention.


First off, typically people that have mental disorders are not going to be very open about them. Of course everyone is different and some people may tell everyone they know, but typically someone with a mental disorder isn't going to tell strangers about it, or even people they're close too. Some people may be afraid of stigma, or feel embarrassed.


Personally I won't openly go into detail about several aspects of my mental state because I find them awkward to talk about. Other things, however, I don't care as much about and may freely talk about them. For example, I started researching psychology after hearing about some possible causes of lacking affective empathy (there's two types- emotional (affective) and intellectual (cognitive)) and a lack of remorse/guilt. (There are several reasons right now why I can't just go and ask a professional/psychiatrist.) Since this is the internet and people who I don't know/care about personally will be reading this, I really couldn't care less who knows. I don't consider it inherently a bad thing or something that has to be fixed.


Some people may not want a diagnosis. This is because certain fields of work in addition to government jobs will not accept you if you have a certain diagnosis, usually the "scary" ones such as ASPD, BPD, schizophrenia, etc. Not to mention the stigma from other people or employers if they found out. Plus, if there isn't any kind of decent treatment currently available for a particular disorder some people may feel that it might not be worth it to gain a diagnosis.


(On the other hand though, many many mental illnesses have a bad enough impact on someones life or social life, or other people lives, for someone to seek out help and diagnosis. I thought this was kind of obvious, but figured I'd add it in anyways just in case. I've had a lot of misunderstandings on this site so stating this outright might be good. I also don't want to make it seem like mental illness isn't a big deal.)


However, self-diagnosis isn't accurate. Since it's a bit of a touchy subject for some, I'm just going to stay out of whether or not self-diagnosis is a good or helpful thing and instead just simply say that it's not as accurate as some people may think it is. Different disorders can have similar or overlapping symptoms, and one symptom could be caused by or found in a multitude of disorders. Generally, people can't look at or study themselves objectively either. Professionals take years to learn everything, and can still misdiagnose people. Doctors and psychologists are not allowed to diagnose themselves because of issues with objectivity. Maybe just something to keep in mind if you're writing a self-dxed character if it's relevant.


Co-morbidity is common. Co-morbidity is when one person has more than one disorder, or one disorder and traits of another. It's rather common. However, not all disorders are comorbid with each other. As always, do! Your! Research!


You generally can't tell who has a mental illness by looking at them, or even interacting with them. While some symptoms of certain disorders may be apparent, mental disorders are generally "invisible" to outside people. Family members or close friends might realize something's wrong, but that's different. I wanted to mention this because of the media and how they love to make everyone think that all mental illnesses make people crazy killer monsters.




Something I wanted to address that I didn't anywhere else is a, for lack of a better word, trope that some people mentioned in the thread Types of Things.This trope, or plot event (I'm not really sure what to refer to it as) is something that appears in media... I'm not sure how often, because personally I'm not into romance. But it appears often enough that I've seen numerous people complain about it. It also must be showing up in rps because it was mentioned in Types of Things. Anyways, it's that trope of "mentally ill person falls in love, and is never sad or bothered again and it's happily ever after for them both."


Now I'm not saying mentally ill people can't either fall in love or be happy. I'm just trying to explain that falling in love or having someone that loves you isn't going to make it go away or cure anyone, and that trope puts unrealistic expectations on what it'll be like to be in love with someone who's mentally ill, and it could give inexperienced/young mentally ill people themselves unrealistic expectation for falling in love. While it might be easier to work through symptoms with someone that loves them and understands and can do their best to help, it won't cure mental illness.


I don't really like the huge emphasis that puts on romance and other implications either, but that's an entire different topic and not the point of the thread, as much as I love ranting about things.


Also, here is a lovely post by @castigat with additional things to consider about writing characters with a mental illness.


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A note about psycho/sociopathy and ASPD

Since I see a ton of character sheets with things like "Oh, by the way, he's a psycho-/sociopath," I figured I'd talk about this and how what you think a psycho-/sociopath is probably isn't accurate. When people hear or see either of those words, they generally think insane, delusional, mentally unstable killer who's far away from reality. However, the media's portrayal of psychopathy is what's far from reality.


Psychotic killers and psychopathic characters in media may get confused, because they're often referred to as psycho. Which is another point- don't call your psychopathic character "psycho," because psycho refers to psychotic.


The term psychopath is a medical term, and as a really short description, is like ASPD but with shallower, shorter-lasting emotions and narcissistic qualities.


It's considered a superset of both ASPD and NPD. Psychopathy and ASPD aren't the same thing, although some people will consider psychopathy a more extreme version of ASPD (which is technically incorrect, but "close enough.")


Sociopath is generally used to refer to the same thing, however, the term isn't used in any academic fields by any professional that actually knows their stuff. Technically it's an incorrect term.


