Portraying Debilitating Mental Illness and/or Disability Responsibly

Without turning this discussion into my personal sob story, I know how debilitating mental illness and disability can get. Long story short, I am not one of those positive, inspirational role models. Because writing is a coping mechanism in my life, but also because it’s simply important to me, I’ve always wanted to write characters who have struggles like mine, struggles they may or may not actually successfully fight. People who aren’t strong and who maybe don’t have to be. People who don’t always function well, or not at all. People who aren’t necessarily the confident, overcoming hero type.

That said, I am concerned that there is a “too far” or content that may be too much of a daisy downer to put in a game. Or worse, that it might reinforce stigma, shine too much negative light on illnesses, so on and so forth. I want to be authentic to my vision and my own experiences as much as possible without being irresponsible basically. Is escapism and positive representation more important here? Should we mostly stray away from/gloss over maladaptive behaviors or otherwise serious problems like intense anger, hypersexuality, alcoholism, suicidal ideation, etc? If not, then what’s some acceptable or appropriate ways to introduce themes like this? How might you introduce them and avoid complaints about making the MC, say, too helpless if it were the MC who suffered with these issues?



Keep your vision in focus and write your story/game. Once it is complete and you brought your vision into reality, it can be modified or changed as you see fit.


Once you write content you feel might be too far or too much, seek out specific testers, in this case look for readers with disabilities to provide you with targeted feedback.

You will want to have specific feedback questions and/or concerns that you want them to address to keep the feedback on this sensitive material both relevant and actionable.


Once you complete your story/writing and you have your feedback: edit your material to reflect the actionable feedback


Repeat steps two and three until you are confident your story and vision match up with what the testers are saying to you.


Prepare trigger warnings, general content warnings and even an “author’s note” for inclusion when you go to publish.


Remember, you are writing for the HG label which has different requirements than writing for Choice of Games or heart’s Choice. Review those for your boundaries on “what is off limits.”

Writing a story that is true to your vision is the first and hardest step. I believe it will be the key to your success.


I’m in a very similar boat. I, too, feel compelled to write about people, like myself, with mental illnesses that they continue to struggle with, and may not always succeed in overcoming. It’s something I feel pretty strongly about, in fact. But, obviously, we can only speak to our own truths, not everyone else’s, and honestly, that terrifies me—the thought that I might, without intending to, balloon outside my scope, fail to afford due consideration, and maybe even become part of the problem.

So, I can’t give you any truly definitive answers, because I haven’t necessarily found them, myself. But I can tell you where I am right now, and the thoughts and approaches I’ve picked up so far.

(I will note, for the record, that I have significantly more experience with, and knowledge about, mental illness than physical disability, so if my points seem skewed toward the former topic, it’s because that’s the one I feel more “qualified” (for lack of a better word) to talk about.)

On the topic of being a "daisy downer"

The first thing I’d say is that I don’t really think topics should be “off-limits” simply for the sake of escapism. I think it’s important, sometimes, to be confronted with a harsh reality in a story. Sometimes, a so-called “safe space” is, in fact, the best place to facilitate broadening one’s understanding of real problems. That’s my personal belief, at least. Others might disagree, and honestly, I think that’s okay. Desires for “true” escapism are valid, but not all games have to appeal to all audiences.

On the topic of representing issues responsibly

As for representing these realities responsibly, Eiwynn’s advice about seeking feedback from people with the struggles you’re trying to represent is a good starting point; doing research on your own will go a long way as well, of course. Having some sort of content warning is definitely a good idea, I think—making sure people know what they’re getting into will curtail a lot of negative reactions with regards to your “daisy downer” concern.

The other thing I’d add from own experience—as somebody who is currently in the midst of an attempt to tell a story with several difficult character arcs about mental illness—is that it’s really important to make a concerted effort to facilitate empathy. Invite your readers to see not just the end-results of your characters’ struggles, but also the very intense feelings and thought processes that accompany them, in a way that your audience can hopefully understand, to the extent that they’re able.

What this means varies depending on what issue, specifically, you’re discussing, of course, but there are a few avenues of translation that you can use to your advantage. For instance: not everybody necessarily knows what it’s like to be suicidal, but most people do know what it’s like to feel overwhelmed or helpless. It’s not the same thing, obviously, but it is an emotional foundation that you can build on, in attempting to foster understanding.

