The Writing of Mental Illness: Panic Disorder

Before assigning your character a mental illness, it is important to understand how that mental illness operates. You don’t need a Ph.D. to write a believable mentally ill character, but it does help to know the markers that physicians look for in a particular diagnosis to make your character more believable. I’ll add specific ones over time, but if there is a diagnosis in particular that you would like me to cover, please ask. I’d be happy to help.

For now, let’s tackle Panic Disorder:

It is included in the anxiety disorders grouping:

ANXIETY DISORDERS: Panic, Specific or Social Phobia, Obsessive-Compulsive, Posttraumatic Stress, Acute Stress, Generalized Anxiety

1.       Panic Disorder:

 If your character has panic disorder, they are afraid that they will have a panic attack. The worry over this lasts at least one month.

 Agoraphobia can develop in panic disordered people, which is the avoidance of places/situations in which the person feels they would not be able to escape and/or would suffer embarrassment should a panic attack happen in that location.

For example: I had a patient who would not shop in the grocery store because she was afraid of leaving her cart of groceries in case she had a panic attack. This possibility was extremely embarrassing for her.

Panic attacks usually last less than ten minutes and come on fast, sometimes for no apparent reason, and others after a situation or a trigger has occurred. The frequency and severity of an attack varies depending on the individual, so as a writer, you can take a lot of creative freedom here.

Your character should experience at least four of the symptoms below during a panic attack.

a.       Heart palpitations

b.      Sweating

c.       Shaking

d.      Shortness of breath

e.      Feeling of choking

f.        Chest pain

g.       Nausea

h.      Dizziness

i.         Feelings of detachment

j.        Fear of losing control or going crazy

k.       Numbness or tingling

l.         Chills or hot flushes

If your character is getting therapy for this illness, Cognitive-Behaviorial therapy is the most common method used and works by helping the patient examine their irrational thoughts and replaces them with more reasonable ones. For further research, you should look up psychologists Aaron Beck, MD, the father of Cognitive Therapy, and Albert Ellis, Ph.D., who created and developed Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavior Therapy (REBT).

Medications that your character might be on for their panic disorder could include an anti-anxiety, which slows the heart rate and can be fatal if taken in excess. Benzodiazepine tranquilizers can be habit-forming so they need to be closely monitored. Xanax (Alprazolam) is a common one, but be careful in naming medications in your book as they change frequently. Xanax currently comes in white (.25 mg), pink (.5 mg), and blue (1 mg) tablets or a long white tablet (2mg). Common side effects can include drowsiness, weakness, confusion, headache, disorientation, dry mouth, and nausea, but may subside after the patient becomes used to the medication.

A panic attack could occur at any moment, even while driving. However, it has been my clinical experience that many patients have their panic attacks after a dangerous situation has occurred and they have entered a safe space.

For example: One patient of mine witnessed gunshots fired. She escaped, thankfully, but it wasn't until she arrived at a safe place that she sat down and had a panic attack.

I hope you find this information helpful in making your mentally ill characters pop off the page. Please check back for more as I will add them periodically.

Until we meet again, Happy Writing!

Sources:
*DSM-V Diagnostic and Statistical Manual of Mental Disorders (American Psychological Association)
*The Pill Book (Fifteenth Edition)

 

 

The Psychology of Perfectionism in Writing

Is perfectionism holding you back from writing?

 If you think you are going to sit down at the computer and tap out a perfect novel from start to finish, you are setting yourself up for failure.

Don't let the idea of perfectionism keep you from writing what's on your heart—that is what the delete key is for.

Take advantage of being able to save many different documents under many different folders. Don’t be afraid to write in chunks of little bits of ideas, or move something that isn’t working in a piece to a ‘Bits and Pieces’ folder so you don’t have to let it go entirely, just store it in a ‘closet’ to pull out later when you find a more suitable place.

