Updated: Oct 28
As writers, we put our characters through the wringer. Sometimes it happens "onscreen"; other times, it happens long before the book begins but continues to affect the characters during the story.
Many authors attempt to write characters who suffer post-traumatic stress disorder (PTSD) as a result of their experiences. This makes sense, as the UK's National Health Service suggests that approximately one in three trauma survivors develops PTSD. (I had no idea the disorder was so common until I read that.)
Unfortunately, authors often rely on stereotypes or inaccurate assumptions to portray PTSD. As someone who has PTSD, I offer some of my experiences to hopefully broaden your understanding of what this disorder can look like and help you portray it more realistically.
People often think of PTSD as something that only affects people who've been in war, such as soldiers or refugees. However, other traumatic events (both singular and ongoing) can lead to PTSD. My trauma involved a lifetime of emotional abuse from my parents: unfair expectations, invalidation of feelings, controlling behavior, and other experiences that I'm not comfortable sharing in a public post.
PTSD doesn't always show itself immediately. My abuse lasted for most of my life, with the worst of it occurring between the ages of five and thirteen. Starting roughly in my early twenties, I seemed to have difficult periods with intrusive memories (which we'll discuss in a moment) every few years, but I wasn't diagnosed with PTSD until I was twenty-nine.
Before diagnosis, people with PTSD might not know that what they're experiencing is mental illness. As I did, they may think that there's something wrong with them because they can't let the bad memories go and get on with their lives, even if they want to. * Other people, even well-meaning ones, can make this problem worse by encouraging those with PTSD to move on, forgive and forget, or "get over it" or by criticizing them for not doing so.
People with PTSD can struggle with flashbacks, intrusive memories, or both. It's tricky to explain the difference, partly because the word flashback gets used in so many ways, but this article does a good job distinguishing between the two symptoms (make sure to use the arrows at the bottom to see all the pages). * As far as I can tell, I've only had one or two flashbacks. But during them, I was so emotionally overwhelmed that I could barely move. I couldn't even think about anything else. About all I could do was press my fist into my forehead. * I've had much more trouble with intrusive memories: awful images and sounds from abusive episodes that pop into my head with or without a trigger and that won't leave me alone. Unlike with a flashback, I don't feel that I'm actually reexperiencing the abuse, but it's still extremely distressing.
Hypervigilance can manifest itself in subtle ways. The stereotypical version is a veteran who hears fireworks and dives for cover. In my case, I physically tense up when I hear loud/angry voices or arguments, especially from an adult to a crying/screaming child. Long silences in conversations make me uneasy. I'm more prone than others I know to jumping at unexpected noises. It scares me if I get emotionally worked up to the point that I think I might lose control. And I'm the worst perfectionist I know; it often takes me hours to write these posts. (I've also been diagnosed with OCPD, which I suspect was greatly exacerbated by the abuse.)
Triggers are difficult to deal with, especially if they're common words, sounds, scents, or substances. Unfortunately, most of my triggers are things I encounter (almost) every day. Sayings such as "Look on the bright side" or "It's not what happens; it's how you handle it" send my internal defenses rocketing up because my parents used those phrases over and over to invalidate my feelings. I can't watch certain movies or read certain stories or articles because characters in them are abused the same way my siblings and I were. I can still hardly bring myself to say certain words, even though there's nothing wrong with them, because I associate them so strongly with the abuse. * Confusingly, the same triggers don't always provoke the same reactions. Sometimes a trigger won't bother me at all one day but will really get under my skin a few days later or vice versa. It can be super frustrating.
Like many mental illnesses, PTSD is often invisible. Unless the person experiences the stereotypical dramatic flashbacks in front of others, many of the person's friends and associates would never guess what he/she is going through. This is especially true in societies that pressure people to "(wo)man up" and not show weakness or ask for help.
The human brain can't tell the difference between something you're really experiencing and something you're vividly imagining/remembering. That's one reason why flashbacks and intrusive memories can trigger such strong physical reactions.
There's actually a logic to the way people with PTSD react to triggers. During their traumatic experiences, especially ones that happened in childhood, those reactions helped these people survive physically and/or emotionally. For example, because my mother yelled, said hurtful things, or did even worse when she was angry, I learned to do everything possible not to upset an adult and/or to try to calm them down if they did get upset. * In fact, when children experience trauma and don't have the loving adult support they need to help them cope with it, their brains focus on building neural passageways that help with survival instead of creating the kinds of connections children need for healthy growth and development. That is, trauma can literally rewire a child's brain. This is one reason why kids who've been exposed to trauma have such a difficult time at school.
As with other "What Writers Need to Know about . . ." posts, I don't say all this to make you feel sorry for me. Mental illness is a tough subject and often doesn't get addressed accurately or sensitively in fiction. (Haunted houses set in insane asylums, anyone?) My hope is that this information helps you better understand what PTSD can look and feel like and also encourages you to do your own research so that we authors can be part of the solution rather than part of the problem.