There are a lot of complaints about how writers (and other creators) portray mental health, and perhaps one of the most mentioned issues is PTSD.
I’ve been writing characters with PTSD for almost ten years. But I didn’t have PTSD of my own until just over two years ago.
Looking back over old works—while there are things I would do differently just because I’ve grown as a writer—I don’t find my portrayals of PTSD that inaccurate. My research was thorough, including the personal experiences of others. The insertion of fictionalized personal anecdotes of symptoms and some of the emotional charge, as in the after the fact pieces, is missing. But I don’t feel dissatisfied with a lot of it. Though there are a few things I’d change.
Shortly after the incident that gave me the PTSD, it took one pointed question from my therapist for me to literally say, “Yes, I’ve also read the PTSD diagnostic criteria.” I knew my stuff, and even while still standing there with my father’s ten day old corpse, I was very aware that it was the kind of thing that tends to leave you with long term effects. The question from my therapist came only a few weeks later, not long enough for a formal diagnosis—something else I knew from research—but I could see the road I was on.
The new symptoms felt strangely familiar. Hypervigilance was something I’d read about, wrote about, for so many years, that it didn’t feel new, especially as someone with pre existing sensory issues and anxiety. It was so tightly woven into characters’ lives that finding it in my own felt kind of like a fan of any work stepping into that world. Of course you’ve never gone to Hogwarts, Harry Potter fans, but you’d kind of know your way around, wouldn’t you?
I did find it interesting that I developed the hypervigilance, since it would’ve done me no good in the traumatic incident. Nightmares, too, beyond what I’d developed as an anxious child with an overactive imagination, felt strangely… familiar. I’d spent enough restless nights writing about characters waking up in a cold sweat that waking up like that myself before turning to the notebook or laptop didn’t feel so new. Flashbacks, too.
But what really made trauma feel so familiar? Was it really just so many years of inflicting it on characters? Was it pre existing anxiety?
But here was another complication, a major wrench to throw in any comorbid disorder group: the schizophrenia.
Over time, my flashbacks manifested a significant portion of the time as true hallucination, something that I was used to from schizophrenia. Now, here’s an almost funny thing: in fiction, one of the most critiqued techniques of portraying PTSD flashbacks and nightmares is in the vivid, clear, straightforward nature. Real PTSD can give you a flashback to one sense but not another, to something somehow connected to the trauma but not directly, show you a hazy overlay, or be an almost purely emotional rather than sensory response. Nightmares often mix up elements of trauma with random elements from your life, not just playing the trauma again and again.
But that’s hard to portray in fiction, especially in visual media like movies, and especially when flashbacks and dreams are also used as narrative devices. Hence, you get those straightforward, easy to comprehend for the audience cutaway scenes.
But for me, schizophrenia mixing with PTSD did make daytime flashbacks manifest as clear cut hallucinations. There wasn’t just the sensory confusion or disconnected emotional responses; I’d be straight up looking at/hallucinating my father’s corpse in the corner of the room, or in the bed—which became one of my biggest triggers—or perpetually behind me. The laughably oversimplified PTSD portrayal was, oddly, spot on for me much of the time.
Now, I have to remember that in all cases, my PTSD is not my characters’ PTSD, and none of them have comorbid schizophrenia. But one reason trauma felt so familiar to me was that it was already a part of the characters already living in my head. And all of the research involved in making that feel real. Another, that the schizophrenia induced hallucinations and anxiety I’d already lived with went a lot like the way PTSD flashbacks eventually manifested for me. Perhaps the biggest complicating factor: my much thinner line between reality and fiction than most peoples’—if my characters experienced anything, it was much more like I was experiencing it than even most creative types would agree with—so maybe, in a way, I’d had a bit of self created trauma all along. Or maybe it was just tortured artist syndrome.
But again, I risk the horrifically oversimplified portrayal of PTSD trope in fiction even if I’m true to some of my experiences, because of what schizophrenia makes it like, an interesting conundrum, and without characters with comorbid schizophrenia, it remains inaccurate.
After my traumatic incident, I wrote a lot of dark material for an already dark project, mostly in the middle phase of largely sleepless nights. I was especially unpacking a pre existing character’s trauma from both previous and new drafts, especially in the immediate fallout, a time period I’d seemed to drift away from before, with many characters’ primary traumas existing far into backstory, aggravated by a dark world. Was it my own recent trauma that drew me into that time period, or was it simply time for it anyway? Hard to tell. Likely at least a bit of both.
Though, wallowing in horror, gore, and otherwise macabre genres is a common trauma trope in itself, something like self inflicted exposure therapy—though I stayed away from my exact triggers, decomposition and the like. But I’d almost always had that draw to dark fiction, pre trauma—again, why? My pre trauma mental health symptoms—schizophrenia, anxiety—did seem to draw me more deeply into those, much like PTSD symptoms do for many others. It’s almost like my mental health experience was always so close to PTSD, but with no real cause, a crucial part of it, before it developed. Some comorbidities are already more likely than others, too; maybe I was always all but doomed to develop PTSD at the slightest provocation, and I got a bit more than the slightest.
Things I think about. Plenty to unpack for myself and characters both.