September 7, 2011

Guest Post: Writing Mental Health Well

I'm delighted to welcome Dr. Sarah Fine from The Strangest Situation to the blog! First, a bit about her:

Sarah Fine got her doctorate in clinical psychology and specializes in working with children and their families. She also writes young adult fiction and is represented by Kathleen Ortiz at Nancy Coffey Literary. Her blog, The Strangest Situation, is about the (messy, awesome, blurred, thrilling) intersection of those two endeavors.
And here's Sarah's guest post for Psychtember:

I frequent the forums at AbsoluteWrite, and fairly regularly, I see folks asking about how to write characters with certain mental illnesses. And sometimes, in the query forums, I see queries referring to characters who are “schizo” (which always makes me cringe) or who have obsessive compulsive disorder, bipolar disorder, or anxiety. I also get plenty of questions in my inbox from writers wanting to make sure their plots and characterizations are accurate. Mental illness is a hot topic!

Some people might ask: Why are people so keen to write this type of “darkness” into their stories and characters (Hi, Meghan Cox Gurdon! Yes, I AM talking to you!)?

Let’s start with this:

About 20% of children and adolescents in the United States have an emotional or mental disorder.

That’s … a lot. Many of us have loved ones and friends who have been diagnosed with a mental illness. Many of us have ourselves been diagnosed with a mental illness. I know of few people whose lives have been untouched by depression or anxiety or some other emotional or mental disorder. And so, many of us want to write stories that include these elements. The question is—how do you do it well?

A few humble suggestions:

1. Go for individuality. Not every person with a certain diagnosis has the same symptoms or behaves in the exact same way. FAR FROM IT. Just because you know one person with bipolar disorder doesn’t mean you understand all people with bipolar disorder, right? Because children and adolescents (and adults) with emotional and mental disorders are an incredibly diverse bunch, don’t go for the obvious stereotype. Examples of books that include highly individualized portrayals of characters with diagnosed mental illnesses: Cryer’s Cross, by Lisa McMann, and The Curious Incident of the Dog in the Night-Time, by Mark Haddon.

2. Go for depth. No matter what the diagnosis, each person IS A PERSON with likes, dislikes, fears, quirks, preferences, strengths, and talents, right? It’s the details that make them 3-D: mannerisms, speech patterns, passions, pet peeves. A good character, regardless of a diagnosis, will have all of these. And without them, all you’ve got is cardboard. Examples of books that have accomplished this kind of depth: Harmonic Feedback, by Tara Kelly and Hold Still, by Nina LaCour.

3. Go for reality. If you’re writing a person who’s been diagnosed with a disorder, there has to be impairment. Some aspect of daily functioning must be problematic as a result. That’s what makes it a disorder. Mental illness is not pretty, or delicate, or elegant, or convenient, or attractive. Mental and emotional disorders bring enormous costs—in lost opportunities and broken relationships, stumbles and tragedies, not to mention incredible suffering. I'm totally not saying it has to be all-painful-all-the-time, because people live and cope and thrive despite having these disorders every day. I'm just saying don’t trivialize it. Use individuality to make your character sympathetic. Use talents and quirks to make the character attractive. Use strengths and resilience to help the character triumph. But don’t gloss over the illness. Awesome examples: Cracked Up To Be, by Courtney Summers, and Willow, by Julia Hoban.

4. Go for accuracy. What are the basic diagnostic criteria for the disorder you’re writing about? Do you understand them? Do you know what they actually mean, how they actually look? Do you know much about the disorder itself? If you’re in the research stage for your book, I suggest you start here or here. (I also suggest you be careful of the internet, because, man, there’s a lot of wild, unfounded information out there.) But don't just read the facts. Read a few personal stories. And of course, if you know someone with that diagnosis who's willing to give you a perspective, listen and take a lot of notes, because that will give you a lot more depth and warmth--and intensity, especially if you’re writing about a teen.

Oh, and if you happen to have the diagnosis yourself, I STILL suggest you get other perspectives. Writing a character who is a thinly veiled version of you can be a trap--what's it going to feel like if one of your betas says your MC is unsympathetic? It's gonna feel personal! So be careful with that (and that goes for every character, not just ones with mental illnesses). Examples of blisteringly accurate portrayals of mental illness: Wintergirls by Laurie Halse Anderson and Compulsion, by Heidi Ayarbe.

5. Go for perspective. Just because your character has a mental illness, that doesn’t mean you have an issue book (unless you want to). It doesn’t mean that your book is about mental illness. Your book is about a character (and probably more than one), right? The mental illness does not define that character. Great examples of this: Will Grayson, Will Grayson, by John Green and David Levithan, and The Things a Brother Knows, by Dana Reinhardt.

There you have it, my quick guide for writing characters with mental or emotional disorders. Any questions? Do you have some additional points to add to this list? What about good books to suggest or that demonstrate one of these points? There are so many excellent ones out there (and, of course, a few that aren’t so excellent, but we don’t have to name those). Are you writing a book that includes a character with a mental illness? How have you gone about it?

Thanks very much, Sarah, for these helpful suggestions!


  1. hi miss dayna and miss sarah! wow! you got soooo much good stuff in this post. im thinking you gotta be careful writing bout a character thats mental ill cause it could take over the whole story and you could lose the reader in it. but for sure it could add lots to reasons for behavior stuff. im gonna try doing one for a kid in one of my stories but i dont want readers feeling sorry for him. im thinking its pretty tricky stuff for sure. cool post!
    ...hugs from lenny

  2. This is great! Such a wonderful list for authors to consider when writing their own characters, even those who will not have a mental illness. These are great suggestions to really dig deep into a character.

  3. This was a great post! Sarah really knows her stuff, and it's nice to see someone give some insight on how to write about mental illness.

  4. I agree with these suggestions. But I would even say not to make a book an issue book. An issue book is a label that seems to imply that that book is only about one thing and most of the time they aren't. It's just about a character that happens a particular problem.

  5. I'll definitely be looking up the books mentioned by Sarah; Wintergirls and Cryer's Cross were amazing! A well written MC, issue book or not, always makes a story even better.

  6. Awesome guest post! I so agree that each of these things is SUPER important!!


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