Before I go on to ramble, let me point out that mental health and mental illness are vastly different. It is akin to physical health; a diagnosis may or may not exist even if your character neglects her health.
Health is the umbrella word under which mental, emotional, physical, spiritual, financial, and cognitive health fall under. Health is health, all-encompassing. Your character’s health “score” or state is based on how well he takes care of himself.
A diagnosis is different–it can be a disorder/illness that is temporary/acute, and chronic, mild, moderate, or severe. It is something that comes with a spectrum of symptoms and how those symptoms manifest in the individual. Some diagnoses (like a broken bone) are the same across the board in terms of treatment and what it looks like for your characters. But others are not–especially when the diagnosis falls under the category of mental illness.
I will not cover every mental illness, but I will take a closer look at the ones you more commonly see in fiction, focusing on one disorder per post.
Anxiety Disorders:
Obsessive Compulsive Disorder; Generalized Anxiety Disorder; Social Anxiety Disorder; Health Anxiety; Panic Disorder; Post-traumatic Stress Disorder; and Specific Phobias
Physical Changes Your Characters Can Experience Include:
- Heart rate increases
- Blood pressure changes–can cause flushing/blushing, sweating, dizziness
- Lightheaded sensation
- Brain fog
- Dissociation
- Adrenaline increases, which can cause your character to fight, flee, or freeze
- Rapid and shallow breathing
- Lump in throat sensation
- Stomach clenching
- Muscle tension in any area
- Visible body language shift–fidgeting, hair pulling, lip pulling, restless, pacing, speaking faster or not speaking at all
- Headache
- Stomach ache
- Heart palpitations
- Increased frequency of urination
- Retching/gagging or vomiting
- Eye pressure and blurry vision
Thought Changes Your Characters Can Experience Include:
- Magnification/catastrophizing: blowing something out of proportion
- Interpretation and reaction does not fit the situation
- Fortune telling: character assumes she knows the future and that it will be the worst case scenario
- Panic-ridden, frantic, fast-paced thought stream
- Overgeneralizing: assuming the same thing will happen over and over based on one or two negative experiences
- Self-doubt
- Self-criticism
- Negative Filtering: only focusing on the negative of a situation, filtering out the positives
- Mind Reading: jumping to conclusions about what another is thinking or feeling based on little information
- Personalization: thinking behaviors or moods of others are somehow the character’s fault
- Hyper aware of others, sounds, or environments with accompanying paranoid thoughts
Behavioral Changes Your Characters Can Display Include:
- Reassurance checking: asking others over and over for validation or reassurance everything is okay
- Procrastination of tasks
- Poor self-care
- Lashing out at others
- Over-checking the internet for information
- Excessive checking of phone; excessive checking of appliances/alarms/doors
- Reinforcing anxiety by avoidance of person, place, or any reminder of what is causing the distress
- Clenching jaw, fists, shoulders
- Teary-eyed
- Crying
- Sobbing
- Shaking
- Pacing
- Complaining
- Self-harming which includes: cutting (shallow without bleeding or deep cut with bleeding), scratching self, burning self, bruising/punching self, nicking, hair pulling, binge-eating with or without purging, skin picking, and excessively working out
- Drug abuse, alcohol dependency, alcohol abuse or abuse of prescribed medications
- Reaching out to others for help
- Trying to control people or environment instead of self-regulating
- Speaking louder, faster, or shutting down entirely and not speaking
- Indecisiveness
- Inability to fall asleep easily, or wake several times throughout the night
- Difficulty waking in the morning
- Go to great lengths to please others
- Outward behavior can mismatch inner thoughts, beliefs, and emotions
- Quit easily
- Empathize well with others
- Perfectionistic tendencies/frustration and intolerance of mistakes, whether from self or others
Cognitive Changes Your Characters Can Display Include:
- Fatigue
- Brain fog
- Easily distracted
- Difficulty focusing
- Poor working memory and short-term memory
- Difficulty remaining present
Spiritual Changes Your Characters Can Experience Include:
- Questioning their beliefs or attaching to them
- No longer going to their place of worship, or overly attending and relying on spiritual/religious community
- Avoiding spiritual-based or religious-based activities
Financial Changes Your Characters Can Display Include:
- Overspend; money declines
- Over save; frugal mindset
- Avoid / miss work often
- Overwork; financially successful
Now, develop and know your character SO well you already can foresee and recognize their unique triggers—someone’s tone or volume of voice; perceived or real criticism; signs of abandonment; someone is upset with them; a restaurant they once became sick from or reminds them of someone no longer in their lives; a physical sensation; a medical diagnosis; disappointing someone and so on—as well as your character’s personal way of displaying anxiety. Do they internalize or externalize? Do they blame others or themselves? Do they manage it well, hide it and people please, or display it intensely?
Feel free to comment below with feedback, ways you have created anxious characters, or questions.
Thanks! Now off I go, until next post.
Kristi Strong 