Discussion: The Challenges of Writing About Mental Illness

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We point out a lot of dodgy disability narratives and painful mental illness tropes this week—and on the site in general—but writing a solid portrayal of mental illness isn’t as straightforward as simply avoiding these tropes. Three authors discuss some of these complications, from honestly portraying the dull aspects to staying true to your character’s capabilities.

Kayla Whaley: Hi, everybody! Thank you all for being here. Let’s get started with brief introductions.

Kody Keplinger: I’m Kody Keplinger (obviously), and I’m the author of five books, including The DUFF. I’m also a co-founder of Disability in Kidlit. And since we’re here to talk about mental illness, I should add that I have Generalized Anxiety Disorder (GAD), which is sort of the perspective I’ll be coming from today. I was diagnosed with GAD a couple years ago. It presents itself in some varied ways, including occasional boughs of depression.

Rachel M. Wilson: Kody interviewed me on Disability in Kidlit a while back. I’m the author of Don’t Touch, my debut, which is about a girl with OCD, which I also have. I should maybe say as an adult, my OCD seems to present more as depression/anxiety. Oh, and mild ADD.

M. Molly Backes: And I’m Molly Backes, the author of The Princesses of Iowa, which doesn’t have much to do with mental illness. 🙂 I’ll be representing the depressives today.

Kayla: And I’m Kayla, co-editor of Disability in Kidlit. I’ll be moderating, not participating. My first question is pretty broad to kick us off. What do you see as some of the challenges when writing mental illness?

Kody: I think the biggest challenge is similar to with any disability—writing it honestly while also keeping the story interesting. In my experience, my mental illness and my disability (I’m blind) are parts of who I am. But they are just parts. They aren’t enough to build a whole story around. It’s important to find that balance, I think.

Rachel: Yes, Kody, there’s the danger of suggesting that the disability is all there is to a person. I talked about this a bit in my interview with Kody, but I think one of the challenges is that being thorough in representing all the symptoms/experiences of mental illness and cohesive storytelling aren’t always the best match.

Molly: That’s interesting, Rachel. Meaning you feel some responsibility to capture the full experience, but that you don’t want it to sound like a science report?

Rachel: Yes, and—this may be particular to OCD—the experience is constant and varied. There might be many obsessions running through the head, and a little of that goes a long way with readers. Trying to capture that, especially in first person, I found that I had to cut back a lot and it still seemed present for readers.

Kody: Rachel—that’s so interesting! Because it’s almost the opposite with GAD (at least in my experience). My anxiety has a big impact on how I live my life, but 90% of the time, not much is happening. It’s just when I’m triggered.

Molly: In my opinion, the biggest challenge with writing depression is that it’s so boring. Depression flattens you, and that impulse is contrary to the needs of story.

Rachel: Yep, that makes a lot of sense.

Kody: I think a big mistake a lot of authors make (usually ones who don’t have a mental illness themselves) is that they catastrophize the situation instead of making it realistic.

Molly: Kody, definitely! In part because catastrophe is interesting and dramatic, and you need interest and drama to tell a good story.

Kayla: I definitely want to talk more about that point, Molly. Can you talk about that a little more?

Molly: I get frustrated with a lot of fiction about depression because it so often seems to angle toward suicide, when in reality the majority of people struggling with depression don’t commit suicide. They may have an episode of suicidal ideation or behavior, but in general—again, going back to the idea of catastrophizing vs. living with something—people live with depression. But it makes sense that fiction would deal with suicide, because it’s a decision, an action, which is something fiction needs. Right? In fiction, you require a plot, a story, characters working toward something, characters wanting something. And in depression, you don’t want anything. So a lot of depression fiction ends up focusing on suicide.

Rachel: That makes so much sense. I’ve been thinking about this too. With mental illness, you’re often dealing with a character who has a negative desire. They may not be actively pursuing something so much as avoiding negative experiences. I once took a great screenwriting class with Corey Mandell where he used The Graduate as a great example of a film with a character who has a negative desire. It harder to build a story around that, but I think one approach is to think about what you want the reader to desire for the character.

Molly: Interesting, Rachel!

Kody: Yes! I love what you just said, Molly, because it’s something I’ve noticed, too. I dealt with depression as a symptom of GAD for several months last year. I never felt suicidal. I just felt—as you said before—flattened. I didn’t want to go anywhere or do anything. Even responding to emails felt like a draining task. Which isn’t very dramatic for fiction.