What you write today is not what is going to be published immediately. In fact, the reason traditional publishing takes so long is that it goes through countless levels of revisions: Your own gazillion revisions, revisions that come from your weekly critique group’s suggestions, Beta readers, an editing service, the agent who falls in love with your work, and finally the publisher, who will direct edits of your work for the bazillionth time (that’s what comes after gazillion, right?).

But don’t let this information overwhelm you, it is meant to encourage you. Why? Because you have tons of chances to get it right.

And if that doesn’t convince you, look at all the people in history who have messed up, but still hold a place in society: Martha Stewart, Bill Clinton, OJ Simson. Okay, the last two were chosen on purpose, to show hard-core examples where people tend to be forgiving and accepting of flaws. As far as I know, no angry pitch-fork wielding mob has come after any of them and stabbed them to death.

Those of us recovering perfectionists (such as yours truly) need to have these gruesome examples to remind us that we are nowhere near that level of scrutiny (except in our own minds) and we are so much better than we give ourselves credit for if we can just put aside our own critical voice and free ourselves to what possibilities can emerge from our fingertips if only we give ourselves permission to be human. This includes letting mistakes,  and good and bad ideas flow onto the page without the worry of who will see it, if it will be deemed worthy, and if it will be accepted by others.

Don’t worry about any of that. Free your mind, free your fingers and let those thoughts fly. How many wonderfully imperfect sentences can you write? Let if flow, revise later, keep the nuggets of gold, and as for the rest? That is what the delete key is for.
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The Psychology of Revision in Writing

How many opportunities do we have in life to start over? In my opinion, revision is the greatest thing in the business of writing, because you get to take a rough idea, and hone it until it shines.

Could you imagine if the De Beers dug up a rock of a diamond and secured it into a setting? Who would make a fuss over a dirty, uncut, unpolished diamond? But give the jeweler some time to do the work, to make all the necessary adjustments, and that diamond becomes a gorgeous work of art that people drool over.

Your novel is no different. I’ve never gone on a diamond excavating trip, but I imagine it must be exciting to pluck such a precious gem out of the earth. You might hold it up and admire it.

The same thing happens when a concept for a story flashes through your mind. It is exciting. You’ve gone and done it—come up with an original idea! You rush to the computer or your notepad and jot it down as it pours out of you, inspired. You jump up! It’s done!

Not so fast, you have plucked a dirty gemstone from the earth, that’s awesome—it’s a diamond! However, don’t set that cloudy thing into a ring just yet. Now that you have your raw clay (yes, your first draft should be thought of as raw clay), think about what you want it to become. Think about all the new scenes you could add to up the stakes, add texture, tie up character threads, can we add in some surprises?

Examine your character arc, does your main character change in the most satisfying way? Have you left any story unfinished among the supporting cast—they are people, too. So many considerations. Plus, there’s fixing and catching grammatical errors, spelling, format problems, and structure.

What a freeing feeling to know that there is no rush to get it right the first time. Enjoy the revision process and ask yourself, How good can I make it?
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The Psychology of Time Management in Writing

The Psychology of Time Management in Writing in a tricky business. Everyone who wants to be a writer says at one point or another, I wish I had time to write.

You do have time. The question is: Do you really want to? Or is it more fun to fantasize about it rather than put in the actual work? Either answer is acceptable if it is your truth.

If you've decided, Enough excuse, let's do this thing!

Here are some helpful tips:

We often put everyone and everything else first before ourselves and sometimes we don't have a choice, but most the time we do.

1. Set aside a time to write on a regular basis. Every day is recommended as writing is a muscles that must be exercised regularly. I write four to six hours every day.

2. Set aside a place to write. Your brain will associate that place with your writing time and it will make a smoother transition for you when it is time to focus on writing.

3. Instead of saying, I will write after I do the laundry, pay this bill, check Facebook, etc, say, I will check Facebook after I write. Make writing a priority.

4. Schedule your writing time realistically. Unless you are a full time writer, you aren't going to have eight hours to devote to your craft. Even one scheduled hour a day will turn into a finished book if you keep at it.

