Fiction Writing and Mental Health Stigmatisation

You’re crazy. Delusional. Mad. Insane. Nuts. Psychotic. Loony. Off your meds. Around the twist. Freak. Psycho. Weirdo. Schizo. Mental.

Other.

We like to think we’ve progressed as a society. In centuries past, humanity liked to just lock away anyone who deviated from the norm, preferring to pretend they didn’t exist. Insane asylums and travelling circuses were where you’d find the humans too “delusional” for regular society. The Nazis aimed to eradicate who they perceived as deplorable and below the rest of humanity, with Josef Mengele, among many in his rank, attempting to normalise eugenics and wipe out what they perceived as defective human beings.

Creative spheres are typically full of progressive people, and literary awards are chock-full of stories about struggle in the human condition, about overcoming adversity and beating the odds. BookTube, BookTok and all the other literature-focused parts of the internet, are always sharing books and entertainment that attempt to fix some of the frankly shocking portrayals of mental illness. In the last few decades, a wealth of literature has come out trying to help with the dismal public awareness of both physical and mental health. Far from the days of WWI vets hiding their PTSD in a locked box and suppressing their emotions, newer generations (millennials and Gen Z) are supposedly more open with mental health and mental illness, proudly proclaiming their diagnoses in their Twitter bios and claiming to be all about empathy and compassion.

And that’s what this month’s blog post is about.

Because as much as we claim to have progressed as a society in relation to mental health, there is still so much more that needs to be done.

Take the most commonly diagnosed mental illnesses: depression and anxiety. To most common folk—those who have lived comfortable, healthy, privileged, middle-class lives—they consume the content and listen and claim to understand. They will watch a video about the struggles Robin Williams or Chester Bennington faced, or they will watch a movie about a protagonist who suffers from depression, and they will proclaim loudly: “I understand.” But the stark reality of depression is not this idealised, romanticised notion. They will see the fake face, and they will say, “I get depressed sometimes too.” But then they see the person pushed into a breakdown, and they panic. They only want the sanitised, PG-13, M15+ safe-for-TV depression. They only want the good times, because handling the rough times is too much. Society just wants to loudly proclaim, “We helped”. When the depressed person spirals, when they’ve called and screamed and begged for help, and they fall off the edge, the neurotypical—the same neurotypical who ignored all the warning signs—will say, “Oh no! How did they fall? We were there for them!” Thus the cycle continues: humanity can go on pretending to be good and moral and the onus is on those with the mental illness.

We’ve definitely come a long way since Freud’s school of psychoanalysis and Nazi eugenicism. But there’s still the same, trite phrases and verbiage; a complete obliviousness by those perceived as “normal” (neurotypical) and those deemed as Other. I hate to use the capital-O Other; it takes me back to uni Literary Studies classes where tutors and professors would take innocuous texts devoid of meaning and arbitrarily assign nonsense to them. But it fits here.

A very recent example is the well-publicised court case between Johnny Depp and Amber Heard. While the court of public opinion (and ostensibly myself) are on the side of the former, mental illness has been used on the latter in a very dangerous way. People have been using Heard’s alleged diagnoses of Borderline Personality Disorder (already a very stigmatised mental illness) and Histrionic Personality to wave away any bad behaviour. “Oh, she’s just the crazy ex-girlfriend.” “Don’t stick your dick in crazy”. “That’s just what borderlines do”. Never mind that the primary experts on personality disorders state that BPD is the only curable personality disorder, with HPD and its cohorts (Antisocial [sociopathy] and Narcissistic Personality Disorder) being the more likely to immutably affect your personality and actions. This catch-all of mental illness being the “excuse” for Heard’s alleged behaviour allows us as a society to just sweep away supposedly abusive and inhumane humans and pretend they’re a “few bad eggs”, and “oh, thank God, we almost thought for a second Heard might be a *gasp* human being like the rest of us!” Doesn’t seem so progressive now?

Even the term “mental illness” itself is still stigmatised. Take the common conservative retort, “Liberalism is a mental disorder!” The logical response is anger, annoyance, shock. An affronted Karen-like, “How dare they!” Of course, this is an exercise in futility, because in a politically-charged divisive debate, debate is nonexistent, and all sides have the sole aim of trying to shout each other into acquiescing. But affront is the wrong take, because it takes on face value that you inherently agree that whatever the conservative is calling a mental illness is wrong because mental illness is wrong and weird because it deviates from the norm and not because the arguer is misinformed about what mental illness entails. To them, liberalism (or LGBT rights, or whatever the debate is about) is a mental disorder because the mentally ill are crazy and delusional and not normal, not like us. It is an ’80s slasher’s portrayal of the escaped mental ward patient, or Single White Female‘s deranged antagonist, or the Daily Mail‘s portrayal of British royal family villain Meghan Markle.

Crystal Shelley summarised some of the more common mental illnesses and how their reality deviates from the assumptions:

◌Having major depression doesn’t mean someone is always in bed crying.

◌Having bipolar disorder doesn’t mean that someone vacillates between being happy and sad in a given day. It’s marked by mood dysregulation, usually with shorter periods of mania (days to weeks) and longer periods of depression (weeks to months) and regulated periods in between.

◌Having obsessive-compulsive disorder (OCD) doesn’t mean being neat and washing hands all the time. OCD is marked by obsessive, intrusive thoughts or images that can be relieved by carrying out certain actions, often in a ritualistic manner. It’s not a fun or quirky personality trait.

To add onto this, Post-Traumatic Stress Disorder isn’t merely a war veteran suffering shellshock—anyone can suffer a trauma that lingers traumatically. Schizophrenia isn’t a screeching man rambling that the TV is trying to send him messages to kill people—conversely, schizophrenics are more likely to be the victims due to being taken advantage of. Autism isn’t just bazinga bazgo smart man weird—it’s a wide spectrum of behaviours with differing level of societal functioning.

Realistic portrayals of mental illness will do a lot in helping neurotypicals understand—to the best of their extent—in helping, rather than harming the mentally ill in their time of need instead of running away and screaming because the mental illness isn’t all sunshine and roses like they thought it’d be. While Joker (2019) is an amazing movie, and a lot of people identified with Joaquin Phoenix’s Arthur Fleck and his alienation and lack of mental health support from society, we need more than just gritty reboots and stark arthouse flicks. Conversely, we need more than the Oscar-baity film and books designed to tick off as many non-“normative” boxes in order to appear cool, when behind closed doors, you’d just close the door in the face of your struggling friend and wipe your hands of it. In late high school or early uni, while I was suffering from mild depression and a then-undiagnosed Obsessive Compulsive Disorder, I read one of these such books. It was called What Does Blue Feel Like? by Jessica Davidson and, regardless of the author’s intention, the representation of depression was cliched and didn’t feel authentic at all. On the other hand, not long after, I read The Perks of Being a Wallflower by Stephen Chbosky, which had the opposite effect. The main character stuck with me greatly. I’m grateful that, thanks to the involvement of a well-known star, the film (and thus the book) reached more heads than it otherwise would have.

It’s a slow road to progress, but if so much has happened in the last half-century, then I—and you too—should have hope for the future. As writers, we have an obligation to rectify the writing mistakes of the past, to help pave the way to destagmatising mental illness and mental health. Last of all, do away with the phrases in the opening paragraph, unless it’s the portrayal of an antagonistic character. It’s not an excuse for you to divert your own assumptions. If you’ve lived a comfortable life, or you have no experience of these issues, then research, research, research. If there’s one thing writers love to do, it’s read (and waste time on social media instead of writing), so why not put that time to good use:

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