Rachel: Totally.

Molly: Kody, exactly! “Everything is so hard and the world feels heavy” doesn’t make for a good story. Not for long, at least!

Kody: And anxiety is somewhat similar. My anxiety keeps me far from confrontations. Feeling like someone is mad at me is a huge trigger and is paralyzing—it makes it hard to do anything about the situation. Which would make facing a climax of a story almost impossible in some ways.

Molly: I love Harry Potter and the Deathly Harrows because it felt like depression to me, in a very realistic way—just tromping through the woods with no idea of where to go or what to do next, just this kind of hopeless, endless thing. It felt very true to life. But so many readers thought it was impossibly boring.

Kayla: How can authors deal with that then? Presenting the frequently dull realities of mental illness without the narrative itself reading as dull?

Rachel: I think sometimes you can get a lot of mileage out of seeing a character with mental illness from another point of view. Not that it’s specifically about mental illness, but the alternating points of view in Jandy Nelson’s I’ll Give You the Sun are so great partly because we get to see what a rough time each character is having from the sibling’s point of view.

Molly: Agreed, Rachel.

Rachel: That takes away some of the danger of having a character who’s very “Oh, woe is me,” too. It’s sometimes easier to empathize with a character who might come off as whiny or self-pitying when you’re given a second character to empathize through.

Kody: I think in some cases, you have to reframe the story. To find drama in the smaller details. In my MG novel The Swift Boys and Me, the MC definitely has some sort of anxiety disorder. (I essentially gave her my symptoms.) After I wrote the first draft, we actually cut the climax because with her anxiety, there was no way the MC would have that confrontation willingly. Instead, I had to find a smaller level of triumph. Something more internal.

Molly: Agreed, Kody. And I think if you can help the reader to understand exactly how difficult small things are, then the smallest triumph can feel huge.

Also through the lens of time. Often with depression, I don’t even realize how bad it’s been until it gets less bad, and then you can see it by contrast. In the moment, you’re just putting one foot in front of another, but in retrospect, you can go, oh wow, I was really depressed there.

Rachel: Yes, Molly. I think that’s often the case, that you don’t really see yourself as in trouble until it’s been bad for a while.

Kody: Molly—my experience with depression is incredibly similar. I had no idea I’d been depressed until I was out of it. Even now, when I fall into depressions, I only realize it’s happening after it gets a little better.

Molly: I’ve been dealing with it for 20 years now, so I’m pretty good at knowing when I’m in it, but I still have that sense of looking back when I’m on the other side and seeing it more clearly in the contrast.

Rachel: I do think it’s possible sometimes even with a close first person point of view for the reader to see how bad a character is doing rather than having to be told. I think of Laurie Halse Anderson’s Speak that way.

Kody: Speak is such a great example. Melinda is not an active protagonist. She is clearly struggling. But the book is still so compelling and so readable, even though the MC barely talks.

Molly: Speak does it really well!

Kody: Laurie Halse Anderson is great with that stuff, though. Wintergirls is also a really well-done book.

Kayla: I’m also curious how to deal with writing a protagonist whose thoughts may not be clear/logical? How do you show your character’s motivations when the character herself may not understand them?

Rachel: Whew! Yeah, that’s a toughie.

Molly: Wintergirls actually handles that so beautifully, Kayla. Halse Anderson uses non-linear and lyrical language to show that the character is not fully inhabiting her body.

Kody: What Molly said. I think Wintergirls really nails that. Because we as the reader understand her thought process isn’t logical, but we also believe that she believes this way.

Rachel: I think OCD Love Story might be a good example of one that handles that well. The main character’s stalking behavior is so disturbing, even to her. Reading it feels a bit like a watching a train wreck—you know it has to crash and you don’t want the character to have to experience that. With my main character, several readers have said they’ve had the experience of wanting to shake her. That’s okay with me because the behavior can be so illogical and frustrating. That’s part of the experience.

Molly: I’m reading Mosquitoland at the moment and it does some interesting things along the same line—the character has moments where she’s not certain if she’s grappling with reality or with what’s happening in her mind.

