Roleplaying a Mental Illness

If you haven’t yet, then please read the first article in this series before reading this one. It will give you an idea of my attitudes toward mental illness and roleplaying, and the direction from which I’m approaching the topic. It will explain why I espouse certain viewpoints and attitudes. Keep in mind that some of this material is generalized for the sake of brevity; I don’t want to write a 200,000-word textbook on the subject. Various mental illnesses are quite different from one another, and should be taken as such. Obligatory disclaimer: this information is provided for roleplaying purposes only!

General Principles

Don’t caricaturize mental illness

Serious mental illness is not “cute.” It is not “fluffy.” There are moments of humor and despair in every portrayal of a character — that isn’t what I’m referring to. Every character gets laughed at now and then — that’s fine. No character can be unrelentingly anything — that also isn’t what I’m referring to.

I mean that mentally ill characters should not be simple comic relief. Their mental illness should not be cutesy, aww-isn’t-that-sweet sort of stuff. The sorts of mentally ill characters that wear pajamas and talk to their teddy bears are pretty offensive to most real people who are mentally ill. So are the one-dimensional total-raving-lunatic slasher-flick characters. You might use one of the former for a brief totally-humorous game, or the latter for a brief slasher-horror game, but they don’t belong in a long-term even reasonably serious game.

Note that it is possible to play a sort of double-edged character, where things seem funny on the surface but produce an underlying uneasiness. Or where the character is frightening, but still fundamentally human. This is what I mean by not playing a caricature. If the character is reasonably three-dimensional, it’s pretty much impossible for it to be a caricature. So put a little extra effort into making your mentally ill characters full characters; it doesn’t take much time and effort, and the results really are worth it.

Do a little research

No, I’m not telling you that you have to spend hours and hours researching mental illness before you can play a mentally ill character. Research for this sort of thing can be done pretty quickly. There are good web sites out there with reasonable lists of symptoms for various mental disorders; do a web-search. You could also check out a copy of the “Diagnostic and Statistical Manual” (or “DSM,” with a number after it; the copy I have right now is referred to as the “DSM-IV” and I think number five is supposed to come out in not all that long from now). It’s a bit expensive, but most libraries should have a copy, and many of the entries can be found summarized on web-sites. A single entry will probably take you about 5-15 minutes to read.

If checking out something like the DSM sounds a little daunting (it does get pretty technical), then try to find a copy of either “The DSM-IV Made Easy” or “The DSM-IV Case Book.” The former tries to explain the academic material in the DSM-IV in concrete terms with some real-life examples. The latter provides primarily real-life examples of various mental illnesses. Again, you might be able to find copies in the library, and both of these are less expensive than the actual DSM-IV.

Be subtle

Play with small details and gradually build up to things rather than relying on stereotypical exaggerated portrayals of mental illness. Look for some of those case studies I mentioned earlier (real life information). Then remember that a case study is all of a person’s worst symptoms distilled down into a few pages of information. In real life, things usually happen comparatively slowly and piece-by-piece. In fact, some mild cases of mental illness (and the beginning stages of some serious illnesses) might be easily mistaken for other “normal” things, like a bad temper, a sad disposition, or a case of being a “neat freak.”

What caused the mental illness?

There are a number of possibilities. Most of the major categories are: biochemical imbalances; physical illness or deformity (such as a brain tumor); physical injury; stressful life events. The line is sometimes blurred between these categories. For example, traumatic events can long-term or permanently change brain and body chemistry as well as hormone levels (this is what happens with post-traumatic stress disorder). Thus the problems stem from life events, but have become biochemical in nature. Scientists are also finding physical differences in the brains of people with various disorders, such as brain structures that differ in size between people with or without a disorder. Some disorders are usually considered to be genetically inherited.

If you have a cause and a reason for your character’s mental illness, you’re already part of the way toward creating a three-dimensional non-stereotypical character.

For Game Masters

This is where issues of trust and comfort come into play. Make sure your players are okay with you mucking with this particular subject. As I pointed out in part I of this series of articles, you might not know it if one of your players has had to deal with a mental illness, either personally or in a loved one.

Use your mechanics. While mental illness is primarily a roleplaying thing, don’t be afraid to back it up with mechanical/system details. If nothing else, it will help the player to keep the effects of the illness on the character’s life firmly in mind. Also use details from the character’s life to give him complexity and realism, just as you would for any character.

Keep in mind one thing: although mental illness does tend to isolate people from those around them, this doesn’t mean that the mentally ill exist entirely in isolation. Remember to connect them to people — family, friends, enemies, co-workers, and so on. This, too, will help to make them three-dimensional and interesting.

For Players

Be careful what you play

Keep playability in mind. For example, many people don’t realize that someone suffering from a clinical depressive episode is not just “sad.” Depressives often find that they literally cannot get out of bed in the morning. Such a character would spend most of his time in bed, would not interact with people very much, might be entirely unable to talk at times, and certainly wouldn’t have the wherewithall to follow clues and solve mysteries. To really play a seriously depressed character would be pretty boring, to be honest.

Make the character a full, complete character

Give him friends, enemies, interesting abilities, hobbies, family, and so on. Not everything has to be tied up in his mental illness. In fact, most things probably shouldn’t.

Think about the real world

How does your character get along in the “real world” of the game? How does she support herself? How does she handle things like food and shelter and paying bills on time? Mental illness does not exist in a vacuum — it must interact with boring old reality. This is where a lot of problems that the mentally ill face come from.

Consider party play

Many people create mentally ill characters as complete and utter loners who cannot work with anyone else. This can cause problems and tear apart some parties. Make sure that your character can at least nominally work within the party structure.

In brief, put a little thought into your mentally ill characters. Don’t misuse them as convenient lunatic slashers or cute plot devices. Make them three-dimensional, just as you would any other character. Fit them into your game, give them friends, enemies, and family, and examine how they relate to the world around them. You may be surprised at the interesting results.

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