Some specific thoughts on mental illness / disability as it pertains to an MC

If it’s the MC you’re talking about, what this means is going out of your way to communicate specifically what the MC is feeling, and why—to the extent that the MC themself can understand it—they behave the way they do. The advantage of using the MC as a vessel for this is that you have free rein to describe their struggles in as much intricacy and detail as you feel is necessary.

As you mention, though, you do risk alienating people that want to avoid helplessness, and I think the important thing here is to remember that feeling helpless and being helpless are not the same thing. Most people, I feel, are specifically averse to the latter—the notion that the MC has no impact or driving force in the plot—more than the former. As long as you incorporate the MC’s struggles in a way that doesn’t invalidate their role in the story, I think the majority of people will accept, or even embrace, their limitations.

Some specific thoughts on mental illness / disability as it pertains to an NPC

If it’s an NPC in question, it’s a little more complicated, because the reader doesn’t get the privilege of seeing inside that character’s head. In this case, I think the most important thing is to present the character as a whole person not solely defined by their illness or disability—let the reader see the character as a person, first, and a representation of mental illness / disability more as an extension of that person.

With regard to stigmatizing mental illnesses, I think a lot of stigmas related to mental illnesses, at least in my experience, have to do with the perception that they’re somehow a threat to other people’s livelihoods—that people with “anger issues” will physically harm the people around them, that people with depression will emotionally drag everyone else down with them, and so on. With that in mind, I think another thing that’s important here is to show the audience how the character’s struggles can negatively impact their own life, not just others’—to show that the character themself is hurting, and, in many cases, in need of support. Again, facilitating empathy is key here.

And finally, some (less focused) thoughts on villains/antagonists with mental illness

You didn’t specifically ask about this, but it’s something that came up for me recently, so I’d like to talk about it, if that’s okay. I was recently involved in a difficult discussion about a villain in my WIP who happens to have a personality disorder (specifically, malignant narcissism), and while the conversation was settled amicably when I made it clear that there would be (and already are) more heroic/sympathetic portrayals of mentally ill characters in the story, it definitely got me thinking about whether I was, in fact, presenting this sort of topic responsibly. Is it unfair for me to portray this disorder—which I don’t personally have—in a negative light, even if I do so with as much consideration and authenticity as I’m capable of?

Honestly, even now, I don’t know if I really know the answer to that.

I guess the thing I would say about this—and again, I don’t know if this is the “right” approach, or if there even is one—is that despite the character’s villainous nature, I really want to approach him with the complexity he deserves, and—as with any NPC—display him as a whole person rather than a caricature. My hope is that people will still be able to empathize with him and understand his point of view, even if they can’t necessarily support or condone his actions.

And I’d like to believe that doing so will still be helpful in fostering understanding, or at the very least, avoiding stigmatizing mental illness more than it already is, but the honest truth is that I don’t know for sure. The mere fact that he’s a bad guy might be too damning. Like I said, this is an issue that I also wrestle with, and I definitely don’t think I have all the answers. But, that’s where I am right now, and what I’m currently trying to figure out.

Anyway, that’s probably a lot more words on the subject than you were really asking for, but, well, this topic is something I’ve been thinking on for a while, myself (and didn’t realize I needed to talk about until now, I suppose). Hopefully I said at least something that resonates with you or helps you in your process.

And if not, well, hopefully you at least found it to be an interesting read.


For the physical disabilities, you have to be extremely careful with how you write it, especially making sure that you have as much correct information that you can find online or speaking with someone that has a physical disability. And here’s some unsolicited advice concerning that, please do be aware that not everyone who shares the physical disability has the same opinion on it, for example one person might love being deaf and the culture that comes with it while the other deaf person hates being deaf and will do anything to portray themselves as a normal hearing person.


See Brandon Sanderson’s Stormlight Archive for a series that is basically a treatise on how to portray characters with significant mental illnesses still being complex and heroic protagonists. Its a subject I’d love to see more of, so honestly, just remember that people with mental illnesses still get to do really cool, important, and heroic things and you should be good.


A friend of mine who has disabilities and works on policy making for disabled people brought to my awareness a stance many years ago when discussing a TV show with a couple disabled characters: the stance of “the key isn’t positive representation; it’s diverse representation”. Similarly, “I don’t want responsible storytelling; I want diverse storytelling”. This was an eye opener after spending ages in circles that decried any type of “negative” or “irresponsible” storytelling.