Rachel: Sometimes a shift in point of view can help, too. In the case of Freewill by Chris Lynch, the second person point of view really captures that sense of being distanced from yourself, a little bit out of time and place.

Kody: With GAD (at least in my case), it’s kind of interesting in that when I’m being illogical, I am fully aware of it. I know my feelings and thoughts aren’t following a logical pattern, but it doesn’t make them stop. In a way, that makes something like this easier to write, because it gives you room for your MC to acknowledge it while also experiencing it. If that makes sense.

Molly: Kody, did you feel that way when you were a teen, though?

Kody: I did. I didn’t know it was GAD then. I just knew that I felt these feelings that didn’t make sense, even to me. Like, I’d panic, thinking a friend was mad at me. I knew there was no reason for her to be mad at me. I knew nothing had happened and that this was just a random thought that had entered my head and had blown up into a bigger thing. I knew I wasn’t making sense, and yet these fears felt real. At the time, I just didn’t know why my brain worked that way.

Rachel: I think mood disorders, anxiety and OCD—and sometimes depression—often allow for that awareness. I definitely had it, and it’s so frustrating. You have these thoughts that don’t totally make sense, and you know they don’t, but you feel controlled by them anyway. But thought disorders might be a different story …

Kody: Yes, exactly. Like, I once felt this extreme guilt-triggered anxiety because I knew someone was upset with me. Even though I knew I was doing the right thing and they had been the one to make a mistake, I still felt like a terrible person who should apologize. It was horrible. I knew, logically, I had done a good thing. But my brain (and body!) told me I needed to feel guilty.

Molly: I think the difference between my experience with depression as an adult and as a teenager is a) now I know when it’s the depression talking—back then, I thought it might just be true? Like I was somehow seeing through the veil to a darker truth about the world (which I think it not uncommon for certain cynical teens). And b) I know it will end sometime. Eventually. Things will get easier again.

Kayla: Let’s switch gears a little bit. So many books dealing with mental illness have recovery as the main arc/goal. So this is a two-part question: a) why do you think that’s the case? and b) how can you show that recovery isn’t a straight line and that there’s rarely a neat ending where you’re Officially Recovered?

Rachel: I think it’s natural to desire resolution, and to some extent in our culture, I think discovery-treatment-recovery has become a stock three-part mental illness narrative.

Molly: Again, I think it’s a limitation of the structure of the novel.

Kody: I think the recovery storyline has a mass appeal. It’s dramatic, it has a perceived end point (though that’s unrealistic), and it gives some readers hope.

Molly: Yes, and a novel is about character change over time. So if the character isn’t different by the end of the story, that’s profoundly unsatisfying for the reader. Even if it is realistic.

Kody: For me, there has not been “recovery.” Though things have gotten better. I started seeing a therapist a few years ago, and while I still struggle, it’s so much better now. I think having a character seek help is actually a nice, believable arc that still leaves things open to the non-linear path it takes.

Rachel: Yes, I think there’s a huge desire to give teens that sense of hope, to show by example that help is possible. I think many editors, gatekeepers, writers, feel almost as if it’s irresponsible to put out a story in which the character doesn’t seek or receive some help and at least move toward recovery.

When my book sold, it didn’t include a visit to a doctor or a diagnosis. For me, the triumph was in the character taking a risk in touch and talking about her fear—to anyone. There is now a doctor and a diagnosis in the finished book. I had some mixed feelings about writing about recovery because my own experience with OCD was that medicine solved it, within two weeks, totally. Symptoms gone. It really was like flipping a light switch, which makes sense because it’s all about brain chemistry. Story-wise, a solution that’s like flipping a light switch isn’t very satisfying. What took way longer for me, and what I hope comes across as an actual struggle for Caddie in the book, is processing what it means to have discovered that your brain is so vulnerable, that your thoughts can take you to irrational and dark places.

Molly: Interesting, Rachel.

Kody: Rachel—that is so interesting! And it just goes to show how different mental illness is for everyone and how the stories need a wide variety of voices. Because, with me, medicine won’t help. It’s less about brain chemistry and more about how my brain processed past “trauma.” (I put quotes because while I logically don’t perceive any of my childhood as traumatic, my brain apparently did.) So for me, “recovery” was just seeing a therapist and learning my triggers and how to prepare for anxiety attacks.

