What You Need To Know To Write PTSD in Fiction
Welcome to my Mental Health in Fiction series! Whether you’re a reader interested in learning more about the ideas behind the characters I write, an author who is writing a character where mental health comes into play, or someone interested in learning more about the world of mental health, this series is for you!
On a universal level, the hope for my books is that people won’t get hung up on the fact that one or more characters is dealing with a mental health disorder, rather that people will enjoy reading a love story about people who happen to have mental health problems. For the sake of this series, however, I’m going to pick out the mental health bits from the novels and take a closer look. The first theme I’m exploring is Post-Traumatic Stress Disorder (PTSD), something that Christina in Prove Me Wrong is suffering from as a result of a childhood of sexual abuse.
Criteria & Symptoms:
PTSD is classified in the DSM-V as a Trauma and Stressor Related Disorder and is defined as being a psychiatric disorder that can occur when a person has been exposed to certain trauma such as a natural disaster, a serious accident, war, rape or a number of other traumatic events.
The symptoms of PTSD can be categorized into four main areas:
Intrusive thoughts- flashbacks, nightmares, or other involuntary memories
Avoiding reminders- resisting exposure to people, places or situations that are associated with the trauma
Negative thoughts and feelings- about themselves, others or the traumatic event, and often times these thoughts are distorted or exaggerated
Arousal and reactive symptoms- outbursts, reckless behaviour, strong negative reaction to loud noise or touch, problems concentrating, panic attacks
These symptoms can be seen on a widespread scale after a mass trauma, such as a natural disaster, war, or large accident, but the diagnosis of PTSD is only applied if these symptoms are persistent and long term. Symptoms may also be latent, not presenting themselves to a degree that would warrant a diagnosis until sometime after the inciting event has occurred. (source)
Example:
In Christina’s case, the more obvious symptoms of her PSTD were dormant for a number of years, due mostly to her primary symptom of avoidance. In that time, she developed many rules and safeguards, whether intentional or subconscious, to ensure she protected herself from being exposed to events that created those uncomfortable feelings dredged up by her past.
Her meticulous planning and cleaning created the sense of control over her physical environment. Her decision to stay in Boulder to complete grad school instead of applying to a more prestigious university allowed her to stay firmly in her comfort zone. Her dating rules ensured she stayed in charge of the direction and intensity of her interaction with men. Essentially, Christina fabricated an environment that relied on her constant management, and even though she didn’t realize it at the time, that kind of balancing act would be impossible to maintain long term.
Enter her relationship with Luke.
Luke, through his genuine personality and their shared traits, unwittingly became the catalyst to Christina’s escalating PTSD symptoms. During the course of their interaction, Christina struggled with two warring factions within her- the side that no longer wanted to walk on mental eggshells, and the side that realized any kind of change would cause her to lose her precarious balance. The perception that she was losing control was the diathesis that created the walls she built up to crumble and the symptoms of her PTSD to be further uncovered. Add to that the unwelcome and unexpected advance made by Luke’s creepy client, and her tenuous hold snapped, exposing the full force of her PTSD.
This is just one scenario involving PTSD, set in a very contrived setting with the limits of fictional constraints. This kind of trauma disorder, set in the real world without the limit of 80,000 words, would probably look much different, but I tried to do justice to the characters and the disorder.
I’ve included the sources for information used in this article and have updated my Resources page with links to some sites that talk more about PTSD. This is by no means a substitute for professional advice or clinical assessment.
Are you writing a character with PTSD? I’d love to hear about it in the comments!
-Everly