"The journey of a thousand miles begins with a single step." Lao-tzu

The journey of a novel begins with a single word.

5. If feeling overwhelmed is keeping you from starting, sit down and write a 'Never Scene.' This idea was given to me by Editor Brian Farrey-Latz at Flux Books, when I attended his Young Adult Workshop at a SCBWI conference in Orlando. Here's what you do: Tell yourself to write a scene that will not be part of your finished book, but just any old thing for fun. It can be outrageous, a Samurai swordfight under the ocean, a mythical creature gobbles up all the farm's chickens. ANYTHING! It helps you start. Which is all you need to get going. And sometimes, you stumble unexpectedly on something exciting that you WILL use in your book, but without the pressure.

6. If you're wishing you were a writer, but you're not writing, then ask yourself why. There is a reason holding you back and it isn't a matter of time, because we always find time to do things we love. Do you watch TV? Do you gossip with friend? Do you surf the internet? Time isn't the problem. It may be serious enough to head off to therapy about, or it could be because of the following:

A. You're afraid of failure. Maybe if you write, it will never get published. That could be the case, but the process of writing is both rewarding and therapeutic by itself, without the publication part.

B. You're afraid people won't take you seriously. They might not, but are you writing for yourself or others? Because to have a real shot at this, you need to write for yourself.

C. You're afraid if you try, you won't be able to think of anything to say. I bet that you will if you put in the time. Your writing might be lame at first, but in time, we all improve through practice and dedication.

D. You're afraid that if you write, people will judge it harshly. They might. But some will like it, too. Writing is art and art is subjective. Focus on the helpful comments and ignore the rest.

E. You're afraid that if you write about something personal you might hurt someone's feelings. This is a valid concern. See if you can cloud the event in fiction and if you can't or don't want to, then talk with that person first to let them know what you're doing and get their input.

F. You're afraid that if you write, someone will  critique it. Yes, they will give their opinions. As a professional, you need to ask yourself about the source of those opinions (Is the reader jealous? Is the reader a pro in his own right? Is the reader a valid expert on your type of writing?) If you think the reader is being mean, say thank you for their comments and ignore them. But don't get too attached to your draft and be so closed-minded that the work can't grow. If you respect the reader, listen closely, they are giving you valuable input that can help your writing reach it's potential.

There are many reasons we can create to hold ourselves back. How many reasons can you create to propel yourself forward?
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Who I Am

My story of resiliency:
My dad’s military career moved us around a lot. We lived in Italy for much of my childhood. Growing up with a bipolar family member made me collateral damage to a brain disorder that doesn’t care how nice you are. Besides the mood swings, a big marker of the disorder is poor judgment and impulsivity: my mom placed me in a different school every single year and my dad allowed it. In ninth grade, my mom thought it would be a good idea to put me into an Italian public school. I was fourteen, but they put me in sixth grade. Why? I didn’t speak Italian. The Italian administrators thought I’d have an easier time learning the language if I started at the beginning of their middle school program.

At first it was all, “Ciao, ciao, ciao,” the only word I knew. I had no idea what was going on and failed every class for about a month or two, but I continued to study my butt off.

By Christmas, I was making real progress, a solid C student, and I could understand about seventy-five percent of the conversation. I finished the middle school program, in a different Italian school than when I started, with a B average.

But I had a huge problem: I was seventeen years-old with an eighth grade education and we were moving back to the United States for my dad’s retirement.

Panicked, I went into an American high school with my ‘Scuola Media’ diploma and they turned me away. Overcrowded schools were not open to someone who already had a diploma. It was in Italian, so it was unclear to them that it was a diploma for middle school.
Several months later, we moved to a small town so my mom could open, The International Café. By March, the restaurant was facing bankruptcy, but now that I wasn’t needed, I was free to go back to school.

