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How to properly portray mental health (Anxiety, OCD, Depression and PTSD)

Mental health is something that is so common in this world but also is so commonly misrepresented. A perfect example of this is the television show “Thirteen Reasons Why.” This Netflix original show was slammed by countless people by their failed attempt at properly portraying suicide and depression. Just one month after season one of this show premiered, suicide rates between individuals of the ages of 10-17 raised by 28.9%.

So, how do you avoid ending up like that show? For starters, do some research. Talk to actual people living with mental illnesses. Don’t just go off of what you perceive it to be if you’ve never experienced it before. Also, even if you have experienced it before it’s always good to talk to other people who have experienced it as well because then you will be able to more accurately represent a wider range of people.

Anxiety is often wrongly portrayed as something that you can just kiss your way through. In television or writing, one of the main characters is often shown having a panic attack or an anxiety attack and their love interest kisses them and it all magically melts away. I hate to break it to you, but it doesn’t work that way. Panic attacks take a lot of time to get over.

Panic attacks can make people feel a range of things. Some people feel like their chest is being tightened like they have a bubble of energy in their chest, some people dissociate, and others have their mind racing like crazy with worst possible scenarios.

Panic attacks are also not cute. Sometimes writers will portray it as some jagged breathing and running away from something. More often, it’s a lot uglier. It can be screaming, disassociating, cursing people out, isolation, and sobbing. Sometimes people having panic attacks can take it out on themselves, too. They can scratch at their skin until they bleed, pull at their hair, or even punch themselves brutally. So often people give panic attacks an instant solution and a pretty facade. They don’t show the ugly truth and that is that they can last a long time, and they can make someone mean and unstable.

A good way to avoid this cliche is to have the character who is having a panic attack show many of the symptoms I've mentioned before. Have them cry while screaming, or have them isolate themselves and pull at their hair.

If you’re trying to write someone helping a character through a panic attack then have the person sit next to someone while calmly and quietly talking them through it. Often if someone is having a panic attack they’ll be very repetitive. They’ll say the same things over and over and/or do the same thing over and over. Have the helper go along with this repetition, and repeatedly reassure the person each time their bad constant behavior comes up.

Sometimes, but not always, the person with a panic attack will want/need to be touched. Try having the helper stroke their arm up and down with the amount of time you should breathe in and out to remind them how to properly breathe, or try having the helper stroke their hair.

If your character is trying to hide a panic attack, then don’t make them seem completely okay. Even if someone is mostly concealing a panic attack, some symptoms will show through. Showcase someone picking at their nails, hiding, breathing heavily, having a shaky voice and/or rocking back and forth.

OCD is not just cleaning your room or list making. OCD is much, much more than that. OCD is a mental disorder that makes people have persistent and unwanted thoughts. It often makes people do certain rituals or avoid certain things. It makes people feel like if they don’t follow the ritual, or if they go up against the thing it tells them to avoid that something truly awful will happen.

OCD makes life incredibly hard. It often makes people strive for repetition and will mentally punish them if they don’t. Writing it can be difficult, as some of the repetition you’re aware of, and some you aren’t. Like for example, staring at a clock and counting up to sixty and then restarting when the minute is over is something you’d realize when you’re doing it If your character is aware of the repetition and it abruptly comes to a stop make sure to write that your character feels uncomfortable. They may feel uneasy and anxious. Sometimes, if their OCD is bad enough, all they can think about is going back to the repetition. It’ll feel like an itch that needs to be scratched. It can sometimes take up their entire mind.

Instinctively cracking your knuckles over and over again may not be something you realizing you’re doing. If you’re writing from the first person this may be a hard thing to capture. Try having another character point it out like “I was sitting in the cafeteria eating my food when my friend pointed out to me that I kept rocking back and forth.” Usually, people feel embarrassed and insecure when their compulsions have been pointed out.

OCD isn’t just repetition as well. Sometimes it’s actions that you feel you have to do; sometimes there are compulsions that your character may face. For example, saying “I love you” to a family member at all costs before leaving a room, or tapping a door frame before entering a room. If your character goes against the compulsion they may experience severe anxiety, depression, they may have a hard time breathing, they may experience a feeling that can only be described as static in their brain, and they may cry.

Don’t be afraid of giving your character cleaning compulsions, but also don’t make it their only compulsion. Often people with OCD have a wide range of different compulsions all stemming from different anxieties.

Depression is not just laziness. Depression can make a person lazy. It can take away all motivation and will and make someone incredibly lazy. That’s not all depression is, though. Make sure to write more symptoms than just laziness. Depression is also a sinking sadness. Try describing it as an anchor in someone’s chest. It feels like your lungs are being dragged down by something and it’s incredibly hard to breathe. Or try describing it as a bubble of filth. Something in your chest is polluting the air and making taking a single breath a struggle. Try being descriptive, as it really paints a picture for people who don’t know what it’s like; it gives them an insight as to what the pain of it can be like.

Depression can take away a person’s motivation and, yes, that means their motivation to do basic things like personal hygiene. It’s disgusting, it should not be sugar-coated. If your character has severe depression make sure to include messy rooms, forgotten showers, unwashed clothes, and/or unbrushed hair and teeth.

Depression often results in isolation as well. Energy is always low, so there’s very little time when someone is feeling well enough to go out with friends. Sometimes, though, it’s possible for someone with depression to maintain a healthy relationship with friends. Sometimes being with friends gives the person with depression a rush of happiness and for a while everything is okay. However, when things have calmed down like when nobody is talking or when they’re once again alone, the depression comes back.

PTSD isn’t just for war veterans. Anyone can get PTSD. PTSD can be caused by any traumatic event. Someone can have it due to a parent’s death or an assault. Triggers for flashbacks aren’t always blatantly obvious things. For example, a trigger for someone who’s father died could be the mention of fathers or something subtle like their father’s favorite color. Think of the small things that happened during their trauma or if the trauma is based around a person, think of the things that the person may have enjoyed, worn, or even physical features that the person had like moles or scars.

Also, Triggers aren’t like a flashback in a movie scene. They don't flash in and out. They’re more like unwanted thoughts or bad memories that just won’t go away. Everyone gets those; except with PTSD, these happen a lot more than for the average person. When your character is having one of these flashbacks, try making them visibly upset, spaced out, anxious, jumpy, and irritable.

It doesn’t always make people have nightmares, though. Sometimes if their trauma can frequently show up in their dreams, but in a pleasant way. For example, if their parent died their parent could show up in their dreams as nothing had ever happened. The dream would be them living as a family again in a pleasant way. Usually, though, when the person wakes up they’re left feeling sad as that dream was only that.

Mental health can get better. Through therapy, sometimes medication, and a great support system things can and will get better. It’s also important to show that. Please, don’t show the cheesy trope that “therapy and medication are bad,” as that is incredibly harmful. The people who genuinely need these things will read/view your work and get the idea in their head that these things are bad when in reality it could greatly help them. If you’re going to portray your character getting better, please add these things into their journey.

I hope you found this article to be helpful and will be keeping all of this information in mind when writing about mental illnesses. Please, do not let this be the only article you read. Do more research, get more perspectives. Portray it right, don’t make the same mistakes that “Thirteen Reasons Why” did.