I’ll make a point by using something that I personally have more personal background on, which is queer representation (mind I’m not equating disability struggles, or narratives, with queer struggles at all - just drawing a comparison). To speak on it kind of superficially, the issue I see with e.g. villains being portrayed as queer isn’t necessarily that well, there are queer villains; rather, the issue stems from that having been the only role queer people would get assigned (explicitly or signalled). Do I think that there shouldn’t ever be a queer character cast in or portrayed a negative or even evil role/light? Not at all. As long as we can also have good and neutral and naive and etc queer characters too. The should be space for all of those in art.

So, personally, I think that you, Corvus, have addressed yourself the crux of this: you have gone to great lengths to try to portray this with as much consideration as possible, and you seem to not have a reductive cast either.

Of course we don’t exist in a vacuum so our portrayal of topics and characters doesn’t either; but I don’t believe this should be reason for you to not tell your story.

That would be my stance on the OP’s qualms as well. Absolutely care about and consider the history and context of storytelling regarding topics; care about and consider people’s feelings on the matter; but don’t withdraw from adding to the pool of diverse stories out there with your own for fear of not doing it in a 100% positive framework.

Dark stories matter too; sad stories matter; stories about abuse matter; despicable issues and fallible people and all of that is simply part of humanity and, therefore, of art. To remove that side of existence from art is to remove also our ability to explore, cope with, and process it.

I’m not inferring your idea is dark/evil/despicable at all, OP. Far from it, it sounds like you want to draw from your own experiences and tell about them - and what would make your experiences any less valid than others? Not to sound presumptuous, but how can your experiences be irresponsible by existing and being explored? I don’t believe they are nor that they can, and truly think you should go for writing drawing from them. If people want escapism and positive representation, they thankfully can search for that from other sources; if that is not the story you want to tell, then you don’t have to. Your story can (and should, IMO) exist too.

Eiwynn’s points are great advice on how to go about that, and especially having content warnings so that people may be aware of what type of story they’d be stepping into if they are not in the headspace (or just don’t want) to go through depictions/interactions of helplessness and other possibly sensitive things (which is of course a totally fair desire to have).


Not in the headspace to get into an in-depth discussions about this, everybody else has had great points already.

Just going to share some reactions as someone who did pretty much that with Fallen Hero.

Write what’s your truth. Trust in it. Sure, it won’t be to everybody’s liking, but that will make for a stronger story. When I published Fallen Hero I was quite convinced that it wouldn’t resonate with people, that they’d treat it as just another supervillain power fantasy and have fun with that.

I did not expect the number of private messages I’ve got from people who connected the deepest to the ugly, dark and painful sides of the story. To the trauma and the pain, to the petty feelings, the confusion, the helplessness and the anger. When I published the story I was convinced this was only for me, because who would be interested in the mental struggles of a deeply traumatized person, especially when you only get bits and pieces of the story and is forced to make decisions you wouldn’t make if you had full control?

Turns out, a lot of people.

Write your own story. The one that resonates with you. Listen to your testers and their feedback, you don’t have to change your story to suit them, but you want them to disagree for the right reasons.

For example, I got criticism for not revealing the backstory and forcing people to make decisions without knowing the truth. That is a valid criticism, but it is also essential to the story I am telling, thus I didn’t change that.

I also got criticism for a lot of other things, that showed me that I had not portrayed what I wanted to portray correctly. Those things I changed, because it’s on me to make people get it.

There is a place out there for mc’s that are not perfect. If there’s not room for us, as authors, to explore our own trauma and hangups and self-destructive behavior, then what use are stories? There’s more people like you out there than you think, and interactive fiction about these subjects can be intensely liberating to explore, both as a reader and as an author.

I suggest you go for it. Don’t worry about being offensive, it’s easy to tone things down in the final edit if things land wrong. For a first draft, live your own truth.

I for one look forward to reading it.


Writing respecting one vision is the scariest thing ever, So I don’t recommend it to people who just write for money or for being pat on the back and bragging about it in social media.