This time I left my diploma at home. Told the guidance counselor that I was eighteen, new in town, and needed to do twelfth grade. She blinked at my transcripts, “No one here speaks Italian; you’ll have to translate these…”

A few months later, I had an American diploma. And I went to Prom! (No proms in Italy.) I applied for tons of scholarships, camping out in the guidance office. The counselor encouraged me to enter the Miss Alexander County pageant for the scholarship money and I won!

Appalachian State University offered me an academic scholarship and an invitation into their honors program. As a quasi-gypsy child, App State will always be my home. I worked three jobs and had to take out a student loan to make ends meet. I ate lots of cereal and Top Ramen; God bless those cheap, wavy noodles!

I graduated with a Bachelor’s Degree in Psychology and a minor in International Business, which allowed me to study abroad in Australia and China.

Next, I completed a Master’s of Science degree in Mental Health Counseling from Stetson University, which included a study abroad tour in Europe.

My professional career began as a therapist at a boys ranch, where my supervisor told me to double bill for services. I refused. The following week, the boys ranch made the front page for insurance fraud. Everyone was laid off, some went to jail. Not a great career start.
My new job was at a private psychological practice. It was a great fit and I learned a lot.

I pursued a Ph.D. in Marriage and Family Therapy, from Barry University. The road to becoming a doctor was a ziggidy-zaggedy one, but once I arrived, it was so worth it.

After getting married, my husband and I moved to a small, developing town and I created Central Florida Mental Health, a private practice for children and families.

Things were going great until we decided to start a family of our own. It turned out I was infertile, but still made every attempt as if I was chained to a terrible hope/failure rollercoaster. It was a very dark time in my life; consumed from the inside out by the jaws of infertility.

Five years later, I got pregnant thanks to the Center for Reproductive Medicine. I decided to close Central Florida Mental Health so I could stay home with my daughter. And nine months later, I had another life growing inside of me without even trying.

Writing is how I make sense of my feelings and provides a wonderful creative outlet. It has always been a part of me and when I don’t write I get cranky. I have no idea where my writer’s journey will take me, but when I look back over my life, there were plenty of times when the future was unknown, but hard work and perseverance paid off.

Day by day; one breath at a time. Some breaks may be longer than others. And some pain may take longer to heal, but I will always get back to work. Because pleasure can’t exist without pain, and you can’t divorce success from failure. Examine each moment for the yumminess it contains, and if you happen to lick a sour patch, wrinkle your nose, but keep searching for something sweet.

I'd like to invite you to add your own quotes or stories of resiliency to my blog, Facebook page or Twitter.  It's our stories that inspire and encourage others to keep fighting the good fight.  I'd love to hear from you!
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Introduction

Hello and thank you for stopping by.

I'd like to invite you on my writer's journey. I am a contemporary realistic fiction writer of books for young adults. That is my present. I was the owner of Central Florida Mental Health, a private practice serving adults, children, and families. Two kids later and that is my past...

Like so many of you, aren't we all trying to figure out where we belong in present day? I think that the past can provide helpful information on what motivates us to continue and also what roadblocks are in our path. Our future goals are what drive us forward.

Sometimes, we lose sight of the most precious gift: Our Present, which is the only point in time over which we have control.

For example: I have my first novel,  a story about a girl with anxiety disorders who wants to escape her criminal past and make a fresh start, out on submission. I have no control over who will pick it up. I can control what I do with my time while I wait. I have chosen to work on my next book, indulge in my love of paper-crafting, and spend time with my family.

I have also chosen to start a blog that will examine the relationship between psychology and writing.

We all have our own baggage we carry with us throughout our lives. Some of these bags lead us to write and can be very therapeutic in the process.

But, what about the characters we create? What makes them tick? Are they believable? Have we done our homework? What about the experiences we are currently facing as authors? Our own emotions impact our work. What if we could transform those emotions into breakthroughs in our writing? Wouldn't that be amazing?

I hope you will accept my invitation to come along for the ride with me, and hopefully we will learn a lot together.

With Love,

Tori Kelley, Ph.D.
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