In this installment of examining how psychology can help writing, we’re going to look at some lifelong mental disorders that are surprisingly common in real life. Manic Depression (called bipolar by many), borderline personality disorders, and antisocial personality disorder are all conditions you would think belong only to villains, but they in NO WAY SHAPE OR FORM make a sufferer automatically bad (but the last two make going bad much easier). With regular therapy and in many cases medicine people with these conditions can live very normal and healthy lives (for the personality disorders it is effective with early treatment in childhood or adolescence).

I am going to ignore some common maladies you hear about thanks to Internet buzz and media over-hype. These disorders are Asperger’s, the entire Autism spectrum (Asperger’s is on it), and various levels of retardation. Please note in the medical community retardation carries no shame as a term, it is merely descriptive. Each of these is easily researched, not nearly as common as you think, and frankly, if you’re going to write about one of them, you likely feel strongly about the condition and are already knowledgeable. 

So let’s dig in to the three common mental disorders that are almost always portrayed incorrectly in media.

MANIC-DEPRESSION:  A condition where neurotransmitters, such as norepinephrine and serotonin, affect the brain in the prefrontal cortex, and cause significant mood shifts from deep mania to deep depression. Each cycle lasts two or more months, except in RAPID-CYCLE MANIC-DEPRESSION where they last approximately two weeks to two months.

What it looks like to an outside observer: Your loved one can get depressed. Really depressed. They won’t come out of their room, shower, or join the living. They have some minor delusions, and extreme feelings of worthlessness. Yet, when they snap out of it, they go into mania. Sometimes they just seem hyperactive and chipper, other times they get into gambling, casual sex, drinking, drugs, other risky behavior.

What it feels like to have: You have no control. You are constantly walking a high wire. If you fall, you can fall into mania, and find yourself acting without thought. If you fall the other way you can end up depressed all the time. No matter what, it feels you’re locked in a burning house with no way out.

How it’s treated: Drugs, first and foremost. Antidepressants, atypical antipsychotics, and mood stabilizers are the most common. Lithium is a popular choice. Long term therapy is also important. General therapy with a bent towards Unconditional Positive Regard often focuses on creating strategies to deal with stress and help manage relationships.
What it’s like during successful treatment: You are still walking a tightrope, but it’s lower to the ground. You are constantly second-guessing yourself, watching for symptoms. You have way more good days than bad days. Sadly, friends and family who know your diagnosis will blame any show of temper or need on it. Very few people understand.

An example of describing a character with it: (Quick note- “Sunny Came Home” is a song by Shawn Colvin, about what it’s like to have manic-depression. It’s worth a listen.) Tara couldn’t believe it had happened again. She had known, just know luck was with her. But now all her money was gone, wasted at craps tables, and she didn’t even have gas money to drive the thousand miles home from Vegas. What was wrong with her? Why did she do these things? God, she’d destroyed her life again. She hung up the payphone, unable to call her sister and ask for help yet again. Slumping to the ground, she sobbed.

BORDERLINE PERSONALITY DISORDER: Often an inherited disorder, it often arises in victims of severe trauma such as rape. Marked by unstable moods and occasional psychotic outbursts, it makes forming relationships difficult and the sufferer is typically very needy and yet has traits designed to repulse others. Typically sufferers are women though a few men have it.

What it looks like to an outside observer: This is the femme-fatale…if she was Glenn Close. She’s that woman who starts dating your friend. She’s too good to be true. She’s sexy, she’s into all the things he’s into…how did he find a girl like that? Then you catch her in some lies. And she always seems to overreact to things. And one night, your buddy leaves the bar early, and she comes onto you. Christ! She’s a total crazy bitch.

I am going to level with you: I mean no offense, but if I meet someone with BPD I run the opposite direction screaming, and my life has been much simpler. Let me give you two examples:  A girl I knew had it, and her husband was so desperate to escape her (she refused divorce and threatened him with knives) he asked me to help him escape. I did. Three years later I make a new friend and find out he’s dating this girl. I try to warn him. She screws around him, lies constantly, and whenever he gets suspicious she simply seduces him. Finally, he escaped her psychotic outbursts because one of the affairs she was having became a marriage.

The second was a a woman who glommed on to my best friend. She lied like a rug, always had melodrama. She began hanging out with me and tried to end a relationship I was having. She spread rumors and lies about everyone she knew. When my best friend and I finally gave her the heave-ho, she called DCFS on my best friend and filed a false complaint.

What it feels like to have: You’re trapped in a car, speeding down the highway, and no one is driving it. Everyone must pay attention to you, because if they ignore you, they don’t love you. Love. It’s what you crave…and you will do anything to have it. Anything.

How it’s treated: No medications are yet approved for this disorder, but general practitioners throw antianxiety meds at it like tossing rice at a wedding. Therapy is the only promising treating, and often Cognitive-Behavioral treatment focuses on growing empathy, controlling emotional reactions, and bringing beliefs closer to reality.

What it’s like during successful treatment: Unfortunately “successful” is not a common word. BPD is still in its infancy when it comes to research. So far, the only benefit you can see in a sufferer is some soothing. Their ego likes being the focus on someone’s attention for an hour a week and sometimes it does help them have long-term relationships. And sometimes it just teaches them to be better manipulators.