However, if you really respect writing and have a deep necessity to express yourself through it following your own vision is the only way to get that urge of jolt stuff on paper satiated. Darkness, depression and anxiety is a great part of people lives. Same with anger or drugs usage. Dysphoria and mistreatment… And I think that if they are not glorified to show edgy stuff could be comforting and a helping hand for readers with similar problems.

@malinryden game it is a game very important for me as the protagonist has mental disorders similar to those I had as a teen, and I understand the character completely for me the concept of can help my Pc through the therapeutic choices and heal her, serve as a literary way to close the circle of The teen I once was.

There are other games, however, that are not made with love or sentiment and authors just want to be edgy adding dark stuff as It all were a game.

I think the most important part of adding Dark or mature content is RESPECT. Treating with the same love and care for everything else.


Thank you for all of your advice, but I will keep this in mind most of all. I tend to be overly vague out of nervousness when actually asking for opinions. I’ll think these questions out ahead of time to prepare probably.

Theoretically, I should have been aware of this, but in practice…I didn’t have the words. They of course, are very different. Even if that sometimes feels like lip-service to me because my brain won’t let me discern the separation in my own life. So, yeah, it wasn’t just a good reminder for my writing, but also for me. Thank you. That’ll be something that sits with me for a while.

I appreciated reading your thorough opinions and advice. You put time and effort into answering which you didn’t have to give and helped me a lot. I would never say no to that. I’m glad you also got something out of it in talking about it, hopefully. :blush:

It’s super important to me being as sensitive as possible. I am currently in the process of researching resources for possible sensitivity readers. My hope is that over the whole writing journey, I’ll find groups of people across all kinds of spectrums that I’ll be able to keep bringing my writing to regarding these and other issues. :smiley:

Thank you for the great recommendation and for your thoughts!

That is all an excellent point. Diversity is as important as responsibility, sensitivity and positive representation are after all. At least to me, it would…kinda sting if the only characters I ever saw were ones who had all their crap together so to speak. Because I know I’m definitely not those people. Thank you for everything you said though.

I wanted to say this is advice/encouragement I needed, and probably will need to reabsorb many more times. Changing myself and my work to try and suit everyone is my eternal temptation and struggle. I can’t articulate all my feelings and ideas after reading your comments, but I do want to acknowledge that I have them. Thank you.

I know I have the care and respect. Now my only wish is that it will be communicated through my writing. It never fails to amaze me how art can have such a poignant effect; if I can produce even a fraction of the resonance that the brilliant authors on here like @malinryden can, then I will be satisfied indeed. Thank you for your views. :blush:

Thank you, I truly appreciate it. You have it too; don’t let anyone tell you otherwise. Not even grumpy, radical Mara. :smiley:


If It serves you as encouragement I am struggling with a similar situation, and I know many of us here are. And I honestly think that you have what it takes. And I really mean it. If I believed otherwise I would say that. It wouldn’t be the first time of a grumpy radical sincerity Mara message, lol. But you are doing great.


Hey! Background, mentally ill person (in recovery, managing it!) who also works professionally in the mental health field here. I’ve also written a book about some pretty severely mentally ill characters. Fwiw.

There are a lot, a lot of good points here, from finding sensitivity readers, to having diversity of representation. One thing that I wanted to add, is when you are writing anything, it’s helpful to keep in mind the audience you are writing for. Are you writing for yourself? (Which is totally valid btw) Are you writing for people without the mental illness in question, who might not be familiar with it? Or are you writing for people who have the mental illness? Are you writing for ones that are currently struggling with it, or more towards ones who are managing it?

I ask that because if I am writing for an audience without a mental illness, I would probably explain more things, try to portray people struggling in more positive light, etc, if only to not spread stigma. If you are writing for people who struggle with the illness in question, it can sometimes be better to go into the unpleasant details of it, because in that case the audience would probably already be aware of those details, and without them it might ring hollow. Of course, with that, like others have mentioned, you will want to be very specific with content warnings. A realistic depiction of mental illness might resonate with someone who has been through something similar, but may also be triggering to someone in a more fragile state.

(Editing to add that it’s possible, and admirable to write for multiple audiences, it just gets progressively harder to each of them justice.)

In short, it’s complicated, but still something I think worth doing. On a personal level I know I loathe and despise stories where a character starts with a mental illness, and by the end is “cured” of it. At the same time I’d be lying if I said I like downers. I try to give my characters a positive change, even if it is really, really small. For example, in one of my books a character goes from thinking that she is beyond any help, to acknowledging that she might need some help. That’s it, she still struggles with mental illness, but even that small change is a victory.

