As Scary as Mental Illness is, Writers Can’t Use it to Scare

You don’t need to tell me how scary mental illness is; I have already seen it. I have cared for individuals with mental illness and I have seen them at their worst when they were escalating – the term used for when their mental illness is out of control. And as the parent of a child with mental illness, I have seen many episodes when my son’s mental illness took over. And as someone with mental illness myself, I know how frightening it can be when I am lost to the tight grip depression has over me or when I am at the mercy of a panic attack.

As a writer, I have to make sure that the source of terror in my stories is not the mental illness itself, even though it can indeed spark terror in real life. I have to be sensitive to how mental illness is portrayed in my writing. In my romantic suspense novel, Faded Reflection, my antagonist was delusional, albeit borderline psychotic. While writing this novel, other writers reminded me that if I decided to make my character full-on psychotic, I shouldn’t use this as the reason why he is evil.

Writers walk a very fine line when it comes to writing about mental illness. In the event we ourselves have that same mental illness, we must ensure we are writing about it in a way which readers with the same mental illness may understand. This isn’t to say that everyone experiences mental illness in the same way; they do not. But as long as the narrative matches most of the recognized reports of the mental illness itself, the writer would not be susceptible to critics complaining that the work is inaccurate.

Who is to say what is accurate about mental illness and what is not? Mental illness can evolve and the recognized signs can change. Some people have more than one mental illness (myself included), and the symptoms of these multiple mental illnesses can overlap. Most people are not aware of the different kinds of mental illness one person may have, and therefore cannot be a good judge of how accurately the mental illness is being portrayed.

When it comes to writing fiction, the line grows even thinner. Writers must tread carefully if including mental illness. Suppose a character with a panic disorder becomes trapped in a haunted house. Surely, she might have panic attacks while enduring frightening experiences. Not only would this make the character realistic, but it would match what readers who understand panic attacks would expect. In my novella, All the Beautiful Things, my character, Q.L., has an undiagnosed mental illness, yet this is not what prompts him to kidnap his neighbor. Mainly, it is his obsessive love for her that drives his actions.

Including characters with mental illness in fiction promotes inclusion, but how will readers accept this? If the writer doesn’t have Borderline Personality Disorder, for example, yet they write a story with a character who lives with BPD, will readers care more about the story itself rather than if the author also has that same disorder?

Writers already know that including a story with a character who has a mental illness, especially in speculative fiction, can spark mixed reactions among readers. In some cases, the writer manages to do the job well.

Look at Of Mice and Men by John Steinbeck. The character, Lennie, seems to be exhibiting symptoms of autism, though the term and diagnosis are never used in the story. And while many characters in the story are afraid of Lennie because he is so tall and seems to be “simpleminded,” he is actually a gentle giant. Nobody complained about Steinbeck using a character with an obvious mental illness which he himself did not have in such a negative way. Why? Because it’s obvious that Lennie’s mental illness was not being treated and he was not taking medication for it. Same goes for Stephen King, whose bipolar character, Annie Wilkes, terrifies the main character she keeps trapped in her home in the novel Misery. Was King ostracized for portraying a character with a mental illness in such a way? He was not, but that’s only because King showed readers just how bad things can get for a person with mental illness who is not receiving treatment. King is a master at characterization and does the job well in portraying characters in a way seen as evil or scary, and not because they have some undiagnosed mental disorder. It’s because they are portrayed as evil and scary.  

And therein lies a key point: Mental illness that is left untreated can lead to scary and evil situations. On the other hand, receiving treatment for mental illness can be horrifying enough, as is portrayed in One Flew Over the Cuckoo’s Nest by Ken Kesey and Flowers for Algernon by Daniel Keyes. But left untreated, the mental illness a character is experiencing can get so bad that they end up creating havoc and, yes, even causing terror.

What’s worse than someone with mental illness not taking medication or receiving treatment? A person with a mental illness that is left undiagnosed. Many scary stories exist in which the antagonist obviously has “something wrong with them,” but while they go around causing trouble and hurting others, no one is actually sure of what is wrong. They just sum it up as “they’re crazy.” The character’s mental illness is never explored, and they continue on their rampage until they are either caught or slain. Gollom in The Lord of the Rings trilogy has Dissociative Identity Disorder, but it is never officially diagnosed or treated. In Edgar Allan Poe's "The Tell-Tale Heart," the main character seems to be afflicted with undiagnosed schizophrenia. In both of these stories, the mental illness that is not medically recognized or acknowledged in other characters creates conflict and even frightening interactions with other characters. Just as art imitates life, fiction must imitate life, and a person living with a mental illness that is left untreated can become a very real, very frightening threat to others.

This alone can clue readers in that they are in for either a fantastical or terrifying ride as they read the rest of the story. And while readers can’t really predict what will happen in the end. they will at least settle in to read the story to find out. They will now know that the mental illness will not be exploited in the story, but portrayed in a way that is similar to what would happen to untreated mental illness in real life.

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About The Author

Dawn Colclasure is a writer in Oregon. She's a book reviewer, freelance writer and columnist. She’s the author of several books. Her work has appeared in magazines, newspapers, websites and anthologies. She publishes The SPARREW Newsletter, a monthly newsletter for writers. Her websites are https://dawnsbooks.com/ and https://www.dmcwriter.com/ Her X (Twitter) is @dawnwilson325 and her Instagram is dawn10325.