5 Guidelines to Consider When Portraying Mental Illness

May 17, 2021

According to the CDC, more than 50 percent of people are diagnosed with a mental illness or disorder in their lifetime. But the suffering human beings those numbers refer to are so much more than statistics. I’m personally prone to anxiety. I’ve watched some of my closest friends battle depression and eating disorders. And I’ve lost loved ones to suicide.


Despite being the most prevalent health condition in the United States, mental illness causes a devastating sense of isolation in the victim. That’s why those readers need characters they can empathize with—to remind them that they’re not alone and inspire them to push through dark moments.


However, misrepresenting mental illness can be far more harmful than avoiding the topic altogether, as Netflix’s adaptation of 13 Reasons Why demonstrates. The month after the show’s premiere, youth suicides increased by 28.9 percent.


Approaching mental illness requires caution and compassion, both of which start with understanding. Once you know what the struggles look like and where the triggers are, you’ll be able to connect with readers in hard-to-reach corners.


1. Research to the Nth Degree

Mental illness is a disease and should be treated as such. You wouldn’t attach a physical ailment or disability to a character if you’re ignorant of how it will affect them. The same standard applies to mental illness. Choose a real condition—not one you invented based on your own impressions—and study it extensively. Like most research, you may not use every fact you unearth in your story. But the more familiar you are with the condition, the more authentic your depictions of it will be, and the less likely you’ll unintentionally upset someone.  


Don’t rely on any and every article that pops up during a Google search, though. Find reputable sources, such as the National Institute of Mental Health or American Psychological Association, and focus on collecting information that answers a series of fundamental questions: How common is the illness? What are the symptoms, both normal and rare? What are the associated risks? What treatments, if any, are available?


Next, interact with people who have experienced or been impacted by the condition. Talk to them, listen carefully, and take notes. (Just don’t let the conversation turn into an intrusive interview!) If no one in your social circle can supply a firsthand testimony, look for blogs and vlogs where individuals share their journeys. You can also explore the posts in online support groups that revolve around mental health. Since you need more than two-dimensional data to flesh out a character, the goal is to discover how the condition disturbs a person’s routine, emotions, and relationships.


2. Beware of Glorification

One of the direst mistakes a writer can make when addressing mental illness is to romanticize it. That downplays the pain and the danger, which deceives anyone who’s facing those realities. The distortion tends to be subtle, but it can appear in multiple forms:


  • As a character’s defining trait. Although mental illness does come with unique challenges, it isn’t an identity. Nor is it a synonym for “hip” or “special.” Rather, mental illness is a by-product of our broken world, and characters who wrestle with it should be no less complex than those who don’t.
  • As a quirk. How often have you seen OCD cast in a humorous light? Maybe enough that you’ve forgotten its true nature: a pattern of invasive thoughts and fears that prompt compulsive behaviors. Mental illness is not a cute idiosyncrasy that shapes a person’s habits. It’s a source of daily (sometimes hourly) distress, and oversimplification is not only inaccurate, it’s insensitive.
  • As a plot device. If your story begs for a heavier dose of drama, mental illness is not the solution any more than killing off a character is. You need a meaningful reason to include it as a serious, ongoing source of conflict.
  • As a minor nuisance. Exploiting or exaggerating mental illness is just as destructive as trivializing it. You’ll demean the victims, making them feel like crybabies.
  • As gratuitous suicide and self-harm. Although these issues are somewhat distinct from mental illness, they’re directly related and call for the same degree of delicate handling. You wouldn’t want your novel to convince a reader that self-harm and suicide are the answers to his or her problems. For a more detailed discussion of how to write a scene involving self-violence, check out Sophia White’s article.

One of the main complaints about Netflix’s 13 Reasons Why is how the show puts Hannah’s mental illness front and center. It dictates who she is and all of her decisions. When she commits suicide, the action is graphic and paired with fantasies of revenge on everyone who’s ever hurt her. Although the producers likely didn’t intend to misguide teenagers, the rise in suicides after the show’s release proves that it stirred up damaging ideas.


If you’re concerned that you may have misconstrued mental illness in your story, request second opinions from trusted friends and mentors. If possible, also consult people who have dealt with the specific situations you’re describing. Their insight will help you determine whether you’ve crossed a line or not.


3. Mental Illness Can (and Likely Will) Sway a Person’s Faith

Mental illness, like any obstacle, will influence a character’s arc either negatively or positively. And the transformation she undergoes will naturally extend to her convictions about God. Even the strongest Christian may start wallowing in doubt, or an unbeliever may come to Christ after hitting rock bottom. Regardless of the outcome, though, mental illness alters how a person interprets every aspect of life.