Most ASPD individuals are not serial killers. While the majority of serial killers may be psychopathic, not all psychopaths are killers.


Hare's research on ASPD individuals and psychopaths is flawed. Most research is biased. Robert Hare's psychopathy checklist is rather popular, but as a researcher Hare was flawed. His sample sizes were small and he focused on only criminal psychopaths in jail. His psychopathic checklist is centered way too much around criminality. Some of the 'psychopaths' he interviewed may not actually have been psychopaths. [x] Unfortunately, a lot of scientific research on them is biased in a similar manner. Don't use Hare as one of your sources.


EDIT: Because I don't want to re-word everything (yay effort), I thought I'd just tack this on to the statement above. From my amazing source: "Hare's research is completely fine, if you only use it to refer to psychopaths who have committed a crime. It's very hard to find psychopaths that haven't committed crimes, as those of us that don't commit crimes have no desire to be revealed as psychopaths to the whole world. Most psychopaths who are even evaluated and assessed are done so because of a court order. The vast majority of psychotherapists won't even work with anyone that shows signs of ASPD or NPD."


A lot of sources are fear-mongering. For ASPD, I wouldn't trust those articles. However, for psychopathy they may be more accurate. Previously I said none could be trusted, but what I was thinking of were websites dedicated to people who were in relationships with psychopaths- as statistically it's unlikely that most of them dated a psychopath. I say "fear-mongering" articles may be more trustworthy because they're written that way since most people are afraid of psychopaths specifically because they lack empathy and typically see nothing wrong with their actions.


The main differences between typical people and psychopaths or ASPD individuals are... a lack of emotional empathy (they have empathy on an intellectual/cognitive level- meaning if they think about it they can understand why someone's upset, etc, but it will have no affect on them emotionally), remorse/guilt (You can feel bad because there were negative consequences for you- remorse implies that you feel bad because of what happened to the other person. So guiltless people can feel bad for themselves because they got in trouble and regret something, but will not feel remorse for the negative effects on others), a generally prevailing sense of boredom, shorter-lasting or less intense emotions (this is mainly in psycopathy- people with ASPD are more likely to have a "normal" amount/intenseness of emotions. There is one personality disorder involving a small to nonexistent display or amount of emotions, but it's not ASPD or psychopathy), a disregard for traditions or rules, more reckless/impulsiveness, and a lack of forward thinking.


It's also in the diagnostic criteria that psychopaths cannot be schizophrenic. They aren't detached from reality.


About violent urges- The common misconception is that all psychopaths are violent criminals, not that all psychopaths have violent urges. The vast majority of psychopaths, if not all, have violent urges. the difference between a violent urge and a violent criminal is whether or not you act on those urges.


Violent urges are on a spectrum. They can range from violent fantasies to actual impulses. Where they are on a spectrum and how strong any impulses may be depend on the individual, and may affect how likely one is to act on them.


Many people with psychopathy go unnoticed because typically they seem normal. They can be adept at wearing a "mask" of normalcy. But this also depends on the individual.


I could go more in-depth, but the focus of this thread is not on psychopathy.


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Links

Some general resources that seem to be okay, but as always fact-check. If anyone knows of any more trusted resources, feel free to comment or send me a link and I'll update this list.


Wikipedia


MayoClinic


PsychCentral


PsychCentral Forums


MentalHealth


MentalHealthAmerica


U.S. National Library of Medicine


PsychForums (For reading topics and created by and for people with mental illnesses.)


PsychoGendered (A professionally diagnosed psychopath shares on a blog her insights about many psychological and philosophical topics pertaining to aspects of psychopathy, psychopaths, and their relation with non-psychopaths/neurotypicals.)


Free PDF of the DSM-V (Stands for Diagnostic and Statistical Manual of Mental Disorders, 5th version. Basically a tool used by professionals to define and diagnose disorders. Might be helpful for a list of symptoms and such, some of the sections might be a bit technical for someone with no prior knowledge.)


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Conclusion

An accurate portrayal of people with mental disorders is important, whether it's in a rp or a movie.


The best thing you can do if you want to write an OC with one is do lots of research. If you don't want to spend time researching, don't write a character with a mental disorder.


While this tutorial/guide/resource thing is longer than almost all of the tutorials on this site, it is really only a brief tutorial and there's absolutely no way you can get all of the information you need to write a mentally ill character from this because I didn't put all the information you need in this guide. It's really only the bare, most important basics that I could think of. If I had included everything you needed, it would be pages and pages and pages longer.


The only reason it is as long as it is is because I thought to put incredibly brief descriptions of the disorders in for a quick reference and explanation. And it definitely doesn't list every possible disorder.


If anyone wants to add something on here, contribute with their own experiences, if I missed something, or got anything wrong please tell me and I'll consider adding/changing it. I'm definitely not a professional.