If you’re interested, Hello Future Me, on youtube, has some really thoughtful videos I think you might find helpful:


Strictly just for alcoholism… I think it’s perfectly acceptable to have an alcoholic in your story, as long as you don’t glorify alcoholism. Especially if they’re trying to get sober, might be inspiring to someone reading it so they go to AA.


Excellent points. I can’t say I’m entirely sure who I am writing for besides myself. Not everyone realistically but my heart still wants to say everyone. I’ll definitely need to ask myself this question before getting too far. And thank you for the helpful videos!

I can only dream!

I have lived and caretaker history. That said, I can definitely appreciate the importance of sensitivity readers for my non-biography. Thank you for sharing your experiences/advice regarding SRs!

It’s already on my steam wishlist! I’m super excited by the premise and characters. Somewhat of a side note from the post I know, but also not as I’m sure there will be much in how you write that I can learn from. A surplus of examples from experienced authors, I think, is also incredibly important. :blush:


It is a good dream! Or maybe it can help someone who’s a friend or family member of the addict seek to set good boundaries with their alcoholic loved one.

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I’m glad to hear that you want to write about mental illness and/or disability (two things that often go together anyway) for two reasons:

  1. Over 10% of the population has some kind of physical or mental illness, but they’re represented on TV less than 1% of the time.

  2. You have lived experience (presumably as a mentally ill and/or disabled person*), so you are uniquely qualified to write about it. The best stories about minority groups are written by people who are part of those minorities (“Own Voices” is a big important deal).

Having said that, unless you’re writing your autobiography, you DEFINITELY need Sensitivity Readers in addition to your own experience AND more research than a story usually needs. SRs cost around $300 each for a novel-length story. And it’s often very painful to hear what they have to say, and to make changes to your book. I STRONGLY recommend hiring an SR or several to look over your OUTLINE before you start reading—so if there are bad tropes embedded in your plot, they can be altered before you write that 100,000 words. :slight_smile:

I am disabled and mentally ill (fibromyalgia etc, anxiety/depression) and I chose to write a story (“The Floating City”, which is coming out soon) with a PC who was born without their lower legs. One of the romantic options in the game is capital-d Deaf (and so is another minor character). Obviously I know SOME tropes about disability as a disabled person, but very little about either being an amputee or being Deaf (the reason I chose those two disabilities is that I’m fascinated with the engineering side of prosthetics, and the linguistic side of many sign languages—plus they’re a great way to illustrate, in a scifi future, that disabilities are disabilities because society isn’t accessible, and society can change). The first SR said the game was so fatally flawed it should not be published at all (and did not get more specific than that). Ouch! The second and third SRs (an amputee and a person who is Hard of Hearing) made a perfectly fine number of editing suggestions, and thanked me for writing it.


Not sure what conclusions to draw there except YES PLEASE DO WRITE WHAT YOU KNOW US SPOONIES** NEED REPRESENTATION (and hire SRs both at the outline stage and when it’s mostly done— and leave plenty of time for editing, possibly in major ways)… but know writing about this stuff is not an easy thing to do well.

Whatever you do, some people will hate it and find it offensive (eg some people will say you’re making light of disabilities because the character successfully does X-Y-Z and some people will say you’re over-representing the difficulty of doing X-Y-Z for a disabled person), but it should be reasonably clear (I hope) if you deserve that hate or not.

By far my most biographical story is one called “Counting Spoons” (it actually needs an edit - eg the partner character’s pronouns default to ‘he’ in some places, and I don’t have the coding skill to have the pop-ups not say “Achievements”) and in my opinion is a major downer (which is why, for my own sake, I haven’t done those edits).

Does it make the world better? I’m not sure.

*If you’re a parent or close relative of a disabled and/or mentally ill person (sorry I haven’t read the whole thread) then it can be offensive to claim that you know what you’re talking about, since what you ACTUALLY know about is the stress of being a carer, NOT actually being disabled etc. It’s a whole thing.
**A term for physically ill people, sometimes stolen by mentally ill people which is apparently offensive (not to me personally, but definitely to others). Spoon theory - Wikipedia