In Tiffany Dawn’s podcast Outgrowing the Good Christian Girl, she explains how anxiety built a barrier between her and God. “I felt this constant pressure to be good enough for Him, like this daughter He could be proud of.” Because her quiet times seemed so inadequate, she lost the heart to complete her daily devotions. As she worked on conquering her anxiety, she began worshipping God in smaller, less restrictive ways throughout her days, which gradually restored her confidence in His love for her.


Singer-songwriter Jamie Grace used to compare her OCD, ADHD, and anxiety to a tunnel she had to stumble through before she could embrace joy again. But then she realized that she didn’t need to be standing in the sunshine for God to fill her with warmth. “Even when you’re in the midst of the tunnel, He’s reaching in there and He’s saying, ‘I’m not about to make it perfect. I didn’t say I was about to make it easy… I’m going to reach you in the middle of that despair; I’m going to be there with you through it.’”


Your character’s response will vary depending on her personality and worldview. She may question Christianity and judge herself unworthy of forgiveness. Or she may cling to God and cry out in desperation. Just remember that her relationship with her Heavenly Father (whether explicitly mentioned or implied) won’t be immune to the strain of her mental illness.


4. Prayer Is Not a Cure-All

In Christian fiction, the most common misconception about mental illness you’ll encounter is that a fervent whisper to God will cure it. The character doesn’t need a therapist or medication. As soon as he repents of a sin he’s harboring or receives salvation, his symptoms fade. But that paints a false image of the Christian life.


Although mental illness can be tied to spiritual issues, and prayer is our best defense against the troubles of this world, that isn’t the only cause and remedy. Clinical treatment and faith are not mutually exclusive. Both are effective and valid, so show how the two overlap as your character pursues healing.


Most writers aren’t doctors or psychologists, though, so what advice can you offer besides praying over a mental illness? God urges us to “take captive every thought to make it obedient to Christ” (2 Corinthians 10:5). In Him, we have power over our minds. Point your characters (and readers) to that truth. Depression and anxiety can be rooted in or worsened by faulty beliefs that counseling may expose. Then Scripture and God’s grace will do the rest.


Of course, as I touched on earlier, mental illness may not be linked to a person’s mindset at all. Even if it is, a combination of internal and external factors usually play a role. Biology and nutrition, for instance, can create chemical imbalances in the brain that make medication, dietary changes, and/or exercise necessary. If you suggest that a character simply needs more faith, you risk discrediting other treatments. But if you cover mental illness from both angles, the characters will come across as fighters who persevere even when the path is rough, and that will bring comfort to readers.


5. Healing Is a Slow Process

Since mental illness is such a complicated condition, perhaps you’ve come to the conclusion that letting a character languish indefinitely is more realistic and poignant than recovery. But that kind of ending deprives readers of hope. Convenient miracles, or ones that happen after salvation, are no better, however. Those are the exception, not the norm. Many at the pool of Bethesda had ailments, but Jesus only commanded one lame man to pick up his bed and walk.


If you provide sudden relief to characters with mental illnesses, you’ll taunt readers with circumstances they won’t ever experience. Conversely, if you leave characters trapped in total darkness, you’ll overwhelm readers with despair. So where is the middle ground?


Although mental illness has no cure, improvement is possible with time and effort. That’s what you need to highlight. Whether a character suffers for months, years, or a lifetime, not all of her days will be nightmares and storms. When a character asks for help after continually denying that she needs it, opens up to a counselor, tamps down a panic attack that she couldn’t control before, or leans on the promise of all her tears being wiped away in heaven, those are signs that she’s on an upward climb.


If you’re interested in learning more about the process of healing from mental illness, I highly recommend Anne Swindell’s Still Waiting. It’s a beautiful, honest memoir about her struggle with trichotillomania and longing for the wholeness that won’t arrive until the hereafter.


Writing with Care

Mental illness is a difficult topic to tackle in fiction. If you’re uncomfortable navigating all of the nuances and pitfalls, that’s nothing to be ashamed of. Maybe you need to gain more maturity first, or maybe God has other plans for your stories.


If you feel ready and led to portray mental illness, though, evaluate the messages you’re sending to readers. Are you encouraging them to stay strong? To seek treatment? To be kind to anyone in their lives who has a mental illness? Most importantly, are you giving them hope?


Those are the questions that matter. As Christians, we should strive to lift others up with our words, not just fuss about accuracy, because we’re called to present the truth in love.


1 Comment

  1. Terah

    Thank you for this!!! It’s a question I’ve been wondering about and some of your points really helped me!!


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