Kayla: That’s a really good point, Rachel. And yet another reason for more and more different narratives and perspectives.

Rachel: Yes, many voices—the more different experiences are represented, the less we’ll feel tied to one stock narrative.

Molly: Also, I think that YA specifically has an inherent hopefulness to its endings, because at the end of the story, the protagonist is still a teenager. No matter how bad things have gotten, you still have your whole life ahead of you, and things can always get better.

Rachel: YES.

Kody: YES. And, honestly? I like a hopeful ending. I like a hopeful ending far more than a “happy” ending. The older I get, the more inclined I am to leave things open and leaning toward hopeful. “Things aren’t better yet, but maybe they will be one day.” I think that’s more honest, in some ways.

Molly: Which feels realistic to me, Kody! I think there’s always hope.

Kody: I would love to see more books that are about the teens that have already sought help. The teens living with mental illness and dealing with it. Obviously, that’s not a plot. But I think it would be good to see more of that in our books.

Molly: Agreed, Kody!

Rachel: I agree. I do think it’s potentially harmful to only have books that feature recovery. It’s a different and winding road for everyone. I’d love to read more about the ongoing struggle.

Molly: It’s interesting, because I’m seeing parallels here between mental illness and LGBTQ stories. The first wave of LGBTQ stories seemed to grapple almost exclusively with coming out — the diagnosis phase, if you will.

Rachel: Yesyes!

Kody: I was just typing that!

Kayla: As one of the queers, now I’m imagining getting my Official Diagnosis: “I’m afraid … you’re bi.”

Molly: Exactly!

Kody: And the book ends RIGHT THERE.

Kayla: BOOM. Mic drop. 🙂

Molly: But the second wave of LGBTQ fiction started to incorporate other kinds of stories, where queerness is more normalized. So it makes sense to me that MI books will follow the same trajectory.

Kody: Personally, I’m far more interested in the sequel. Where the bi girl dates another cute girl or maybe a boy and it’s just how life goes. And where the kid with a mental illness is seeing a therapist and living their life now. I want those stories.

Kayla: Let’s talk a bit about how to write your own mental illness. Rachel, you already touched on this a bit, but what are the challenges there when you share a diagnosis/experience with your character?

Rachel: Yes, it can be tricky to remember that the reader doesn’t necessarily share the experience, so things that seem obvious to you need drawing out.

Kody: So I sort of wrote my own mental illness in my MG (it’s never explicitly diagnosed or stated, but she has all of the same symptoms as me, and since she’s 11, she doesn’t fully understand them). For me, the biggest challenge was what we discussed earlier. Making the story still feel dramatic. Because I have lived my life mostly avoiding difficult conversations and confrontations because of my anxiety. But in fiction, those confrontations and conversations are important. Finding a realistic balance, making the MC feel active while still being honest to her anxiety, was hard.

Rachel: This is a little tangential, but … we all know writers need thick skins. I think when you’re writing about a mental illness you know well, you need an extra thick skin. It can pose a real challenge to put out material that seems to reveal things about yourself—even if the character is very different from you, people will associate you with it—and preparing for that can bring up a lot of anxiety. I started writing about OCD years and years before I got up the guts to share the text with anyone, much less try to sell it and allow strangers to read it.

Kody: I so get that. I’ve been lucky that most readers have taken well to that MC I mentioned, but I have had a few people call her “weak” and “whiny” and that stings, because her experience is so similar to my own.

Rachel: Right—I mean, I think feeling protective of your character happens for a lot of fiction writers, but it feels especially weighty when your character’s representing a marginalized group. When someone dislikes my main character, I don’t take it personally, but I do think about a teen who’s going through a rough time taking it personally. It’s almost like I’m worried for or protective of my teen self.

Kody: YES! Exactly. I don’t necessarily feel like people who call the character weak or whiny are targeting me, but I feel protective of the girl I was at 11 who had no idea she had this anxiety issue.

Molly: And I think when you’re writing about any marginalized group, there will always be readers who want your one character to somehow encapsulate the whole wide spectrum of possible experience within that group.

Rachel: Yes, absolutely. It can be hard to write around that pressure—you don’t want to misrepresent or cause harm.

Kody: Molly—YES! I am writing a book right now that is not about mental illness but deals with blindness, and even though I am blind, it is so hard because I worry so much about how other blind readers will feel about this character.