An example of describing a character with it: Cynthia couldn’t believe her luck: Ben was a charming and funny, not the kind of guy she usually met out and about. But then, goddamnit, up strolled Natalie with a hip roll Nicky Minaj would envy. 

“Hello there, who’s your friend?” Natalie purred, stroking her fingers up Ben’s arm.

“Ben. He’s an IT guy, works with my brother.”

“Oh? I just love computers,” Natalie purred again.

Cyn’s eyebrows shot up. Since when the hell did Nat like computers? 

“Maybe, Bennie, you can help me with this little problem I’m having…”

Cyn turned away. Once Nat pulled the damsel-in-distress, there was no hope for the poor man to escape her net.

ANTISOCIAL PERSONALITY DISORDER: A disorder of some cognitive dissonance (incorrect thought patterns) often inherited from a parent, but also caused by isolation, abuse, trauma, and incorrect bonding in childhood. In children it’s called CONDUCT DISORDER. The terms sociopath and psychopath are actually interchangeable but often sociopath refers to the nonviolent or organized sociopath (the stockbroker) or the disorganized or psychotic sociopath (the serial killer). Most often diagnosed in men but thought to have a nearly equal number of female sufferers.

What it looks like to an outside observer: Let’s stick to the organized sociopath (the psychotic one is this plus delusions). He’s that douchebag. No respect for rules, he’s a user, he’s an asshole. He’s that guy that somehow can charm the pants off any woman before he uses her and dumps her. He never works, but always gets by. Or if he does work he’s competitive to the extreme. You really hate that guy.

Their emotions are shallow. They can shake off something sad with the snap of a finger. They can’t hold down a relationship to save their life. But vengeance…nobody does vengeance like that guy. Cross him once and he will burn your house down, kill your family, and salt the earth.

What it feels like to have: Hey man, everybody loves you. Stupid fools. You’re the shit, they are pieces of shit. Funny how they could cry at the dog dying in a movie, stupid cattle. Nothing sad in that. Everyone should worship you like the god you are. It’s funny how much you can get away with, and the idiots never know.

How it’s treated: Therapy. Mainly focuses on increasing empathy which is nonexistent if untreated, it also focuses on correcting thought patterns to better understand why society holds certain views.

What it’s like during successful treatment: Hard to say. These are professional liars. There is no evidence it can be cured and they pretty much only go into therapy if forced, and it’s hard to say if they are getting better or just lying? One way to check is their reaction to horrifying videos. Show a normal person a video of a leg breaking through the skin and a normal person gasps and flinches automatically. Sociopaths either have no reaction or laugh.

An example of describing a character with it: That fucking Brandon! He was the one who was stealing shoes from the shoe department, Kyle knew it, but somehow now the shoes were in Lydia’s locker.

Well, made perfect sense. Brandon and Lydia were up for the promotion, but now Lydia was fired. How did they guy do it?

He slept on John’s couch and never paid rent, stole all the food, and now had stepped on every foot he could to rise on the ladder at the store. Kyle wanted to smash his stupid, lying face. How could their manager Nick never pick up on what a slime Brandon was?

You may have noticed in my writing examples I painted the last two as villains and the first as a sympathetic character. The simple truth is that most symptoms of manic-depression are destroying your own life when you have it, but most symptoms of the other two are destroying lives.

But for fun, let’s see how both personality disorders can appear in protagonists.

BORDERLINE PERSONALITY DISORDER: Julie loved to watch the razor slide across her arm. Pain. Pain was real, it was the only real thing. They didn’t like her, nobody did. Even Uncle Paul, he didn’t really like her. He liked her body.

Thinking of him hurt, it hurt too much. The razor cut down her arm again. Why would nobody listen? Why would nobody help her? She just wanted to be loved, she just wanted somebody to love her. Oh, why did Dad have to leave?

ANTISOCIAL PERSONALITY DISORDER:  Eliot flashed his badge and the uniform let him through. He waded through CSU personnel until he found his partner Sykes.

“Is it him?”

Sykes looked up. “Yeah, Ragdoll Murderer strikes again. Jesus, she’s only fourteen. Found her head over there. It fell off, the stitching was weak on the neck.” He pulled back the sheet and let Eliot stare down impassively at the body. “Good on the hands and legs though. Pervert likes ‘em younger and younger.”

Why was Sykes as stupid as the rest? The killer was moving to younger targets, craving innocence. The younger they were, the more paternal that trust they gave felt. The killer wanted to be a god, he wanted total control, but he was slipping. Eliot smiled: a mistake had been made, the head not sewn on. That was how they’d catch him.

Eliot walked over to the head under its own sheet and knelt down. He’d solve it, get a commendation, be in the papers. He glanced back at Sykes. Well, he’d find a way to keep Sykes’ moon-face out of the photo. Eliot stood, remembering he was due for a haircut. Oh, damn it, there was the grieving mother. Let Sykes deal with that shit, he had clues to find.

There you have it, some views on three common life-long disorders that are not typically portrayed correctly in media. Next time we’ll look at what psychology can offer us in writing about relationships, and then in our final part we’ll see what psychology can teach us about individual behavior and motivations we all experience.