If anyone wants to talk to me about my own experiences I might consider it, but I'm definitely not going to talk about every aspect of myself on a public thread.


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Bookmarked, favourited, close to hand when someone inevitably needs to read this.


Thank you. You've saved me a ton of work and probably did this better than I would have.
 
Thanks so much, that means a lot to me!


There are some topics I meant to cover that are important but accidentally forgot about, I might add them on later when I have more time.
 
As someone repeatedly misrepresented because I have an "easy" disorder to write, I'm saving this link so when the next person to do it does, it's ready


Thanks~
 
Really glad it could help you guys!


Sometime soon I'll add to the misc section (because the way I formatted it, I can't just put posts in the middle.... the sacrifice for having an easily-navigable guide...) some stuff about how DID isn't like the media loves to portray it, and some stuff about the unfortunate "mentally ill person falls in love and everything cured just like that" trope thing.
 
Gotta love the good old, "I'm sad because X happened. I'm still not over it, but this white male protagonist will make me better and restore me to the Manic Pixie Dream Girl I outta be!"


That's more of a writing criticism in general than specifically RPing, but eh, whacanyedo?
 
Thank you for this. I was considering writing a character with a mental illness (had nothing in mind, it just seemed interesting to do), and this has helped sum up a lot of what I could consider doing, as well as giving more ideas to boot. Well done, and thanks again!
 
Instead of doing psychology homework, I updated a few things that I said I would and some stuff I just decided to do now:


Added a small section on the bottom of the Misc. post about "Mentally Ill Person Falls in Love and is Cured Forever"


Added some stuff about common myths vs facts about DID (previously known as Multiple Personality Disorder) in the Somatoform and Dissociative Disorders section of Brief Overview/Description of Disorders because it's a common one to see in rps.


Added some stuff to the Depersonalization section of Somatoform and Dissociative Disorders section of Brief Overview/Description of Disorders, because it was really short and I already knew more about it so why not?


Added to the bottom of posts the little "Jump back to top" links so that it's even easier to navigate, and added a "Jump back to index" button on the posts in Brief Overview/Description of Disorders to navigate that even easier.


I had a joke about dissociation, but I forgot the punchline.


Also, sometimes the links for navigating won't work for me. After trying to replace the links I'm not really sure if there was anything actually wrong with them, or if it's just RPN being weird.


 
More updates with additional info provided by @SaphireTsuki !


Added and changed some stuff to the OCD section Anxiety Disorders.


Added and changed some stuff about Histrionic PD in Personality Disorders.


Added and changed some stuff about Narcissistic PD in Personality Disorders.


Added some stuff to Bipolar Disorder in Mood Disorders.


Possibly more additions or changes to come, I'll just edit this post.
 
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Actually, I'm done. That's all I know from my Introduction to Abnormal Psychology class. Like I said, please make sure to also look up the actual inventories from Europe, so you can list some of the symptoms. Many people who make a character with a Mental Illness may not even know what the name is, only the symptoms, and that might help them figure out what to study. Also, I want to add... a character with a Mental Illness will be consumed by it. It's not just a passing, oh I'm depressed or Oh I have Dissociative Identity Disorder... it is who they are! Everything they do is colored by the disease, or the fear of it, or past experiences with it.


You (reader) may not understand it, but think of this... you're scared of heights. Every time you go up stairs, stand on a hill, or are in any way aware that you're higher than something else... you will be VERY aware of this. Elevators will feel like torture devices, Airplanes like deathtraps, Stairs like the Doorway to Heck. Valleys will feel like you're slowly walking to your doom. (Admittedly this is an extreme case, but you've got the idea from it, right?) Even mild phobias will have some kind of aversion. They're not going to be distracted by the view around them, ALL they can do is look down, and think about how horrible it is that they're so high, because it's so far down... ect.
 
Considering that this tutorial now has over 1,000 views, I just want to say again that if anyone sees anything in this that is inaccurate or could be worded better, or if you think that something can/should be added, please inform me. With so many views and such an important topic I want to be as correct as possible. Since it is so important though I may or may not ask for a source or two for corrections/changes and additions. Re-wording things though, I'll probably do as soon as someone asks me.


Any other problems someone might have with something, please don't feel hesitant to speak up.


And also, I'd appreciate if anyone happened to have more good links to add in the Links section. While I feel that there is a good amount and someone could learn most of what they need to know from them, anything more that could help anyone would be great.


Any questions anyone might have I'll try to answer as best as I can, too.


 
Also, I made a few really tiny edits here and there, did some things like fix spelling errors I noticed, and finally got around to attempting to fix the Somatoform and Dissociative Disorder section now that I know a lot more about BBC code than when I started. The formatting problems weren't huge issues, but the extra bullet points were bothering me.
 
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