Molly: Kody, especially with a topic that’s so rarely treated in fiction. Though with things like that, I find a useful trick is to call it out in your manuscript—like, have your character tell someone flat out that she’s not every blind person. Just one person.

Rachel: That’s a good call.

Kody: I love that.

Molly: It’s a good workaround. If a beta reader says “this would never happen!” just have one of your characters go, “This is so bizarre! This would never happen in real life, except here it is, happening!” #authorcheats

Kayla: I have a feeling we could all talk about all this forever, so let’s go ahead and wrap up. Anyone have anything else to add about anything?

Molly: I just want to say that I’m so happy the YA world has such awesome, smart women thinking & writing about these things. Rock on, ladies.

Kody: Amen.

Rachel: Yes! I love that there’s a space where we can think through some of these things. I fully believe it’s important to tell the stories, even when we’re fearful of getting things wrong.

Kayla: Maybe even especially when we’re fearful of getting it wrong. I think the people who are worried about causing harm are the ones with the best chance of avoiding.

Rachel: That is lovely, and yes, if you’re concerned about it, you’re probably coming from a sensitive place, so let yourself write, right?

Molly: If you’re not worried about getting it wrong, you’re not going far enough. 🙂

Rachel: Ooh, love that!

Kayla: And on that awesome note, thank you all so much for participating! It’s been such a great discussion!



About Author

Molly Backes

M. Molly Backes is the author of the young adult novel The Princesses of Iowa (Candlewick Press, 2012). She writes the “Writing Tips” column for The Prairie Wind (the newsletter of the Illinois Chapter of SCBWI), and has performed her personal essays at reading series across Chicago including Essay Fiesta, Funny Ha-Ha, Sunday Salon, and Is This a Thing? She works as an editor by day and writer by night and spends her free time hanging out with her retired racing greyhound, Zia.

Kody Keplinger

Kody Keplinger is the author of several books for teens: The DUFF (Designated Ugly Fat Friend), Shut Out, A Midsummer's Nightmare, Lying Out Loud, and the upcoming Run, as well as a middle grade novel, The Swift Boys & Me,. Currently, Kody lives in New York City with her guide dog, a very upbeat German Shepherd named Corey. When she isn't writing, Kody teaches writing workshops and spends a lot of time eating Thai food and marathoning Joss Whedon's TV shows.

Rachel M. Wilson

Rachel M. Wilson studied theater at Northwestern and received her MFA in writing for children and young adults from Vermont College of Fine Arts. Her debut novel Don't Touch, about a girl with obsessive compulsive disorder, came out from HarperTeen in September 2014. The Bulletin of the Center for Children's Books called it: "A vulnerable, moving, and often witty story about the terrible price of self-protection." Also look for “The Game of Boys and Monsters,” an eerie standalone short from HarperTeen Impulse. Originally from Birmingham, Alabama, Rachel now writes, acts, and teaches in Chicago, Illinois.

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3 Comments

  1. Another thank you (I posted one earlier to the review of Forman’s book)!

    And–adding a bit of info, too.

    Of late, there have been several news stories about suicides of Native youth. The data is frightening. Suicide prevention sites report that the suicide rate of young Native people between the ages of 10 and 15 is four times higher than that of other ethnicities combined.

    We assert that kids can feel empowered by what they read. That belief speaks to the power of words. But the flip side is that kids can feel disempowered, too, by what they read. It is why I push so hard for writers to be mindful of what they do with respect to American Indian culture and how they use it–or things associated with it–in their writing.

    MOSQUITOLAND, mentioned above, employs stereotypes. While some people are praising it because it takes on mental health, Arnold’s misuse of “war paint” and “Cherokee” identity throws Native youth under the bus. We need not do that to any population, but given the data on Native suicide, it seems especially important to me that we pay attention to misrepresentations of Native culture.

    The same is true of TIGERLILY. The names for characters are stereotypical. Of relevance to your conversation above is Tik Tok (so named because he liked the sound of a clock). He’s a transgender character who commits suicide due to pressure from the people in his village. The name was problematic, but to have him commit suicide was absolutely brutal.

    Again–thanks for these discussions and all that you’re doing on this site. It is much-needed, and I recommend it whenever I can.

    Debbie

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